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Aconite Poisoning

"But ravening tigers come not nigh, nor breed
Of savage lion, nor aconite betrays
Its hapless gatherers..."

Virgil, The Georgics (II.152)

Aconitum is a poisonous genus of the buttercup family (ranunculaceae), the most familiar species of which is aconite (Aconitum napellus), also known as lycotonum ("wolfsbane") and, in the Middle Ages, as monkshood because of the shape of its upper sepal or galea. Akoniton, itself, may derive from the Greek akon for dart or javelin, the tips of which were poisoned with the substance, or from akonae, because of the rocky ground on which the plant was thought to grow. Pliny struggled with the etymology of aconitum as well, attributing the name to "the port of Aconae, of evil repute for the poison called aconite" (Natural History, VI.i.4) but also deriving it from the rocky crags on which the plant grew, "which are called aconae, and for that reason some have given it the name of aconite, there being nothing near, not even dust, to give it nourishment." He even associates the plant with "whetstone" (akone) "because it had the same power to cause rapid death as whetstones had to give an edge to an iron blade" (XXVII.ii.10).

In the Metamorphoses (VI.129ff), Ovid tells how Athena sprinkled aconite on Arachne, transforming her into a spider. The sorceress Medea contrived to have king Aegeus unwittingly kill his own son, the hero Theseus, by offering him a cup poisoned with aconite (VII.404ff). The herb, he says, came from the slavering mouth of Cerberus, the three-headed dog that guarded the gates to Hades. Dragged from the underworld by Hercules (as his twelfth labor),

"The dog struggled, twisting its head away from the daylight and the shining sun. Mad with rage, it filled the air with its triple barking, and sprinkled the green fields with flecks of white foam. These flecks are thought to have taken root and, finding nourishment in the rich and fertile soil, acquired harmful properties. Since they flourish on hard rock, the country folk call them aconites, rock-flowers."

Indeed, so deadly was this foam that it was used as part of a concoction to madden king Athamas and Ino, his new wife (IV.464ff). Pliny also relates the story of Cerberus, indicating that the plant grew around Heraclea in Pontus (on the Black Sea) because that is where Hercules entered the underworld (XXVII.ii.4). This, too, is where it is "most abundant and best" (Theophrastus, Enquiry into Plants, IX.16.2). Aconite is said by Diodorus Siculus (IV.45.2-3) to have been discovered by Hecate, here identified as the mother of Medea, and a goddess associated with witchcraft, who first used it to poison her father. And Claudius is thought to have been killed with aconite by his wife, Agrippina, in part because of the pain he was said to have felt (Suetonius, Life of Claudius, XLIV.3).

In De Materia Medica ("The Materials of Medicine"), Dioscorides describes two different plants, the first Akoniton lycoctonum (IV.77), which was used as an anodyne (pain reliever) in eye medications, and to kill panthers, wolves, and other wild beasts. In the next chapter (IV.78), he describes "the other aconitum," Aconitum napellus (monkshood), which also is poisonous and used to kill wolves. Aconitum napellus is so named, says Theophrastus (IX.16.45), because the tuberous root of the plant was thought to resemble a small turnip (napus) and "in this root resides its deadly property" (the alkaloid aconitine). He goes on to say that, depending upon how it is compounded, the effect of the poison can be immediate or fatal in several months or even a year or twothe longer the time, the more painful the death. In general, it was deadly to any four-footed animal and "kills them the same day if the root or leaf is put on the genitals" (IX.18.2).

Women were thought to be especially vulnerable to the poison, which Nicander (fl 130 BC) actually calls "woman-killer" (Alexipharmaca, XLI). Pliny contends that "It is established that of all poisons the quickest to act is aconite, and that death occurs on the same day if the genitals of a female creature are but touched by it" (XXVII.ii.4). He goes on to say that Marcus Caelius had accused Calpurnius Bestia (or rather, his finger) of using aconite to kill his wives while they slept (the cognomen "Bestia," meaning brute or beast, is therefore understandable), presumably by applying it to the mucous membrane of the vulva.

Aconitine acts by disrupting the normal ion balance in heart muscle cells, which can cause potentially fatal arrhythmias, including ventricular tachycardia (excessively rapid heart rate), the principal cause of death. Case reports of aconite poisoning continue to appear in the medical literature and often are associated with traditional Chinese herbal medicine and the inadequate decoction of Aconitum carmichaeli.

References: The Greek Herbal of Dioscorides (1655/1933) translated by John Goodyer and edited by Robert T. Gunther; Dioscorides on Pharmacy and Medicine (1985) by John M. Riddle; Theophrastus: Enquiry into Plants (1926) translated by Arthur Hort (Loeb Classical Library); "Aconite: A Case Study in Doctrinal Conflict and the Meaning of Scientific Medicine" (1984) by John S. Haller, Jr., Bulletin of the New York Academy of Medicine, 60, 888-904; Diodorus of Sicily (1935) translated by C. H. Oldfather (Loeb Classical Library); "Clinical Features and Management of Herb-Induced Aconitine Poisoning" (2004) by C. C. Lin, T. Y. Chan, and J. F. Deng, Annals of Emergency Medicine, 43, 574-579.

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