Dr. Paromita Goswami, a Senior research fellow
in Homoeopathy, CCRH, New Delhi has authoured articles and presented
papers in scientific seminars. Recently she presented a paper
at international seminar held at Kolkata . She has been graduated
from University of Calcutta and her post graduation from National
Institute of Homoeopathy, Kolkata, Affiliated, to West Bengal
University of Health Sciences.
Introduction
“It is impossible to begin speaking
on Aconite without a sense of gratification and pride”——
Hughes.1
Paracelsus - The alchemical genius 2of
the Middle Ages had mentioned that “Poison is
in everything, and nothing is without poison. The dosage makes
it either a poison or a remedy.” Indeed, the
dynamization and the minimum dose of Homoeopathy has converted
one of the deadliest and most rapidly acting poisons into one
of the best friend of mankind.
Aconitum Napellus (Aconite) is a very poisonous
herb3. The Wolfsbane, monkshood, grows in the damp
and covered parts of almost every mountainous country in north
or middle of Europe, especially in the Jura, Switzerland, Germany,
and Sweden. It belongs to the natural order- Ranunculaceae,
The tincture of the whole plant with root when beginning to
flower should be used for preparing the Homoeopathic medicine.
Ancient use of Aconitum napellus
Aconite contains several poisonous compounds4,
including enough cardiac poison that it was used on spears and
arrows for hunting and battle in ancient times. Aconite has
a long history of use as a poison, with cases going back thousands
of years. During the ancient Roman period of European history
the plant was often used to eliminate criminals and enemies,
and by the end of the period it was banned and any one growing
Aconite could have been legally sentenced to death. Aconites
have been used more recently in murder plots; they contain the
Chemical alkaloids aconitine, mesaconitine, hypaconitine and
jesaconitine, which are highly toxic.
Aconite – Poisoning
Aconitine and related alkaloids 5
found in the Aconitum species are highly toxic cardio toxins
and neurotoxins. The wild plant (especially the roots and root
tubers) is extremely toxic. Severe aconite poisoning can occur
after accidental ingestion of the wild plant or consumption
of an herbal decoction made from aconite roots.
The cardio toxicity and neurotoxicity of aconitine
and related alkaloids are due to their actions on the voltage-sensitive
sodium channels of the cell membranes of excitable tissues,
including the myocardium, nerves, and muscles.
The Patients present predominantly with a
combination of neurological, cardiovascular, and gastrointestinal
features. The neurological features can be sensory, motor or
both. The cardiovascular features include hypotension, chest
pain, palpitations, bradycardia, sinus tachycardia, ventricular
ectopics, ventricular tachycardia, and ventricular fibrillation.
The gastrointestinal features include nausea, vomiting, abdominal
pain, and diarrhea. The main causes of death are refractory
ventricular arrhythmias and asystole.
Teste5 mentions that Aconite has
the reputation of being much more poisonous to carnivorous animals
than to the herbivore. This Statement can be validated by the
fact that a vain attempt was made to poison an elephant with
Aconitine a carrot was scraped out and enough Aconitine to poison
2, 000 men was put in the elephant ate it readily, but nothing
happened at all, and three hours later a large dose of prussic
acid had to be administered, which proved fatal in a short time.
Dynamization of Aconite
From the above discussions it is clear that
the deadly poison Aconite was used only for the purpose of poisoning,
murders, and for other criminal activities.
In traditional Chinese medicine6, aconite
roots were used only after processing to reduce the toxic alkaloid
content. Soaking and boiling during processing or decoction
preparation hydrolyzed aconite alkaloids into less toxic and
non-toxic derivatives. However, even this procedure was not
adequate to reduce the toxic potentials of this dreaded poison
as such use has been shown in some cases to negatively affect
the cardiovascular and central nervous systems including documented
instances of poisoning and death. The magic of Dynamization
could convert this lethal poison to one of the most important
gem in the Homoeopathic treasury. It has been rightly commented
by Richard Hughes1 –”If Homoeopathy
had done nothing for therapeutics but reveal the virtues of
Aconite it might die content”.
