ACOKITUM. 177 



structures; and finally the cardiac action becomes more fre- 

 quent, irregular, and more and more feeble, tending to cease 

 -tole. The blood pressure falls continuously, partly from 

 cardiac, partly from vaso-motor depression. Respiration is 

 slowed and deepened, with spasmodic irregularity of rhythm, 

 and finally is arrested after poisonous quantities. The skin 

 is stimulated, perspiration becoming abundant. The kidneys 

 are also stimulated, the fluids and solids of the urine being 

 increased in amount. The temperature falls steadily. The 

 muscular weakness appears to be primarily due to depression 

 of the motor-nerve endings; but this condition extends to 

 the cord. The brain itself is not directly affected, and even 

 in cases of poisoning by aconite, consciousness is preserved 

 almost to the end. The sensory nerves are probably paralysed 

 from their periphery inwards by the internal, as by the 

 external, administration of the drug. 



Such being the specific action of aconite, its use is obviously 

 indicated in the treatment of two conditions, namely, fever and 

 pain. The cardio- vascular excitement, the dry skin, the high 

 temperature, and the scanty secretions of fever, will all be re- 

 lieved by this drug. For this purpose the tincture is given in 

 small and closely repeated doses, say 1 minim in water every 

 15, 20, or 30 minutes, the effect being watched. Acute 

 tonsillitis, bronchitis, pleurisy, and febrile conditions attending 

 other local inflammations, have been treated with aconite, the 

 effect being to control the urgent symptoms, relieve the dis- 

 tress of the patient, and even to cut short the disease. Some 

 of the symptoms of scarlatina and measles may be similarly 

 alleviated. The powerfully depressant action of aconite on the 

 circulation altogether forbids its use as an antipyretic in 

 heart disease, and suggests caution in its employment in all 



In neuralgia and other painful affections connected with the 

 nerves and muscles, aconite may be given internally instead of 

 being locally applied; facial neuralgia with spasm (tic-douloureux} 

 particularly being relieved by it. In these cases, also, the 

 tincture should be given in minim doses, repeated three or four 

 times in an hour, and the effect watched. 



4. REMOTE LOCAL ACTION AND USES. 



Aconite is probably excreted by the kidneys, and, as we 

 have already seen, increases the activity of their secretion. 

 The stimulation of the sweat-glands and the occasional appear- 

 ance of an eruption suggest that it also leaves the body by the 

 skin. 



M 8 



