excreted decreases with the increasing dose. of the amount excreted by the kidneys, about 70% is excreted in the first 6 hours, and almost 90% in the first 24 hours. excretion is virtually complete in 48 to 72 hours. treatment there is no specific antidote for strychnine but recovery from exposure is possible with early supportive medical treatment. strychnine poisoning demands aggressive management with early control of muscle spasms, intubation for loss of airway control, toxin removal (decontamination), intravenous hydration and potentially active cooling efforts in the context of hyperthermia as well as hemodialysis in kidney failure (strychnine has not been shown to be removed by hemodialysis). strychnine poisoning in today's age generally results from herbal remedies and strychnine-containing rodenticides. moreover, management should be tailored to the patient's history of chief complaint and workup to rule out other causes. if a poisoned person is able to survive for 6 to 12 hours subsequent to initial dose, they have a good prognosis. the patient should be kept in a quiet and darkened room, because excessive manipulation and loud noises may cause convulsions. because these convulsions are extremely painful, appropriate analgesics should be administered. treatment of strychnine poisoning involves oral administration of activated charcoal which adsorbs strychnine within the digestive tract; unabsorbed strychnine is removed from the stomach by gastric lavage, along with tannic acid or potassium permanganate solutions to oxidize strychnine. activated charcoal may be beneficial, but its benefit remains unproven, and its use should be avoided in any patient with a tenuous airway or altered mental status. seizures are controlled by anticonvulsants such as phenobarbital or diazepam, along with muscle relaxants such as dantrolene to combat muscle rigidity. historically chloroform or heavy doses of chloral, bromide, urethane or amyl nitrite were used to restrain the convulsions. because medications such as diazepam are not effective to relieve convulsions in all cases, concurrent use of barbiturates and/or propofol can be utilized. the sine qua non of strychnine toxicity is the "awake" seizure, in which tonic-clonic activity occurs but the patient is alert and oriented throughout and afterwards. accordingly, george harley (1829–1896) showed in 1850 that curare (wourali) was effective for the treatment of tetanus and strychnine poisoning. curare causes paralysis, and it is important to note that, if seizure activity is present, the use of muscle paralysis will only mask the signs of ongoing seizure activity despite otherwise ongoing present brain damage. history strychnine was the first alkaloid to be identified in plants of the genus strychnos, family loganiaceae. strychnos, named by carl linnaeus in 1753, is a genus of trees and climbing shrubs of the gentianales order. the genus contains 196 various species and is distributed throughout the warm regions of asia (58 species), america (64 species), and africa (75 species). the seeds and bark of many plants in this genus contain strychnine. the toxic and medicinal effects of strychnos nux-vomica have been well known from the times of ancient india, although the chemical compound itself was not identified and characterized until the 19th century. the inhabitants of these countries had historical knowledge of the species strychnos nux-vomica and saint-ignatius' bean (strychnos ignatii). strychnos nux-vomica is a tree native to the tropical forests on the malabar coast in southern india, sri lanka and indonesia, which attains a height of about 12 metres (39 ft). the tree has a crooked, short, thick trunk and the wood is close grained and very durable. the fruit has an orange color and is about the size of a large apple with a hard rind and contains five seeds, which are covered with a soft wool-like substance. the ripe seeds look like flattened disks, which are very hard. these seeds are the chief commercial source of strychnine and were first imported to and marketed in europe as a poison to kill rodents and small predators. strychnos ignatii is a woody climbing shrub of the philippines. the fruit of the plant, known as saint ignatius' bean, contains as many as 25 seeds embedded in the pulp. the seeds contain more strychnine than other commercial alkaloids. the properties of s. nux-vomica and s. ignatii are substantially those of the alkaloid strychnine. strychnine was first discovered by french chemists joseph bienaimé caventou and pierre-joseph pelletier in 1818 in the saint-ignatius' bean. in some strychnos plants a 9,10-dimethoxy derivative of strychnine, the alkaloid brucine, is also present. brucine is not as poisonous as strychnine. historic records indicate that preparations containing strychnine (presumably) had been used to kill dogs, cats, and birds in europe as far back as 1640. it was also used during world war ii by the dirlewanger brigade against civilian population. the structure of strychnine was first determined in 1946 by sir robert robinson and in 1954 this alkaloid was synthesized in a laboratory by robert b. woodward. this is one of the most famous syntheses in the history of organic chemistry. both chemists won the nobel prize (robinson in 1947 and woodward in 1965). strychnine has been used as a plot device in the author agatha christie's murder mysteries. performance enhancer strychnine was popularly used as an athletic performance enhancer and recreational stimulant in the late 19th century and early 20th century, due to its convulsant effects. one notorious instance of its use was during the 1904 olympics marathon, when track-and-field athlete thomas hicks was unwillingly administered a concoction of egg whites and brandy laced with a small amount of strychnine by his assistants to boost his stamina. hicks won the race, but was hallucinating by the time he reached the finish line, and soon after collapsed. maximilian theodor buch proposed it as a cure for alcoholism around the same time. it was thought to be similar to coffee. its effects are well-described in h. g. wells' novella the invisible man: the title character states "strychnine is a grand tonic ... to take the flabbiness out of a man." dr kemp, an acquaintance replies: "it's the devil, ... it's the palaeolithic in a bottle."