Aconitum napellus

Lecture XXXI — Ranunculaceae — Aconitum napellus

Ranunculaceae.

Aconitum napellus.

Helleborus niger.

Clematis erecta.

Paeonia.

Pulsatilla.

Hydrastis Canadensis.

Staphisagria.

Actea racemosa (Cimicifuga).

Actea spicata.

Radix coptidis.

Ranunculus bulbosus.

Ranunculus sceleratus.

Today we have on the board the Ranunculaceae , an order of plants containing many medicines. It receives its name from the different varieties of the buttercup. As a whole, the order seems to be characterized by acridity, and some of its members are slightly narcotic. From this order we obtain Aconite , Actea racemosa, Actea spicata, Radix coptidis, Ranunculus bulbosus, Ranunculus sceleratus, Hepatica, Pulsatilla, Hydrastis Canadensis, Clematis erecta, Staphisagria, Helleborus and Pceonia. Staphisagria contains Delphinine. Hydrastis Can. when fresh is said to be narcotic as well as acid. It is used for its tonic action, and it is said to cause, when abused, symptoms like those of Sulphate of Quinine, such as tight feeling, buzzing and ringing in the ears and reduction of the pulse. The Clematis vitalba is so caustic that it has been used as a substitute for Cantharides. Similar properties belong to Clematis crispi, on which the Spanish flies feed with avidity. The Clematis viorna whose tough shoots are made into paper, is also vesicant. We shall have time to study only the principal members of this order, and first of all let us consider Aconite. Aconitum Napki^us.

Aconitum napellus is the monkshood. Aconite itself means "without dust." The plant has been so named from the botanical fact that it grows on dry rocks, with scarcely enough earth about to enable it to take root. This shows the hardiness of the plant. It is called the monkshood because of the shape of the flowers, which turn over and give the appearance of a hood thrown over the head.

Aconitum napellus contains a crystalline alkaloid called Aconitine. It is found in largest quantity in the root. Several other active principles occur with it. They are of uncertain composition and are difficult to isolate. In fact, commercial Aconitiiie practically always contains some of these substances. Aconitine and its related active principles are found in differing proportions in many of the members of the order. Aconitic acid is said to occur in some of them combined with calcium. I have heard that some of the inhabitants of Persia dry the tops of the Aconitum ferox, and eat them with impunity. I cannot say how true this is, but it is known that this species of Acoiiite contains Pseudo-aconiti?ie , which is less toxic than true Aco7iiti?ie. It is also asserted (this, too, I cannot vouch for) that, in some parts of Switzerland, Aconite is grown in rows along the streets, and the tops are cut off and used as greens. Perhaps this illustrates the fact that plants alter their properties under domestication.

When taken in poisonous doses, Aconite acts as a depressant to the cerebro-spinal nervous system. It produces a sensation of numbness attended with pricking and tingling in the extremities, and even complete anaesthesia. It also affects the circulatory system. After the first sensation of diffused warmth is experienced, there follows an intense internal heat and profuse hot sweat. At other times the skin becomes covered with a miliary rash which itches intensely. The pulse and respirations are greatly accelerated. Secondarily, the surface of the body becomes cool, with cold clammy sweat, the pulse grows feeble, and death ends the scene.

Aconite does not at first impair the intellect and the emotions. In its action on the nerves it thus differs from Cocculus Zndicus, which early disturbs consciousness. This drug, moreover, produces a complete motor and not sensory paralysis. It differs also from Geisemium, Coninm and Nux vomica, which early destroy motor rather than sensory activity. As regards its symptoms of collapse, they resemble those of Camphor and Veratrum album. But only Veratrum has the characteristic purging and vomiting, with cold sweat on the forehead. Both Aconite and Nux vomica cause tetanic convulsions, but they are only partial in Aconite, and are accompanied by great muscular weakness.

