ACONITUM FEROX

Aconitum ferox, Wall.; A. virosum, Don.; Bisch or Bikh (Ativisha). Ranunculaceae. Tincture of the root.

General Action.
Species most poisonous known, containing large proportions of aconitine; produces intense burning pains and mental overactivity followed by great depression; anxiety and fear of suffocation from paralysis of respiratory muscles, compelling semi-sitting posture with head supported on hands; cold drinks and sitting ameliorate; hot food aggravates; coffee ameliorates; respiration of Cheyne-Stokes type; dyspnoea; gastralgia; chilliness; numbness; violent eructations; generalised tingling, < by temperature change or movement; symptoms worst between 7 and 7.30 p.m.; vomiting > all symptoms.

Mind.
Great mental activity with rapid succession of ideas; incessant speech; acute memory for detailed past experiences and comparisons (6 hrs); during symptom-free intervals laughs and jokes on his comic state, but on return of dyspnoea and anxiety insults aconite and toxicology (4–6 hrs); next day, unable to perform even simple mental work, confused understanding (2nd day).

Mouth.
Tongue almost insensible, felt as a piece of leather on raw flesh (6 hrs); coated with yellowish-white saburra; violent burning in mouth within two minutes, renewed by eating (2nd day); ameliorated by cold water.

Throat.
Violent burning in pharynx.

Stomach.
Pressure with pain and heat in stomach; violent drawing pain in stomach and sacral region extending to entire abdomen; < by pressure in epigastrium; on pressure, dull internal pressing pain.

Abdomen.
Borborygmi five minutes after dose; constant rumbling for four hours.

Stool.
Two medium, semi-aqueous, dark evacuations on second day.

Urinary Organs.
Frequent, copious micturition.

Respiratory Organs.
Dyspnoea increased to extent that patient obliged to breathe semi-sitting with head in hands; constant fear of suffocation from respiratory paralysis; Cheyne-Stokes breathing.

Heart.

Extremities.
Staggering gait; marked weakness of lower limbs, especially right.

Generalities.
Tingling extending over whole body, less in cooled areas; < by temperature change or movement; greatest severity 7–7.30 p.m.; painful restlessness preventing lying still; on rising symptoms return which were relieved by lying; numbness as if wearing gloves; no pain on pinching cheeks; sensation of walking on cotton (2nd–4th day).

Sleep.
Insomnia; on waking, violent burning in mouth and throat, heat in stomach, stupefaction of head.

Fever.
Ice-cold surface objectively and subjectively for four hours; no amount of coverings or external heat ameliorates; patient compelled to sit by stove to warm himself, but vertigo, tremor, oppression and nausea persist; repeated experience; intense heat in forehead, cheeks and hands as from innumerable glowing wires; ameliorated by sweating (4–6 hrs).

Relations.
Compare Curare and Phosphorus for respiratory paralysis and Cheyne-Stokes breathing.