Medical Jurisprudence And Toxicology

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.
•A.VJJL, part 11, ly^y, p. 85.