SPINAL POISON NUX VOMICA DR SANJU S ASSISTANT

SPINAL POISON – NUX VOMICA DR. SANJU. S. ASSISTANT PROFESSOR DEPT OF FORENSIC MEDICINE AND TOXICOLOGY

NUX VOMICA �FRUIT- round , hard, slightly rough, glassy orange, with jelly –like white or pale yellow pulp. It has 3 to 5 seeds. �SEEDS-poisonous , flat , circular discs or slightly convex on one side , concave on the other ash – grey or light brown in colour , have a shining surface & covered with radiating silky fibres. Very hard , tough & difficult to pulverize.

ACTIVE PRINCIPLE STRYCHNINE – Colourless, odourless, rhombic prisms , having an intensely bitter taste.

ACTION Blocks the ventral horn motor neurone postganglionic receptor sites in the spinal cord and brain stem and prevents the effects of glycine.

SIGNS AND SYMPTOMS �If swallowed uncrushed, seeds have no poisonous action. �When crushed seeds are taken, symptoms are delayed for an hr or more. �If alkaloid is swallowed, symptoms occur very rapidly, within 5 to 15 mins. �Bitter taste in mouth, sense of uneasiness & restlessness, feeling of suffocation & tear & difficulty in swallowing occur

Convulsion �PRODROMAL SYMPTOMS – increased acuity of perception, increased rigidity of muscles, and muscular twitching. �Convulsions are first clonic and then tonic. �DURING CONVULSION – face is cyanosed & has anxious look, eyes are staring, eyeballs prominent & pupils are dilated. �RISUS SARDONICUS results from contraction of jaws & facial muscles in which corners of mouth are drawn back.

Convulsion The mouth is covered with froth , frequently blood stained. the convulsions are most marked in antigravity muscles, so that the body arches in hyperextension (opisthotonus). In supine position , the body is supported by heels & head. Legs are adducted & extended, arms are flexed over the chest or rigidly extended & hands are tightly clenched. The head is bent backwards & whole of the body becomes rigid, often assuming bow –like form. consciousness is not lost and the mind

Convulsion The spasm of abdominal muscles may bend the body forward (emprosthotonus) or to the side (pleurosthotonus). The suffering during the spasm is severe & the patient is conscious of impending danger of death. The duration of convulsion varies from half to two minutes. In between the convulsions the muscles are completely relaxed and the patient looks well though exhausted & breathing is resumed. . The cyanosis lessens , cold perspiration cover the skin; dilated pupils may contract. After 5 to 15 minutes or on slightest impulse e. g. A sudden noise , a current of air , or gently touching the patient , another convulsions occurs.

Convulsion In fatal cases , convulsions rapidly succeed one another, & increase in severity & in duration & death usually occurs after 4 to 5 convulsions. The patient cannot breath as the diaphragm & the thoracic muscles are fully contracted. Hypoxia causes medullary paralysis and death. In non- fatal cases intervals between the convulsions become longer and the spasm less , until these entirely stops within 12 to 24 hrs & recovery takes place in a day or two.

STRYCHNINE AND TETANUS POISONING TRAIT STRYCHNINE TETANUS HISTORY No history of injury History of injury present ONSET sudden Gradual CONVULSION All muscles are affected at a time All muscles are not affected at a time LOWER JAW Does not start in , nor especially affect the jaw Starts in & especially affect lower jaw MUSCULAR CONDITION Between fits muscles are completely relaxed Between fits muscles are slightly rigid FATAL PERIOD 1 to 2 hrs More than 24 hrs CHEMICAL ANALYSIS Strychnine found No poison found

FD, FP, TREATMENT & PM APPEARANCE FD-50 to 100 mg ; one crushed seed FP- 1 to 2 hrs TREATMENT- Control the convulsions, Stomach wash, activated charcoal or tannic acid, acidify the urine. PM APPEARANCE- Rigor mortis appears early. There may be signs of asphyxia. Extravasated blood may be present in the muscles. Haemorrhages are sometimes found under the peritoneal coat of the stomach. Mucosa of stomach , duodenum , lungs, liver, kidneys, brain & spinal cord shows congestion.

PHYSIOLOGICAL TEST Injection of an aqueous solution of the suspected material into the dorsal lymph sac of a frog , will produce tetanic convulsions in a few minutes if strychnine is present. Later stimulation of frog will produce convulsions