17, 1901).
When aconite is applied directly to the heart. the number and force of the beats are lessened, and its action is finally arrested in diastole. It lowers the blood pressure and pulse-rate when given in ternally by a direct action on the heart itself. Bartholow concludes that it is a direct cardiac poison, affecting its gan glia and muscle, and also a sedative to the vasomotor nerve-system. Hare calls attention to the fact that the fall in pulse-rate from poisonous doses is some times preceded by a quickening due to a condition of weakness and abortive car diac action. All agree that it is a re spiratory poison by direct action on the muscles of respiration, but that the heart ceases before the respiratory movements.
Aconite reduces the temperature when given in health. Bartholow tells of a medical student poisoned with aconite, in whom the temperature fell two de arees- It also increases the action of the skin and kidneys, and with the increase of water there is augmentation of the solids excreted. (F. E. Stewart.) Aconite Poisoning. — The symptoms following the ingestion of a poisonous dose usually show themselves after a few minutes. The tingling, prickling, and numbness already mentioned rapidly ex tend from the mouth and fauces to the face, thence to the body. Speaking re quires marked effort. Great prostration and muscular impotency follow, and the skin becomes cold and clammy, the per spiration covering the surface, and the cold tissues communicating to the hand an icy coldness. Muscular pains may be present in the early stages, especially in the face. There is usually experienced marked epigastric pain with nausea and vomiting. Later on, however, the nausea ceases, owing to paralysis of the stomach walls.
The heart-beats are greatly reduced in number and power; the pulse is usually irregular, compressible, and slow, and so weak, at times, as hardly to be felt. The breathing is labored, irregular, and shallow. the number of respirations being at first decreased then increased. The temperature may be considerably lowered.
The pupils may be dilated or remain of normal size and react equally. The eyes may protrude or be sunken; there fore they afford no differential informa tion as to the nature of the drug.
The mind is usually clear, and the patient calm, though apprehensive of impending death. Occasionally epilep toid convulsions occur. Spasmodic purg ing, the stools being sometimes bloody, and rectal tenesmus are frequently pres ent.
Aconite causes paralysis of respiration and circulation, death usually being due to sudden arrest of the heart in diastole.
Case of poisoning from tincture of aconite-root. Two doses of 1 minim each, given one hour apart, produced tingling, mild delirium, diplopia, and other indica tions of aconite poisoning. Frank Wood bury (Phila. Med. Times, Jan. 1, '90).
Personal case of death following a minimum dose. There are many eases of individual intolerance, and syncope may occur in certain patients from small quantities. Ferrand (La France M6d., Dec. 8, '93).
Treatment of Aconite Poisoning. Death in these cases usually follows exertion by the patient. He should, therefore, be kept perfectly motionless in the recumbent position even during emesis, his head being slightly turned and the defections received on a towel. An important feature of the treatment is to keep the patient as warm as possible by means of warm blankets and hot water bottles, taking care not to place the latter against the skin. The head should also be kept warm. If the patient is seen early the stomach-tube should be used at once to empty the stomach. If no stomach-tube be at hand, apomor phine, 1/12 to grain, should be ad ministered hypodermically, or some other active emetic, such as zinc sulphate, 15 to 30 grains, be given by the mouth.
A point of practical importance, not mentioned in the text-books, is that of wrapping up the head and applying heaters there. This apparently gives especial comfort to the patient. Elevat ing the foot of the bed is of some use. R. W. Greenleaf (Boston Med. and Surg. Jour., July 15, '97).