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Spinal poisons
Strychnos Nux Vomica
Curare
Conium Maculatum (Hemlock)
Strychnos Nux vomica
Seeds
• Flat , circular discs , slightly convex on one side
• Concave on other
• 2.5 cm D, 6 mm thickness
• Ash grey or light brown in colour
• Shining surface , and covered with radiating
silky fibres
• Hard tough and difficult to pulvarize
Fruits
• Round
• Hard
• Slightly rough
• Glossy orange
• 4-5 cm
• Jelly like white or pale yellow pulp pulp has
very low strychnine content
• 3- 5 seeds
• Strychnine /Kuchila  powerful alkaloid
• The seeds of the ripe fruit are poisonous
• Contains
1. Strychnine 1.5%
2. Brucine 1.5%
3. Loganin (glucoside)
• Strychnine  colourless, odourless, rhombic
prisms , having an intensely bitter taste
• Bark/wood/leaves contains only brucine
• All parts of the tree are toxic
• Brucine is similar to strychnine in composition
and action
• Strychnine is 10 – 20 times more poisonous
than brucine
• Strychnine is used as a respiratory stimulant ,
rodenticide , and for killing stray dogs
Metabolism
• All mucous membrane absorbs strychnine
• Much is taken up by liver and muscles 
destroyed or later released
• This release can cause convulsions on the
second or third day of poisoning after
sedation is discontinued
• 80% is oxidised mainly in liver
• Excreted by kidneys , traces in saliva , milk ,
bile
• It may be found in cadaver upto 4 years
Action
• Competitively blocks  Anterior horn cell
Post ganglionic receptor site in the spinal cord
• Prevents the effect of glycine (presumed
inhibitory transmitter )
• Widespread inhibition of spinal cord results in
release excitation
• Action is particularly noted in the anterior
horn cells
• It stimulates cerebral cortex
• If swallowed uncrushed  no poisonous
action
• Crushed  symptoms within 1 hour or more
• Alkaloid swallowed  5 to 15 min
Symptoms
• Bitter taste in mouth
• Sense of uneasiness
• Restlessness
• Feeling of suffocation
• Fear and difficulty in swallowing
• Convulsions follow increased acuity of
perception , increased rigidity of muscles , and
muscular twitchings
• Convulsions by direct action on reflex
centers of spinal cord and affect all the
muscles at a time
• First clonic  later become tonic
• Face cyanosed, anxious look ,eyes staring , eye
balls prominent , pupils are dilated
• Risus sardonicus  contaction of jaws and
facial muscles in which the corners of the
mouth are drawn back
• Mouth  covered with froth frequently blood
stained
• Convulsions are most marked in Anti gravity
muscles
• So the body typically arches in hyper
extension  Opisthotonus
• Emprosthotonus
• Pleurosthotonus
• Consciousness is not lost and mind remains
clear till death
• Suffering during spasm is severe , and the
patient is conscious of impending danger of
death
• Duration of convulsions vary from half to 2
min
• In between convulsions patient may be
normal
• After 5 – 15 min  /slightest impulse 
sudden noise, air current, touching  another
convulsion occurs
• Death usually occurs after 4 – 5 convulsions
• Patient cannot breath  diaphragm and
thoracic muscles are fully CONTRACTED
• Hypoxia causes mudullary paralysis and death
• Non fatal  convulsions and spasms stops
within 12 – 24 hours and recovery takes place
in a day or two
• Fatal dose  50 – 100 mg / one crushed seed
• Fatal period  1 -2 hours
Treatment
