Beyond the condition above described, the effects of the medicine become poisonous. The spasms are more frequent, extensive, and severe, sometimes involving almost the whole frame, and are attended with a tetanic rigidity which is probably the most characteristic symptom. The attacks come on suddenly, like electric shocks, last usually from a quarter of a minute to two or three minutes, and, after a longer or shorter interval, seldom exceeding ten minutes, recur with increased violence, and at last, if not relieved, with fatal effect. If the patient is seized with them when attempting to walk, he staggers and falls. During the spasms, the muscles affected feel hard like a board, and different parts of the body are drawn fixedly into various abnormal positions, from which they cannot be removed. Thus, the head may be thrown backward, the jaws firmly closed, the face distorted, the arms or lower limbs extended outward, the hands clenched, the toes flexed, and the trunk bent backward, forward, or to either side, or stifly erect. The respiratory muscles become involved, and the breathing is hurried or imperfect, and temporarily suspended, with a purple hue of the face, lips, and extremities, coolness of the surface, and a pulse which is sometimes slow, sometimes quickened, but always feeble, and occasionally almost or quite imperceptible. In some instances, there are involuntary discharges of urine or feces. The attacks are often brought on by very slight causes affecting the surface, as by a fresh contact of the bedclothes, or a gentle touch with the finger. As in tetanus and hydrophobia, an attempt to swallow, or even the idea of swallowing, will sometimes induce spasms of the respiratory muscles + The spasms are often attended with a violent shivering or tremulous movement through the body; and the muscles may be felt vibrating as it were under the hand. Sometimes the patient, when asked if he has suffered pain in the spasms, answers in the negative; in other instances, they are inure or less painful, and in others, again, extremely so. In the intervals, there is often a feeling of trepidation, alarm, or anxiety strongly expressed on the countenance; the stomach is sometimes nauseated; the pulse is feeble and often agitated, or even fluttering; and the patient complains of thirst, sweats profusely, and, after a severe attack, has a feeling of fatigue and exhaustion. At length, in one of the spasmodic-attacks, respiration is quite arrested, the pulse ceases to beat, and the patient dies with asphyxia. The mind is usually clear throughout the case, until near the fatal issue, which is preceded for a short period by insensibility and unconsciousness. When the poisoning has resulted from one large dose, the characteristic symptoms make their appearance from ten minutes to half an hour after it has been taken, and death generally occurs very quickly, sometimes in the course of a few minutes, after the third, fourth, or fifth paroxysm. One instance is on record, in which death followed in fourteen minutes after the poison was swallowed; and from half an hour to an hour and a half is not an uncommon period. Under other circumstances, the poisonous phenomena may he developed much later, and the termination be much longer postponed. When the case is to end favourably, which not unfrequently happens, there is a gradual subsidence of the violent symptoms; but more or less rigidity, may linger for a day or longer; and soreness of the muscles, as if they had been bruised, is felt after other symptoms have ceased.

* See remarks by W. G. Thomas, M.D., in the N. Jersey Med. and Surg. Reporter, Jan. 1857, p. 3.

+ See the account of a case by Mr. Hennel in the Lond. Med. Times and Gaz., April, 1855, p. 414.

After death, the muscles often remain in a state of tetanic rigidity, and there is frequently more or less blueness or lividity about the face, hands, and feet. Internally the ordinary signs of venous congestion are presented, as of persons dying from asphyxia. This is especially observable in the lungs; and the bronchial mucous membrane, as well as that of the stomach and bowels, sometimes exhibits hemorrhagic spots or patches. The heart has in some instances been found firmly contracted. in others quite relaxed, and either empty, or distended with blood. The blood itself has by some examiners been seen coagulated; while by others no clot could be anywhere discovered. Congestion of the brain and its vessels, redness and increased vascularity of the membranes of the spinal cord, patches of extravasated blood in these membranes, and effusion into the spinal sheath have been noticed; and both the brain and the spinal marrow are said to have been found in a softened state: but nothing has yet been discovered by post-mortem examination which can throw a very clear light on the action of the poison. Though evidences of inflammation of the stomach are stated to have been exhibited in several cases, yet in the great majority nothing of the kind has been noticed; and the poisonous effects must, therefore, be quite independent of gastric irritation. The; bulk of the spleen has been observed to be strikingly diminished, after death from strychnia in the lower animals. Strychnia may usually be detected in the stomach and bowels if not evacuated or absorbed during life, in the urine if it has had time to pass off by the kidneys, in the blood, and in some of the tissues, especially in the liver; but the absence of any discoverable chemical evidences of strychnia in these positions, though a presumption, should not be considered as a positive proof that the death did not result from the poison

Quantity requisite for Poisoning. The quantity of nux vomica or of its preparations requisite to destroy life is very uncertain. The susceptibility to its influence is extremely different in different persons. A case is on record in which fifteen grains of the powder are stated to have proved fatal; another in which the same effect was produced by thirty grains in two doses; and in two others, which occurred in 1839 in London, death resulted from fifty grains {Taylor on Poisons, p. 775); yet the last-mentioned quantity has been repeatedly administered without inconvenience; and, as a general rule, the poisonous dose would probably much exceed a drachm. Recoveries have frequently taken place, under proper treatment, after quantities had been swallowed varying from half an ounce to an ounce. As the bean of St. Ignatius contains probably three times as much strychnia as nux vomica, it may be considered as in an equal degree more poisonous. The extract of nux vomica is said to have proved fatal in the quantity of three grains (Ibid.); and as M. Recluz obtained from the seeds an average product of about one-twelfth of extract, this would be equivalent to somewhat more than half a drachm of the powder. The smallest quantity of strychnia, known to have caused death in an adult, is half a grain; which is much larger relatively than the smallest fatal doses above mentioned of the powder and extract.