PHYSOSTIGMATIS SEMINA 707 he failed to detect it in a case in which there was ample evidence that death occurred from poisoning by strychnine. PHYSOSTIGMATIS SEMINA (CALABAR BEAN) This is the dried ripe seed of Physostigma (Venenosum, belonging to N.O. Legu- minosse. It is known as the Ordeal Bean of West Africa, as it is used there as a test in suspected witchcraft. It is blackish-brown in colour, and slightly kidney-shaped, having a black groove along its convex border, measures li"x5"X a", and weighs about 1| to 2 drachms. It has no odour, nor has it any distinctive taste. If cut longitudinally, it is seen to consist of a brown, rind, containing two hard, white, brittle cotyledons which adhere to the shell. The poisonous properties are due to two alkaloids, physostigmine or eserine and calabarine, contained in the cotyledons of the seed. Physostigmine (Eserine), CicHaiNaO*.—In the pure state this is a white, crystalline substance, but becomes yellowish on exposure to air and light. It is bitter in taste and alkaline in reaction. It is slightly soluble in water, but readily dissolves in alcohol, chloroform and ether. With acids it forms salts, which are soluble in water. Of these physostigminaz salicylas (physostigmine or eserine salicylate) is a pharmacopoeial pre- paration, the dose being 1/100 to 1/50 gram. It enters into the composition of the phar- macopoeial preparations of Lamelice physostigmince, Oculentum physostigminoe and Injectio physostigmince salicylatis. Symptoms.—These are giddiness, salivation, thirst, violent peristalsis, pain in the stomach, vomiting, sometimes diarrhoea, slow, feeble and irregular pulse, laboured breathing, cold clammy skin, contracted pupils, muscular twitchings, paralysis of the voluntary muscles, mystagmus and dysarthria. The intellect remains clear to the last. Death occurs from asphyxia due to paralysis of the respiratory centre. Fatal Dose and Fatal Period.—Not determined. Six seeds of beans of Physostigma venenosum caused the death of a child. According to Blyth 6 mg. of physostigmine would be likely to be dangerous and about 205 mg. or 3 grains would be much beyond the least fatal dose.ls A patient was given after an operation for hernia 0.1 gramme of eserine sulphate (a non-official preparation, dose being 1/64 to 1/32 grain) to stimulate peristalsis, but he got convulsions and cyanosis and died from failure of respiration and of the heart's action.10 A case20 is recorded in which recovery took place after intra- venous injection of J grain of eserine sulphate in 15 minims of water. Treatment—Give emetics or wash out the stomach with charcoal and tannic acid. Atropine and chloral hydrate are both regarded as physiological antidotes. Give sti- mulants, and oxygen inhalation and artificial respiration may be resorted to, if necessary. Post-mortem Appearances.—Not characteristic. The mucous membrane of the stomach may be red and congested and may sometimes be covered with a tenacious mucus, The lungs are generally congested and oadematous. The brain is slightly hypersemic. Chemical Analysis.—Physostigmine may be extracted from organic matter by rendering it alkaline with sodium bicarbonate and using ether or chloroform as a sol- vent. It is decomposed very easily; hence special care must be taken not to allow excess of mineral acids, heat or light to come into play. Tests.—1. Bromine water produces a red or orange-coloured turbid solution which will clear away on heating. Strong chlorine water produces a red colour. 2. On exposure to air and light, an aqueous solution of physostigmine is readily oxidized and produces rubreserine, which is red in colour. The red colour is decolourised on the addition of a reducing agent, such as sulphurous acid or hydrogen sulphide. If it is now shaken with excess of caustic alkali, it acquires a pink red colour. The red colouring matter, rubreserine, is dissolved out by chloroform and colours the solution orange-red. 3. Two or three drops of a very weak solution of physostigmine dropped into a cat's eye will produce contraction of the pupil. Medico-Legal Points.—Accidental cases of poisoning have occurred among children from eating the seeds. Accidental poisoning has also resulted from an overdose in medi- cine or from eserine solution having been instilled into the eyes or sprayed into the nose. Suicidal cases have occurred, but no homicidal case has yet been recorded. Physostigmine increases the irritability of the voluntary and involuntary muscles, causing muscular twitchings and peristaltic movements of the intestines. It contracts the pupils by stimulating the ends of the third nerve. It increases the secretions by stimulating the peripheral nerve endings. It augments the irritability of the peripheral 18. Poisons, their Efects and Detection, Ed. V, pp. 422, 423. 19. Ars. Medici, Jan. 1932, p. 14. 20. Slater, Brit. Med. Jour,, Dec. 9, 1922, p. 1120.