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The fact that the sauce was packaged in a box shaped like a coffin should have been a clue. On a trip to New Orleans I walked into one of the many shops that sell an array of hot sauces and are set up for sampling. You dip a tortilla chip and go for it. I went for the wrong one! The burning sensation in the mouth was indescribable. Water was no remedy since capsaicin, the active ingredient isn鈥檛 water soluble. It is soluble in fat or alcohol. The store was out of milk that they normally stocked for the 鈥渨imps鈥� who couldn鈥檛 handle the heat and they had no license to sell alcohol. I scooted out the door in desperate search of milk and finally found a corner store. After repeated gargles with a liter of milk, the pain subsided. But the memory of the moment still burns.聽

That memory was now resuscitated because of the massive media attention being paid to the ludicrous 鈥淧aqui Challenge鈥� that has run amuck on TikTok because of the possibility that this nonsense may have been responsible for the death of a fourteen-year-old boy. Like with my painful experience, the tortilla chip at the heart of the 鈥渃hallenge鈥� is in a coffin-shaped package with a scary picture of a skull to boot! The chip is dusted with two of the world鈥檚 hottest peppers, the 鈥淐arolina Reaper鈥� and the 鈥淣aga Viper.鈥� These are off the scale when it comes to measuring the heat of peppers on the Scoville scale. It鈥檚 like chomping on glowing charcoal.聽

The mindless challenge, promoted by the manufacturer is to see how long the pain can be endured before scuttling for help from some food or drink. This is not akin to the benign 鈥淚ce Bucket Challenge鈥� that aimed to promote awareness of amyotrophic lateral sclerosis (ALS). This challenge is just nuts! The pain caused by capsaicin is intense and consequences can be dire. Without results from an autopsy, it is premature to conclude that the 鈥渄eath chip,鈥� as it has been called, was responsible for the tragic demise of the young student, but it is a possibility. In the meantime, the manufacturer has removed the chip from the market, but without a doubt lawyers are rattling their sabers, ready to slice up the large financial pie they see forthcoming from lawsuits by people who claim pepper injuries.聽

Capsaicin has been found to interact with a specific protein, a 鈥渞eceptor,鈥� on the surface of nerve cells and triggers an influx of calcium into the cell. This then liberates a string of amino acids known as 鈥渟ubstance P鈥� from nerve endings which send the pain message to the brain. The 鈥淧aqui Challenge鈥� is not the first time the pain caused by capsaicin has come under scrutiny. Pity the young man who burst into a clinic in Chicago, waving his hands and moaning in pain. With some difficulty he described that he had been in the midst of preparing a "Hunan" Chinese lunch with hot peppers when he began to experience a terrible burning sensation in his fingertips. The pain started to radiate up his arm, his face turned red, he perspired profusely and began to feel faint. A quick medical history revealed that just prior to the painful onslaught he had been sanding furniture.聽聽

Now the sequence of events became clear to the attending physician. The unfortunate gentleman's finger tips had been abraded by the sanding and the capsaicin from the peppers was directly absorbed into his bloodstream. Treatment with a local anesthetic cream brought relief from "Hunan Hand." If you think "Hunan Hand" is painful, imagine the torture of "Jalapeno Eye." This time our victim was a backyard gardener who had just picked her crop of jalapeno peppers. She washed her hands and then proceeded to put in her contacts. Immediately she was struck by a piercing, burning sensation in the eyes. Undoubtedly this lady can identify with the victims of 鈥減epper spray,鈥� the special capsaicin preparation used by the police to subdue rioters or violent criminals. It works. It鈥檚 pretty tough to keep rioting when you鈥檝e been sprayed in the face with cayenne pepper extract.聽聽聽

Capsaicin does have a positive side. It can help treat the pain of shingles, an affliction caused by the same virus that is responsible for chicken pox. After the symptoms of chicken pox disappear, the 鈥渧aricella-zoster鈥� virus can take up residence in the nervous system in an inactive form. Many years later, usually due to a weakening of the immune system with age or disease, the virus can become active. The result now is not chicken pox, but shingles.聽

The word derives from the Latin "cingulum" meaning belt because the blisters and rash that are the hallmarks of the disease usually form around the waist. Other areas of the body, such as the face, can also be involved. The symptoms usually disappear after a few weeks, but in rare cases the pain can persist for months or even years. 鈥淧ostherpetic neuralgia鈥� can make the skin so sensitive that even clothing cannot be tolerated. Now there is some hope for the management of this horrendous pain with a cream formulated with capsaicin. Apparently, after triggering an initial release of substance P, capsaicin prevents nerve cells from reaccumulating it. The medication is not problem free. As one would expect from a product formulated with hot peppers, the cream itself can produce a burning sensation on the skin, although this usually subsides with prolonged application.聽