All parts of this plant are extremely toxic, and it has historically been used as a poison on arrows. If not prepared properly by a trained person,
Aconitum can be deadly when taken internally.
Toxicology Marked symptoms may appear almost immediately, usually not later than one hour, and "with large doses death is almost instantaneous." Death usually occurs within two to six hours in fatal poisoning (20 to 40 mL of
tincture may prove fatal). The initial signs are
gastrointestinal including nausea,
vomiting, and
diarrhea. This is followed by a sensation of burning, tingling, and numbness in the mouth and face, and of burning in the abdomen. In severe poisonings pronounced motor weakness occurs and cutaneous sensations of tingling and numbness spread to the limbs.
Cardiovascular features include
hypotension,
sinus bradycardia, and ventricular
arrhythmias. Other features may include sweating, dizziness, difficulty in breathing, headache, and confusion. The main causes of death are ventricular arrhythmias and asystole, paralysis of the heart or of the respiratory center. The only post-mortem signs are those of
asphyxia. The major physiological antidote is
atropine, which is used to treat bradycardia. Other drugs used for ventricular arrhythmia include
lidocaine,
amiodarone,
bretylium,
flecainide,
procainamide, and
mexiletine.
Cardiopulmonary bypass is used if symptoms are refractory to treatment with these drugs. Poisoning may also occur following picking the leaves without wearing gloves; the aconitine toxin is absorbed easily through the skin. In this event, there will be no gastrointestinal effects. Tingling will start at the point of absorption and extend up the arm to the shoulder, after which the heart will start to be affected. The tingling will be followed by unpleasant numbness. Treatment is similar to poisoning caused by oral ingestion. Aconitine is a potent
neurotoxin that opens
tetrodotoxin-sensitive sodium channels. It increases influx of sodium through these channels and delays repolarization, thus increasing excitability and promoting ventricular dysrhythmias. Image:AconitumNapellusByKoehler1887.jpg|19th-century illustration File:Modell von Aconitum napellus (Blauer Eisenhut) -Osterloh Nr. 105-.jpg| Model,
Botanical Museum Greifswald File:Aconitum napellus MHNT.BOT.2007.52.9.jpg|Aconitum napellus -
MHNT == Traditional medicine ==