Semen Strychni, also known as Bitter Fruit, Semen Strychni and Semen Strychni, is the seed of Semen Strychni, a plant of the family Strychnaceae. Cold in nature, bitter in taste and poisonous. Entering the liver and spleen meridians. Has the effects of dispersing stagnation, relieving swelling, dredging collaterals and relieving pain. Traditionally used for rheumatism, numbness, paralysis, carbuncle, swelling and pain, traumatic injury and so on. According to "The Enthusiasm of Western Medicine", Semen Strychni "is much better than other drugs in dredging meridians and joints". The clinical application of nux vomica for nearly a thousand years shows that its curative effect is remarkable, and it can be said that it is a "vicious poison". But at the same time, its clinical application is limited because of its blindly "toxicity".

I. Poisoning Mechanism of Semen Strychni

The understanding of the toxicity of nux vomica has gone through the process from "non-toxic" to "toxic" and then to "extremely toxic". Modern pharmacological research shows that semen Strychni contains brucine (strychnine), brucine (brucine), γ-brucine and β-brucine, brucine, brucine and so on. The main alkaloids are strychnine and brucine. The therapeutic dose first excites the reflex function of spinal cord, then excites the respiratory center and vascular motor center of medulla oblongata, and can improve the sensory center function of cerebral cortex. Toxic doses can inhibit the respiratory center. Strychnine can also enhance the effect of preventing cholinesterase from destroying acetylcholine, strengthen intestinal peristalsis, and lead to abdominal pain and diarrhea. Both brucine and strychnine can block neuromuscular afferent at very high dose, which shows the effect of curare. Semen Strychni can also directly damage renal tubular epithelial cells, leading to acute renal failure and uremia. Oral administration of strychnine 1 5 ~ 10 mg can cause poisoning and 30 mg can cause death. Seven grams of nux vomica can kill you. The incubation period of poisoning is 30 ~ 180 minutes.

Second, the factors affecting the toxicity of nux vomica

1. The quality of processed products of Semen Strychni is generally based on the content of strychnine in processed products, in order to reduce the content of brucine with poor curative effect and high toxicity. There are many traditional processing methods, such as tofu agent (outline) and beef stir-frying (prohibition) in Ming Dynasty. In the Qing dynasty, there were fragrant frying, soaking hair (good friends) and repeatedly processing soil powder after soaking hair (lifetime collection). At present, there are two widely used methods in China, namely sand frying and frying, which have been accepted as legal methods in People's Republic of China (PRC) Pharmacopoeia. Sand frying method until there is sonic boom, the surface bulges, crushed when pressed, and the appearance turns brown. The appropriate sand temperature is 240℃ ~ 250℃ for 3 ~ 4 minutes. The optimum oil temperature for frying is 250℃. After high-temperature treatment such as sand frying or frying, brucine with low efficacy and high toxicity was destroyed and lost, while strychnine was partially destroyed, and alkaloids with low toxicity such as isorhynchophylline and isorhynchophylline were produced.

2. Compatibility with the preface of Shennong Materia Medica: "If it is toxic and should be controlled, you may be afraid of killing each other." Studies have shown that musk and corydalis tuber can enhance the toxicity of nux vomica, so they should not be used together. Radix Paeoniae Rubra can reduce the toxicity of Semen Strychni, and mixing Semen Strychni with a certain amount of Radix Paeoniae Rubra can reduce the toxicity. With the increase of the dosage of Radix Paeoniae Rubra, the degree of attenuation of Semen Strychni will increase. Licorice also has an effect on the toxicity of nux vomica. It has been reported that decocting Semen Strychni with twice the amount of licorice can reduce or alleviate the toxicity of Semen Strychni.

3. The dose of Semen Strychni is close to the toxic dose, so we must be careful in clinical application. We can start with a small dose, 0.3 ~ 0.6 g, and add the pill powder after processing. The content of strychnine is controlled at about 6 mg. Due to the difference of patients' physique and age, the actual application should vary from person to person, depending on the severity of the disease.

Third, the clinical application of nux vomica

Although nux vomica is poisonous, its curative effect is positive. In clinical application, the processing of nux vomica must be standardized and the dosage must be accurate. Semen Strychni has the effect of dredging collaterals and relieving pain, and is often used to treat rheumatic pain and meridian contracture in clinic. It is often used with Notopterygium Rhizoma, Radix Aconiti, Olibanum and Myrrha. In traumatology and surgery, Semen Strychni has the function of relieving swelling and pain, and can be used equally with Pyritum, Rhizoma Drynariae, Olibanum and Myrrha to treat traumatic injury and swelling. For the treatment of vulvar gangrene, it can be used with Radix Aconiti Kusnezoffii, Radix Angelicae Sinensis and Lumbricus.