Evolution of ideas in the mind of Master Hahnemann
Aconite was first mentioned by master Hahnemann
in his “Essays on a new principle for ascertaining
the curative power of Drugs” 1published
in Hufeland’s journal in 1796.He evidently
knew no more of it than was known by toxicologist and therapeutist
of his day.
1805-Fragmenta deviribus medica mentorum
positivis contained pathogenetic effects of a number
of substances obtained by provings on healthy human body. Among
them was Aconite and in a note to his article upon it Hahnemann
had written-”Through the whole course of action of this
plant ,its effects of the first and second order were repeated
in short paroxysms two, three, or four times before the whole
effect ceased which it did in 8-16 hrs” The effect described
included-Coldness of the whole body and dry internal heat, Chilliness,
sense of heat first in the hands, then in the whole body, especially
in the thorax, without sensible external heat. Alternating paroxysms
(during third, fourth, fifth hours); general sense of heat,
with red cheeks and headache, worse on moving the eyeballs upwards
and laterally, then shuddering of the whole body with red cheeks
and hot head; then shuddering and lachrymation with pressing
headache and red cheeks.” This shows that the idea as
reflected in the essays has proceeded further as Master Hahnemann
started exploring the symptomatology not known adequately to
the toxicologist of his days. The Salutary effects of Aconite
can be testified further based on the comment of Ringer, an
old school author who in the year 1876 startled the world with
the comment that “Perhaps no drug is more valuable
than Aconite. Its virtues are far from being adequately appreciated
but I venture to predict that it will ere long, if extensively
employed”.
In Materia Medica Pura7 (1811-1821)
The therapeutic potentials of Aconite was discerned further
when seven provers namely Ahner, Gross, Friedrich Hahnemann,
Hornburg, Ruckert, Stapf and Wahle proved Aconite .Master Hahnemann
confidently claimed in the introduction to Aconitum Napellus
that “ It is precisely in the great acute inflammatory
fevers in which allopathy chiefly plumes itself as alone able
to save life by means of bold, frequent venesections and imagines
that here it is superior in curative efficacy to all Homoeopathic
treatment-it is precisely here that it is mistaken, it is precisely
here that the infinite superiority of homoeopathy is manifest,
that it need not shed a single drop of blood ,in order to transform
this dangerous fever into health in as many hours as the allopathic
vitality-diminishing treatment often require months for the
perfect restoration”.
The Dynamization of aconitum napellus has
unfolded a large number of symptoms with a wide range of action
Some of the physicians, like Dr William
Burt, however believed that to endure the crucial test
of science the Materia medica of the future must stand upon
a physiological basis. In his book8 he mentions that
in collating the therapeutics of each drug, it has been the
aim to select those symptoms only, whether pathogenetic or clinical,
that has been declared characteristics or keynotes of the drug.
It is mentioned that through the cerebrospinal nervous system,
Aconite is believed to have nine special centres of action:}
Heart-Inhibitory
paralysis; Blood pressure lessened.
Circulation-
Vasomotor Paralysis
Temperature-Depressed
with diaphoresis
Cerebrospinal
Nervous system-paralysis
Mucous
membrane - inflammation
Stomach-Emesis;Congestion;Neuralgia
Lungs-
Centric vagal paralysis;Congestion;inflammation
Tendons
and Fibrous tissue-Rheumatoid inflammation
Serous
membrane-Plastic inflammation
However, Aconite cannot be prescribed in Homoeopathic
practice without knowledge of the Keynotes and Redline
symptoms of Aconite9 which includes symptoms
like
Is generally
indicated in acute or recent cases occurring in young persons,
especially girls of a full plethoric habit, who lead a sedentary
life
Persons
easily affected by atmospheric changes; dark hair and eyes,
rigid muscular fibres.
The pain
is insupportable driving to despair.
The patient
is full of fears, and tosses about in agony.
