Materia Medica

Aconitum napellus – Farrington

Aconitum napellus
acon

Aconitum napellus is the monkshood. Aconite itself, means without dust. The plant has been so named from the botanical fact that it grows on dry rocks, with scarcely enough earth about to enable it to take root. This shows the hardiness of the plant. It is called the monkshood because of the shape of the flowers, which turn over and give the appearance of a hood thrown over the head. Aconitum napellus contains an active principle called ACONITINE, crystalline in some instances and amorphous in others. In the root of the Aconitum napellus is another principle called NAPELLINE. Aconitine is also contained in one variety of the Staphisagria, the larkspur. It is also said that Helleborus contains ACONITIC ACID. I have heard, but with how much truth I cannot say, that some of the inhabitants of Persia eat the tops of the Aconitum ferox. It is also asserted (this, too, I cannot vouch for) that in some parts of Switzerland, Aconite is grown in rows along the streets, and the tops are cut off and used as greens. This illustrates the fact that plants alter their properties from domestication.

 

When taken in poisonous doses, Aconite acts as a depressant to the cerebro-spinal nervous system. It produces a sensation of numbness attended with pricking and tingling in the extremities, and even complete anaesthesia. At first the emotions are not at all impaired. It also affects the circulatory system. After the first sensation of diffused warmth is experienced there follows an intense internal heat and profuse hot sweat. At other times, the skin becomes covered with a miliary rash which itches intensely. The pulse and respiration are greatly accelerated. Secondarily, the surface of the body becomes cool, with cold clammy sweat, the pulse grows feeble, and death ends the scene.

 

In poisoning by COCCULUS INDICUS, consciousness is early disturbed. This drug, moreover, produces a complete motor and not sensory paralysis.

 

Aconite produces two different sets of symptoms, entirely distinct in their character, and as separate as though the drug were composed of two substances, each developing its own symptoms. The second set of symptoms, that which is most thoroughly known, is the tendency of Aconite to develop fever and inflammation. This it does through its action on the sympathetic nervous system. We find it indicated in genuine inflammatory fever, in what is called synochal fever, otherwise termed sthenic fever. All these terms apply to a fever which has about it no quality of weakness or asthenia. The symptoms of the fevers calling for Aconite are these: There are usually dry heat of the skin, and full, hard, bounding pulse. This fever is usually associated with anxiety. The mental symptoms and those which are local, Hahnemann has told us, are the true guiding symptoms in the selection of Aconite. It cannot be the remedy unless there is present anxiety, restlessness and fear of death. The sweat which follows this fever is usually critical and gives relief to all the symptoms. It is profuse, warm or even hot. It has been proven that Aconite does not produce any alteration in the quality of the blood, hence you cannot expect it to be indicated in any form of fever in which there is a poison in the blood, destroying that fluid or impairing its corpuscles, altering its plasma or in any way changing its quality. The type of the Aconite fever is sthenic and continuous and not intermittent or remittent. It has no symptom in its pathogenesis which points to intermittency. Beginning with the initial chill or chills, the dry heat follows and continues until sweat brings relief. Then the fever is over so far as Aconite is concerned. It has no typical return of these febrile attacks. Hence you cannot give Aconite in intermittent fever. Then again, it must be borne in mind, that sometimes the fever is not the disease itself, but a symptom which is necessary for the proper development of the disease. You should no more attempt to lop oif this fever by the administration of Aconite, than you would lop off one symptom in any other disease. When, then, fever is only a symptom, Aconite should not be given to control it. Take scarlatina for instance. The fever here may run high, the skin may be hot and dry and the pulse hard. Superficially, Aconite appears to be indicated, yet you know, with the other symptoms present, backache, vomiting, sore-throat apd the existence of other cases of the disease in the neighborhood, that scarlatina is developing. You know by removing this fever, you take away a symptom which is necessary for the proper development of the rash belonging to the disease. Therefore Aconite is seldom to be thought of in scarlatina. There may be exceptional cases when the fever is disproportionately severe and the characteristic mental symptoms are present, in which case you may administer it, but nine cases out of ten would only be spoiled by the administration of Aconite.

 

Again a mistake is made in giving Aconite in typhoid types of fever to diminish the pulse and control the temperature. Aconite has no relation whatever to typhoid fever. It is here given from mere symptom practice and not through any knowledge of pathology and symptomatology. Let me beg of you not to commence this practice; it will only lead you to alternation.

