This plant grows in Europe. The tuberous root is collected in the fall carefully dried. This root is used by the English in the preparation of the drug. In Germany the whole plant is collected when flowering. The homoeopathic preparation is made from the whole plant when flowering. The root contains a number of alkaloids, of which aconitine, the principle, is present in about 0.75 percent. It is dark brown in colour, from 4 to 10 cm. long and 5 to 20 cm. in diameter. When broken, the interior is of a mealy yellowish-acrid and pungent, leaving a sensation of numbness or tingling in the tongue.
Allied plants are the Japanese aconite, the India aconite, and the aconitum ferox.
In the British Pharmacopoeia for 1932 there are no preparations of aconite listed other than a liniment. This drug has therefore become a “has been” among other old school brethren.
Dr.Rudolf, of Toronto University, published a paper about 1910 upon the action of aconite in reducing fever, and found it valueless.
A recent authentic case of aconite poisoning is reported by Edward F.Hartung, M.D., in the J.A.M.A. 1265, October, 1930. It is as follows:.
A strong healthy man age 31, weight 242 lbs., drank a small amount of whisky, 11 cc. in all at 4 p.m. At first he felt stimulated and took a walk. In one-half hour he felt depressed, ate some food, and went to a theatre. He remained sitting quietly in the theatre until about 9 p.m., when he began to have difficulty in breathing and became faint., weak and dizzy. Soon he became cold and clammy, and collapsed for two hours; he was then assisted home and into bed. There was no vomiting, diarrhoea, or tingling in the mouth, or on the skin.
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The physician gave stimulants. The following day he still complained of weakness, faintness, and a feeling of uneasiness over the pericardium. The skin was cold and he was pale. The heart sounds, at this time were weak, S.B.P.75, D.40.Urine O.K. An electrocardiogram was taken, which disclosed a first degree heart block. He gradually improved, but this period of recovery lasted four weeks. Through the entire illness he exhibited great panic and anxiety, and complained of uneasiness over the precordium. Except for the absence of tingling and neuralgic pains, this report bears out the homoeopathic proving of Aconite. The whisky when analyzed was found to contain tincture of Aconite in considerable amount.
This drug is quick and violent in its action, but some or it results nay be quite long lasting, and remote. The provings show tumultuous heart action, chills, a rapid rise in temperature, sweat and great weakness accompanied by great mental distress, fear and restlessness, tingling, and numbness. T.F.Allen says that even animals exhibit this great restlessness and anxiety when taking the drug. In heavy doses there are said to be caused paralysis of the sensory and motor nerves, vomiting, purging, convulsions and death. THE GENERALITIES ARE;.
Cannot lie upon the right side.
Cannot lie still, restless, tossing about.
Convulsions coming on suddenly from fright or exposure to cold, with shaking chill in the intervals between he convulsions.
The convulsions alternate with relaxed state, the face and body sweats.
The face may be red or pale and fear is always present.
Twitching of the muscles, prickling, tingling sensation indifferent parts, sensations like electric shocks through and part.
Anxious trembling of the lower jaw, cannot keep still during the chill.
Stitching pains here and there, but more frequently about the head.
Sensitive to touch, to drafts of air. Weakness.
AGGRAVATIONS:.
From exposure to cold and cold winds, from becoming wet and chilled.
In the evening. In a closed room.
AMELIORATIONS:.
In open air, after a sweat, and some times from cold applications, as in croup. MENTAL SYMPTOMS:.
The mental symptoms are the key to the use of this remedy. All acute cases exhibit in greater or less degree, the fear of death or apprehension. If the patient wants the doctor he wants him in a great hurry, he is afraid he will suffocate or that he is getting pneumonia, or he may not fear death, but he is afraid, wants help and wants it right away. If he is delirious he will rave about death, be terribly restless and frightened. In the milder states requiring this remedy he will be found restless, sweating easily, and overly concerned about his complaint; is inclined to suggest a consultation, even where the physical findings do not point to any serious condition. HEAD:.
Acute congestions, supraorbital neuralgias, facial neuralgias, burning stinging or tingling pains accompanied by restlessness and anxiety, from exposure and worse every night. EYES:.