• Symptoms are treated before disease
• Effective control of convulsions
• Dark room
• Diazepam , phenobarbital , GA, Sch, Curare ,
gallamine, pancuronium
• Inhalation anaesthetics are of little value
• Antidotes  short acting barbiturates like
pentobarbital sodium or sodium amytal
• 0.3 – 0.6 g iv
• Stomach wash  warm water , dilutue
solution of potassium permanganate ,
activated charcoal /tannic acid
• Acidifying the urine will increase the excretion
of strychnine
PM appearances
• Not characteristic
• Rigor mortis appears early but not necessarily
prolonged
• There may be signs of asphyxia
• Extravasated blood may be found in muscles
• Hemorrages may be seen under the peritoneal
coat of stomach
• Mucosa of stomach and duodenum may show
patches of ecchymosis and congestion
• Lungs, liver , brain and spinal cord are
congested
Physiological test
• Suspected material  dorsal lymph sac of frog
 convulsions
Circumstances of poisoning
• Suicide is rare because of painful death
Peripheral nerve poisons
CURARE
• Found in various species of strychnos
• Curarine  active principle
• Action  entirely peripheral at the myoneural
junction  blocks post synaptic nicotinic
Ach receptors  flaccid paralysis of skeletal
muscles
• Not poisonous when swallowed
• Absorbed through wounds
Symptoms
• Paralysis
• Death from asphyxia
• Mydriasis
• Liberated histamine
• Mind clear till end
•
curare
• Fatal dose  60 mg
• Fatal period  1-2 hours
Treatment of cuare
• Atropine 0.6 – 1.2 mg
• Neostigmine 5 – 10 mg
• Physostimine  3 ml of 1:200 solution iv
PMA
• Those of asphyxia
• Its used as arrow poison
CONIUM MACULATUM (HEMLOCK)
• Devil's Bread" or "Devil's Porridge", there are
also Poison Parsley, Spotted Corobane, and
Spotted Hemlock. The seeds are sometimes
called Kecksies or Kex.
• Conium comes from the Greek konas
(meaning to whirl), in reference to vertigo one
of the symptoms of ingesting the plant
• Contains coniine
• Highest in unripe fruits and seeds
• Root
• Leaves
• Fatal dose  60 mg of coniine
Signs and symptoms
• Fresh leaves  Nauseating taste , mousy
odour
• Progressive motor paralysis

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Spinal poisons

  • 1. Spinal poisons Strychnos Nux Vomica Curare Conium Maculatum (Hemlock)
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  • 4. Seeds • Flat , circular discs , slightly convex on one side • Concave on other • 2.5 cm D, 6 mm thickness • Ash grey or light brown in colour • Shining surface , and covered with radiating silky fibres • Hard tough and difficult to pulvarize
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  • 8. Fruits • Round • Hard • Slightly rough • Glossy orange • 4-5 cm • Jelly like white or pale yellow pulp pulp has very low strychnine content • 3- 5 seeds
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  • 13. • Strychnine /Kuchila  powerful alkaloid • The seeds of the ripe fruit are poisonous • Contains 1. Strychnine 1.5% 2. Brucine 1.5% 3. Loganin (glucoside)
  • 14. • Strychnine  colourless, odourless, rhombic prisms , having an intensely bitter taste • Bark/wood/leaves contains only brucine • All parts of the tree are toxic • Brucine is similar to strychnine in composition and action • Strychnine is 10 – 20 times more poisonous than brucine
  • 15. • Strychnine is used as a respiratory stimulant , rodenticide , and for killing stray dogs
  • 16.
