On the action and use of aconitia / by John Harley.

  • Harley, John, 1833-1921.
Date:
[1872?]
    By JOHN HAELEY, M.D. Bond., LECTURED ON PHYSIOLOGY AND ASSISTANT PHYSICIAN AT ST. THOMAS’S [HOSPITAL. The following observations have been made, firstly with the view of elucidating the precise action of aconite ; and, secondly, of ascertaining whether or not it exercises any control over the febrile state. The pure crystallized aconitia of Mr.^Morson, or of Messrs. T. and H. Smith, of Edinburgh, was employed in every case. On the Horse.—The subject of this and the two following experiments was a weakly brown colt of the pure race-horse breed. Observation 1.—Thepulse being 48, of good volume and power, and the respirations 7, -^o of a grain of aconitia dissolved in rectified spirit was injected under the skin of the shoulder. After one hour there was no change except a falling- or sucking-in of the false nostril at each inspiration. After two hours the pulse was accelerated ten beats; it was strong, full, and irregular. The respirations and pupils were unchanged. The falling-in of the false nostril at each inspi- ration continued; it was marked by a linear depression of the external skin corresponding to the false nostril, and there was manifestly a slight impediment to the entrance of air. The
    dilator of the nostril was evidently paralysed, for there was no tendency to retraction when the part was supported by the finger. The skin and mucous membrane about the nasal orifices were not sensitive to the prick of a pin. After seven and three quarter hours (midnight) the horse was lying down in his box apparently comfortable. Pulse 48, of initial volume and power ; the lips, gums, and tongue dryish. He had continued to munch a little hay throughout. In this observation two effects were observable:—1. Palsy of foremost inspiratory muscle, the dilator narium; this was the earliest symptom, and was rendered apparent by an impediment to the inspiratory act in the chest itself, but which was too slight to cause any other appreciable effect on the respiration. 2. Increased arterial pressure, due to the same respiratory impediment. Obs. 2.—After an interval of a month, the pulse being 48, and the respirations 7, as before, the TV of a grain of aconitia dissolved in iqxx of rectified spirit was injected. The animal dunged immediately after the needle was withdrawn. After one hour palsy of the dilator narium as before. Pulse 50, increased in volume and power. Continued to eat, and did not seem much affected ; but there was great irritation at the seat of puncture, for the horse frequently bit at it. After an hour and a half pulse 60, full and strong. After three hours pulse 68, full and strong; there was thirst and the horse drank a pailful of water; had dunged a second time. Stood very quiet. After six and a half hours lay down quietly in his stall. Pulse 52, regular, but weak; respirations 6 to 8, unequal and irregular; false nostril collapsed. Champed a good deal, and a considerable quantity of frothy mucus flowed at intervals slowly from the mouth. Had dunged and passed urine, but now refused both hay and water, and was evidently weak, allowing both the head and ears to hang down. He raised himself without trouble, but then stood stock-still; was quiet and dull, and, though naturally irritable, allowed me to pinch his skin. He continued in this state up to the end of the eighth hour.
    The next day, after an interval of eighteen hours from the time of injection, he seemed quite recovered, but the pulse was 40 and decidedly weak. In this case the chest movements were appreciably affected; the respiration was impeded; the cardiac acceleration and arterial pressure were proportionately increased. When the effects of the aconitia had ceased, the result of increased cardiac action and prolonged tension was indicated by feebleness of the pulse. It is doubtful whether the apathy on pinching the skin was due to anaesthesia or to the indifference of languor; from further observations I am inclined to attribute it to the latter cause. General muscular weakness was very marked. Thirst at the end of the third hour, no doubt, indicated congestion of the gastric mucous membrane. The subsequent refusal of water was probably due to lingering spasm of the gullet (see next Obs.). The excretions were normal. Obs. 3.—After a long interval, the pulse being 50, and the respirations 8, the -~t of a grain of aconitia dissolved in iq xx of rectified spirit was injected. No change took place until the end of an hour, when the falling-in of the false nostril was observed. Ten minutes later the respirations fell to 5, and the inspi- rations were long drawn; there was a rumbling of air and water in the abdomen. Pulse 56, stronger. After an hour and a half the pulse was 68, full, regular, and soft; some beats even feeble ; the inspirations were sudden and spasmodic, and the expirations slow and laboured, but not audibly so. Ten minutes later the horse was restless, walking and turning about, and making an audible noise in expiration from vibra- tion of the nostrils. Respiration 5, irregular; two deep inspirations, then a long pause of one third of a minute, fol- lowed by two inspirations and another pause. After an hour and three quarters restlessness and distress, with diminution of muscular power indicated by a tendency to stumble or totter. After two hours the slow, irregular breathing which had continued to the present time was now succeeded by great