NERVOUS DrsounERs.—Strychnine is valuable in functional nervous atony or depression, but is harmful in organic dis ease during the period of acute inflam mation or in acute infantile palsy.
In acute or subacute neuritis the use of strychnine is harmful, as the nerves are already inflamed.
In progressive lead palsy large doses of strychnine will check the progress of the disease; potassium iodide taken concur rently will hasten the elimination of the lead.
Amaurosis due to the excessive use of alcohol or tobacco is particularly amen able to strychnine. Beginning with grain, the dose may be gradually in creased to or grain; improvement may not he apparent until the larger doses have been reached. Eye-strain from insufficiency of the ocular muscles may be relieved by strychnine. (See Nux Vomic.A..) After the occurrence of brain-lesions, strychnine may be employed to main tain the nutrition of the paralyzed limb; but, if palsy is due to a disease of the trophic cells of the cord, little benefit will result save the stimulation of the remaining cells. Used too early in cere bral paralysis, especially when due to haemorrhage, it may do serious harm; and in the early stages of organic disease it may he decidedly harmful, especially in large doses.
In hemiplegia when degeneration has not set in and the paralyzed muscle is not completely relaxed, strychnine is an efficient remedy; it is of no avail in recent cases or when electrical contrac tility is lost. Strychnine should never be used during the presence of acute symptoms of congestion or inflammation of either the spinal cord or of its me ninges.
In tremors and ataxic movements of various kinds (but not in locomotor ataxia), and also in chorea, epilepsy, and idiopathic tetanus strychnine will be found of value.
Strychnine is highly efficient in many forms of neuralgia, especially visceral (gastralgia, hepatalgia, etc.), and also in infra-orbital and other neuralgias ac companying anaemia and general de bility, in all of which small doses grain) should be exhibited.
Hypodermic injections of very large doses of sulphate of strychnine are of value in tic doulourenx. The injections, once a day, should begin with grain and be rapidly increased to '/, or V4 grain. Usually the injections should be
discontinued after five or six weeks' usage, but repetition may be required once or twice again. On discontinuing the strychnine, iodide of potassium, nitroglycerin, or other drugs should be ordered. Rest in bed with freedom from care are enjoined during treatment. C. L. Dana (Va. Med. Monthly, May 22, '96).
Local paralysis and diphtheritic pa ralyses are amenable to strychnine in ternallv administered.
— In pneu monia, and in other acute diseases, threatened collapse may be averted by hypodermic injections of strychnine (1/. to'/, / grain); the beneficial effect will be improved by the addition of atro pine sulphate to 7,„ grain) to each injection. Habershon (St. Bar tholomew Hosp. Reports, '86), Kidd (London Pract., Sept., '94), and Hare (Ther. Gaz., Apr., '95) testify to the value of strychnine in pneumonia.
Dyspncea from any cause—winter cough or bronchorrhcea in the aged, em physema, and phthisis—is relieved by strychnine.
The value of strychnine in the treat ment of phthisis has been fully set forth by Thomas J. Mays, of Philadelphia (Jour. Amer. Med. Assoc., Oct. 10, '96; N. Y. Med. Jour., Oct. 27, '96). He re gards the state of the nervous system as an important factor in giving rise to pul monary tuberculosis, and concludes that no drug compares favorably with strych nine in the treatment of this disease. He begins with 1/36 grain, given four times a day; give this for a week and increase it to 1/24 grain for another week; during the next give grain; the following week raise the dose to about grain; and so on until the signs of beginning strychnine intoxication appear (usually when or V, grain is reached). The object is to impress the nervous system with the full stimulant effect of this drug, keeping the strychnine up to the highest level of safety. but shunning the point where its stimulus extends into the region of tetanus or paralysis. At this point he reduced the dose from '/, grain to grain and then gradually increases it again, alternately. Given in this way the symptoms and general condition of the patient will improve in every way.