The monopoly by homoeopathic practitioners of the use of aconite has aroused a prejudice against it, which has discouraged its employment. Aconite is, however, an antagonist to the fever-process; it is not applicable in accordance with the so-called law of similars. It is used by these quacks because it is a powerful agent which will produce manifest effects in small doses, that may easily be disguised.

The author can quite agree with Dr. Ringer in the statement that aconite is a very valuable medicine, in the class of cases to which it is adapted. It lessens the pulse-rate, lowers arterial tension, diminishes abnormal heat; it therefore antagonizes that condition of the organism known as fever. As it also slows the respiratory movements, and thus lessens the amount of work done by the breathing apparatus, it is especially indicated in inflammatory states of the respiratory organs. As it diminishes the sensibility of the sensory nerves, it is useful in certain forms of neuralgiae. As it induces muscular weakness and lowers the activity of the reflex functions, it is indicated in morbid states characterized by an excess of motor activity.

Tonsillitis, acute pharyngitis, ulceration of tonsils, when accompanied by fever and elevated arterial tension, are greatly relieved by the use of the tincture of aconite. From a half-drop to one drop every half-hour, until an impression is made on the fever-movement, and then every hour or two, is the best mode of administration. In acute catarrh (nasal and faucial), acute otitis, and in acute catarrhal bronchitis, the best results may be obtained by the use of aconite, as above described. The author's observations entitle him to speak with confidence of the good effects of this remedy in catarrhal and fibrinous pneumonia. It is more especially serviceable before exudations have taken place, but is not without utility at any stage, provided the inflammatory process continues. It not only abates the symptoms, but it favors the removal of the products of inflammation, by increasing elimination through the skin and kidneys. The use of aconite is not incompatible with the employment of other measures which may be needed; but, generally, in fibrinous pneumonia, aconite is sufficient up to the period of crisis. The author has witnessed excellent results from the use of aconite in small doses frequently repeated (one drop every hour) in lowering the temperature of phthisis, especially when new districts of pulmonary tissue are invaded by pneumonitis. For the treatment of acute pleuri-tis, previous to the stage of effusion, no remedies are more effective than aconite and opium. Rx Tinct. aconiti rad., 3 ij; tinct. opii deodor., 3 vj. M. Sig.: Eight drops in water every hour or two. If the pain is severe, a larger dose of opium should be administered, when the effect can be maintained by the quantity directed in the above prescription.

Overaction of the heart, with hypertrophy and without valvular lesion, especially if there be present a condition of plethora, is benefited by a quantity of aconite sufficiently large to moderate the cardiac movements.

Aconite is contraindicated in inflammatory states of the gastrointestinal mucous membrane. It is very serviceable in acute congestion of the liver and hepatitis: it diminishes the fever, and, by causing free transpiration, lessens the pungent heat of the skin. Peritonitis is best treated by a combination of aconite and opium, as described above for pleuritis. Generally, the opium needs to be given in somewhat larger quantity in peritonitis than in pleuritis. In pelvic peritonitis, puerperal metritis, and peritonitis, aconite is indicated, and is of unquestionable utility, provided there be present a condition of sthenic reaction. A condition of adynamia, on the other hand, always contraindi-cates the use of aconite.

The simple fevers of childhood, febricula, ephemeral fever, arising from various causes, as cold, fatigue, excitement, etc., are best treated by small and repeated doses of aconite. The remedy induces sweating, and then the fever-movement subsides. The hot stage of intermit-tents and remittent fever, if any febrifuge is required, may be relieved of its intensity by frequently-repeated doses of aconite. The continued fevers are not benefited by this remedy unless a condition of hyperpyrexia is threatened, when aconite may be used in connection with other antipyretic remedies.

