The convulsions begin with a restless, excited state; the special senses are sharpened. Muscular symptoms come on very rapidly, either beginning in the extremities or appearing simultaneously over the body. The jaw is the last part affected and the first relaxed. The eyes are open, and the muscles are relaxed between the convulsions.

Tetanus

The symptoms come on gradually, with pain and stiffness of the back of the neck and occasional slight muscular twitchings. The jaw is the first part affected, and is rigid (trismus, or lock-jaw). There is a permanent state of general muscular rigidity.

Hysteria

Begins with weakness and blindness. The muscular symptoms begin with stiffness of the neck. The extremities are affected last. The jaw is set before a convulsion and remains fixed between them. The eyes are closed.

Treatment Of Poisoning

In treating strychnine poisoning, tannic acid or a soluble iodine salt is given as an antidote, followed quickly by emetics, as the compounds thus formed are not permanent. The bladder must be emptied to prevent re-absorption; then absolute quiet is of the greatest importance. Inhalations of chloroform are used, with full doses of chloral and bromide of potassium given internally.

Precautions

In giving strychnine, the possibility of its cumulative action must always be kept in mind as a grave feature. It is more likely to develop if the medicine is in pill form than if in solution. With the liquid preparation of iron, strychnine, and quinine, the danger exists also as the strychnine is apt to precipitate. It must always therefore be well shaken. Strychnine is more effective with old people.

The first constitutional symptoms are to be looked for with care: twitching, trembling, starting, or stiffness of the muscles. It is of great importance to know exactly when they begin, especially when, as is often the case, the orders received are to push the medicine to the utmost limit.

Preparations Of Nux Vomica

Extractum Nucis Vomicae. Extract Of Nux Vomica

Average dose, gr. 1/4-0.015 Gm.

Tinctura Nucis Vomicae. Tincture Of Nux Vomica

Between 0.237 Gm. and 0.263 Gm. of the alkaloids of nux vomica are contained in 100 mils of tincture. Average dose,  viii.-0.5 mil.

Fluidextractum Nucis Vomicae. Fluidextractum Of Nux Vomica

Average dose,  i.-0.05 mil.

Extractum Nucis Vomicae. Extract Of Nux Vomica

Average dose, gr. 1/4-0.015 Gm.

All preparations of nux vomica are given before meals.

Preparations Of Strychnine

Strychninae Sulphas. Strychnine Sulphate

Average dose, gr. 1/40-0.0015 Gm.

Strychninae Nitras. Strychnine Nitrate

Average dose, gr. 1/40-0.0015 Gm.