Peyote stored in a jar for months before it was ingested caused three recent cases of botulism among members of the Native American Church, according to a report in the July 16th issue of The New England Journal of Medicine.

Native Americans can legally use peyote, a hallucinogenic cactus, in religious ceremonies.

The three church members fell ill after drinking tea made from the peyote, which had been stored in a jar of water in the refrigerator 2 months, report the authors of the article, a group of researchers led by Dr. Hirofumi Hashimoto, of the Northern Navajo Medical Center in Shiprock, New Mexico.

Botulism can cause severe nerve damage, can paralyze skeletal and respiratory muscles, and, in extreme cases, can cause respiratory failure and death. The illness is caused by a potent toxin produced by the Clostridium botulinum bacteria, which grow in airless conditions.

"We believe that this prolonged, nontraditional storage of unsterilized peyote produced an... environment that favored the growth and production of toxin from spores of Clostridium botulinum that were probably on the cactus," the researchers write.

Thirteen church members drank tea made from the peyote during a religious ceremony, Hashimoto and colleagues report. A few days later, three began to complain of muscle weakness and difficulty swallowing -- common symptoms of botulism.

Tests suggested the men had botulism, and confirmed that the peyote contained type B botulinum toxin.

One of the three had to be fed intravenously for 2 weeks. But all recovered within 2 or 3 months, the researchers report. None needed anti-botulinum toxin, treatment for patients whose condition deteriorates rapidly after they ingest the toxin.

"These cases of botulism from peyote illustrate that all ingested substances, including herbal medications and religious sacraments, must be considered as sources when botulism is suspected," Hashimoto and colleagues conclude.