 

In traumatic or inflammatory fevers, Aconite must give way to other remedies unless this restlessness or anxiety is present. One of these remedies is BRYONIA, which has full hard pulse, increased action of the heart, dry skin and aggravation of all the symptoms by motion. The patient lies perfectly quiet. He is not at all restless.

 

It is important that you distinguish between ACONITE, GELSEMIUM and APIS in febrile states. I will therefore give you in detail, the symptoms and conditions which make the selection of one or the other of these remedies certain. If I repeat what has already been said, the repetition will only serve to impress the distinction between these remedies the more firmly in your minds. Aconite typifies the synochal fever; Gelsemium the remittent or intermittent; Apis the intermittent or typhoid. Aconite causes decided chill, followed by dry, hot skin and full, hard, bounding pulse; later follows warm, profuse, critical sweat, with relief. Gelsemium causes partial chill, beginning in the hands or running up and down the spine; followed by general heat, most decided about the head and face. Sweat is gradual and moderate, but always gives relief. Apis causes a chill, which is followed by burning heat all over, or some places are hot and some cool. Heat is felt particularly in the abdomen. Skin is hot and dry, or alternately dry and moist.” Sweat is absent or breaks out in spells, soon drying off. Under Aconite the pulse is, as stated, full, hard, bounding. Under Gelsemium it is full, flowing, but not hard. Under Apis it is accelerated, full and strong, or fluttering, wiry and frequent. Aconite presupposes that the blood is not qualitatively altered. Gelsemium admits of any change which may favor depression. Apis tends towards toxaemia, with a typhoid type. Aconite, therefore, is the remedy only when the fever is sthenic; such as arises from exposure to dry, cold winds; from exposure after overheating; from cooling suddenly when warm and sweating, etc. In bilious fever, it is indicated in the early stages when of the sthenic type, especially because it acts on the liver. It is also the remedy in inflammatory fever, whether traumatic or not, the type agreeing; particularly in full-blooded, robust individuals, who readily suffer from sudden active congestions. It bears no relation to the intermitting type of fever; and when given during such a fever, acts only by subduing the heart’s action, and never curatively, hence never homeopathically. Neither does it hold any relation to typhoid fever. Gelsemium is the remedy when the fever develops under circumstances which favor a paresis of motor nerves of both voluntary and involuntary muscles. It corresponds to that stage in which the bloodvessels are dilated and full, but lack the firmness and resistance of a fully developed sthenic inflammation. Such a form of fever is accompanied by languor, muscular weakness, desire for absolute rest, and drowsiness. Under such conditions, congestions might still be arterial, as under Aconite, but they exhibit a passivity which is sufficiently characteristic. The pulse is full, flowing, but not hard. So Gelsemium may be indicated in bilious fevers, the liver being passively congested. Again, it applies in typhoid forms, but never after the languor, and drowsiness belonging to relaxation, and consequent passive congestion of the brain pass into great prostration and stupor. Apis has an apparent resemblance to the sthenic fever of Aconite in its hot skin, strong pulse, etc., and this is especially so in the beginning of erysipelatous inflammations, or, still more, in inflammmation of serous or synovial membranes. But the tendency of the Apis is typhoid-ward or towards effusions; Aconite never either. Thus Aconite may suit the fever attending the initiation of a meningitis, pleuritis or synovitis; but its power ceases when the cri encephalique, dyspnoea and dull percussion, or puffy, doughy swelling about the joint, as the case may be, announces effusion. In its intermittent form of fever, Apis bears no resemblance to either Aconite or Gelsemium. Even in a rheumatic type in which Aconite and Apis both appear, the resemblance is only superficial; for Apis either develops an erysipelatous inflammation, or causes burning-stinging pain and an exquisite soreness, all referable to the bloodvessels. In its lower forms Apis deserts Aconite and completely supersedes Gelsemium. It is indicated in genuine scarlatina, in diphtheria and in typhoid fever. There is a tendency to defibrination of the blood, and lastly to decomposition of the fluids. In such cases, the anxious restlessness of Aconite and the irritability or drowsiness of Gelsemium are replaced by a fidgety restlessness and stupefaction. The excitement and delirium of Aconite and the semi-conscious muttering of Gelsemium are changed into a low muttering delirium and unconsciousness. Arranging the respective symptoms according to the requirements of the Organon, we have each remedy characterized as follows: Aconite anguish, despair, restless tossing about during the fever; fears he will die ; throws off the clothes; pulse full, hard, bounding ; skin hot, dry. All ends in copious sweats. Gelsemium, irritable, sensitive; children sometimes wakeful, nervous, even threatened with convulsions, or drowsy, eyelids heavy, look as if intoxicated ; want to remain perfectly quiet. Chill up and down the back, followed by fever with increased drowsiness; pulse full, flowing. Sweat moderate, gradual, but giving relief. Apis mellifica, fidgety restlessness; wants to sleep but so nervous cannot; or, low, muttering delirium; sopor. Chill begins in the knees or abdomen, three P.M. ; heat, with dry skin or occasional transient spells of sweating; desire to uncover; great oppression of the chest; skin hot in some places and cool in others. Pulse accelerated and strong; or, as debility shows itself, wiry and frequent; intermittent, imperceptible.