Aconite produces two different sets of symptoms, entirely distinct in their character, and as separate as though the drug were composed of two substances, each developing its own symptoms. The second set of symptoms, that which is most thoroughly known, is the tendency of Aconite to develop fever and inflammation. This it does through its action on the sympathetic nervous system. We find it indicated in genuine inflammatory fever of the type called synochal or sthenic fever. These terms apply to a fever which has about it no quality of weakness or asthenia. The symptoms of the fevers calling for Aconite are these: there are usually dry heat of the skin, and full, hard, bounding pulse. This fever is always associated with anxiety. The mental symptoms and those which are local, Hahnemann has told us, are the true guiding symptoms in the selection of Aconite. It cannot be the remedy unless there are present anxiety, restlessness and fear of death. The sweat which follows the fever is usually critical, and gives relief to all the symptoms; it is profuse, warm or even hot. It has been proved that Aconite does not produce any alteration in the quality of the blood; hence, you cannot expect it to be indicated in any form of fever in which there is a poison in the blood, destroying that fluid or impairing its corpuscles, altering its plasma, or in any way changing its quality. The type of the Aconite fever is sthenic and continuous, and not intermittent or remittent. It has no symptom in its pathogenesis which points to intermittency. Beginning with the initial chill or chills, the dry heat follows and continues until sweat brings relief. Then the fever is over so far as Aconite is concerned. It has no typical return of these febrile attacks. Hence, you cannot give Aconite in intermittent fever. Then, again, it must be borne in mind that sometimes the fever is not the disease itself, but a symptom which is necessary for the proper development of the disease. You should no more attempt to remove this fever by the administration of Acoyiite than you would attempt to remove a single symptom in any other disease. Hence when fever is only a symptom, Aconite should not be given to control it. Take scarlatina, for instance. The fever here may run high, the skin may be hot and dry, and the pulse hard. Superficially, Aconite appears to be indicated, yet you know, with the other symptoms present, backache, vomiting, sorethroat and the existence of other cases of the disease in the neighborhood, that scarlatina is developing. You know, by removing this fever, you take away a symptom which is necessary for the proper development of the rash belonging to the disease. Therefore, Aconite is rarely to be thought of in scarlatina. There may be exceptional cases, when the fever is disproportionately severe and the characteristic mental symptoms are present, in which Aconite may be administered, but nine cases out of ten would only be spoiled by its administration. Again, a mistake is made in giving Aconite in typhoid types of fever to diminish the pulse and control the temperature. Aconite has no relation whatever to typhoid fever. It is here given from mere symptom practice and not through any knowledge of pathology and symptomatology. Let me beg of you not to commence this practice; it will only lead you to alternation.

In traumatic or inflammatory fevers, Aconite must give way to other remedies unless this restlessness or anxiety is present. One of these remedies is Bryonia, which has full, hard pulse, increased action of the heart, dry skin and aggravation of all the symptoms by motion. The patient lies perfectly quiet. He is not at all restless. It is important that you distinguish between Aconite, Gelsemium and Apis mellifica in febrile states. I will therefore give you in detail the symptoms and conditions which make the selection of one or the other of these remedies certain. If I repeat what has already been said, the repetition will only serve to impress the distinction between these remedies more firmly on your minds.

