290 MATERIA MEDICA AND THERAPEUTICS. 



this in such a way that their reflex excitability is enormously 

 increased. The very slightest stimulation of the skin, such as 

 a breath of air, a loud sound, or a bright light, is sufficient 

 to originate reflex muscular spasms. The muscles of respiration 

 are manifestly involved in this effect, and the vigour of their 

 action greatly increased ; and this is carried so far that they 

 remain contracted in inspiration, and give rise to asphyxia. 



The medulla is stimulated by strychnia in all its important 

 centres. The respiratory centre is increased in activity, 

 and transmits powerful impulses downwards to the already 

 excited cord, thus causing increased frequency and depth of the 

 movements of the chest. The cardiac centre and the cardiac 

 ganglia and nerves appear to be stimulated by strychnia, but 

 the violent contractions of the voluntary muscles completely 

 modify the direct effect of the alkaloid, which is said actually 

 to cause slowing of the heart (in animals paralysed by curare). 

 Death does not occur through the heart, which beats after 

 respiratory death, and remains contracted. The vaso-motor 

 centre is also increased in vigour, an effect which is heightened 

 by the general muscular spasm, and finally by the asphyxial 

 state of the blood ; thus the arterial pressure rises enormously 

 for a time. 



The motor nerves and muscles are comparatively unaffected 

 by strychnia, but its local application appears to stimulate them. 

 Probably the same may be said of the sensory nerves, vision 

 being improved by injections of strychnia in the temple. The 

 body temperature naturally rises during the convulsions. 



4. SPECIFIC USES. 



Strychnia is indicated in paralysis, especially paralysis 

 from disease or disorder of the cord, but is not of much real 

 service in this class of cases. Its function in cerebral disease 

 is mainly to sustain the activity of the spinal centres, nerves, 

 and muscles until the higher centres are restored ; but elec- 

 tricity has almost entirely displaced it for this purpose 

 It appears, however, to be useful in the so-called " reHex," or 

 " functional," paralysis of neurotic subjects, diphtheria, or 

 anaemia; and in peripheral paralysis, of the fore-arm, eyes, 

 larynx, sphincters, etc., often toxic in origin, e.g. due to lead, 

 tobacco, or alcohol. For these local cases, strychnia is best 

 given in the form of hypodermic or intra-muscular injection 

 (t*& g 1 "- of sulphate of strychnia in 10 min. of distilled water). 

 In sensory paralysis strychnia is useless, but it appears to 

 relieve some forms of blindness (amaurosis) when applied 

 locally, i.e. hypodermically in the temple. In chronic nervous 

 disorders, such as chorea, epilepsy, neuralgia, and asthma, it is 



