July 2010|Vol 7|Issue 7

July 2010 | Volume 7 | Issue 7

 

Article
 
Dynamism in Aconitum napellus
 



 



Dr. Paromita Goswami, BHMS, M.D.(hom)
WZ113A/1,Lajwanti Gardens
Lane no 8, New Delhi-110046
Email:paromitanih@gmail.com
Phone no-09711183620


       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 edition. New Delhi. B. Jain Publishers Pvt. Ltd.; 2002: Page 28-55