Aconite typifies the synochal fever; Gelsemium the remittent or intermittent; Apis the intermittent or typhoid. Aconite causes decided chill, followed by dry, hot skin and full, hard, bounding pulse, followed later by a warm, profuse, critical sweat, with relief. Gelsemium causes partial chill, beginning in the hands or running up and down the spine, followed by general heat, most decided about the head and face. Sweat is gradual and moderate, but always gives relief. Apis causes a chill, which is followed by burning heat all over, or heat in some places and coolness in others. The heat is felt particularly in the abdomen. The skin is hot and dry, or alternately dry and moist. Sweat is absent or breaks out only in spells, soon drying off. Under Aconite the pulse is, as stated, full, hard and bounding. Under Gelsemiu??i it is full and flowing, but not hard—the so-called " waterhammer pulse." Under Apis it is accelerated, full and strong, or fluttering, wiry and frequent. Aconite presupposes that the blood is not qualitatively altered. Gelsemium admits of any change which may favor depression. Apis tends towards toxaemia, with a typhoid type. Aconite, therefore, is the remedy only when the fever is sthenic, such as arises from exposure to dry, cold winds; from exposure after overheating; from cooling suddenly when warm and sweating, etc. In bilious fever it is indicated in the early stages when the fever is sthenic, especially because it acts on the liver. It is also the remedy in inflammatory fever, whether traumatic or not, the type agreeing; it is particularly applicable to full-blooded, robust individuals, who readily suffer from sudden active congestions. It bears no relation to the intermitting type of fever, and, when given during such a fever, acts only by subduing the heart's action, and never curatively, hence never homceopathically. Neither does it hold any relation to typhoid fever. Gelsemium is the remedy when the fever develops under circumstances which favor a paresis of motor nerves of both voluntary and involuntary muscles. It corresponds to that stage in which the blood-vessels are dilated and full, but lack the firmness and resistance of a fully developed sthenic inflammation. Such a form of fever is accompanied by languor, muscular weakness, desire for absolute rest, and drowsiness. Under such conditions congestions might still be arterial, as under Aconite, but they exhibit a passivity which is sufficiently characteristic. The pulse is full, flowing, but not hard. So Gelsemium may be indicated in bilious fevers, the liver being passively congested. Again, it applies in typhoid forms, but never after the languor and drowsiness belonging to relaxation, and consequent passive congestion of the brain, pass into great prostration and stupor. Apis has an apparent resemblance to the sthenic fever of Aconite in its hot skin, strong pulse, etc., and this is especially so in the beginning of erysipelatous inflammations, or, still more, in inflammation of serous or synovial membranes. But the tendency of Apis is toward typhoid or toward effusions; Aconite never develops either. Thus Aconite may suit the fever attending the initiation of a meningitis, pleuritis or synovitis; but its power ceases when the cri cephalique, the dyspnoea and dull percussion note, or the puffy, doughy swelling about the joint, announce the appearance of effusion. In its intermittent form of fever, Apis bears no resemblance to either Aconite or Gelsemium. Even in a rheumatic type, in which Aconite and Apis both appear, the resemblance is only superficial; for Apis either develops an erysipelatous inflammation, or causes burning-stinging pain and an exquisite soreness, all referable to the blood-vessels. In its lower forms Apis deserts Aconite and completely supersedes Gelsemium. It is indicated in genuine scarlatina, in diphtheria and in typhoid fever. There is a tendency to defibrination of the blood, and lastly to decomposition of the fluids. In such cases the anxious restlessness of Aconite and the irritability or drowsiness of Gelsemium are replaced by a fidgety restlessness and stupefaction. The excitement and delirium of Aconite and the semi-conscious muttering of Gelsemium are changed into low muttering delirium and unconciousness. Arranging the respective symptoms according to the requirements of the Organon, we have each remedy characterized as follows: Aconite y anguish; despair; restless tossing about during the fever; fears he will die; throws off the clothes; pulse full, hard, bounding; skin hot, dry; all symptoms end in copious sweat. Gelse??iium, irritable; sensitive; children sometimes wakeful; nervous; even threatened with convulsions; or drowsy; eyelids heavy; look as if intoxicated; want to remain perfectly quiet. Chill up and down the back, followed by fever with increased drowsiness; pulse full, flowing. Sweat moderate, gradual, but giving relief. Apis, fidgety restlessness; wants to sleep, but so. nervous, cannot; or low, muttering delirium; sopor. Chill begins in the knees or abdomen at three p. m.; heat, with dry skin or occasional transient spells of sweating; desire to uncover; great oppression of the chest; skin hot in some places and cool in others. Pulse accelerated and strong; or, as debility shows itself, wiry and frequent, intermittent, or imperceptible.

Belladonna comes in as another concordant remedy to Aconite. This drug, as we shall see in the future, does not act primarily on the vasomotor nerves or sympathetic ganglia; hence it does not control the calibre of the blood-vessels. It acts primarily on the cerebro-spinal nervous system, and we therefore find it indicated in fevers which begin with symptoms of the brain and spinal cord, or in fevers which have commenced with the Aconite type, but have, by extension, involved the brain. Thus we often find Belladomia following Aconite well. Remember that Belladonna requires the presence of brain symptoms, such as starting from sleep, throbbing headache, hot head and cold body and extremities.

Veratrum viride takes the place of Aconite in fever marking the onset of pneumonia, when there is great arterial excitement and engorgement, as indicated by full rapid pulse; labored and difficult breathing; or later, nausea on rising, faintness, slow pulse and coldness.

When synochal fever fails to yield to Aconite, the best remedy is Sulphur. The symptoms that will lead you to the selection of this remedy are these: despite the administration of Aconite, the dry heat persists; either no perspiration shows itself, or, if any, it is simply transient. The patient, at first sleepless and restless, becomes drowsy and answers questions slowly or permits an interval to elapse between your question and his reply, as if not fully comprehending. The tongue becomes dry and the speech a little thick. The patient gives evidence of falling into a typhoid state owing to the continued exhaustion from this heat.

