This section is from the book "Materia Medica And Therapeutics - Vegetable Kingdom", by Charles D. F. Phillips. Also available from Amazon: Materia Medica And Therapeutics: Vegetable Kingdom.
Diseases of Women. - Turning our attention specially to the congestive and inflammatory disorders of women, we meet with cases in our every-day practice of sudden and abrupt suppression of the catamenia through a chill, though the flow has appeared at its usual time and in its normal character. In these cases there is no remedy which will act so promptly as aconite in removing the discomfort produced, and in quickly causing the flow to reappear, especially if the body be kept warm so as to favor any tendency there may be to perspiration. One drop every half-hour or every hour is generally quite sufficient to bring on the discharge in from four to eight hours after the first administration, and if given within the first few hours after the suspension has occurred.
Puerperal Fever. - Deaths during childbed are in the great majority of cases caused by puerperal fever. This is mostly accompanied by peritonitis, and usually comes on about the second to the fifth day after confinement, ushered in by severe rigors, followed by high fever. When we consider that more than 3,000 women die annually in childbed in England alone, any remedy deserves careful and patient trial which seems to give rational hope of reducing so sad a mortality. I must therefore lay stress upon the fact that I have recorded five cases of puerperal peritonitis of the usual type, and that all five of my patients recovered through the operation of aconite and an occasional dose of castor-oil. Two of the sufferers were attacked upon the third day after delivery, and three upon the second day. With two of them the pulse rose to 140, and the temperature to
105 1/5° and 105 2/5°, while with the other three the pulse rose to about 120 to 135, and the temperature to 103 4/5° and a maximum of 104 3/5°. I gave nothing but aconite and an occasional dose of castor-oil, the former in drop doses every one or two hours steadily through the day and night, and had the satisfaction of seeing my treatment perfectly successful. Repeated hot poultices or laudanum fomentations were employed throughout the whole of the period of the exhibition of the medicine. If we have recourse to aconite in puerperal fever immediately after the rigors set in, it will assert its beneficial power and declare its superiority over venesection, antimony, mercury, and any ordinary mode of treatment.
In puerperal mania, accompanied by high fever, restlessness, head symptoms, and scanty secretion of milk, I have frequently used aconite with speedy and marked success; and here again, in order to secure the full benefit of the medicine, it must be administered soon after the chill has occurred. I am fully persuaded that in puerperal convulsions aconite is one of the best agents we possess, although I have failed in one or two cases; and although chloroform was freely employed as a subsequent means of relief, I was obliged to resort to the lancet, followed by opium, before the desired effect was produced.
Surgical Fever. - The analogy between surgical and puerperal fever (the former of which is no less deadly) was pointed out by Sir James Simpson; and I am satisfied, from extensive experience, that were aconite given quickly and repeatedty in the early stage of surgical fever, during the chill or soon after, the mortality would be much reduced, and become relatively trifling.
As regards the influence of aconite in pyaemia, Dr. Ch. Isnard reports three interesting cases ' of a traumatic character, and one of childbed fever, in which favorable results were obtained, the fever having quickly abated, and a critical profuse sweat appearing.
In all the latter class of cases, namely puerperal fever, mania, or convulsions, and also in surgical fever, one or two drops of tincture of aconite may be given every ten or fifteen minutes for the first hour, and afterwards every half-hour or hour, according to the severity of the symptoms. As the pulse falls, the interval between the doses should be prolonged; but if the fever should not abate, and the temperature should not fall within a reasonable time after commencing the medicine it would be almost useless to continue it, for this might easily bring about sudden prostration.
In conclusion, in all pyrexial diseases for which aconite is prescribed, I recommend that it be given from every half-hour to every one, two, or three hours, in single or two-drop doses of the Pharmacopoeia tincture, according to the special necessities of the case. In very acute cases it may be given every fifteen minutes during the first hour. Very important is it to observe, also, that this medicine should never be given in any vehicle except water. (We have used aconite to advantage in gonorrhoea and epididymitis when the imflammation runs high, and in urethral fever. It is also of service as a preventive of chill after the passage of sounds, as first pointed out by Mr. Long nearly thirty years ago, a drop or two of the tincture being given after the passage of the instrument. When effective it is preferable to quinine usually given for this purpose.)
Pain and Spasm. - We have now to consider the therapeutic properties of aconite in painful and spasmodic affections which are unconnected in their origin with inflammation or congestion. In neuralgia, the efficacy of aconite has been very variously estimated by different authors; but doubtless a good deal of this disagreement is to be traced to the very vague way in which the word "neuralgia" has been used. As Dr. Ringer correctly observes, the drug is of little service in those cases where the principal cause of the pain is the existence of some permanent peripheral irritation, like a decayed tooth. In the neuralgias which are more properly so called, especially those of the face or brow, aconite proves useful in a considerable number of cases. (The effect is probably due to its elective influence on the trigeminus, and Ott suggests that the relief is obtained through a benumbing influence on the peripheral ends of the nerve.)