Strychnos nux vomica is a moderate-sized tree native of the Coromandel Coast and Cochin China. The fruit is very like an orange in appearance and contains numerous seeds of flattened circular outline, about the size of a halfpenny, ash-grey in colour, covered with fine silky hairs. The seeds are intensely bitter, owing to the presence of Strychnia and Brucia which exist in the seeds together with certain peculiar acids; but the pulp is innocuous and is said to be eaten by birds. If nitric acid be added to the seeds a deep orange-yellow colour is produced. The wood of the tree is very bitter. It is used in India in cases of intermittent fever and snake-bites. A decoction of the leaves is used externally in rheumatism (abridged from Treas. of Bot.). Under Brucea antidysenterica I have told how the bark of the tree was imported into Europe in mistake for Angustura. The tree from which the Ignatia" beans" are obtained is unknown, but it is not doubted to be a Strychnos; the seeds actually contain a larger proportion of Strychnia than those of Nux vomica. The difference in the character of the two remedies proves the wisdom of Hahnemann's method of studying medicines. If there was nothing more than the chemistry of the drugs to go by Ignatia and Nux vomica might be used indifferently; with the knowledge Hahnemann has given us of their characteristic features they are seldom even thought of in connection with the same case.—In the cases of poisoning with Nux, the most marked feature is the spasms and convulsions which cause death by arresting respiratory movements. "Convulsions with consciousness." "Spasms with tetanic rigidity of nearly all the muscles of the body, with interruption of a few minutes, during which the muscles were relaxed; the pulse became soft and the patient recovered consciousness and speech; the spasm was renewed by the slightest touch, though at times it would immediately cease when the patient was tightly grasped, or the elbow was straightened up." "During the spasms evident relief was afforded by forcible extension of the body." In the case of two persons, a man and wife, who both took the poison, the reporter says: "As the convulsions came on the heads were drawn back, there was spasmodic clenching of teeth, heels fixed to the ground, eyes as if protruding from their sockets, and both, curiously enough, kept exclaiming, 'Hold me! Hold me!' although there was a person on either side of each." One of the patients afterwards said that if a fire had been lit under him he could not have moved, although at the same time he kept crying, "Hold me!" "Convulsions came on beginning with slight twitchings in muscles of lower extremities." "Convulsions with red face and closed eyes." The general effect of the spasms was to cause opisthotonos and throwing back of the head, though in some the body was spasmodically drawn sideways. The tetanus of Nux differs from traumatic or idiopathic tetanus in that the spasms of the former are less continuous, do not invariably begin with the muscles of the jaws, but preferably in the lower extremities, and are not accompanied by rise of temperature. "Spasm" is the first keynote of Nux and the second is "exaggerated sensitiveness." Both are brought to the front in the poisoning cases, and the provings bring out their developments in almost all regions of the body. The spasms affect all the voluntary muscles of the body and the involuntary muscles as well—oesophagus, stomach, intestines, uterus, bladder, rectum, and the spasms and irritability go through the pathogenesis. There is irritability of bladder and rectum at the same time; constant urging and desire and very little passed; prolapse of rectum with constipation; or there may be incontinence of both urine and faeces. Uterine bearing down and prolapse; cramps at menstrual periods and pressure on bladder and rectum. The irritability and excessive sensitiveness of Nux depicted in the tetanic seizures and drawn facial expression applies to mind as well as body. Nux is especially suited to: (1) Very particular, zealous persons, inclined to get angry and excited, or of a spiteful, malicious disposition. (2) Ardent persons; or, disposed to anger, spite, or deception; always irritable or impatient. (3) Nervous, melancholic people, troubled with indigestion; venous constitution with tendency to haemorrhoids. (4) Thin, irritable, choleric persons with dark hair, who make great mental exertion or lead a sedentary life. (5) Vigorous persons of dry habit, tense fibre, ardent and irascible temperament and tenacious disposition. (6) Bilious temperament. (7) Persons addicted to wine, coffee, or pepper and condiments, who live a sedentary life with much mental exertion. (8) Debauchees, thin, irritable, venous. (9) Drugged subjects. Throughout all these classes moral, mental, nervous, and muscular tension or spasms may be traced (but ennui, loss of energy may also be indications for Nux: they are alternating states). There are few drugs which produce a greater degree of irritability than Nux, running, as it does, to the verge of homicidal and suicidal impulse. Intestinal spasm is exemplified in the spasms which follow eating unripe fruit and other digestive irregularities; and sometimes they take the form of incipient hernia. Hernia, inguinal and umbilical, has been cured with Nux, and I have seen a case of strangulated hernia resolved by Nux whilst preparations for operation were in progress.