  • 17. Metabolism • All mucous membrane absorbs strychnine • Much is taken up by liver and muscles  destroyed or later released • This release can cause convulsions on the second or third day of poisoning after sedation is discontinued • 80% is oxidised mainly in liver • Excreted by kidneys , traces in saliva , milk , bile
  • 18. • It may be found in cadaver upto 4 years
  • 19. Action • Competitively blocks  Anterior horn cell Post ganglionic receptor site in the spinal cord • Prevents the effect of glycine (presumed inhibitory transmitter ) • Widespread inhibition of spinal cord results in release excitation • Action is particularly noted in the anterior horn cells • It stimulates cerebral cortex
  • 20. • If swallowed uncrushed  no poisonous action • Crushed  symptoms within 1 hour or more • Alkaloid swallowed  5 to 15 min
  • 21. Symptoms • Bitter taste in mouth • Sense of uneasiness • Restlessness • Feeling of suffocation • Fear and difficulty in swallowing • Convulsions follow increased acuity of perception , increased rigidity of muscles , and muscular twitchings
  • 22. • Convulsions by direct action on reflex centers of spinal cord and affect all the muscles at a time • First clonic  later become tonic • Face cyanosed, anxious look ,eyes staring , eye balls prominent , pupils are dilated • Risus sardonicus  contaction of jaws and facial muscles in which the corners of the mouth are drawn back
  • 23. • Mouth  covered with froth frequently blood stained • Convulsions are most marked in Anti gravity muscles • So the body typically arches in hyper extension  Opisthotonus • Emprosthotonus • Pleurosthotonus
  • 24. • Consciousness is not lost and mind remains clear till death • Suffering during spasm is severe , and the patient is conscious of impending danger of death • Duration of convulsions vary from half to 2 min
  • 25. • In between convulsions patient may be normal • After 5 – 15 min  /slightest impulse  sudden noise, air current, touching  another convulsion occurs • Death usually occurs after 4 – 5 convulsions • Patient cannot breath  diaphragm and thoracic muscles are fully CONTRACTED
  • 26. • Hypoxia causes mudullary paralysis and death • Non fatal  convulsions and spasms stops within 12 – 24 hours and recovery takes place in a day or two
  • 27. • Fatal dose  50 – 100 mg / one crushed seed • Fatal period  1 -2 hours
  • 28. Treatment • Symptoms are treated before disease • Effective control of convulsions • Dark room • Diazepam , phenobarbital , GA, Sch, Curare , gallamine, pancuronium • Inhalation anaesthetics are of little value
  • 29. • Antidotes  short acting barbiturates like pentobarbital sodium or sodium amytal • 0.3 – 0.6 g iv • Stomach wash  warm water , dilutue solution of potassium permanganate , activated charcoal /tannic acid • Acidifying the urine will increase the excretion of strychnine
  • 30. PM appearances • Not characteristic • Rigor mortis appears early but not necessarily prolonged • There may be signs of asphyxia • Extravasated blood may be found in muscles • Hemorrages may be seen under the peritoneal coat of stomach
  • 31. • Mucosa of stomach and duodenum may show patches of ecchymosis and congestion • Lungs, liver , brain and spinal cord are congested
  • 32. Physiological test • Suspected material  dorsal lymph sac of frog  convulsions
  • 33. Circumstances of poisoning • Suicide is rare because of painful death
  • 35. CURARE • Found in various species of strychnos • Curarine  active principle • Action  entirely peripheral at the myoneural junction  blocks post synaptic nicotinic Ach receptors  flaccid paralysis of skeletal muscles • Not poisonous when swallowed • Absorbed through wounds
  • 36. Symptoms • Paralysis • Death from asphyxia • Mydriasis • Liberated histamine • Mind clear till end •
  • 37. curare • Fatal dose  60 mg • Fatal period  1-2 hours
  • 38. Treatment of cuare • Atropine 0.6 – 1.2 mg • Neostigmine 5 – 10 mg • Physostimine  3 ml of 1:200 solution iv
  • 39. PMA • Those of asphyxia • Its used as arrow poison
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  • 47. • Devil's Bread" or "Devil's Porridge", there are also Poison Parsley, Spotted Corobane, and Spotted Hemlock. The seeds are sometimes called Kecksies or Kex. • Conium comes from the Greek konas (meaning to whirl), in reference to vertigo one of the symptoms of ingesting the plant
  • 48. • Contains coniine • Highest in unripe fruits and seeds • Root • Leaves • Fatal dose  60 mg of coniine
  • 49. Signs and symptoms • Fresh leaves  Nauseating taste , mousy odour • Progressive motor paralysis