Restlessness
and inconsolable anxiety, is afraid to go out into a crowd,
where there is any excitement or many people to cross the streets
Sudden
and great sinking of strength
The most
valuable febrifuge in the entire range of therapeutic agents.
Pulse
full, large or imperceptible
Dry burning
heat,
When
rising paleness of the face,
Retention
of urine in the new born infants
Dysentery
when the days are hot and nights are cold
Frequent
stools with tenesmus; Small brown painful, at last bloody or
pure blood passes without faeces
Palpitation:
from anxiety; during fever; after fright; from motion; and on
waking.
Master Hahnemann says “Whenever
Aconite is chosen homoeopathically, you must, above all, observe
the moral symptoms, and be careful that it closely resembles
them; the anguish of mind and body; the restlessness; the disquiet
not to be allayed”.
Basically, the most important symptomatology
of Aconitum napellus unfolded by dynamization is its psychological
symptoms as suggested by Master Hahnemann in Materia Medica
Pura.
Dr. Guernsey 10 has an illuminating
article on Aconite where he states that “The Genius
of this highly useful remedy is through the mental sphere, and
it is always important to consider the mental symptoms. Almost
certainly this remedy should never be given in case where sickness
is borne with calmness and patience.”
If aconite is even thought of ,we will find
mental uneasiness ,worry, or fear accompanying a most trifling
ailment ,such as inflammation of the eyelids, great fear and
uncontrollable, anxiety are the characteristic of aconite.
In Materia Medica Pura under the prover’s symptoms the
most highlighted points include
Unsteadiness
of ideas; if she wants to pursue one train of thoughts a second
chases this away, a third again displaces this, and so on and
on ,until she becomes quite confused.
Want
of memory; he feels as if what he had just done were a dream,
and he can scarcely recall what it was
Anxiety
with fear of suffocation
Anxious
urging to urinate
Palpitation
of heart and anxiety; oppression of the breathing and great
weariness in the limbs
Inconsolable
anxiety and piteous howling, with complaints and reproaches
about (often trifling) evils
The slightest
noise is intolerable to him
Excessive
tendency to be startled
She is
extremely disposed to be cross
Hamentable
fear of some impending death
Fear
of some misfortune happening to him
Dr C.Hering 11 had made a very
careful and judicious selection of symptoms to be incorporated
in his Materia medica. His judgment was influenced only by the
test of time and experience. There are symptoms appearing in
Hahnemann’s Materia medica pura and Allen’s encyclopaedia,
which Dr Hering ignored, but emphasized others, which although
having comparatively lower gradation, were verified and confirmed
more often in clinical practice. Although, there is a large
number of high grade mental symptoms in Hering guiding symptoms
but only one symptom in mind is given the rank of approved characteristics-Fear
of death during Pregnancy or confinement; with Prolapsus -uteri,
with great loquacity or anxiety in region of the heart.
One of my personal experiences with Aconitum
Napellus also validates that Fear is a very important component
for Aconite prescription irrespective of the status of the patient.
The patient A.M (M/M/45yrs) was brought to
the National Institute of Homoeopathy (NIH)OPD on 25 th of March
2007 .His face was anxious and his gaze was staring when he
sat down in the chair. On enquiring about his complaints the
patient –party informed that the patient was a manual
labourer by profession and enjoyed good health status till 24th
January 2007.On that day the patient accompanied by a fellow
worker, had gone to the nearby town for some work and was late
in returning back to his village. On returning back home he
started shouting and screaming without any apparent cause, his
violence increased and he started throwing utensils targeting
his family member’s and finally he started damaging his
hut. The villagers immediately tied him up and all of them thrashed
him mercilessly till he fainted. The next morning he was prescribed
some medicines by the local quack and taken to the town for
treatment. Post- treatment the patient became absolutely silent
and stopped all forms of communication with everyone. The concerned
relatives brought him to Kolkata for treatment. At the end of
two months when no improvement followed they brought him to
N.I.H for treatment. After, Careful case taking, it was revealed
by the patient party that on the night of 24th January while
returning from the town ,on the way, he had to cross a burial
ground (Kabristhan). His friend reported that the patient was
very apprehensive in crossing that place at night and after
considerable persuation and arguments he agreed to cross that
place.However, the patient who was overpowered by fear did not
show any irrational behaviour till he reached his house.