 

BELLADONNA comes in as another concordant remedy to Aconite. Belladonna, as we shall see in the future, does not act primarily on the vaso-motor nerves or sympathetic ganglia, hence it does not control the calibre of the bloodvessels. It acts primarily on the cerebro-spinal nervous system, hence we find it indicated in fevers which begin with symptoms of the brain and spinal cord. We find it indicated in fever which begins with the Aconite type, but which by extension, has involved the brain. Thus we often find Belladonna following Aconite well. Belladonna requires that brain symptoms such as starting from sleep, throbbing headache, hot head and cold body and extremities be present.

 

VERATRUM VIRIDE takes the place of Aconite in fever marking the onset of pneumonia, when there is great arterial excitement. The breathing is labored and difficult.

 

When synochal fever fails to yield to Aconite, the best remedy then is SULPHUR. The symptoms that will lead you to the selection of this remedy are these: Despite the administration of Aconite, the dry heat persists. Either no perspiration shows itself or if any, it is simply transient. The patient, at first sleepless and restless, becomes drowsy and answers questions slowly or permits an interval to elapse between your questions and his reply. The tongue becomes dry and the speech a little thick. The patient gives evidence of falling into a typhoid state owing to the continued exhaustion from this heat.

 

FERRUM PHOSPHORICUM, of which I have already spoken more than Once, should be distinguished from Aconite. It acts upon the bloodvessels, producing a sort of semi-paretic state, in which they become dilated as in the second stage of inflammation. The pulse is full and rather soft, and not hard or tense as with Aconite. It is indicated in congestions of any part of the body when the discharges from that part are blood-streaked. This may be applied to dysentery, to haemoptysis, and to secondary pneumonia.

 

ARSENICUM ALBUM, like Aconite, causes intense fever, with anxiety, fear of death, and restlessness; but the fever and inflammation of Arsenic are such as belong to intense local disease, to inflammation progressing to the destruction of the part, to fever of a typhoid type with putrid discharges, etc.

 

Aconite may be used in inflammatory affections of the brain. You must, however, distinguish between an idiopathic cerebral inflammation and one arising from deep-seated disease. Aconite can have but little influence over tubercular meningitis. But in meningitis or cerebral congestion from lying with the head exposed to the direct rays of the sun, especially when asleep, it is the remedy, here being superior to either GLONOIN or BELLADONNA. It may also be used when cerebral congestion results from a fit of anger.

 

Aconite may further be indicated in sunstroke when the great heat has had a paralyzing effect on the circulation. At first the heart works harder. It then begins to lose its force and beat from 120 to 130 beats per minute.

 

You may use Aconite in affections of the eyes, in conjunctivitis following surgical operations, or resulting from a foreign body in the eye. It is also indicated in inflammatory affections of the eyes, arising from exposure to dry cold winds. There is a great deal of heat and burning in the eye. The eye feels as if full of sand, and is exceedingly sensitive. The pains are so intense that the patient wishes to die; he declares that he cannot stand them. The eye-ball feels as if forced out of the orbit, and aches; this aching is worse when the affected part is moved or touched. Photophobia is intense. The pupils are contracted, and there is a blue circle around the cornea, and violent aching in the balls as in episcleritis. Even glaucoma may demand Aconite when, in addition to the symptoms above enumerated, there are pains extending down the face as in TIC DOULOUREUX, especially after exposure to intense cold or to cold winds or in rheumatic patients. If, however, Aconite does not relieve promptly, you must resort to other measures at once, as this disease may destroy sight in an incredibly short time.

