In fatal cases the morbid appearances vary according to the period at which death occurs. When death results from asphyxia, the brain is gorged with blood, and the texture softer than natural. When death takes place at a late period, sometimes appearances of inflamma tion are found in the stomach and intestines ; but frequently these are absent. A tetanic stiffness remains in the corpse till decay commences : this state of rigidity, however, does not invariably occur.
The powerful properties of nax-econica, and the rapidity of its action when administered in the state of a pure alkaloid, strychnia, or its salts, have deterred medical men from making so extensive a use of it as its therapeutic qualities entitle it to. The necessity for care in its administration is manifest from the facts, that death resulted in one instance merely from a woman grating cheese with a file which had been previously used to rasp seeds of nux-romica ; and in another instance death ensued from three grains of the alcoholic extract being taken at once. The consequence of a salutary dread of it being enter tained has been that it is generally employed only as a last resource, instead of being used at an earlier period. It might, however, be bene ficially used, with due caution and careful superintendence, in many cases of hysteria and hypochondriasis, dependent on irregular action of the nerves of the ganglionic system. In cases of hysterical paralysis, accompanied with greatly impaired sensibility, it would be more influential than any other agent in a disease at once tedious and distressing.
In paralysis it has been found more uniformly beneficial than moat other remedies, though success has not always attended its employ ment. It is certainly better suited for some forms of paralysis than for others.
It is most serviceable in cases of paralysis of parts which derive their nerves from the ganglionic system or spinal cord. Hence it is more serviceable in paraplegia than iu honiplegia, in palsy of the bladder, of the rectum, and even in some cases of chromic diarrhoea dependent on atony of the intestines. It is more serviceable in the palsies which follow fevers, rhettniatisms, repelled eruptions, habitual drunkenness, and exposure to noxious metals, such as lead or mercury, and merely depressed nervous power, than in those which result from effusion of blood. Its use is altogether improper immediately after an apoplectic seizure, and indeed whenever vascular fulness ur organic disease of the brain is supposed to exist. Though less useful in affections of the nerves which arise from the brain, it has nevertheless proved beneficial in some cases of amaurosis, in which the cndermic method of applica tion has been employed, rather than the internal administration of it. Deafness has also been cured by it. When employed in paralysis of any of the limbs, an auspicious sign of its beueficial influence is a feeling of formication, and often of sweating, with or without an erup-. tion, and spasmodic twitchings in the limb, while the rest of the body is unaffected.
It was conjectured by Batka, and it has since been proved by Dr. O'Shaughnessy, that the false Angustura bark [Gatasaa] was the bark of the Strychuos nux-romica ; so that in case of poisoning by that article, the same mode of treatment is to be pursued as in poisoning by nux-vomica or strychnia. " Nux-vomica bark (kuchila) is commonly aold in Calcutta for rohun, the harmless bark of Soymida febrifuga—a most dangerous aubstitution." (Pereira.) Notwithstanding the " Act to regulate the Sale of Poisona " in this country, nux-romica, compounded in various ways, is too freely sold, and used for nefarious purposes.
In cases of poisoning by sex-minim, the most prompt treatment is necessary, and still more eo if any of the soluble salts of strychnia have been taken. " Nux-vomica is occasionally made the instru ment of voluntary death, although no poison causes such torture." (Christison.) The stomach-pump should instantly be had recourse to, when nux-vomica has been taken in powder ; and as it adheres very obstinately to the coat of the atomach, it must be perseveringly used, with plenty of water. Emetics are too tedious in their action to be
depended upon. M. Donn6 has recommended, when atrychnia or any of its salts have been taken, to endeavour to form an insoluble salt ; and for this purpose proposes chlorine, bromine, or iodine. The tincture of iodine may be procured promptly, but if ten minutes elapse before it be administered, it is unavailing. When the quan tity of strychnia taken is not large, nor the symptoms very urgent, vital stimulants or sedatives are often sufficient ; and for this purpose, wine, brandy, or a mixture of acetone ether and laudanum, or laudanum alone, will remove the present danger. Chloroform is sometimes successful, as is also ice applied along the spine. Coal= or its tincture offers probable means of antagonising the action of strychnia, as suggested by Dr. Pereira. It is said that the leaves of the lcuillea cordifolia furnish an antidote to nux•vomiea and several other vegetable poisons. It must ever be remembered that the danger is not entirely removed, though the spasms may have subsided, and the respiration become easy. Inflammation of the stomach may super vene, which will require time usual treatment, or secondary asphyxia may Meal on, and destroy the patient. To prevent this last occurrence, great watchfulness is necessary, especially dining the night, and the patient should be frequently awakened, and made to drink freely of green tea. But perhaps the most potent cud efficient antidote to the other poisonous strychnias would be the era ri poison of South America, as suggested by Mr. Morgan. (See Morgan's 'Lecture on Tetanus,' p. 31.) The preparation of this substance, which has been an object of curiosity and interest since the time of Sir Walter Raleigh, luts been fully detailed by Sir Robert Schomburgk. (' Annals of Natural History,' vol. Ili.) It is an article of much importance to the natives of Guiana, as much of their means of subsistence depends upon their possessing this poison, in which to dip their arrows for the chase. The chief, if not the only, active ingredient is the Strychnos larifcra (Schorr.), and perhaps, in some places, Sirychnoa cogens (Bentham), the other ingre dients (most of which are obtained from climbing plants, lianos, or " nebbeea," except one bulbous plant, a eissus, and another supposed to belong to the Xanthoxyle(r) are used only to bring the juice to a proper degree of consistency and adhesiveness. Arrows dipped in it have been known to retain their poisonous properties for twenty-seven years. (iiff, in 'Medical Gazette,' voL xx., p. 261.) The poison when mspissated may he rendered liquid by heat, and is soluble in water, in alcohol, in hydrochloric acid, and in volatile alkaline spirit. It unites with acids without commotion or change of colour. If it be united with alkalies, no ebullition is observable, but it changes its colour from a dark brown to a yellowish-brown. It possesses a remarkable influence over the blood after it is taken from a vein. "A few grains, mixed with as many ounces of human blood warm from the veins, entirely prevents a separation of serum and craasamentum, and the whole mass continues in a state of fluidity similar to that in which it was drawn, until, after some days, it petrifies." (Bancroft.) This property seems to point out the propriety of employing it in cholera, in which the separation of the scrum from the crassamentum, while the blood is yet in the body, is one of the most remarkable symptoms of that disease. Dr. Hancock is of opinion that it is one of the most potent sedatives in nature, and, could it be safely managed, he had no doubt it might become a valuable remedial agent in the treat ment of spasmodic or convulsive disorders. Its taste is an agreeable bitter, and it has a tonic and febrifuge effect, frequently proving a valuable cure in intermittents. It, as well as the venom of the viper, seems to be disarmed of its virulence by undergoing the process of digestion.