Acute conjunctivitis, frequently caused by foreign particles. A few doses of Aconite will rapidly remove the offending particle. THROAT:.
Sudden attacks of croup, following exposure to cold, coming on in the evening with fear of suffocation. Dry ringing frequent cough. Dry croupy cough. (These cases are quickly helped by the application of a cold wet towel about the abdomen). The voice is husky. CHEST:.
In acute chest pains, congestion of the lungs and acute pleurisy, coming suddenly. The pain is often agonizing, the onset sudden, a chill, severe shaking, short hard dry cough, rapid heart action, tumultuous beating, sensation of impending disaster. These symptoms are quickly improved by Aconite, and often entirely cured. The stage of chill is frequently passed before you arrive, but if the patient is still frightened, restless, and presents that appearance of fear with rapid hard pulse, do not fail to prescribe Aconite at once.
On physical examination even if you detect a congestion, crepitant rales, a pleuritic rub, it is not too late to exhibit Aconite. Frequently he will complain of heart or hot feeling behind the sternum with sensations of fullness or pressure over the lungs or heart with sharp pains from deep breathing, sneezing or cough. He may need Bryonia later on but give him Aconite at once. HEART:.
The case of poisoning just cited would indicate a field for the exhibition of Aconite which we are apt to overlook. Most cases of coronary thrombosis come suddenly, as you know, and the more fearful and sudden this pain is, the more fearful is your patient. Do not forger Aconite when prescribing. Mayhap the patient needs Spigelia or Latrodectus, or Kalmia, but possibly Aconite.
A case in point comes to mind. A woman aged 50 was working hard in her garden on May 16, 1934. That evening she received word of her fathers death, and immediately proceeded south to Toronto by motor car. This trip was about 100 miles, and was made at a good rate of speed. The front window of the car was open, she sat in the rear seat, getting the full force of the draft.
During the trip she was seized with a violent pain in the region of the heart and became chilled and covered with a cold sweat, and was put to bed upon her arrival in the city. Seen early on the 17th found her frightened, fearful, temperature 102.3, pulse 120, heart gallop rhythm, chest both front and back on both sides filled with coarse crepitant rales. It is hard to say whether this case is one of commencing double pneumonia or of coronary thrombosis with hypostatic congestion. The sensation over the heart is one of fulness and pressure.
She is slightly grey, cool to the touch, and must sit propped up. In all, it looks more like a heart case. Aconite 200 every half hour for six doses, then every two hours, and strict injunction to remain quiet and lie down as she feels more able. May 18 a.m. pulse 98,. temperature 99.3, chest nearly clear of rales, gallop rhythm gone, anxiety gone, skin warm. May 19; temperature 98.4., pulse 88, improving nicely. May 20. Cactus grand.6x Q.I.D., improving steadily, voice stronger. So much for the use of Aconite in heart conditions. ABDOMEN AND BLADDER:.
Strange to say I have not had many cases of abdominal complaints in which I thought Aconite was indicated. In bladder conditions, however, where there is sudden retention of the urine following exposure, or fright, or a long drive, it will speedily relieve the congestion, and relax the sphincter muscle, thus giving relief. Following the use of the catheter, Aconite is very frequently indicated.
Now for some of the more remote indications of Aconite. We are often inclined to overlook its use in more chronic cases. Here it has a field indeed, and works as quickly when indicated as it does in the more acute cases. I do not mean that in these cases Aconite was not first indicated; it probably was, but its use has been overlooked.
The case of rheumatic fever which has been so puzzling and reluctant to respond, or that case of neuralgia which has tried your, and the patients patience; perhaps Aconite is indicated. The following will well illustrate my point.
The rheumatic patient has nightly aggravations, sweats easily and profusely. The pains wander from side to side, from legs to back, and eventually locate in the eyes, which are congested and sensitive to light. He fears for his recovery, for the loss of his vision. He has had Belladonna, Mercuries, Lac caninum, and Calcarea, all to no avail. But this condition came on following exposure to every extreme cold in February,. The specialist says to remove a tooth, feed him on aspirin and prescribe an atropine ointment to prevent his iris from becoming fixed to the lens behind. He is worried, frightened.
