Kuchhala.

KUCHHALA.

It is a spinal poison.

*Synonyms:-

Kuchela, Vishatinduka, Kakatinduk, Karaskar, Garadrum, Vishakdhtika, Kapilu.

 English-Nux vomica, Poison nut, Crow figure.

Marathi-Kajara.

Hindi-Kuchala.

Latin-Strychnous nux vomica.

Family-Loganiaceae.

*Classification:-According to Ayurveda- Sthavar vanaspatik visha.

According to modern- Spinal poison.

*General description:-

1) Trees are 12-13c.m. long.

2) Leaves are green and shiny, hairy with bad odour.

3) Yellowish juice comes out on crushing them.

4) Flowers are soft, small, white coloured.

5) Fruits are round and orange coloured; each fruit contains 4-5 seeds. Seeds are hard and flat about 2c.m. in diameter and ½ c.m. in thickness. Slightly convex on one side and concave on other.

6) Yellowish brown colour and have shining hard pericarp covered with fine silky hair. They are intensively bitter in taste.

*Poisonous part:-Seed.

*Active principle:-1) Strychnine.

2) Brucine.

3) Loganine

All these are present in seeds. The bark, wood and leaves contain only Brucine.

*Fatal dose:-1 Crushed seed.

Strickening-15-30m.g.

*Fatal period-1-2 Hours.

*Signs and symptoms:-

If unbroken seeds are ingested; they are not poisonous as hard pericarp is not soluble in digestive juices.

If broken seeds are taken; symptoms appear within 15 minutes as given below:-

1) Intensely bitter taste of mouth.

2) Patient is anxious and restless.

3) Stiffness of muscles of face and neck.

4) Convulgence are at first clonic in nature and then become tonic. They affect simultaneously flexors and extensors. During this stage muscle become so stiff and rigid; that the body is arched with only the back of hand and hills touching the ground. This stage is known as opisthotonus. Sometimes the body is curved forward and hence; condition is called as emprosthotonus and pleurothotonus sideways. 

 5) Difficulty in breathing.

6) Synosis.

7) Blood stained froth maybe at mouth.

8) The facial muscles contract into a fix grim called risus sardonicus.

9) Eyes appear prominent and starry.

10) Extreme pain during convulgence.

11) Mind remains clear in the end.

After about a minute the convulgence passes off and the muscles are completely relaxed. The renission is only temporary; as poisoning progresses. Spasms increases in severity, duration and frequency. Death occurs due to aspexia or exhaustion.

 *Differential diagnosis:-

STRICKENING. 1)   There will be history of poisoning. 2)    Onset is sudden. 3)    Generalized convulgence. 4)    Chest fixing. 5)    Complete relaxation in between the convulgence. 6)    End fatally in few hours. 7)    Chemical analysis reveals poison.

TITANUS. 1)   There will be history of injury. 2)    Onset is gradual. 3)    Lock jaw. 4) No chest fixing. 5) Relaxation between the spasms is never complete. 6) Death is rare. 7) Not so.

*Treatment:-

1) Patient should be kept in dark and quite room.

2) Anesthesia with chloroform or I.V. barbiturates should be given and then stomach wash is carried out with dilute solution of KMnO4.A suspension animal charcoal should be introduced to absorb any free strikening.

 3) Barbiturates like phenobarbitone sodium, sodium amytal etc. acts as antidotes and should be given in 500-750m.g.

4) Slow intravenous drip of mephenesin in a dose of 3 m.g. /k.g. should be given for muscle relaxation.

5) I.V. diazepam in a dose of 2.5m.g. May be given for seduction.

6) Antirespiratory; O2 inhalation and other supportive therapy.

7) In Ayurveda; Nagavali ras mixed with goghruta.

*Postpartum appearances:-

1) Signs of asphyxia.

2) Rigor mortises sets in almost immediately after death and passes off after 24 hours.

3) Remains of the seeds maybe found in the stomach.

4) Strickening resists putrifaction and can be detacted from (decaying).

*Medicolegal aspect:-

1) Mostly accidental.

2) From its uses as aphrodisise.

3) Homicidal poisoning is rare.

4) Suicide by strikening is rare because death is incredibly painful.

5) Catal poison.

6) Arrow poison.