Monkshood. Nat. Ord. Ranuncu-laceae. Linn. Syst. Polyandria Trigynia. Hab. Mountains and Hills of various parts of Europe and Asia. England.
Med. Prop. and Action. Sedative, anodyne, and antiphlogistic.
Offic. Prep. 1. Tinctura Aconiti (Aconite Root in fine powder oz. iiss.; Rect. Sp. Oj. Prepared by maceration and percolation). Each fluid ounce of the Tincture represents 54 1/2 grs. of the dried root It is one-third the strength of the Tincture of the Pharmacopoeia Londinensis, and one-fourth the strength of the Tincture of the Dublin Pharmacopoeia. Dose, eiij. - x.
2. Extractum Aconiti (Prepared from the juice of the fresh leaves and flowering tops). An uncerkiin preparation. Dose, gr. 1/2 to gr. iij. or v.
xx.; Camphor oz. j.; Rect. Sp. fl. oz. xxx., or q. s. to make a pint after seven days' maceration of the root and subsequent percolation). It is intended only for external application. One fluid ounce represents one ounce of the dried root.
The comparative activity of the different parts of the plant has been closely examined by Drs. Fleming and TurnbulL They agree that the root is the part which is the most active, certain, and eligible for medicinal use. The seeds rank Second, the leaves third, the flowers fourth, and the fruit and stem last, in the order of medicinal activity.
* On the Med. Prop. of the Ranun-culaceae, p. 126. Lib. of Medicine, vol ii. p. 271.
Medical Gazette, Nov. 1836.
Op. cit. || Lectures, vol. i. p. 716.
Remarks on it* Use. The physiological and therapeutic effects of Aconite have been carefully investigated by Dr. Fleming.* The formulAe, however, recommended by him in his valuable Monograph are considerably stronger than the officinal. The Tincture he used (Aconite Rootxvj. Spirit f.xxiv.) is six times as strong as that ordered in the British Pharmacopoeia. (See Prep.). In other hands it has been found to be a dangerous preparation. Mr. Redfern has related a case in which five drops of a Tincture. supposed to be I pleming's, three times a day for two days, and two doses on the third day of six drops each, following each other at an interval of two hours. produced most alarming symptoms. The dose of Fleming's Tincture as prescribed by him is ev. gradually increased, and of the Alcoholic Extract gr. 1/8 thrice daily. It is to the former of these preparations most of the following observations refer.
When a small piece of the root is chewed, it causes an increased flow of saliva, a peculiar numbness of the lips and tongue, with a tingling sensation, and partial loss of the use of the former. Its topical application is unaccompanied either by pain, redness, or swelling, even when the physiological effects are developed to the fullest extent. Given internally, Dr. Fleming divides its operation into four degrees.
First Degree. Half an hour after a dose of ev. of his Tincture, warmth is felt in the stomach, accompanied with slight nausea, and oppression of breathing, followed in about ten minutes by general warmth of the body, numbness, tingling, and a sense of distension of the lips and tongue. T here is also tingling at the tips of the fingers, and a peculiar sensation is felt at the roots of the teeth. These sensations continue more or less from one to three hours. Slight muscular weakness is generally experienced, with indisposition for exertion, either mental or bodily. In about half an hour more, the pulse is found diminished in strength, and in another hour, both the pulse and the respiration have become less frequent. Thus, a pulse, which in the normal state, beats 72 in the minute, will, by that time, have fallen to 64, and the respirations from 18 to 15 or 16.
Second Degree. Should a dose of x. be given at first, or the first dose of ev. be succeeded in two hours by another of equal amount, these symptoms supervene more rapidly and with greater severity. The tingling extends along the arms, and the sensibility of the surface is more or less impaired. In an hour and a half, the pulse will probably have fallen to about 56 beats in the minute, and become smaller and weaker, still maintaining, however, perfect regularity. Respirations about 13, and labouring; great muscular debility, giddiness, and confusion of sight come on when in an erect pesture. A lethargic state ensues, with great disinclination to be disturbed, coldness of the surface, and particularly of the extremities, which are cold to the touch.
2'his is the utmost extent to which Aconite can be administered with safety and success.
Third Degree. On the administration of ev. more, two hours subsequent to the last dose, the sense of warmth and the numbness and tingling agai spread rapidly over the body; diminished sensibility of the surface; pains in the joints are complained of; and the vertigo and dimness of vision are increased; the countenance becomes pale and anxious; the voice becomes weak, and there is often a dread of approaching death. The pulse occasionally falls to 40, or even 36, but, more generally, rises to 70 or 80, small, weak, and irregular. Respiration, short, hurried, and irregular, accompanied with dee sighing; surface, moist and cold; and vomiting sometimes occurs, These symptoms do not subside for one or two days.
Fourth Degree. If the medicine be continued, the countenance becomes pale and sunken, froth issues from the mouth, and the prostration increases: sensations, as if sinking from loss of blood; the pulse becomes smaller, weaker, and more irregular; with a cold clammy sweat. Consciousness usually remains. If the action be carried to a fatal extent, the patient becomes entirely blind, deaf, and speechless; the pupils are dilated; slight convulsions ensue, and after a few hurried gasps, death by syncope takes place.
* On the Med. Prop. &c. of Aco-nitum, 8vo. 1845. A very complete Treatise.
Pereira's Mat. Med. 4th Edition, vol. ii. pt. 2. p. 962.
Aconite proves fatal, 1, by a powerfully sedative impression on the nervous system; 2, by suspension of the respiratory function; 3, by syncope.
Contra-Indications. 1. Great depression, or constitutional feebleness of the vital powers. 2. Headache and other affections, arising from anaemia, or chlorosis; or, whenever there is a torpid or paralytic condition of the muscular system. 3. All cases in which there is obvious mechanical impediment to the passage of the blood, particularly through the heart and lungs. 4. Irritability of the circulation, with great diminution of power, such as occurs after serious haemorrhage.