The phenomena above referred to generally begin to appear in twenty or thirty minutes, are at their height in an hour or two, and continue with little abatement for three, four, or five hours; and, if the dose be repeated before the influence of the first has subsided, so as to produce a cumulative effect, the symptoms will continue for twelve hours, a day, or even two or three days, according to the greater or less length of time during which the medicine has been administered. Not unfre-quently, after the direct sedative operation has ceased, a degree of reaction takes place, according to a well-known law of the system; and the circulation, respiration, and general temperature are somewhat increased.

A remarkable quality in the operation of aconite is that, while it diminishes both general and special sensibility, consciousness is usually in no degree impaired. Thus, Dr. Pereira observed that a dog, under the influence of a full dose, would wag his tail when noticed by his master, and endeavour to follow him around the room, though quite insensible to pinching, the pricking of a needle, etc. Yet, along with this insensibility to impressions upon the surface, it is said that neuralgic pains about the joints are sometimes felt, when large quantities have been taken.

As in the instance of digitalis, it is said that, when under the influence of aconite, the pulse is increased considerably in rapidity upon rising from the recumbent to the sitting or standing posture, showing its debilitating influence; for a weakened pulse is almost always more increased in frequency by exertion than a healthy one. The effect of change of position, or other muscular effort, is sometimes so great, when the system is under the full effect of aconite, as to induce a feeling of faintness, and even an approach to syncope; so that, in the use of the medicine, when the patient is found to be decidedly affected by it, care should be taken to guard against undue movement, lest serious prostration might occur.

Allusion has been made to the effect of aconite on the pupil when locally used. There is the same contradiction of statement as in regard to its effects when internally administered; some stating that it contracts, others that it dilates the pupil. The probability is that the contraction is the general rule; but that, when the depressing effect is very great, the iris may become paralyzed with other parts, and dilatation consequently take place.

Poisonous Effects

Aconite is a powerful poison, and has often caused death when too largely taken. The root has occasionally been mistaken for that of the horse-radish, or other culinary plant, and eaten with fatal effect. The symptoms are simply an exaggeration of those already described. The characteristic sensation in the mouth and fauces is very strong; the patient complains of intense burning in his oesophagus and stomach, with much thirst; severe and distressing nausea comes on, attended generally with violent and protracted vomiting, and sometimes with purging; and spasmodic pains are often experienced in the stomach and bowels. These are the results of the direct action of the poison upon the alimentary canal. At the same time, symptoms of the most severe nervous disturbance make their appearance, as headache, sometimes violent; giddiness; dimness of vision, with contracted or expanded pupil; constriction of the throat; prickling and tingling, with numbness, over the whole system; general diminution of sensibility; tremors; loss of command over the muscles; inability to speak distinctly; sometimes lancinating pains in the joints, and a general condition of nervous prostration. The circulation and respiration are also greatly depressed, the pulse being at first reduced to 50, 40, or even 36 in the minute, and afterwards, as the weakness increases, becoming more frequent again, but small, irregular, and extremely feeble. Consciousness is retained till near the close; but at last, in fatal cases, slight delirium comes on, followed by stupor, and sometimes spasmodic movements resembling convulsions; general paralysis of voluntary motion and sensation ensues; the patient becomes blind, deaf, and speechless; the pulse is no longer perceptible; the extremities are cold, and the body is often bathed in sweat; the face is pallid and shrunken, and the eyes glassy; and the universal prostration ends in death, sometimes in little more than an hour, sometimes as late as eight hours from the taking of the poison, but generally in about three or four hours. All these symptoms are not present in every case; but there is not one which does not sometimes occur. Convulsions are not common; and the movements which do occasionally take place are scarcely entitled to the name. Not unfre-quently the muscles are perfectly quiescent to the last. As in poisoning with other narcotics, the dose necessary to destroy life varies exceedingly in different individuals, but is greater, as a general rule, when free vomiting has been early produced by the medicine. Five grains of the fresh extract, one drachm of the root, and eighty drops of the strong tincture of the root, are said severally to have caused death; and it is stated that even fifteen minims or about thirty drops of the British officinal tincture have proved fatal. (Geo. Puckle, Med. T. and Gaz., Dec. 1863, p. 597.) Larger quantities, however, have often been taken without the same result.

On dissection, inflammation of the stomach and bowels is said to have been noticed, with general venous congestion, and the blood in a coagulated or coagulable state. According to some observers, the heart of animals poisoned with aconite has been found perfectly quiescent immediately after apparent death; others have found it contracting; and the probability is that sometimes one of these conditions exists, and sometimes the other.

The treatment consists in washing out the stomach thoroughly with diluent drinks if vomiting has already taken place, and, if not, by means of an emetic dose of ipecacuanha, with similar dilution; and afterwards administering opiates to allay irritation, and carbonate of ammonia and alcoholic stimulants to support the strength. Generally speaking, the opiate would be best given by enema. Stimulation externally, also, by a sinapism to the epigastrium and heated rubefacients to the extremities, is called for. Should respiration have ceased, it ought to be restored artificially, in the hope that the heart may not have completely ceased to act, or at least not entirely lost its susceptibility; and, if apparent death from syncope has occurred, efforts should still be made to rouse the heart into action by means of an electro-magnetic machine. if the medicine has been taken a considerable time previously to the commencement of treatment, so that a portion of it may have entered the bowels, a dose of castor oil or other quick non-irritating cathartic should be given, in addition to the other measures. iodine has recently been recommended as an antidote. it may be given in the form of the officinal compound solution. Animal charcoal may be used for the same purpose, but should not be relied on to the exclusion of other measures. Nux vomica has been given in the advanced stage of aconite poisoning, with the apparent effect of saving life. A coloured boy of five years, in the lowest state of prostration from the effects of this poison, after emetics had been used without operating, was apparently saved by tincture of nux vomica, given in doses of three drops. The pulse very soon revived, sensibility to the action of the emetic medicines seems to have been awakened in the stomach, full vomiting occurred, and the patient recovered. (Dr. D. D. Hanson, Boston Med. and Surg. Journ., Sept. 26, 1864 ) It is sometimes astonishing to see how rapidly, under the influence of opiates and stimulants, the patient passes from a state of the most profound prostration, and greatest danger, into complete safety; showing that the action of the poison is mainly functional, and that, whatever active congestion or inflammation may be induced by it, is comparatively trivial.