 

SULPHUR is indicated in conjunctivitis from irritation of foreign bodies when Aconite fails.

 

SPIGELIA has many pains similar to those of Aconite, especially in the left eye; but its inflammation is less general than in the case of Aconite.

 

The other action of Aconite is very different from that already considered. These symptoms belong more to the cerebro-spinal nervous system. First, we will speak of the symptoms of the mind itself. We find Aconite useful for mental disease or hysteria when there is particular aversion to excitement, especially to busy streets. The patients dare not cross these streets because of fear that something will happen to them. This symptom is perfectly normal under some circumstances, but when extreme denotes over-excitement of the brain, common enough in hysterical patients. They are anxious. They show an intolerance of music. They can bear no sounds, so sensitive are the ears. They imagine that some part of the body is deformed, E. G., a limb displaced, lips too thick, features distorted, imagine they do all their thinking from the stomach. Sometimes such patients during attacks of illness have “spells” in which they predict the hour of death. You may sometimes note this symptom in puerperal fever. COFFEA also has the symptom, predicts the hour of death.

 

Further than this Aconite causes paralysis; a paralysis which may easily be remembered from two or three subjective symptoms; paralysis accompanied by coldness, numbness, and tingling. Unless there is tingling in the affected part we seldom find Aconite indicated. Even paralysis of both legs, paraplegia, may yield to Aconite with this characteristic coldness of the limbs and tingling. We may also use Aconite in various forms of local palsies, as facial paralysis, when associated with the above mentioned symptoms, and when traceable to exposure to dry cold winds.

 

CANNABIS INDICA and STAPHISAGRIA should be remembered in paralysis, with tingling in the affected parts; and RHUS TOX., SULPHUR, and CAUSTICUM in paralysis from cold.

 

The neuralgia for which Aconite is the remedy, is caused by exposure to dry cold winds. Especially is it indicated when there is violent congestion of the affected part, which is usually the face. The face will be red and swollen. The pains drive the patient almost to despair. There is usually tingling in the affected part. You may here compare SPIGELIA, which is useful in left-sided prosopalgia, with severe burning sticking pains. The patient exhibits intense excitement and great intolerance of the pains.

 

COLCHICUM is likewise indicated in left-sided prosopalgia. The pains are associated with a paralytic weakness of the muscles, but lack the severity of those of Spigelia.

 

Aconite is a very important remedy in the treatment of affections of the heart. The symptoms indicating it in these cases are numerous and important, and necessarily so, since Aconite so disturbs the blood-flow, and also exerts a special action on the heart and its nerves. There are congestions to both heart and lungs, palpitation with anxiety, cardiac oppression, and even syncope. The palpitation is worse when walking. Lancinating stitches occur and prevent the patient from assuming an erect posture or taking a deep inspiration. Attacks of intense pain extend from the heart down the left arm and are associated with numbness and tingling in the fingers.

 

In hypertrophy of the heart Aconite is indicated by this numbness and tingling in the fingers. It is in uncomplicated hypertrophy of the heart only that you should give this remedy. In hypertrophy from valvular disease it may do great harm. You should here compare Aconite with ARNICA, AURUM, RHUS TOX., and CACTUS GRANDIFLORUS. KALMIA and RHUS also have numbness and tingling in the left arm with heart disease.

 

Aconite may be used in the first stages of pneumonia when the fever is high and has been preceded by a chill. Symptoms of engorgement of the lungs are present. The cough is usually hard and dry and rather painful. At most, the expectoration is serous or watery, and a little blood-streaked, but not thick and blood-streaked. The patient is necessarily full of anxiety.

 

BRYONIA comes in to take the place of Aconite, especially when hepatization has commenced. The cough is still hard and painful, and is associated with thicker expectoration. The anguish is now traceable to oppression of breathing and not to the fever ; the patient prefers to lie still rather than to be tossed about. Aconite may also be indicated in pleurisy, in the very beginning before there is any exudation; when there are sharp stitches on either side of the chest; when there are chills, followed by febrile action; when the whole trouble has arisen from a checked perspiration or confinement from the fresh air.

