ACONITINE. —1-‘conitine is an alka loid obtained from Aconitum napellus, and represents the active principle of aconite. It occurs in colorless, tabular crystals, slightly soluble in wafer, but soluble in alcohol, ether, and chloro form. It is extremely poisonous.
Dose. — The preparations entitled to confidence are those of Merck and of Duquesnel, the latter especially, owing to its constant strength. The German preparations of aconitine are thought to be impure. The dose is from to grain.
The virulence of aconitine causes the responsibility of the physician to be volved to a greater degree than in the case of other poisons. It should be ad ministered in small doses only, if used at all.
Case of fatal poisoning by a single dose of aconitine in France. Physician fined 100 francs. Editorial (Gaz. des Hop., Paris, Sept. S, '91).
Nitrate of aconitine given by practi tioners in doses of V22, and grain. These relatively large quantities are apt to be followed by serious results. Edi torial (Medical Age, May 25, '92).
The activity of aconitine is markedly increased when it is administered hypo dermically.
Injections of the alkaloid in various neuralgias excessively painful and pro ductive of toxic symptoms. A. Cohn (Deutsche med.-Zeit., Oct. 22, 'SS).
From experiments on rabbits and dogs it was thought that as much as '/, grain of aconitine could be given to the horse, whereas half that dose would be fatal. It is, therefore, illogical to calculate the toxicity of a poison by the weight of an animal, and still more so to draw con clusions as to one species from experi ments on another. Aconitine possesses great activity when given by hypodermic injection. Weber (Le Bull. Med., Mar. 20, '95).
The fact that the preparations dis pensed vary greatly in strength accord ing to the source of production militates against its use.
Especial attention called to the various degrees of strength of the several varie ties of aconitine on the market. The division into French, German, and Eng lish aeonitine is as unreliable as it is unscientific. William Murrell (Medical Bulletin, June, '90).
Physiological Action. Aconitine in minute doses reduces the action of the heart and thereby reduces arterial ten sion. In large doses, or in persons pre senting undue sensitiveness to the effects of aconite, this action manifests itself more markedly, reaching, in fatal cases, to arrest of the heart in diastole. Aconi tine reduces temperature by this influ ence on cardiac action; it also tends to inhibit respiratory action by its paralyz ing influence upon the muscles of res piration. On general principles, aconi tine tends to reduce functional action through its paralyzing influence upon nerve-centres.
Aconitine Poisoning.—The symptoms following a poisonous dose are those of aconite poisoning, but they occur more rapidly; hypodermically administered, aconitine may cause •death in less than a minute. Tingling in the mouth and throat, numbness of the face and ex tremities, reduction of the cardiac pul sations, shallow breathing, dilatation of the pupils, cold sweats, purging, etc.,
follow in quick succession, death com ing on through paralysis of the heart.
Case of poisoning in which a stout German took eighteen tablets of aconi tine each containing grain, probably within half an hour's time. One hour and a half afterward there appeared symptoms of paraplegia; stertorous, irregular respirations, from six to thir teen times a minute; strangling; and tingling in the fauees. Pulse irregular, pupils slightly dilated and sluggish. Re covery under morphine hypodermically, emetic•, Ivhisky, and ammonia. Valen tine (N. V. Med. Jour., Dec. 1.5, '88).
Treatment of A conitin.e The general indication is to prevent syn cope. The recumbent position, warmth, and stimulants are pre-eminent among the measures to be employed. The stomach-tube may be used if the heart's action is not too weak, while the stim ulation is procured by hypodermic in jections of ether, ammonia, or whisky. Strychnine, digitalis, or caffeine are also valuable, but their action is not as rapid. They may be utilized to great advantage to sustain the heart's action, however, after the patient has shown evidences of reaction.
Case in which 'A grain of crystallized aconitine was taken in mistake; the pa tient saved through energetic measures, combined with large doses of caffeine, subcutaneously, to sustain the heart. Veil (La France 1116d., Sept. 20. '93).
Therapeutics.—Aeonitine is possessed of no advantage that the preparations of aconite usually employed do not offer, and is much more likely to give rise to untoward results. It has been used with advantage in neuralgia and pneumonia, especially in the broncho-pneumonia fol lowing upon influenza. Erysipelas seems also to have been successfully treated with aconitine.
Treatment of erysipelas of the face by the use of nitrate of aconitine eminently successful in doses of Veio grain every two hours, taking care not to exceed a daily dose of grain. Course greatly lessened and great relief from pain. Tison and Bourbon (London Med. Re corder, Jan., '91).
Spurious Preparations,—Aconitine has also been obtained from other varieties of aconite,—Aconitum ferox and Aconituns japonicion ,—but the properties of the preparations are still insufficiently known.
Aconitine obtained from .4conitunt napellus possesses the same diaphoretic properties as pilocarpine. This effect is not obtained by the doses ordinarily em ployed. Aconitine from Aco-nitum Taw and A. japonicton has no such property. P. Aubert (Pharm. Centralhalle filr Deutschland, No. 22, '94).
Pseudaconitine, a highly poisonous con stituent of the aconite found in Nepali], probably Aconition ferox. Small, color less, transparent, dextrorotatory crystals, very slightly soluble in water, readily in alcohol, chloroform, and acetone. Per sistent tingling sensation on the tongue; slightly more toxic than aeonitine. W. R. Dunstan and Francis H. Carr (Jour nal of the Chemical Society, p. '97).