—Although there are many pains in connection with the rectum, constipation or spasm is the leading feature: "Constrictive sensation at times as if he would be obliged to go to stool." "After a stool it seemed as if some remained behind and could not be evacuated, with a sensation of constriction in rectum, not in anus." "Discharge of bright blood with the faeces, with sensation of constriction and contraction in rectum during stool." "Stool daily though always with a colicky sensation in abdomen, and with the stool, it always seems as if it was not enough." "Frequent, ineffectual desire for stool; after the usual evacuation." Nux is very far from being a panacea for constipation and haemorrhoids, but its indications are perfectly clear and when they are present it will not disappoint the prescriber. The diarrhoea of Nux is sudden and drives patient out of bed; or is involuntary; or comes on after a meal. Alternate constipation and diarrhoea. In the dysentery of Nux the straining ceases as soon as the motion passes. This distinguishes Nux from some other remedies. There is tendency to faint after diarrhroeic stools; and also after vomiting. This tendency to fainting is another example of the Nux sensitiveness. It occurs from odours; in a warm room; after eating; after every labour pain. Nux has proved curative in epilepsy when the fit occurred during stool. Nux is haemorrhagic. There is metrorrhagia (in high livers), and also menorrhagia. Menses too early and profuse, flow dark; faints easily; irregular, cease flowing at night-time. The pains are cramping and cause nausea and fainting; twisting, moving about in abdomen; soreness across pubes; cramps in bladder. During pregnancy: hiccough; morning sickness; varicose veins; haemorrhoids; false pains. Labour pains are violent and = fainting. Lochia scanty, offensive; nipples sore, white spot in centre; tensive pains when nursing. Desire is excited in both sexes, and here again the sensitiveness of Nux is observed—the slightest provocation suffices to excite the sexual passion. Spasm is the chief note of Nux in the respiratory sphere, where it produces a variety of asthmatic states, a dry, persistent fatiguing cough which = headache as if the skull would split. The general conditions of Nux are the best guides in such cases. But it must not be supposed that Nux cannot cure cases which are not purely spasmodic. I have cured with Nux many cases of bronchitis with copious moist râles and expectoration. In addition to spasms, Nux causes languor; great nervous debility (as from sexual or other excesses); trembling; excitement with trembling; paralysis. Paralysis after apoplexy, parts cold, numb, emaciated. Hemiplegia. Locomotor ataxy has been relieved by it. Nux is a drowsy medicine and it also produces sleeplessness. Wakes 3 a.m. and lies awake for hours, falls asleep when it is time to rise and feels heavy and unrefreshed. It is curative in cases where sleep is unattainable except from a stimulant. The symptoms of Nux are > after undisturbed sleep; < when sleep is disturbed. The third keynote of Nux is Chilliness. Nux is one of Grauvogl's chief hydrogenoids, and, like so many other "bitters," it is a great remedy in intermittents—intermittent fevers, periodic neuralgias. Chilliness: Cannot get warm in bed at night. Coldness of whole body with blue hands; with blue skin. Cold, moist hands with cold tip of nose. Repugnance to cold or cold air; chilly on least movement; from being uncovered; must be covered in every stage of fever, chill, heat, or sweat. In the fever there is great heat, whole body burning hot, face red and hot, yet patient cannot move or uncover without being chilly (H. C. Allen). But Nux may have "Intolerance of covering during sweat with heat." Nux has hunger with aversion to food; loss of appetite; and sudden satiety. A patient to whom I gave Nux 30 said that immediately after each dose she felt as if she had had nothing to eat for a week. Another patient from the same medicine developed: "Hot feeling up in throat. Biliousness. General heat and scarlet redness of face. Headache." The red face of Nux is a characteristic feature. Nash gives a characteristic of the menses of Nux: "Catamenia a few days before the time, and rather too