Strychnos 1990 - 2004 - Crops for the Future

Author
Title
Year
Source title
Reference
Abstract
Cao, H., Y. Liu and S. d. Jin
Determination of strychnine and brucine in Strychnos nux vomica L. and its prepa
2002
Chinese Journal of Pharmaceutical Analysis
22(4): 279-281
-
Author
Title
Year
Source title
Reference
Chan, T. Y. K.
Herbal medicine causing likely strychnine poisoning
2002
Human and Experimental Toxicology
21(8): 467-468
Abstract
'Maqianzi' (the dried ripe seed of Strychnos nux-vomica L.) contains 1.0-1.4% each of strychnine
and brucine. After processing to reduce its toxicity, 'maqianzi' was used as a herbal remedy for
rheumatism, musculoskeletal injuries and limb paralysis. A 42-year old woman with neck pain was
prescribed 15 g of 'maqianzi' to be taken in two doses at 7 hours apart, although the recommended
dose was 0.3-0.6 g. She was apparently well after drinking the first of two bowls of 'maqianzi'
decoction. One hour after she drank the second bowl of herbal decoction, she suddenly developed
tonic contractions of all her limb muscles and carpopedal spasm lasting 5 min, difficulty in
breathing, chest discomfort and perioral numbness. The second bowl of decoction probably became
more concentrated because of evaporation of water during continued boiling and contained a larger
amount of 'maqianzi'. On arrival in the hospital 1 hour later, she complained of muscle pain and
tiredness. She was found to have hyperventilation and weakness of four limbs, with muscle power of
grade 5(-)/5. All her symptoms gradually subsided over the next few hours. This case illustrated that
'maqianzi' can cause strychnine poisoning even after processing, especially when the recommended
dose is greatly exceeded. In any patient with 'unexplained' muscle spasms or convulsions, strychnine
poisoning should be included in the differential diagnosis and they should be asked about the use of
h e r b a l m e d i c i n e s .