OF THE CALABAR BEAN. 741 



of reflex action, had occurred. Thirty-eight minutes after the strychnia had been applied, the 

 diastaltic function had disappeared, though galvanism of the exposed sciatics still caused muscular 

 contractions, and though the heart was beating at the rate of twenty-eight per minute. 



The subject of opposing physiological actions has been a favourite one with 

 many writers on poisons, and " antagonistic" effects have been largely discussed, 

 as might be expected from their interest and practical applications. Nicotia,* 

 aconitiaf and curare:]: have been proposed as counter agents to strychnia, and 

 atropia has been proposed as one to morphia. § Calabar bean has been, before now, 

 pointed out by myself and others as an opponent in action to strychnia ; and, as 

 with curare, its application to the treatment of tetanus has been recommended. I 

 believe that no other drug so directly diminishes reflex action, and is, therefore, 

 so likely to be employed with advantage in tetanus, as physostigma. Curare 

 opposes spasm by paralysing motor nerves, nicotia by destroying muscular 

 contractility ; but physostigma attacks (if we may use the word) the spinal cord 

 which is necessarily implicated as the centre of every diastaltic action. There 

 seems to be no reason why it should not always prove a certain cure in traumatic 

 tetanus. Its success in strychnia poisoning will probably depend on the quantity, 

 in relation to the case, that has been administered; as this poison may be con- 

 sidered to have two fatal doses — a smaller, where death is caused by asphyxia 

 or exhaustion, and a larger, where, even if its tendency thereto by asphyxia or 

 exhaustion shall be averted, it will still certainly occur, by the special action of 

 the poison on the histological structures it attacks. || Such a substance as 

 Calabar bean may be employed with advantage to prevent death after the admin- 

 istration of the smaller quantity. 



Physostigma has lately been proposed as a physiological antidote for atropia 

 poisoning; and Kleinwachter has had the courage to employ it for this purpose, 

 principally on the ground of its anti-mydriatic property.^" As will be afterwards 

 shown, these two substances appear to act in opposite modes on the ganglionic 

 system of the blood-vessels ; but the nature of their effects on the cerebro-spinal 

 system is such as to make it irrational to anticipate any success in their employ- 

 ment as counter-agents. 



* Rev. Samuel Haugtiton, Dublin Quarterly Journal of Medical Science, August 1862. 



t E. Woakes, British Medical Journal, October 1860, &c. 



J Harley, Lancet, 1856 ; L. Vella, Comptes Rendus, 1860; Claude Bernard (opposes the 

 view of counteraction), Lecons, &c, p. 377. 



§ Graves, Clinical Lectures on the Practice of Medicine ; Anderson, Effects of Belladona in 

 Poisoning by Opium, 1854; Lopez, American Medico-Chirurgical Review, vol. iv. 1859; Dr W. 

 F. Norris, American Journal of Medical Science, Oct. 1862; Camus (experimentally disproves this 

 asserted antagonism), Gazette Hebdr., 11 Aout 1865, and Canstatt's Jahresbericht, &c, Fiinfter 

 Band, 1866, p. 123. 



|| It has been found that frogs, after fatal doses of strychnia, may die without any convulsions, 

 if care be taken to protect them from all causes of excitation — Marshall Hall, Apercu du Systeme 

 Spinal, p. 170 ; Claude Bernard, Lectures on Experimental Pathology and Operative Physiology, 

 Medical Times and Gazette, 1860, v. ii., p. 25. 



1 Berliner klin. Wochschr, 38, 1864. 



