On the use of Strychnia in Intermittent Fever. By S. E. McKin-
ley, M. D., of Williamsport, Tenn.
To the Editor of the Medical Examiner :
Dear Sir:—The object of this communication is to lay before
you the experience I have had in the use of Strychnia as a reme-
dial agent in intermittent fever. I know the ordinary treatment
consists in the employment of quinine—and in ninety-nine cases
in a hundred it answers, but in the hundredth it fails—given in
any form or quantity, or under whatever circumstances, either
during, or in the absence of either of the paroxysms, pyrexial or
congestive. Calomel or blue mass may be given until ptyalism
is induced, and often by such treatment alone, but more especially
when followed by quinine, the attacks are postponed, but only to
return in a very short time with redoubled violence. Found thus
tedious in its progress, causing great emaciation and exhaustion,
we ought not, without special reasons, to persist in measures
calculated to lessen the powers of life, such as nauseants, bleed-
ing, excessive sweating and repeated salivations, the ordinary
treatment used in obstinate cases. And with equal propriety
should we abstain from the use of that “ renowned anti-periodic,”
when wTe know that it only aggravates and does not cure the dis-
ease. At the commencement it might, if properly governed, have
done good and cured the patient; but now, from repeated attacks
of the disease and corresponding repetition in the use of quinine,
the nervous system has lost its susceptibility of being acted upon,
and being brought back to a state of integrity by the use of that me-
dicine. I have for a number of years been engaged in the active
duties of my profession in many of the most malarious districts,
both in the western and south-western states, and every opportu-
nity has been afforded me of testing the various remedies for inter-
mittent fever. But none have proved so potent in my hands as
“ strychnos nux vomica,”—none so cheap—none so easily adminis-
tered—none that the patient will take more cheerfully—none, in
fine, that acts with more certainty as a permanent cure, if persisted
in for two or more weeks.
My mode of using it is to give one-sixteenth to one-eighth of a
grain of strychnia every three hours, gradually augmenting the
dose in proportion to the lost susceptibility. Thus we may
gradually increase the quantity until, in some cases, one grain
may be given three and four times per day, and without any toxi-
cal symptoms arising whatever. By pursuing the above plan, I
have found my patients to recover in a very short time; and to
lose the chill, in general, on the second day after commencing
the medicine. I give it in pill of bread crumb. Hoping that others
may meet with as satisfactory results from its use, as I have, and that
it may be more used and less feared than it now is, I submit its
results in my hands to the scrutiny of the profession, through the
medium of the Medical Examiner.
S. E. McKinley.
P. S. Owing to the tedium of the process and the space it would
require, I omit the illustration of the infinite variety of cases,
with which my case-book is replete, wherein I have used the
strychnia with the most marked and happy effects. The greatest
number of the cases referred to were persons who contracted the
seeds of their intractable malady while on a visit to, or a residence
in, the “ Slashes of Indiana,” “ Blue Ponds of Arkansas,” “ Black
Marshes of Mississippi” and West Tennessee, and low lands on
the Tennessee river. Prior to the employment of strychnia, sul-
phate of quinine, in the greatest number of cases, conjoined with
other acknowledged tonics, such as gentian, columba, quassia,
camphor, piperine, iron, &c., (after the constitutional effects of
mercurials,) had been fruitlessly resorted to. Owing, probably,
to the ravages the constitutional powers of the system have sus-
tained from repeated attacks of this “ Western Pest,” it would
seem that the nervous system has contracted a species of paralysis,
amenable only to such remedies as are addressed to the system
where unequivocal paralysis exists. It is well known in the
w’estern country, in malarious districts, that horses become af-
fected—are sluggish, loathe and refuse their food—become shaggy
and lose their hair—when the owners of them will at once give
what they call “ ox-vomit,” nux vomica, and simultaneously with
its action the animal revives.