Aconite

Kenisha saxena
124
Topics to be covered -
Introduction
Action
Signs and Symptoms
Fatal dose and fatal period
Treatment
Post-mortem findings
Medico-legal aspects
Introduction
Synonyms: Monk’s hood, mitha zaher, bish, wolf’s bane, women’s
bane, devil’s helmet or blue rocket
Aconite is an alkaloid produced by plants of the aconitum genus.
TASTE: sweet ( sweet poison)
All parts of the plant are poisonous,
however, the root and root tubers are the most potent.
It’s root colour is externally brown.
When cut internally white.
 Active principles: Aconitine,
pseudo-aconitine,
indaconitine, picraconitine and
aconine.
Properties of aconitine:
colourless, transparent, rhombic
crystal.
Insoluble in water, but readily soluble
in benzene and chloroform.
Mechanism of Action
Toxicity of aconitine and related alkaloids are due
to their actions on the voltage-sensitive sodium
channels of the cell membranes of excitable
tissues.
Aconitine first stimulates and then paralyzes the
peripheral terminations of sensory and secretory
nerves, CNS, and nerves of the myocardium,
skeletal and smooth muscles.
It does not affect the higher centers of the brain as
consciousness remains intact till the end.
Signs and symptoms
Patients present mainly with a combination of
gastrointestinal, cardiovascular and
neurological features.
In GIT : Nausea, vomiting, salivation, pain in the
abdomen.
Bitter-sweet taste, severe burning and tingling of
tongue, mouth, perioral area and throat,
followed by numbness.
In CVS : Hypotension, chest pain, palpitations,
bradycardia, sinus tachycardia, ventricular
ectopics and ventricular
tachycardia/fibrillation.
Pupils alternately contract and dilate (hippus). Diplopia
and impaired vision occurs.
Weakness of the muscles of the limbs with twitchings and
spasms.
Terminal stages are marked by severe pain and paralysis
of facial muscles.
Many victims remain conscious until near death; some
complain of yellow-green vision and tinnitus.
Death is due to respiratory failure or ventricular
fibrillation.
 Fatal dose: Root: 1-2 g
Aconitine: 2–5 mg.
Fatal period: 2-6 hours
Treatment includes:
There is no specific antidote for aconite, and
treatment
is supportive.
1. Gastric lavage with tannic acid/activated

charcoal.
2. Inotropic therapy is required if hypotension

persists, and atropine (0.5–1 mg IV) should be

amiodarone
and flecainide (first-line treatment).
4. Symptomatic treatment.
Post-mortem findings
i. Not specific, those of asphyxia.
ii. Organs are congested.
iii. Stomach: Fragments of root may be
found in the
stomach.
iv. Lungs: Hemorrhagic pulmonary
edema.
v. Heart: Diffuse contraction-band
necrosis in
myocardium.
Medico legal Aspects
It is often regarded as an ideal homicidal poison.
Advantages are:
a. It is cheap and easily available.
b. Lethal dose is small and the fatal period is short.
c. Color can be disguised by mixing it with pink
colored drinks.
d. Taste can be masked by mixing it with sweets
or by giving it with betel (paan) leaves.
e. Extremely unstable and destroyed by putre­faction,
hence cannot be detected by chemical analysis.
 Accidental poisoning occurs due
to:
a. Eating the roots mistaking it
for horseradish.
b. Use of quack remedies.
c. Taking of liquor mixed with
aconitine to increase
intoxication.
d. Consumption of herbal
decoction made from
aconite roots.
It is also used as an
abortifacient, cattle and arrow
poison.
Suicide is not common.
Case Study: Aconite
Poisoning in India
Case Title: Mysterious Death in Himachal Pradesh -
Aconite Poisoning
Background: In 2012, a 45-year-old man from a remote
village in Himachal Pradesh was found dead in his home
under suspicious circumstances.
Initially, locals believed it to be a heart attack, but the
suddenness of the death and foaming at the mouth
raised doubts.
Scene Investigation:
No signs of struggle or injury.
A cup of herbal tea was found on the table.
Villagers reported the man had taken a herbal remedy from a
local healer for joint pain.
Autopsy Findings:
Congested organs, especially lungs and brain.
Signs of asphyxia.
No physical trauma.
Toxicology Report:
Detected presence of aconitine, a potent alkaloid from the
Aconitum plant (locally called Meetha Vish or Bachnag).
Aconite is known for its use in Ayurvedic medicine but can be
highly toxic if not processed properly.
Forensic Conclusion:
Cause of death: Cardiac arrest due to aconite poisoning.
Manner of death: Accidental, due to improper dosage and
lack of medical supervision.
Legal Outcome:
The healer was questioned but not prosecuted, as it was
established he used a traditional remedy without intent to
harm.
The case led to increased awareness of safe handling and
regulation of herbal medicines in the area.
THANKYOU
Referrals:
Review of Forensic Medicine
and Toxicology- Gautam biswas
Essentials of Forensic Medicine
and Toxicology- K.S Narayan
Reddy
Forensic medicine and
jurisprudence- S.k Singhal