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Related article: Depressant Effects of Toxic Doses of Strychnin. The medullary and
spinal functions all show a curious mixture of stimulant and depressant
response to strychnin; the stimulation predominating during the con- Cardura Online
vulsions, the depression during the intermissions. The paralytic effects
gradually increase as death approaches, the respiratory center, vasomotor
center, vagus center, and the cardiac muscle failing in about this order.
Exhaustion and asphyxia as well as the direct depressant action of
strychnin, are Cardura Online important factors in this paralysis.
13
194 MANUAL OF PHARMACOLOGY
Contributory Factors in Strychnin Paralysis. That exhaustion is an important con-
tributory factor is shown by the fact that life may be greatly prolonged by preventing
the convulsions through chloral or curare. The prolongation of life by artificial res-
piration shows the contributory action of asphyxia. However, animals die from large
doses of strychnin, when exhaustion and asphyxia are both excluded, in Cardura Online the manner
indicated. Indeed, the direct depression seems generally to be the main factor (Heub-
ner and Loewe, 1913).
There seems considerable reason to believe that in the frog the paralysis of the cen-
tral nervous system is caused largely by the failure of the circulation through cardiac
paralysis; but this is not the sole cause, for the heart is often still beating when the re-
flexes have disappeared. In the case of mammals death usually Cardura Online occurs before the heart
has stopped.
Importance of Treating the Paralysis. It is important to bear in mind
that the convulsions are Cardura Online not in themselves the dangerous element in
strychnin poisoning. Death is rather due to paralysis. Remedial meas- Cardura Online
ures must therefore be directed not only against the convulsions, but
also against the subsequent paralysis.
Tetanus alone is not such a dangerous condition. Thus, tetanus quite as violent
as that of strychnin has been produced, e.g., by camphor, without being fatal, and the
very severe convulsions of traumatic tetanus may last for weeks, whereas large doses of
strychnin may kill after a single twitch or even without Cardura Online any signs of convulsions
(death may then, however, be due to cardiac paralysis).
Special Senses. Strychnin (2 to 3 mg.) increases the sharpness and field of vision
for all colors (Dreser, 1894), and also the olfactory sense. The sense of touch is little,
if at all, affected. These actions are central. In the eye it acts probably also on the
retinal ganglion cells, the effects being obtainable unilaterally by injection into the tem-
ples or under the conjunctiva. It has been employed to arrest the progress of optic
atrophy amaurosis (Nagel 1 ), sometimes with temporary improvement; % to i c.c. of
a Yi P er cent - solution (2.5 to 5 mg.) being injected into the temple.
Bitter and Tonic Actions. Cardura Online Strychnin is extremely bitter (perceptible
in dilution of i : 400,000 to i : 100,000, according Cardura Online to the sensitiveness of
the observer) . It shares the stomachic effect of other bitters, and is therefore
used to improve appetite and digestion in nervous dyspepsias, chronic gastric
and intestinal catarrhs, hyperemesis, seasickness, etc., and thus favor nutri-
tion. The increased tone of the muscles creates a feeling of vigor which con-
tributes to the "tonic" effect. To enhance the local action, the tincture of
nux vomica (i c.c. diluted, before meals) is often preferred to the alkaloid
(i to 2 mg). It is often combined with other tonics (Elixir Ferri, Quininae
et Strychninae Phosphatum). If the bitter effect alone is desired, the dose
of the tincture may be reduced to i or 3 drops, which is too small to pro-
duce any central effects.
In seasickness it has been employed as a prophylactic in conjunction with atropin
(Skinner, N. Y. Med. Jour., December, 1893; Girard, 1906).
Drug Habit. The bitter and tonic effects of strychnin make it a useful adjuvant in
the treatment of chronic alcoholism and other drug habits.
Diabetes Insipidus. Strychnin is said to be occasionally effective in reducing the
polyuria. There is no pharmacologic explanation for this action, if it exists.
Peristalsis. Strychnin is often used as an addition to other cathartics ("Aloin,
Belladonna and Strychnin") with the idea of improving their action, especially in atonic
constipation. It stimulates the Auerbach ganglia on direct application (Langley and
Magnus, 1907). It has not been shown whether this Cardura Online action would occur in its thera-
peutic use. Hypodermically, it probably has no direct effect in ordinary Cardura Online doses, whilst
toxic doses weaken or arrest peristalsis (Pollak, 1910). Any results may perhaps be
explained by increased tone of the spinal centers which influence intestinal move-
ments and defecation. For this purpose, the extract of Nux Vomica is generally used
(15 mg. in pills).
Other Peripheral Actions. Strychnin, when used systemically, has practically no
peripheral action on muscle, nerve, or glands except the bitter effect.
1 Cf. Derby, 1902, Boston Med. & Surg. Jour., 20, 508.
STRYCHNIN 195
The local application of strong solutions paralyzes most nervous and muscular tissues;
for instance, the heart muscle, superior cervical ganglion, striped muscle endings.
The last effect (curare action, Lapicque, 1913) also occurs weakly in living frogs.
Small doses seem to sensitize the neuro-muscular junction, lowering the threshold to
indirect stimulation, and delaying fatigue (Hammett, 1916). The curare effects are
stronger in brucin; and methyl-strychnin may be counted in the curare group. After
death, strychninized forgs cease to respond to sciatic stimulation much earlier than
normally (Githens and Meltzer, 1912).
Action on Invertebrates. Strychnin acts as a weak protoplasmic poison on ameboid
cells, yeast, etc. Higher invertebrate animals are also relatively insusceptible. Many
insects are quite immune, others are only slightly injured (Juchenack and Griebel,
1910).
Absorption. Strychnin is promptly absorbed, mainly from the intes-
tine. In rabbits, none is absorbed from the stomach proper; it is not
known whether this is also true for man.
Gastric Absorption. Rather variable results have been obtained by different in-
vestigators when strychnin Cardura Online was placed in ligated stomachs. Generally, alcoholic
solutions are absorbed readily, aqueous solutions scarcely at all. These results seem to
depend partly on the ligation; for from unligated stomachs (Pawlow's pouch) aqueous
solutions are well absorbed, better than alcoholic (Ryan, 1912).
Excretion. A part of the strychnin is excreted unchanged, mainly by the urine.
Small quantities occur also in the saliva, milk, sweat, bile, and feces. The excretion
starts within five minutes after absorption (Ipsen, 1892); and is practically completed
within forty-eight to seventy-two hours (Bukunin and Majone, 1906), although
traces may be found even after five days (Plugge, 1885; Hale, 1909; Kuenzer, 1914).
In the remarkable case of a patient who had swallowed 15 grains and recovered, Hewlett,
1913, recovered 4% grains from the first stomach washings, and a total of i% grains
from the urine, mainly between the first and tenth hour. Traces were present on the
fourth, none on the fifth day.
Destruction. At least a fourth, and often much more, of the administered strychnin
can not be recovered from the excreta (Kobert), and is presumably destroyed in the
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