706* MEDICAL JURISPRUDENCE Accidental cases of poisoning by nux vomica have occurred from an over- dose for it is largely used in medicinal practice by vaids and hakims. In his annual report for the year 1927, the Chemical Examiner, Bengal, cites two cases of accidental poisoning. In one case two female children, aged 3 and 5 years respectively, were given some powder as a quack remedy for worms, and both died from convulsions within half-an-hour. In the other case a woman was given some stuff which was alleged to be opium, and she died. It turned out to be nux vomica as the viscera showed the presence of strychnine and brucine. In his annual report for the year 1944, the Chemical Examiner, Bengal, describes a case in which nux vomica seeds acted merely as an irritant poison. In July 1944, a boy took two seeds of nux vomica and suffered from vomiting and diarrhoea. He looked very anxious, and had spasms with pain in the epigastric region. His pupils were dilated. The vomiting and diarrhoea lasted for three days. The bark of the tree (strychnos nux vomica) has been mistaken,for kurchi bark (holarrhena antidysenterica) or for angostura bark. Not only has poisoning occurred from the administration of strychnine by the mouth or hypodermically, but also from absorption through its exter- nal application to a mucous surface, ulcer or wound. The poisonous effects depend upon an individual idiosyncrasy, and tolerance is established by habitually taking the drug for a long time. In India, nux vomica is taken as an aphrodisiac. According to Baker those who get into the habit of taking it begin with 4th of a grain morning and evening and gradually increase it to about 20 grains.15 Strychnine is eliminated unchanged mainly in the urine. Elimination begins even in the first hour of ingestion, continues for two to three days and ceases entirely from three to eight days. It is excreted to some extent in the bile, milk and saliva and possibly in the sweat. Strychnine is also said to act as a cumulative poison as it tends to stop its own elimination by con- tracting the renal arteries. A small portion of strychnine is taken up by the liver and undergoes oxidation. In cases of fatal poisoning strychnine is found especially in, the liver and kidneys, and an unabsorbed portion of it is generally found in the stomach and its contents. According to Bakunin and Majone,10 the amount of strychnine found in the organs of animals is usually very small and rarely exceeds a tenth of the quantity administered. Traces of strychnine have been detected in the organs in fatal cases of non-strychnine poisoning where strychnine had been administered as a remedial agent two or three days prior to death. It is, therefore, essential for a medical jurist to bear these points in mind before he draws an inference from a very small quantity of strychnine found in the organs by the Chemical Examiner. , Strychnine is not destroyed for a long time in putrefactive changes I occurring in a body after death and has often been detected in exhumed bodies. Thus, strychnine was recovered from the stomach, duodenum and liver of a-female body exhumed four years and nine months after burial.17 It must, however, be borne in mind that in cases of death from undoubted strychnine poisoning the alkaloid may not be detected in the body. Dr. N. J. Vazifdar, late Chemical Analyser of Bombay, once informed me that 15. Chevers, Med. Juris., p. 241. 16. Toxicological Experiments with Strychnine, Gaz. chim, ital, 36 (1905), 227 : Warren Autenrieth's Detection of Poisons and Powerful Drugs, Ed. VI, p 166 Y^r R ^T^fe Ne^KZeal(l^ Med. Jour,, 47, Oct. 1948, p. 448; Med<~Leg. Jour., Vol. ĽA.VJJL, part 11, ly^y, p. 85.