Nux Vomica

Natural Order : Loganaceae

Alkaloids
Strychnine and Brucine

Use
IP products – used as wormin paste.

Medico-legal Importance

1. Homicidal: Used as arrow poison
2. Suicidal
3. Accidental

Fatal Dose

1. Strychnine: 50-100 mg
2. Seed: 1 crashed seed

Fatal Period : 1-2 hours

Signs and Symptoms

1. Bitter taste with choking in throat.
2. Stiffness of neck, face and twitching of muscles.
3. Causes convulsions: Clonic first and then tonic and longer paroxysms (face becomes cyanosed with anxious look eyes scary, eyeballs, prominent and pupils dilated); Risus sardonicus.
4. Opistotonus
5. Mental faculties are not affected.
6. Reflex excitability high with symmetrical extensor thrust.
7. Death is from medullary paralysis.

Treatment

1. No specific antidote.
2. Move patient to dark room.
3. Anesthetized by barbiturate.

Differences between Strychnine and Tetanus

Traits	Strychnine	Tetanus
Onset	Sudden; no history of injury but history of ingestion of bitter object.	Gradual, with history of injury
Muscle involvement	All muscles at a time.	Muscles of neck and lower jaw affected first and spreads further.
Muscle relaxation	During interval muscles are relaxed.	During interval muscles are rigid.
Fatal period	Death occurs within few hours. If patient survives for 6 hours probability of survival is great.	Death takes place within few hours.
Chemical analysis	Detected	No poison detected but Clostridium tetani is detected.

Reference: A Handbook of Forensic Medicine and Toxicology by Dr Madona Joseph & Dr Harpreet Kaur