Aconitum.

The root of Aconitum napellus.—Europe.

Preparation.—Tincture of Aconite.

Dose.—The dose of Acouite should be small to obtain its best effect: gtt. v. to gtt. x. to water ℥iv., a teaspoonful every hour, serves the purpose best in most cases.

Specific Indications.—The pulse is small and frequent; usually the temperature is above the normal standard, but it is equally a remedy when the temperature is lowered. It exerts a specific action in relieving irritation and determination of blood to all mucous membranes, and is thus indicated by mucous irritation.

Therapeutic Action.—This agent, in large doses, is a virulent poison, producing numbness and tingling sensation in the mouth and throat, difficult deglutition, numbness and tingling of the extremities, vomiting, slowness and feebleness of the circulation, impaired sensibility, and finally death. Sometimes, but rarely, the muscular power of the individual is impaired, producing inability to walk or use the arms; but in no case reported was there narcotism, the individual being generally conscious almost to the last.

In small or medicinal doses, we find that it produces but little effect perceptible to the patient, except a slight numbness and tingling in the mouth and throat; but on examination, the pulse will be found less frequent and softer, the perspiration increased, as well as the secretion from the kidneys.

If there is any one remedy which holds a first place in the treatment of disease, that remedy is Aconite. Its action is positive, and yet gentle, and always in the direction of normal function; and the indications are so frequently met with that there is hardly a case in which it is not employed at some period of its treatment.

The small frequent pulse is the prominent symptom in acute diseases of children, so that we have been accustomed to say, "Aconite is the child's sedative." With it alone many cases of infantile fever can be successfully treated, the only difficulty being (if the doctor is looking after fees) that the little ones are cured too rapidly. In other cases, remedies that exert a direct influence upon the nervous system, as Gelsemium, Rhus, Belladonna, etc., are employed to aid its curative action.

But we do not confine its use to children, for in a large number of cases (the majority in this locality) of the fevers of adult years, the small frequent pulse calls for Aconite. In evanescent fevers it gives relief, and is sometimes the only remedy required. In the periodic fevers it prepares the patient for the kindly action of antiperiodics. In the continued fevers, and other zymotic diseases, its action is to give a regular and uniform circulation, lessen the temperature, and favor a better functional activity of any part.

The action of Aconite in inflammation is just as direct as in febrile disease. In so far as it controls the pulse and temperature, it relieves inflammatory action in every part of the body. But it goes further, and by its action upon the sympathetic system of uerves it controls local excitement, hyperaemia.

Aconite is a favorite remedy in the early stage of tonsillitis, or quinsy. It is the remedy in mucous and in many cases of pseudo-membranous croup. With small doses of Aconite, frequently repeated, and the external application of Stillingia liniment, we feel confideut of success, if success is possible.

Aconite will be indicated in many cases of tracheitis, bronchitis and pneumonia, in which it relieves the local irritation and hyperaemia, in addition to its general sedative effect.

It has a specific influence upon the mucous membrane of the intestinal canal, relieving irritation. Thus it is a very common remedy for diarrhoea, combined with ipecac. It is also the remedy (usually associated with ipecac) in sporadic or strictly inflammatory dysentery, the anti-zymotics and other remedies being used in addition.

It is a prominent remedy in the treatment of cholera infantum, or the summer complaint of children. It takes that group of cases which have increased heat of the trunk.

As a topical remedy we use it in the treatment of neuralgia with hyperemia, and in the early stage of inflammation. As a spray (diluted) it is used in quinsy, pharyngitis, and some cases of laryngitis. It exerts a good influence when applied over the nasal bones in catarrh, or over the frontal sinus when the pain points there.

In acute conjunctivitis with photophobia, the tincture, of full strength, may be applied over the eye-brows. In earache it is a favorite application, the prescription usually reading—Rx. Tinc. Aconite gtt. x., Tinc. Opium gtt. xxx., Glycerine ʒj. It is also a valuable remedy in the early stage of inflammation of the external ear, and applied over the mastoid process, in inflammation of the middle ear. It is a good remedy for toothache, and especially for a sensitive tooth-bone, or when there is irritation and hypenemia of the pulp cavity.

Antidote to Aconite.—Aconite sometimes produces very unpleasant sensations of constriction and burning in the mouth and fauces, and children will sometimes become almost wild from the suffering, clutching at the mouth and throat, and breathing with difficulty. Let it be remembered that acetic acid, vinegar and water, is an antidote to these effects, and should be administered until relief is obtained. Acetic acid is also the antidote to its general poisonous influence. When we are forced to suspend the administration of Aconite, on account of its toxical effect, Veratrum should be substituted at once.

The American Eclectic Materia Medica and Therapeutics, 1898, was written by John M. Scudder, M.D.