Ferrum phosphoricum, of which I have already spoken more than once, should be distinguished from Aconite. It acts upon the bloodvessels, producing a sort of semi-paretic state, in which they become dilated as in the second stage of inflammation. The pulse is full and rather soft; not hard or tense, as with Aconite. It is indicated in congestions of any part of the body when the discharges from that part are blood-streaked. This may be applied to dysentery; to haemoptysis, or to secondary pneumonia.

Arsenicum album, like Aconite, causes intense fever, with anxiety, restlessness, and fear of death; but the fever and inflammation of Arsenic are such as belong to intense local disease, to inflammation progressing to the destruction of the part, to fever of a typhoid type with putrid discharges, etc.

Aconite may be used in inflammatory affections of the brain. You must, however, distinguish between an idiopathic cerebral inflammation and one arising from deep-seated disease. Aconite can have but little influence over tuberculous meningitis. But in meningitis or cerebral congestion from lying with the head exposed to the direct rays of the sun, especially when asleep, it is the best remedy, being superior here to either Glonoi?i or Belladonna. But Glo?win and Belladonna are preferable in sunstroke from exposure under ordinary conditions. Aconite may further be indicated in sunstroke when the great heat has had a paralyzing effect on the circulation. At first the heart works harder. It then begins to lose its force and beat from 120 to 130 beats per minute.

AmyI nitrite causes a similar picture. The face is flushed; the eyes protruding; there are roaring in the ears, vaso-motor paralysis and paralysis of the heart secondary to reduced pressure in the capillaries. Aconite may also be used when cerebral congestion results from a fit of anger.

You may use Aconite in affections of the eyes. It is of service in conjunctivitis following surgical operations, or resulting from a foreign body in the eye. It is also indicated in inflammatory affections of the eyes, arising from exposure to dry cold winds. There is a great deal of heat, dryness and burning in the eye. The eye feels as if full of sand, and is exceedingly sensitive. The pains are so intense that the patient wishes to die; he declares that he cannot stand them. The eye-ball feels as if forced out of the orbit, and aches; this aching is worse when the affected part is moved or touched. Photophobia is intense. The pupils are contracted, and there is a blue circle around the cornea, and violent aching in the eye-balls as in episcleritis. Kven glaucoma may demand Aconite when, in addition to the symptoms above enumerated, there are pains extending down the face, as in tic douloureux, especially after exposure to intense cold or to cold winds or in rheumatic patients. If, however, Aconite does not relieve promptly, you must resort to other measures at once, as this disease may destroy sight in an incredibly short time.

Sulphur is indicated in conjunctivitis from irritation of foreign bodies when Aconite fails.

Spigelia has many pains similar to those of Aconite, especially in the left eye; but its inflammation is less general than in the case of Aconite.

You will recall that I said Aconite had two distinct types of action. We have considered the second and better known type; let us now study the other, which is very different from the former. The symptoms of this type belong more to the cerebro-spinal nervous system. First, we shall speak of the symptoms of the mind itself. We find Aconite useful for mental disease or hysteria when there is particular aversion to excitement, especially to busy streets. The patient dare not cross these streets because of fear that something will happen to him. This symptom is perfectly normal under some circumstances, but when extreme, denotes over-excitement of the brain, common enough in hysterical patients. They are anxious. They show an intolerance of music. They can bear no sounds, so sensitive are the ears. They imagine that some part of the body is deformed, e.g., a limb displaced, lips too thick, or features distorted. They imagine that they do all their thinking from the stomach. Sometimes such patients, during attacks of illness, have "spells" in which they predict the hour of death. You may note this symptom in puerperal fever. Argentum nitricum and Coffea also have the symptom, prediction of the hour of death, the latter especially in child-bed. Furthermore, Aconite causes paralysis; a paralysis which may easily he remembered from two or three subjective symptoms; paralysis accompanied by coldness, numbness and tingling. Unless there is tingling in the affected part, we seldom find Aconite indicated. Even paralysis of both legs—paraplegia—may yield to Aconite with this characteristic coldness of the limbs and tingling. We may also use Aconite in various forms of local palsies, as facial paralysis, when associated with the above-mentioned symptoms, and when traceable to exposure to dry cold winds. But this paralysis is never of organic origin.

Sulphur is the main antidote when paralysis results from overdoses of Aconite.

