WHO KNOWS?  NUX VOMICA

by Steve Goldfinger

When we made early morning rounds on the open ward, moving from bedside to bedside, I listened carefully to the resident in charge as he tended to each woman. Whenever he learned that one was suffering from abdominal discomfort—be it heartburn, cramps, gas or constipation—he would always prescribe a dose of something called nux vomica. A strange name, I thought. But even stranger, it often seemed to work, as we would find out at our next visit.

A year later, it was I who was the resident overseeing rounds, trailed by two interns. And it was I who was routinely prescribing nux vomica for belly distress. After a week or so, one of my interns threw a question at me that I had never thought about. “What is nux vomica?” he asked. When I looked it up, I couldn’t believe the answer: strychnine!

Only now, in recalling my long-ago reaction of horror and embarrassment, have I done a bit more research on nux vomica. Yes, it is indeed derived from the highly poisonous seeds of strychnos nux-vomica, a medium-sized deciduous tree native to India. Strychnine poisoning is a ghastly way for a life to end. Within 20 minutes of swallowing it, a person develops intense muscle spasms that cause gruesome facial contortions. Soon, every muscle of the body is activated into stiffening contractions that progress to writhing convulsions. The backbone arches taut. High fever adds to the agony.  After two hours, mercifully, breathing ceases.

The lethality of strychnine has hardly gone unnoticed by writers, including Agatha Christie (employing it to murder characters in three of her mysteries), Arthur Conan Doyle, Stephen King, and Alexandre Dumas. Strychnine killed Norman Bates’ mother and her lover in Psycho. And in Cape Fear, it ended the life of Sam Bowden’s dog.

So what about the women with belly cramps we were treating with nux vomica? Well, we were using an exceedingly diluted preparation that had made its way into our hospital’s pharmacy back in the 1960s. I doubt that it is there today, but one can still obtain nux vomica online from a host of vendors—herbalists, homeopaths, naturalists, and the like. They promote it as a remedy for digestive disorders but also for ailments affecting the circulation, eyes, and lungs as well as migraine, erectile dysfunction, and menopausal distress. Of course, there is not a single scientific study showing that nux vomica does any of these things.

So, what about the women on that ward?  Maybe strychnine, in miniscule dosage, actually did suppress their intestinal spasms.  Maybe it blocked the specific nerve fibers carrying pain to their brains. Or maybe it was simply a placebo effect that brought them relief.

In the absence of studies, it’s easy to dismiss all the claims made for nux vomica. But, of course, for the very same reason, it’s a real question–who knows?

After a long career in medicine, Steve has been exploring his artistic side.  At BOLLI, he has taken writing courses, been active in the Writers Guild, and even tried CAST (Creativity in Acting, Storytelling, and Theatre) where his imagination made him a singular player!