The seeds of Strychnos nux vomica.—East Indies.
Preparations.—Tincture of Nux Vomica. Strychnia.
Dose.—The dose of the tincture will vary from the fraction of a drop to five drops. For its specific use we add from one to five drops to four ounces of water, and give in teaspoonful doses every half hour or hour. The dose of strychnia will range from one-hundredth to one-twentieth of a grain, according to the effect desired.
Specific Indications.—The patient has pain in the abdomen which shifts its position; pain pointing to the umbilicus; hypogastric pain resembling colic; nausea and vomiting, the tongue being pallid; yellowness about the mouth, sallowness of skin; pain in right shoulder and region of the liver; difficulty in breathing, especially when the patient sleeps; inability to command the voluntary muscles; want of power in the bladder to void urine.
Therapeutic Action.—In small doses it is stimulant, tonic, diuretic, diaphoretic, laxative, anthelmintic. In large doses it is tetanic or cerebro-spinant, poisonous.
In small and repeated doses Nux Vomica promotes the appetite, aids digestion, renders the secretion of urine more copious and its excretion more frequent, acts as a laxative and diaphoretic.
In larger doses it causes weakness and a weighty sensation in the limbs—sensibility to surrounding impressions is increased, as the sensation to touch, change of temperature, sound, light, etc. There is depression of spirits and anxiety, tremors, rigidity or stiffness of muscles, with inability to maintain the erect posture; he staggers as he walks, and if the medicine be continued the intensity of its action becomes increased; the voluntary muscles are easily thrown into a spasmodic state, so that by a deep inspiration, or any effort or exertion, a convulsive paroxysm ensues.
In poisonous doses it causes tetanus, asphyxia and death. Slight and transient convulsions appear at first, with great thirst; finally the convulsions become more frequent and severe, every muscle is fixed and rigid, the face and hands become livid, the spasm is short, and during the intervals the patient is sensible; no pain is experienced, the pulse and respiration are suspended, and a fatal asphyxia ensues.
We employ Nux for the relief of nausea and vomiting depending upon gastric atony and enfeebled spinal innervation. The indication is clear: the tongue is pallid and expressionless—atonic; the lower part of the face gives the same evidence—yellowness or sallowness about the mouth and feeble expression. The dose should be small—just enough to render the water bitter is sufficient.
We employ it in the treatment of colic, both in infants and adults. In infantile colic, whether gastric or intestinal, it stands first in the list of remedies. One drop in a third of a glass of water, given in small doses frequently repeated, gives speedy relief. In the adult we do not want to mistake an inflammatory condition for a purely nervous disturbance, or the colic from hyperesthesia of the intestines for that which is associated with atony. Nux being a stimulant is especially adapted to the atonic cases, in which it gives prompt relief. Five or ten drops are added to a half glass of water, and given in teaspoonful doses frequently repeated.
In "uterine colic" it is an admirable remedy. The pain is violent, and simulates colic, and there is evidence of an atonic condition, both general and local. It is also a remedy in dysmenorrhoea with symptoms as above; in this ease it is usually given with Macrotys.
We employ Nux and Strychnia in the treatment of atonic diarrhoea, associating it with Ipecac, Euphorbia hyper. or Bismuth. It is an admirable remedy in cholera morbus, and finds a place in the treatment of Asiatic cholera. In these cases, if it can not be taken by mouth, on account of the irritability of the stomach, we use it by hypodermic injection. If the circulation is feeble, the injection should be thrown in over the sternum.
Nux is an admirable remedy in the treatment of cholera infantum, being especially adapted to those cases characterized by atony. It relieves nausea and vomiting, strengthens the stomach, improves digestion, gives better innervation, and, with Ipecac or Euphorbia, checks the bowels.
We employ Strychnia as an antiperiodic in the treatment of ague when there is marked atony of the stomach and feeble spinal innervation. The specific indications given at the commencement of this article will point the way to its successful use. The antiperiodic quantity will be about one-fifth of a grain in divided doses. If the remedy can not be given by mouth, it may be used by hypodermic injection.
In the cold stage of congestive intermittents, as well as in cholera, the hypodermic injection of Strychnia is one of our most powerful means. In some cases the patient is in such condition that no remedy will be absorbed from the stomach, but so long as there is a chance for life, it will be absorbed from the cellular tissue of the chest.
It should not be forgotten that Nux is a good remedy in sonic cases of habitual constipation. One drop in a glass of cold water in the morning on rising, will frequently overcome this unpleasant condition.
Its utility in paralysis appears to depend upon an increased or preternatural irritation or excitement in that portion of the spinal cord from which the nerves emanate that supply the paralyzed muscles, and from which the nervous influence is derived.
Its capacity to increase the susceptibility to external impressions, has secured its exhibition in the treatment of paralysis depending upon functional lesion of the sentient nerves, as well as in that affecting the motor nerves. Its exhibition in paralysis of the sentient nerves has not been attended will: the same happy results as in that of the motor nerves.
It has been successfully employed in impotency. The excitement which the Nux Vomica has been known to occasion in the sexual organs induced Trousseau to employ it in that affection, wben he found it successful in both males and females.
The American Eclectic Materia Medica and Therapeutics, 1898, was written by John M. Scudder, M.D.