Aconite is a tall perennial plant bearing a spike of blue flowers; found native in Europe, and cultivated in the United States. The official portion is the root, which is from 3 to 4 inches long, about 3/4 inch in diameter at the base, and tapers to a fine point. It is brown in color, externally, and has been mistaken for horse-radish, but the latter is whitish, does not taper gradually but has almost the same diameter for several inches, and has a strong odor when scraped, which aconite root has not.

There are several varieties of the plant, all more or less poisonous.

Physiological Actions

Aconite applied locally to the skin or mucous membrane acts on the terminations first of the sensory and next of the motor nerves, as a depressant or sedative, and causes tingling followed by numbness and insensibility.

Taken internally aconite is sedative to the heart and respirations; is diuretic and diaphoretic, and reduces temperature. It has no effect on the brain. Medicinal doses, given close together, reduce the frequency, force, and tension of the pulse, produce a gentle perspiration, and increase the amount of urine. Respiration becomes slower and deeper; the temperature falls. The tendency of the pulse under the influence of aconite is to become small, compressible, and weak.

Larger doses, or a single full medicinal dose, produce a tingling feeling, usually first noticeable in the lips or extremities; or, if the impression be decided, the tingling may be felt over the whole body.

There may be also a raw, irritable, or constricted feeling in the throat, and difficulty in swallowing, caused by anaemia of the throat. There is muscular weakness; giddiness and disorders of vision may be produced, especially if any exertion be made; the respirations are diminished, and the pulse may fall to 30 or 40 a minute.

The first effects of medicinal doses are usually shown in half an hour, and the symptoms mentioned will pass off in three or four hours. After poisonous doses, if large, death may occur immediately from instant paralysis of the heart-muscles; or the symptoms may come on in a few moments and death occur soon after, the average time being between three and four hours.

Symptoms Of Poisoning

The first symptom of poisoning is the characteristic tingling, which is diagnostic of every variety and preparation of aconite.

The pulse fails rapidly, becoming weak, irregular, intermittent, and slow; the respirations are shallow, weak, and sighing, irregular and slow. There is anaesthesia of the surface and great muscular weakness; the tongue and breath are cold; the skin covered with a cold sweat. The face has an anxious look and is sunken and livid. The eyes are glaring, the eyeballs protruding; the pupils are generally dilated. The voice is suppressed. There may be vomiting, although it does not always occur. The mind usually remains clear, but there are sometimes convulsions, and in these cases stupor and unconsciousness may be present. In the latter stages of collapse the special senses may be lost, especially the sight.

Treatment Of Poisoning

The first thing necessary is to empty the stomach and wash it out with the stomach-pump. Hot and concentrated alcoholic stimulants are given; external heat applied; the patient's head lowered beneath the line of his feet by taking out the pillows and elevating the foot of the bed; and absolute quiet and rest maintained. Artificial respiration may be practised, and cardiac stimulants given hypodermically.

Atropine is a physiological antagonist, stimulating respiration, and ammonia has the same effect.

Digitalis counteracts the depression of the heart, but acts slowly, while aconite is exceedingly rapid in action.

Precautions

The pulse should always be taken before giving a dose of aconite, and respirations and temperature watched. Any possibility of cold air or draughts must be guarded against, the skin being relaxed, and no exertion on the part of the patient - such as sitting up in bed - allowed.