 

In croup, whether catarrhal or membranous, you should give Aconite when the trouble has arisen from exposure to dry cold northwest winds. The patient is aroused from sleep with long suffocative attacks. The cough is of a hard, dry, barking character, and may be heard all over the house. There are great difficulty of breathing, anxiety, and high fever.

 

SPONGIA is to be used when the breathing becomes “sawing.” The cough is still barking, harsh, and rasping. It is especially indicated in light complexioned blue-eyed children, especially if the trouble is worse before midnight.

 

HEPAR should be given if the cough is worse towards morning, and is associated with rattling of mucus.

 

SAMBUCUS is called for when there is spasm of the glottis. The breathing is of a wheezing crowing character, and is worse after midnight and from lying with the head low.

 

In haemoptysis calling for Aconite the blood is bright red. The trouble is always associated with anxiety and with fever. In haemoptysis you may compare with Aconite the following :

 

MILLEFOLIUM, which has haemoptysis, with profuse flow of bright red blood, but without fever.

 

LEDUM for haemoptysis of drunkards or persons of a rheumatic constitution. The blood is bright red and foamy.

 

CACTUS GRANDIFLORUS for haemoptysis with strong throbbing of the heart. It has, however, less anxiety and less fever than has Aconite.

 

Aconite is frequently of use in abdominal diseases, especially in inflammatory affections of these parts. Thus you may give it in inflammatory colic, the pains from which, force the patient to bend double, yet are not relieved by any position. (Compare COLOCYNTH.)

 

This symptom is invaluable in the beginning of inflammatory processes within the abdomen, and also in some cases of ovarian dysmenorrhoea.

 

Aconite may be used in dysentery, especially when the disease occurs in the autumn when warm days are followed by cold nights. In this disease, Aconite is followed very well by MERCURIUS.

 

The diarrhoea of Aconite is of inflammatory origin. The stools are watery, slimy and bloody. It usually appears in summer as the result of indulgence in cold drinks or from checked perspiration.

 

Cholera infantum calls for Aconite when the stools look like chopped spinach, and the inflammatory symptoms already mentioned, are present.

 

You should also remember Aconite in incarcerated hernia when inflammation has started up in the strangulated bowel, with burning pain in the affected part. There are also vomiting of bile, great anxiety and cold sweat.

 

Coming now to the genital organs, we sometimes find Aconite indicated in dysmenorrhoea which has been supposed to result from thickening of the peritoneum over the ovaries. The characteristic colic, which I described a few minutes ago, is present.

 

During pregnancy, Aconite may be administered for certain mental symptoms, such as fear of death, excitable temperament, etc. It may also be used for impending abortion caused by anger.

 

During labor itself it may be given when the pains are unnaturally violent and frequent. The patient complains that she cannot breathe, that she cannot bear the pains. She is restless and anxious and the body is covered with a hot sweat.

 

In the milk-fever, Aconite is to be given when the mammary glands are hot and swollen, and the skin hot and dry. These symptoms are associated with restlessness and anxiety.

 

Suppression of the lochia is an indication for Aconite, when caused by some violent emotion, and when associated with high fever, thirst and anxiety. The mammae are lax and the abdomen distended and sensitive to touch.

 

Aconite is not often indicated in puerperal fevers because they are generally of septic origin, but for one form of child-bed fever it is the only remedy capable of subduing the whole affair within a few hours.

 

The nurse, perhaps, has carelessly exposed the patient after a hard labor, has bathed her with too cold water or thoughtlessly changed her clothing without the necessary precautions; then you may give Aconite, the symptoms, of course, agreeing.

 

While Aconite is not called for in scarlatina, still it may be used in that disease, when after the stage of desquamation, the child catches cold and acute Bright’s disease results. The child starts up from sleep in perfect agony, with cold sweat on the forehead and with cold limbs. Dropsy is also present.

 

In acute coryza you find Aconite indicated when the trouble has arisen from the usual Aconite causes, when the nasal mucous membrane is dry and hot, and when there is most violent throbbing headache. The patient feels better when in the open air. The muscles all over the body feel sore so that sneezing forces him to support his chest.

 

In skin diseases, Aconite is sometimes indicated. Though not a remedy for scarlatina, it is for scarlet-rash with high fever.

 

In measles, it is early called for, when with the fever there are red eyes, restlessness, dry barking cough and itching and burning of tha surface.

 

SULPHUR is the proper remedy when Aconite has been abused.