copious, or keeping on several days longer, with complaints at the onset which remain until it is over." Nash remarks that Calc. has the same, but the temperaments differ, and he adds this useful note: He found that patients that required Nux for this condition could hardly ever take Puls. for anything. For instance, if they had a green, bland, thick discharge, and Puls. were given, it would often bring on too early and profuse menstruation. Sep., on the other hand, would cure the catarrh and not interfere with the menses. Nash deservedly italicises Boeninghausen's keynote: "Feels < in morning, soon after waking; also after mental exertion; after eating and in cold air." Sour breath I have noticed to be a very leading indication for Nux. Hering gives the gastric disorder of Nux thus: "After eating; sour taste, pressure in stomach an hour or two afterwards, with hypochondriacal mood, tightness about waist; must loosen clothing, confused, cannot use mind two or three hours after a meal, epigastrium bloated, with pressure as from a stone in stomach." The pressure two or three hours after eating distinguishes Nux from Nux m. and K. bi., which have it immediately after.—Nux has many eye-symptoms. Sircar cured cases of night-blindness with Nux 6. He connected the disorder with the liver (Calcutta J. of Med., xiv. 454). F. A. Griffith (H. P., ix. 211) gives an interesting example of the use of Nux in cases which have been much drugged. Living in a part where there are no other homoeopaths he had mostly heavily-drugged patients to deal with. His plan was to give Nux 30 four times daily for four days and then see the patient again and take a new picture. A man, 45, had had sciatica for six months and had taken a great deal of strong medicine internally. After four days of Nux 30 Griffith was surprised to find his patient almost well; the trouble having "got well from above downward"; at last localising in the heel. One dose of Sep. c.m. completed the cure.—O. W. Smith (H. P., ix. 210) reports this symptom as having been caused by Nux: "Sensation under middle of sternum like a lump of hot lead as large as two fists." Among the peculiar sensations are: As if something heavy fell into head. As if his head were immensely larger than his body. As if pressing a nail into brain; into vertex. As if brain beaten or cleft with an axe. As if skull pressed asunder. As if hot water in eye. As if eyes would be pressed out. As if he had received a bruise over eye. As if a hot plate of iron were nearly in contact with face. Face feels as if he were sitting before a hot fire. As if a ball or plug in throat. As if skin scratched off throat with a sharp instrument. As if throat too narrow. As if a stone in abdomen. As if abdomen raw and sore. As if bowels, bladder, and rectum were pressed with a sharp instrument. As if hernia would occur. As if everything in region of umbilicus were being shattered and torn. Navel as if drawn in. Chest as if drawn together. As if room had been exhausted of air. As if something torn loose in chest. As if blood would be jerked out of veins. As of a band above knees; round body. Stiffness. Numbness. Burning. Stitches. Symptoms are < in morning; in open air; by motion; by mental exertion. Each of these is a characteristic; a combination of two or three of them may be considered a keynote. < In morning is the greatly predominating feature of Nux. [The best time to give Nux is in the evening at bedtime, that is, well away from the time of its chief aggravations.] Cough and some other symptoms are < in night; < after midnight; < 3 or 4 a.m. During day, drowsiness. Menses return at full moon. Although Nux is sensitive to chill, draught, and air, most symptoms being < by cold, cold water, and by getting wet; still the symptoms generally are < in dry weather, > in wet weather. But wet weather < facial neuralgia; and wet, warm weather = gastric and bilious fever. Warm room and warm covering > headache. But warm room = fainting. Summer heat is insupportable; sunshine < headache. Open air > flatulence and asthma and < all other symptoms. < In wind. Rest >. > Lying down; on side. Motion <. Exertion, physical or mental, <. < From shaking head. Eating <. Milk sours on stomach. When eating: heat in head. < From coffee; cold food; cold water; wine. Alcoholic drinks both < and >. Touch <. Pressure >; but cannot bear tight clothing. Rubbing >. Riding in carriage = sickness. Coughing <; shocks are felt in pit of stomach with every cough. < From pollutions. < From stomach derangement. < After stool; before urinating; when yawning; < during and after menses (old symptoms are renewed and new ones occur). < On waking at night. When it "all medicines disagree" Nux will often cure the morbid sensitiveness and other troubles with it. < From music. There is very great > for a short time after a stool.