Strychnine poisoning | |
---|---|
Strychnine | |
Specialty | Emergency medicine |
Complications | Lactic acidosis, Hyperthermia, Rhabdomyolysis |
Usual onset | 10–20 minutes after exposure |
Causes | Exposure to strychnine |
Diagnostic method | 1–30 mg/L strychnine in blood |
Medication | Anticonvulsants |
Strychnine poisoning can be fatal to humans and other animals and can occur by inhalation, swallowing or absorption through eyes or mouth. It produces some of the most dramatic and painful symptoms of any known toxic reaction, making it quite noticeable and a common choice for assassinations and poison attacks. For this reason, strychnine poisoning is often portrayed in literature and film, such as the murder mysteries written by Agatha Christie. [1]
The probable lethal oral dose in humans is 1.5 to 2 mg/kg. [2] Similarly, the median lethal dose for dogs, cats, and rats ranges from 0.5 to 2.35 mg/kg. [3]
Ten to twenty minutes after exposure, the body's muscles begin to spasm, starting with the head and neck in the form of trismus and risus sardonicus. The spasms then spread to every muscle in the body, with nearly continuous convulsions, and get worse at the slightest stimulus. The convulsions progress, increasing in intensity and frequency until the backbone arches continually. Convulsions lead to lactic acidosis, hyperthermia and rhabdomyolysis. These are followed by postictal depression. Death comes from asphyxiation caused by paralysis of the neural pathways that control breathing, or by exhaustion from the convulsions. The subject usually dies within 2–3 hours after exposure.
One medical student in 1896 described the experience in a letter to the Lancet:
Three years ago I was reading for an examination, and feeling "run down". I took 10 minims of strychnia solution (B.P.) with the same quantity of dilute phosphoric acid well diluted twice a day. On the second day of taking it, towards the evening, I felt a tightness in the "facial muscles " and a peculiar metallic taste in the mouth. There was great uneasiness and restlessness, and I felt a desire to walk about and do something rather than sit still and read. I lay on the bed and the calf muscles began to stiffen and jerk. My toes drew up under my feet, and as I moved or turned my head flashes of light kept darting across my eyes. I then knew something serious was developing, so I crawled off the bed and scrambled to a case in my room and got out (fortunately) the bromide of potassium and the chloral. I had no confidence or courage to weigh them, so I guessed the quantity-about 30 gr. [30 grains, about 2 grams] bromide of potassium and 10 gr. chloral-put them in a tumbler with some water, and drank it off. My whole body was in a cold sweat, with anginous attacks in the precordial region, and a feeling of "going off." I did not call for medical aid, as I thought that the symptoms were declining. I felt better, but my lower limbs were as cold as ice, and the calf muscles kept tense and were jerking. There was no opisthotonos, only a slight stiffness at the back of the neck. Half an hour later, as I could judge, I took the same quantity of bromide, potassium and chloral– and a little time after I lost consciousness and fell into a " profound sleep," awaking in the morning with no unpleasant symptoms, no headache, &c., but a desire " to be on the move " and a slight feeling of stiffness in the jaw.
These worked off during the day. [4]
There is no specific antidote for strychnine. "The convulsions are often triggered by stimuli – when your body senses something, neurons want to fire, and if they aren’t controlled seizures occur – so patients are generally kept in quiet, dark rooms." [5] Treatment of strychnine poisoning involves an oral application of an activated charcoal infusion which serves to absorb any poison within the digestive tract that has not yet been absorbed into the blood. Anticonvulsants such as phenobarbital or diazepam are administered to control convulsions, along with muscle relaxants such as dantrolene to combat muscle rigidity. [6] If the patient survives past 24 hours, recovery is probable.
The treatment for strychnine poisoning in the late 19th and early 20th centuries was to administer tannic acid which precipitates the strychnine as an insoluble tannate salt, and then to anaesthetise the patient with chloroform until the effects of the strychnine had worn off.
Strychnine is easily quantitated in body fluids and tissues using instrumental methods in order to confirm a diagnosis of poisoning in hospitalized victims or to assist in the forensic investigation of a case of fatal overdosage. The concentrations in blood or urine of those with symptoms are often in the 1–30 mg/L range. [7]
Strychnine poisoning in animals occurs usually from ingestion of baits designed for use against rodents (especially gophers and moles) and coyotes. Rodent baits are commonly available over-the-counter, but coyote baits are illegal in the United States. However, since 1990 in the United States most baits containing strychnine have been replaced with zinc phosphide baits. [8] The most common domestic animal to be affected is the dog, either through accidental ingestion or intentional poisoning. The onset of symptoms is 10 to 120 minutes after ingestion. [9] Symptoms include seizures, a "sawhorse" stance, and opisthotonus (rigid extension of all four limbs). Death is usually secondary to respiratory paralysis. Treatment is by detoxification using activated charcoal, pentobarbital for the symptoms, and artificial respiration for apnea.
