Of fifteen cases of headaches, arising from various causes, treated with Aconite by Dr. Fleming, ten were completely cured. Of the ten successful cases, three were nervotis, four plethoric, and three rheumatic. In headaches arising from a deranged state of the digestive organs (the most common cause), it failed to afford any relief. Great caution is necessary in administering the remedy in these cases. Dr. Copland* mentions a case, in which the incautious employment of Aconitine caused an apoplectic seizure and hemiplegia.
* British For. Med. Chir. Rev., April, 1859.
Madras Quart. Med. Jouni., Jan. 1861.
Brit. Med. Journ., Jan. 20tb, 1860.
§ Brit. Med. Journ., Oct. 26th, 1861.
Fleming, appears to have been particularly successful. In acute cases, the average period of cure was from five to six days; in three instances, a complete cure was effected in two days; one patient recovered in three days, and six in four days, periods much shorter than the averages under any other form of treatment. The improvement under its use was often very speedy, some alleviation of the pains being occasionally experienced in the course of an hour after the first dose had been taken, while there were few cases in which decided relief, with abatement of the redness, tension, and tenderness, was not obtained in a few hours. A longer period seems to be necessary to disperse the inflammation in the smaller joints than in the larger ones. In these cases, Dr. Fleming directs that it should be given internally, in the doses recommended as an anodyne (ante). Dr. Greiner, of Leipsic, corroborates, from his own experience, the good effects detailed by Dr. Fleming; and Lombard, of Geneva, states that he has had remarkable success with the Alcoholic Extract, in doses of 1/2 gr. gradually increased to gr. ij. or even gr. iij., every three hours. Notwithstanding these evidences of its value, it often fails to make an impression on the disease, the failure probably being due, either to the impurity of the drug, or to an improper mode of administration.
38. In Sub-Acute and Chronic Rheumatism, Aconite may be used, both internally and externally with advantage. Dr. Fleming prefers the internal exhibition, in what has been termed the "Active Chronic Rheumatism;" that variety which is, perhaps, properly speaking, only a very mild form of acute rheumatism, being attended with some heat, swelling of the part, and slight constitutional disturbance. In this variety, and also in Rheumatic Gout, it is highly spoken of, both as an external and internal remedy, by Prof. Graves.§ In purely Chronic Rheumatism, the external application is attended with most benefit.
Fleming employed Aconite in ten cases; and in each a complete cure was effected. To the internal administration of the Tincture was added its external application to the loins, and relief was speedily experienced in every case.
40. In Gout, Aconite is recommended by Murray; but it has been ehiefiy employed by the German and French physicians', amongst whom, Stoerck, Stoll, Vogel, Quarin, and Breva are noticed. Dr. Copland,* who cites these and other authorities, in favour of its employment, remarks that " it is certainly a medicine of greater efficacy in this disease than is generally supposed in England, and that it is more appropriate to old or chronic cases, or to weak habits of body, than to recent attacks, attended with general vascular excitement." Its external application to the painful part is sometimes attended with marked relief.
* Dict. Pract. Med. vol. ii. p. 153. Die Rheumat. Krankkeitcn, p. 119.
Hope on Diseases of the Heart, p. 180. § Clinical Lectures, vol ii. p. 547.