Aconitinum

Our knowledge of this alkaloid is chiefly derived from cases of poisoning and

over-dosing. The numbness, tingling, prickling and heat of the Aconite provings are produced by

the alkaloid, but with increased intensity. On local application, first there is sensation of warmth,

then of burning with sharp pains and itching; finally numbness and anesthesia. The symptoms

often proceed from below upwards: "A tingling, prickling sensation, running up leg to spine and

head, and tingling of fingers." "Ice-cold sensation creeps up from his feet." Fear of death,

anguish, intense chilliness; feeling of sickness; constricting burning sensation, extending from

mouth to stomach. Twitchings and spasms over whole body, especially in face. All symptoms

are > by vomiting. In one poisoning case "vomiting recurred every two or three minutes, and was

performed by a sudden jerking action of abdominal muscles, accompanied by a loud shout,

probably dependent on a sudden contraction of the diaphragm. Every attempt to swallow was

followed by the spasmodic contractions So characteristic of hydrophobia, but they were not

renewed by the sight of water. The slightest touch renewed the spasms." Aconitine should be

helpful in cases of hydrophobia, whether of the convulsive or the paralytic kind. The senses are

disordered or lost-sight, hearing, smell. In one poisoning case the blindness was coincident with

sudden dilatation of the pupils, and sight partially returned as the pupils contracted. A heavy

feeling as of lead all over the body. All parts except head and stomach feel as if filled with lead.

Neuralgia of 5th nerve. Creeping on face with feeling of swelling and tension. Pains in

supraorbital nerve were especially prominent. Post-mortem examinations show the spleen very

much enlarged; posterior part of liver dark and almost black. Kidneys hyperemic.

The symptoms of Aconitine set in with great rapidity, and develop with extreme intensity. If

recovery occurs it is rapid and complete. There is relaxation of the limbs and every exertion < the

• ▸symptoms.
• ▸< By mental exertion; by agitation.
• ▸< By touch.
• ▸Erect position = nausea (M)

Anguish; fear of death.—Intellect perfect, even vivid.—Flow of ideas sluggish, long

reflection impossible, power of attention impaired.—Feels like one sleeping and

dreaming.—Forgetfulness and trembling of limbs.

Malaise; feebleness; muscular prostration.—Twitchings and convulsions over

whole body.—Heaviness as of lead all over body.

Vertigo and confusion, with ringing in ears; falls almost immediately.—With

giddiness, dimness of vision, and muscular weakness (M).—Fulness in the head, with noises in

the ears—Head and faceache; often darting pains in face, sometimes accompanied by

vomiting.—(Hemicrania cured).—Weight about head; unable to hold it up.

Strained feeling in eyes.—Pupils dilated (both from internal and external

use).—Complete blindness; accompanying dilatation of pupils, sight returning when pupils

contract.—Vision hazy, with giddiness and nausea (M).—Pupils insensible to light.

Fulness in cheeks and temples gradually changing to painful sense of tension,

formication, and prickling.—Face tense and swollen —Creepings in face and forearms.—Peculiar

drawing, stretching, pressing sensation in cheeks, upper jaws, forehead—in short, through whole

tract of trigeminus, increasing by degrees in intensity, alternating with actual pain, which, at first

occasional and fugitive, finally became steady and severe.—Pain at temple and along course of

supraorbital nerve.—Darting pains in face accompanied by vomiting —Beginning in fingers, then

in face, tonic contractions, trismus; after a while clonic convulsions over whole body.—Eyes

closed, lips dry and fissured, tongue stiff; felt chilly and as if dying; breathing became rattling,

moaning, quick.—Facies hippocratica.

Burning on tip of tongue and lips—Burning, constricting, acrid, dry sensation in

mouth and fauces.—Tongue stiff.—Taste disagreeable and disgustingly bitter—Taste completely

lost.—Taste impaired; teeth more sensitive when biting.—Salivation.

Burning anguish in throat.—Constriction and burning from mouth to

stomach.—Every attempt to swallow followed by spasms like hydrophobia but not renewed by

sight of water.—Difficulty of swallowing and a pain in back of neck and behind jaws in parotid

region, so that in eating he had to press back of neck with hand (M).—Burning in gullet as if a hot

coal were there (M).

Eructations immediately.—Severe vomiting, which recurred every two or three

minutes and was performed by a sudden, jerking action of abdominal muscles accompanied by a

• ▸loud shout.
• ▸—Nausea induced by erect position (M).
• ▸—Vomiting relieves all symptoms.
• ▸—Warmth

most marked in region of stomach.

Rumbling in bowels (immediately in one case, two hours after dose in

another).—Sudden contraction of diaphragm.—Liver and spleen greatly enlarged.

Copious diuresis. —Difficulty in voiding urine (M).—Dysuria and

occasionally retention with hypogastric pain (M).

Respiration difficult—Oppressive anguish in precordial

region.—Sighing breathing.

Pulse at first, on entering a warm room, more frequent, then sinks far below normal,

small, weak, intermittent—Sounds of heart only heard at apex.

Surface cold, sweating, and quite pale.—Intense coldness.—Head and face became

suddenly warm; warmth extended over rest of body, was more intense in region of stomach, and

was accompanied by sweat.

• ▸Blindness.
• ▸Chill.
• ▸Convulsions.
• ▸Deafness.
• ▸Dyspncea.
• ▸Ears, noises in.
• ▸Hemicrania.

• ▸Hydrophobia.
• ▸Landry's paralysis.
• ▸Liver, enlargement of.
• ▸Neuralgia.
• ▸Esophagus, spasms of.

• ▸Spasms.
• ▸Spleen, enlargement of.
• ▸Tetanus.
• ▸Tongue, affections of.
• ▸Trismus.
• ▸Vomiting.