Aconitum Ferox

A. ferox, Wall. A. virosum, Don. Bisch, or Bikh, Ativisha. (The most poisonous species known, containing greatest proportion of Aconitine; from the Himalaya Mountains.) N. O. Ranunculaceæ. Tincture of root.

Clinical

Burning pains / Cheyne-Stokes breathing / Chill / Dyspnœa / Gastralgia / Neuralgia / Numbness

Characteristics

A. ferox was proved by Dworzack, who also proved Aconitine. The Ferox developed burning pains in greater intensity than the alkaloid; more intense mental activity followed by greater depression. The Aconite note of unendurability of suffering was marked. Anxiety and fear of suffocation from paralysis of respiratory muscles; obliged to breathe half-sitting up with head resting on palms of hands. Cold drinks >; sitting up >; warm food <; coffee >.

Relations

Compare: Curare and Phosph. (respiratory paralysis; Cheyne-Stokes breathing).

1. Mind

Mind very active; sequence of ideas rapid; talked constantly, remembered easily the minutest circumstances of his former experiment, compared them with present one, and readily drew conclusions (6 h.). In intervals of relief from distressing symptoms laughed and joked about his very comical condition; but when the dyspnœa, anxiety, &c., returned, he could not seem to endure them, and abused heartily Aconite and toxicology in general (4 to 6 h.). Incapable of any mental work, even the simplest addition; comprehension and understanding confused (2nd day).

8. Mouth

Tongue almost insensible; feels like a piece of raw leather in mouth (6 h.). Tongue covered with a thick yellowish-white fur. Violent burning in mouth (in two minutes), renewed by eating (2nd day); > by drinking cold water.

9. Throat

Violent burning in pharynx.

11. Stomach

Pressure in stomach with pain. Warmth in stomach. Violent drawing pain in region of stomach and sacral region, soon spreading over whole abdomen; < by pressure on epigastrium. On pressing in stomach, an internal, dull pressing pain.

12. Abdomen

Rumbling in bowels (5 m.); constant gurgling (4 h.).

13. Stool

Two half-watery, dark, not copious stools (2nd d.).

14. Urinary Organs

Frequent and copious evacuations of urine.

17. Respiratory Organs

Dyspnœa increased to such a degree that he was obliged to breathe half-sitting up, with head resting on palms of hands; constantly feared suffocation from respiratory paralysis.

21. Limbs

Gait tottering; remarkable weakness in lower extremities, esp. r.

24. Generalities . . Formication spread over whole body, least noticeable on parts that had been cold; <, or excited by, change of temperature or motion. Having changed from one nerve to another, reached its greatest severity from 7 to 7.30 p.m. It caused a painful unrest so that he could not possibly lie quietly more than a few minutes. Getting up set up all the train of symptoms, which were > immediately on lying down. Benumbed sensation, as if he had on gloves; on pinching cheeks no pain felt; seemed to walk on woollen carpets (2nd, 3rd, and 4th d.).

26. Sleep

Sleeplessness. On waking, violent burning in mouth and throat, warmth in stomach, dull sensation in head.

27. Fever

Icy coldness of body (4 h.), objective and subjective, no amount of wraps and external warmth relieved. Desire to get warm drove him to get out of bed and sit near stove. Tottered to stove and warmth was pleasant, but vertigo, trembling, oppression, and nausea ensued and compelled him to return to bed. This experience was repeated. Fierce heat (calor mordax) on forehead, cheek, and hands, with sensation as if numerous glowing hot wires were stuck into him: > by perspiration (4 to 6 h.).