Aconite possesses the highest value in the eruptive fevers, especially in scarlet fever. There are two conditions of this disease especially requiring the use of aconite—the eruptive stage, and the period of desquamation, if, as is usual, a marked rise of temperature takes place at this period of the disease. Several important purposes are subserved by the use of this remedy: it lowers the fever-heat, favors the action of the skin and kidneys, and checks the nasal, faucial, and aural inflammations, which constitute such troublesome complications and sequelae. The particular utility of aconite in measles consists in its power to arrest the catarrhal pneumonia, one of the most serious complications of this disease. We have no remedy more useful in erysipe~ las—idiopathic, so called, and not arising from trauma; but, on the other hand, Ringer describes an apparently erysipelatous inflammation following vaccination, which is quickly cured by aconite. According to the author's observations, it is facial erysipelas which is most decidedly benefited, and cases characterized by sthenic reaction. When there is a state of adynamia present, the eruption being dusky and the cutaneous circulation languid, belladonna is preferable to aconite. When, in acute rheumatism, there are much heat and a dry skin, instead of the usual sweating, aconite is very serviceable. It affords very considerable relief in muscular rheumatism when there is much fever.

In acute inflammation of the cerebral and spinal meninges, and in cerebrospinal meningitis before effusion has taken place, aconite is as serviceable as in other acute inflammations. It is generally advisable to combine opium with it, especially in cerebro-spinal meningitis. In acute maniacal delirium, and in mental disorders generally, when there is much motor activity, with vascular excitement and increased arterial tension, aconite is useful, but is not so effective as gelsemium. Aconite renders important service in the active form of acute cerebral congestion.

Neuralgia, when accompanied by arterial excitement and muscular spasm, is relieved by aconite; but generally the neuralgias are much more successfully treated by hypodermatic injections and galvanism.

It is asserted by Ringer, and also by Phillips, that sudden suppression of the catamenial flow, caused by cold, can be relieved by aconite, in drop-doses of the tincture every half-hour or hour. The author can assert that this remedy has a high degree of utility in congestive dysmenorrhea, occurring in plethoric subjects. These are cases, also, in which gelsemium is so undoubtedly beneficial.

Aconitine in Trigeminal Neuralgia

Remarkable results have lately been obtained by the use of Duquesnel's aconitine in this malady. The following formula is proposed by the New York Therapeutical Society: Rx Aconitinae (Duquesnel's), gr. 1/10; glycerini, alcohol., āā 3 j; aquam menthae pip., ad oz ij. M. Dose, a tea-spoonful. The dose is sometimes very slowly and cautiously increased to 1/8. Although it does not succeed in all cases of tic-douloureux for obvious reasons, it relieves remarkably in others (Seguin).

Napelline

Duquesnel has lately rediscovered (?) a principle to which he has applied the name napelline. Its physiological actions have been studied by Laborde. He finds it weaker than aconitine, and was able to administer without ill results from a half (½) grain to three fifths (3/5) of a grain. It possesses valuable hypnotic properties, and it is proposed to use it as a substitute for opium and chloral. On trial it proved to be an effective remedy in neuralgia, and as a sleep-producing agent in cases of wakefulness, mental excitement, and allied conditions. If further investigations confirm those observations, it will be a valuable addition to the materia medica.

Authorities referred to:

Achscharumow, Dr. Archiv für Anal, und Physiologie, 1866, p. 255.

Bohm und Ewers. Weber die phys. Wirk., etc. Archiv für experimentelle Pathologis und Pharmakologie, 1873, p. 385.

Fothergill, Dr. J. M. The British Medical Journal, 1870. Ibid., January 17,1874.

Hottot, M. Journal de l'Anatomie et de la Physiologie, 1864, p. 113.

Hottot et LiÉgeois. Ibid., 1861, p. 520.

Husemann, Drs. Theo. und Aug. Pflanzenstoffe, p. 210.

Husemann, Dr. Theod. Handbuch der gesammten Arzneimittellehre, p. 1153.

Phillips, Dr. C. D. F. The Practitioner. Ibid., Materia Medica and Therapeutics, 1874, p. 2.

Ringer, Dr. Sydney. Handbook of Therapeutics, article Aconite.                                     

Taylor, Dr. A. S. On Poisons, third London edition, p. 747.

Van Praag, Dr. L. Archiv für path. Anat., vii, p. 438.