Cannabis Indica and Staphisagria should be remembered in paralysis, with tingling in the affected parts; Rhus tox., Sulphur and Causticum are preferable later, especially in paralysis from cold. The neuralgia for which Aconite is the remedy, is caused by exposure to dry cold winds. Especially is it indicated when there is violent congestion of the affected part, which is usually the face. The face will be red and swollen. The pains drive the patient almost to despair. There is usually tingling in the affected part. You may here compare Spigelia, which is indispensable in left-sided prosopalgia, with severe burning, sticking pains. The patient exhibits intense excitement and great intolerance of the pains.

Colchicum is likewise indicated in left-sided prosopalgia. The pains are associated with a paralytic weakness of the muscles, but lack the severity of those of Spigelia, and the excitement and intolerance of pain which characterizes that remedy is wanting under Colchicum. Amyl nitrite may be needed rather than Aconite in prosopalgia with much local congestion.

Aconite is a very important remedy in the treatment of affections of the heart. The symptoms indicating it in these cases are numerous and important—necessarily so, since Aconite disturbs the blood-flow so markedly, and in addition exerts a special action on the heart and its nerves. There are congestions to both heart and lungs, palpitation with anxiety, cardiac oppression, and even syncope. The palpitation is worse when walking. Lancinating stitches occur and prevent the patient from assuming an erect posture or taking a deep inspiration. Attacks of intense pain extend from the heart down the left arm, and are associated with numbness and tingling in the fingers. - In hypertrophy of the heart, Aconite is indicated by this numbness and tingling in the fingers. It is in uncomplicated hypertrophy of the heart only that jqm should give this remedy. In hypertrophy from valvular disease it may do great harm. You should here compare Aconite with Arnica, Aurum met., Rhus tox., and Cactus grandifloms. Kahnia and Rhus tox. also have numbness and tingling in the left arm with heart disease.

Aconite may be used in the first stage of pneumonia when the fever is high and has been preceded by a chill. Symptoms of engorgement of the lungs are present. The cough is usually hard and dry and rather painful. The expectoration is serous or watery, and a little blood-streaked, but never thick and blood-streaked. The patient is necessarily full of anxiety.

Veratrum viride, as already indicated, competes with Aconite in the incipiency of pneumonia. It acts admirably when the pneumonic engorgement is severe, with violent excitement of the heart, as indicated by rapid full pulse, nausea, faintuess on rising, tongue red down the centre.

B/youia comes in to take the place of Aconite especially when hepatization has commenced. The cough is still hard and painful, and is associated with thicker expectoration. The anguish is now traceable to oppression of breathing and not to the fever; the patient prefers to lie still rather than to toss about.

Aconite may also be indicated in pleurisy, in the very beginning, before there is any exudation; there are sharp stitches on either side of the chest, with chills followed by febrile action. Aconite is to be thought of here particularly when the trouble has arisen from a checked perspiration or confinement from the fresh air. In croup you should give Aconite when the trouble has arisen from exposure to dry cold northwest winds. The patient is aroused from sleep with long suffocating attacks. The cough is of a hard, dry, barking character, and may be heard all over the house. There are great difficulty of breathing, anxiety, and high fever. Spongia is to be used when the breathing becomes " sawing." The cough is still barking, harsh, and rasping. It is especially indicated in light-complexioned blue-eyed children, when the trouble is worse before midnight.

Hepar should be given when the cough is worse toward morning,, and on uncovering, and is associated with rattling of mucus. Sambiicus is called for when there is spasm of the glottis. The breathing is of a wheezing, crowing character, and is worse after midnight and from lying with the head low.

In haemoptysis calling for Aconite the blood is bright red. The trouble is always associated with anxiety, and fever is invariably present. In haemoptysis, you may compare with Aconite the following remedies:

Millefolium, which has haemoptysis, with profuse flow of bright red blood, but without fever.

Ledum for haemoptysis of drunkards or persons of a rheumatic constitution. The blood is bright red and foamy.

Cactus grandiflorus for haemoptysis with strong throbbing of the heart and a sensation of constriction, as of a band about the chest. It has, however, less anxiety and less fever than has Aconite. Aconite is frequently of use in abdominal diseases, especially if they be inflammatory. You may use it in gastritis or gastric catarrh,, when the trouble has been caused by exposure, by the checking of an acute eruption, or by sudden chilling of the stomach from drinking ice water. There is pressure in the stomach as if a cold stone lay there, persisting even after repeated vomiting. Compare also Colchicum, Arsenicum, Elaps, etc. You may also give Aconite in inflammatory colic when the pains force the patient to bend double, yet are not relieved by this or any other position. This symptom is invaluable in the beginning of inflammatory processes within the abdomen, and also in some cases of ovarian dysmenorrhcea. Colocynth may be compared here. This drug lacks the inflammation, however, and finds relief in bending double and from pressure.