This was a very important finding in the patient’s
case. Fear was the most important causative factor which lead
to the disturbed mental faculty of the patient. The question
which arose was whether to prescribe this patient Aconitum Napellus
or to apply some other medicines like Sambucus- nigra, or Opium
for combating the bad effects of fear ‘still remaining’.
The most important limitation in this case was the fact that
the patient was absolutely speechless and he was not able to
give any valuable symptoms.
The prescription for this case was Aconitum
napellus in 1M potency two doses in saclac for two days followed
by placebo twice daily for remaining five days. The justification
for prescribing aconite, a well known acute remedy was the fact
that Master Hahnemann in his Materia Medica Pura mentioned that-
“Although aconite, on account of the short duration
of its action (which in such small dose doesn’t exceed
48hrs) might seem to be useful only in acute diseases, yet it
is an indispensable accessory remedy in the most obstinate chronic
affections———-’’
The patient came for follow-up after one week (31.03.07) the
party reported that not much of improvement in the patient’s
health status in general was noted although some improvement
could be seen in his sleeping patterns in that his restless
during sleep had decreased. Placebo was continued as before.
By the end of one month the patient started responding in form
of gestures to the questions asked to him. His progress continued
slowly such that by the month of June 2007 he was able to return
back to his routine life. Aconite was not repeated again the
only medicine used other than Aconite was Kali phos 6x which
was administered to him during the attacks of restlessness.
Aconite has many laurels to offer to every
Homoeopathic physician. Indeed, this great weapon in the armamentarium
of Homoeopathy was a matter of regret for the old school physician
Bartlow1 who once commented that “Aconitum
Napellus —is used by these quacks because it is a powerful
agent which will produce manifest effects in small doses that
may be easily disguised”
Indeed, all of us in the Homoeopathic fraternity
do believe that the theory of dynamization in homoeopathy may
prick us in the question of scientificity from time to time
but its potentials will be our treasure for the life time. The
Dynamization of Aconite stands tall to testify this fact.
Reference
1. Hughes Richard. A manual of Pharmacodynamics. Sixth edition.
New Delhi. B. Jain Publishers Pvt. Ltd; 2001: pg 140-166
2. “Paracelsus”. http://www.alchemylab.com/paracelsus.htm
(Accessed on 15.05.10)
3. Clarke J.H. A dictionary of Materia Medica. Reprint edition.
New Delhi. B. Jain Publishers Pvt. Ltd; 2002: pg no -15-16
4. Bisset NG. Arrow poisons in China. Part II. J Ethnopharmacol.
1981 Nov; 4(3):247-336.
5. Y. K. Chan. Aconite poisoning. Clinical Toxicology. April
2000; Volume 47, (Issue 4) , page 279 – 285.
6. Chan TY, Tomlinson B, T LK, Chan JC, Chan WW, Critchley.
Aconitine poisoning due to Chinese herbal medicines: a review.
Vet Hum Toxicology. 1994 Oct; 36(5):452-5.
7. Hahnemann, S. Materia Medica Pura. Reprint edition. New Delhi.
B. Jain Publishers Pvt. Ltd.; 2000: Pg no-25-46
8. Burt William. Physiological Materia Medica. Third edition.
New Delhi. Jain Publishers Pvt Ltd; 1978: Page no 33-49.
9. Lippe A. Keynotes and Redline Symptoms of the Materia Medica.
Reprint edition. New Delhi. B. Jain Publishers Pvt. Ltd; 2006:
Pg 21-24.
10. Tyler, M.L. Homoeopathic Drug Picture; New Delhi, B. Jain
Publishers Pvt. Ltd; Reprint edition 1998.Pg no-4-5
11. Hering C. The Guiding Symptoms of Our Materia Medica. Reprint
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