In most western nations a special license is needed to use and possess strychnine for agricultural use.
The most notable incidents which probably involved strychnine poisoning, are listed here.
Strychnine has also served as an inspiration in several books, movies and TV series.
Strychnine is a highly toxic, colorless, bitter, crystalline alkaloid used as a pesticide, particularly for killing small vertebrates such as birds and rodents. Strychnine, when inhaled, swallowed, or absorbed through the eyes or mouth, causes poisoning which results in muscular convulsions and eventually death through asphyxia. While it is no longer used medicinally, it was used historically in small doses to strengthen muscle contractions, such as a heart and bowel stimulant and performance-enhancing drug. The most common source is from the seeds of the Strychnos nux-vomica tree.
Death in the Clouds is a work of detective fiction by British writer Agatha Christie, published in 1935. It features the Belgian detective Hercule Poirot and Chief Inspector Japp. It is a "closed circle" murder mystery: the victim is a passenger on a cross-Channel aircraft flight, and the perpetrator can only be one of eleven fellow-passengers and crew.
The Mysterious Affair at Styles is the first detective novel by British writer Agatha Christie, introducing her fictional detective Hercule Poirot. It was written in the middle of the First World War, in 1916, and first published by John Lane in the United States in October 1920 and in the United Kingdom by The Bodley Head on 21 January 1921.
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Brucine, is an alkaloid closely related to strychnine, most commonly found in the Strychnos nux-vomica tree. Brucine poisoning is rare, since it is usually ingested with strychnine, and strychnine is more toxic than brucine. In synthetic chemistry, it can be used as a tool for stereospecific chemical syntheses.
These are lists of poisonings, deliberate and accidental, in chronological order by the date of death of the victim(s). They include mass poisonings, confirmed attempted poisonings, suicides, fictional poisonings and people who are known or suspected to have killed multiple people.
Curtain: Poirot's Last Case is a work of detective fiction by British writer Agatha Christie, first published in the UK by the Collins Crime Club in September 1975 and in the US by Dodd, Mead and Company later in the same year, selling for $7.95.
Dumb Witness is a detective fiction novel by British writer Agatha Christie, first published in the UK by the Collins Crime Club on 5 July 1937 and in the US by Dodd, Mead and Company later in the same year under the title of Poirot Loses a Client. The UK edition retailed at seven shillings and sixpence (7/6) and the US edition at $2.00.
Murder Is Easy is a detective fiction novel by Agatha Christie first published in the UK by the Collins Crime Club in June 1939, and in the US by Dodd, Mead and Company in September the same year under the title Easy to Kill. Christie's Superintendent Battle has a cameo appearance at the end, but plays no part in either the solution of the mystery or the apprehension of the criminal. The UK edition retailed at seven shillings and sixpence (7/6), and the US edition at $2.
Death Comes as the End is a historical mystery novel by Agatha Christie, first published in the US by Dodd, Mead and Company in October 1944 and in the UK by the Collins Crime Club in March of the following year. The US Edition retailed at $2.00 and the UK edition at seven shillings and sixpence (7/6).
The Pale Horse is a work of detective fiction by British writer Agatha Christie, first published in the UK by the Collins Crime Club on 6 November 1961, and in the US by Dodd, Mead and Company the following year. The UK edition retailed at fifteen shillings and the US edition at $3.75. The novel features her novelist detective Ariadne Oliver as a minor character, and reflects in tone the supernatural novels of Dennis Wheatley who was then at the height of his popularity. The Pale Horse is mentioned in Revelation 6:8, where it is ridden by Death.
A Caribbean Mystery is a work of detective fiction by British writer Agatha Christie, first published in the UK by the Collins Crime Club on 16 November 1964 and in the United States by Dodd, Mead and Company the following year. The UK edition retailed at sixteen shillings (16/-) and the US edition at $4.50. It features the detective Miss Marple.
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And Then There Were None is a mystery novel by the English writer Agatha Christie, who described it as the most difficult of her books to write. It was first published in the United Kingdom by the Collins Crime Club on 6 November 1939, as Ten Little Niggers, after an 1869 minstrel song that serves as a major plot element. The US edition was released in January 1940 with the title And Then There Were None, taken from the last five words of the song. Successive American reprints and adaptations use that title, though American Pocket Books paperbacks used the title Ten Little Indians between 1964 and 1986. UK editions continued to use the original title until 1985.
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: CS1 maint: multiple names: authors list (link)The tale most often told about how Johnson met his fate is that he was poisoned by a jealous husband who put strychnine in his whiskey.