External

As aconite produces local anaesthesia, it is applied externally and often with great benefit in cases of neuralgia, especially facial neuralgia. Frequently it fails, and we cannot tell beforehand whether it will succeed. A small piece of the ointment B. P. maybe rubbed in till numbness is produced, but as this is a very expensive preparation it is usually better to paint on the liniment B. P., a 40 per cent. solution of the powdered root in alcohol, to which 2 per cent. of camphor is added, with a camel's-hair brush. The pain of chronic rheumatism is sometimes relieved by aconite. Linimentum Aconiti Composi-tum, commonly called A. B. C. liniment because it contains equal parts of Aconite, Belladonna and Camphor liniments, is an excellent preparation for external use. Aconite should never be used externally unless the skin is quite sound.

Internal

It may be given internally for neuralgia, but it does not succeed nearly so well as when applied externally. It is not used internally as much as formerly, when it was administered in almost every febrile disease, with the object of decreasing the force and tension of the pulse. Certainly it does this very effectually, and the only reason why it is not so popular at the present time is, that it is not now thought desirable to reduce the force and frequency of the heart in these diseases. Perhaps it is used too little, for many believe that the milder febrile diseases, such as tonsilitis, laryngitis, or a common cold, are distinctly benefited by aconite, especially if they occur in children.

In addition to retarding the pulse it increases perspiration and lowers the temperature. As large doses diminish the force of the heart, it is usually given in doses of two or three minims .12 or .20 c.c. of the tincture every hour or so till the pulse falls to nearly normal; for the same reason it is not advisable to use it for prolonged fevers, as typhoid, nor when the heart is diseased, except in the few cases in which there is sufficient compensative cardiac hypertrophy. In such cardiac cases it is sometimes useful to slow the pulse, even when there is no fever. It will occasionally relieve the pain of aneurism. A common practice was to combine with it one or two minims; .06 or .12 c.c. of Vinum Antimonii, as that has much the same action on the heart. Formerly it was much used in surgery if it was feared that inflammation might set in after injuries.

Toxicology

Symptoms

They come on quickly; in a few minutes there is a severe burning, tingling sensation in the mouth, followed by numbness. Vomiting is not common, but may begin in an hour or so, and then is very severe. There is an intense abdominal burning sensation. The skin is cold and clammy. Numbness and tingling, with a sense of formication of the whole skin, trouble the patient very much. The pupils are dilated, the eyes fixed and staring. The muscles become very feeble, hence he staggers. His pulse is small, weak and irregular. There is difficulty of respiration. Death takes place from asphyxia, or in some cases from syncope. The patient is often conscious to the last.

Post-mortem

The usual signs of death from asphyxia are seen.

Treatment

Wash out the stomach promptly, give emetics (see p. 139). Use artificial respiration early. Inject stimulants, as ether or brandy, subcu-taneously; apply warmth. Atropine and the tincture of digitalis should be given subcutaneously. Hot blankets and bottles are useful.