Aconite may be used in dysentery, especially if the disease occurs in the autumn, when warm days are followed by cold nights; the stools are scanty, bloody and slimy, with much tenesmus. In this disease, Aconite is followed very well by Mercurius.

The diarrhoea of Aconite is of inflammatory origin. It usually appears in summer, as the result of indulgence in cold drinks or from checked perspiration.

• The stools are watery, slimy and bloody.

Cholera infantum calls for Aconite when the stools look like chopped spinach, and the inflammatory symptoms already mentioned are present.

You should also remember Aconite in incarcerated hernia, when inflammation has started in the strangulated bowel, with burning pain in the affected part. There are also vomiting of bile, great anxiety and cold sweat.

In incipient nephritis, whether true Bright' s disease or not, Aconite has relieved when the patient complains of sharp cutting pains going in a circle from the renal region around to the abdomen over each ilium.

Coming now to the genital organs, we find Aconite sometimes indicated in dysmenorrhea supposed to result from thickening of the peritoneum over the ovaries, and in suppression of the menses, due to anger or fright. The characteristic colic which I described a few minutes ago is present.

During pregnancy, Aconite may be administered for certain mental symptoms, such as fear of death, excitable temperament, etc. It may also be used for impending abortion caused by fright or anger. During labor itself it may be given when the pains are unnatural^ violent, rapid and frequent. The patient complains that she cannot breathe; that she cannot bear the pains. She is restless and anxious, and the body is covered with a hot sweat.

In the so-called "milk-fever," Aconite is to be given when the mammary glands are hot and swollen, and the skin hot and dry. These symptoms are associated with restlessness and anxiety. Suppression of the lochia is an indication for Aconite, when the trouble is caused by exposure or by some violent emotion, provided high fever, thirst and anxiety are present. The mammae are lax, and the abdomen is distended and sensitive to touch.

Aconite is not often indicated in puerperal fevers because they are generally of septic origin, but for one form of child-bed fever it is the only remedy capable of subduing the whole affair within a few hours. The nurse, perhaps, has carelessly exposed the patient after a hard labor, or she has bathed her with too cold water, or has thoughtlessly changed her clothing without the necessary precautions, and the following symptoms result. High fever; thirst; eyes glaring and wild; sharp, anxious expression; abdomen distended and sensitive to touch; mammae lax and without milk. When you have this symptom-picture, you may confidently give Aconite.

While Aconite is not called for in scarlatina, still it may be used during that disease, after the stage of desquamation, when the child catches cold and acute Bright's disease results. The child starts up from sleep in perfect agony, with cold sweat on the forehead and with cold limbs. Dropsy is also present.

In measles Aconite is called for early in the case, where there are high fever; redness of the conjunctivae; dry, barking cough; restlessness; and itching, burning of the skin. It precedes Pulsatilla, and may be relied upon so long as the high fever lasts. The rash is rough and miliary.

Gelsemium differs in that it causes more drowsiness and desire to remain quiet.

In acute coryza you will find Aconite indicated when the nasal mucous membrane is dry and hot, and when there is most violent throbbing headache, better in the open air. Or, the coryza may be fluent and hot, with frequent sneezing. The muscles all over the body feel sore, so that sneezing forces him to support his chest. There are fever, restlessness and the accompanying symptoms. All these are provoked—not by damp weather, and not, as some teach, by exposure to any sort of atmosphere capable of producing cold, but by cold, dry winds, or checked sweat.

You may compare Nux vomica in colds caused by cold weather. The nose is stuffed and dry, and the throat feels rough as if scraped:. Belladonna is to be given if the head is intensely hot, the throat red and the tonsils swollen.

China is useful if there is headache from suppressed coryza, with pains worse in the open air, instead of better, as under Aconite. In skin diseases, Aconite is sometimes indicated. It is not a remedy for scarlatina, but you will sometimes find it useful in so-called scarletrash, with high fever, anxiety and other appropriate symptoms. Sulphur is the proper remedy when Acoyiite has been abused.