On Aconite in Dysentery. By M. Marbot.—M. Marbot, surgeon-
major of the Crocodile man-of-war, found himself in the midst of an
epidemic of dysentery, a few days after the vessel had left Zanzibar,
nearly every one on board being sooner or later attacked during its two
months’ continuance. At first a condition of embarras gastrique prevail-
ing, the cases were successfully treated by ipecacuanha and sulphate of
soda; but the vessel returning into the warmer latitudes, the affection
assumed an inflammatory type. There was intense fever, hard, con-
tracted, rapid pulse, violent headache, a dry and bitter mouth, though
the tongue was flattened and not much-loaded; tenderness of the abdo-
men, colic, distressing pulsation in the right hypochondrium, and te-
nesmus were present. The emetico-purgative plan now entirely failed,
and M. Marbot feared the necessity of bloodletting, of the general in-
utility of which, in hot climates, he had had frequent opportunities of
judging. He however bethought himself of aconite, from which he
had derived great benefit in acute rheumatism. • Its effects quite sur-
passed his expectations, for the inflammatory excitement subsided in
less than a day, and the blood disappeared from the stools in a few
hours. From this time he gave the remedy even from the commence-
ment of the disease, and he always found it remove the hemorrhage
and abate the fever, the pain in the belly, too, becoming relieved, and
the stools passing easier, even a few hours after the first dose. But
the aconite exerts no other effects upon the stools than removing the
blood from them, their mucous, glairy, &c. characters continuing as be-
fore, and even their number not undergoing a diminution proportionate
to the improvement of other symptoms. The aconite, then, would
seem to exert a very feeble action on the intestinal contractions, but
promptly subdues the febrile reaction and the excitement produced in
the various organs. The dose required is not large, being but from
five to ten centigrammes of the extract in the twenty-four hours, diluted
in water, and given in fractional portions every two or three hours.
The aconite does not cure the dysentery, but so modifies its nature,
as to render it amenable to treatment that before proved useless. Thus,
as soon as the reaction is reduced, M. Marbot has at once recourse to
ipecacuanha, allowing a day to intervene between each dose. After
the stools become somewhat reduced in number, we may follow up the
advantage, by the use of the starch and opium clysters. Mercury should
be substituted for ipecacuanha, when hepatitis or a disturbance of the
secretions of the liver or pancreas is present, and the stools are found
green, opaque, or foamy, i. e. muco-purulent. Opiates are useful only
after the above-named remedies have produced their effects, and are in-
jurious as long as any inflammatory action is present. Quinine is use-
ful in hot climates, when the disease is masking a remittent.
Upon these principles M. Marbot treated his 300 cases, some of
which were of the severest character, and others attended by relapses,
without losing a patient. A trial made in Paris of this remedy leads
to the belief that it may be advantageously used to render the evacua-
tions in dysentery and diarrhoea less irritating, and for the relief of the
febrile reaction set up at the end of phlegmasiae. The extracts prepared
from the plant growing near Paris, and from that growing on the Alps,
differ so much in activity, that it is recommended whenever, the extract
seems not to avail, to substitute the tincture, as a more certain pre-
paration.—Brit, and For. Med. Chir. Rev. from Bulletin de Therapeu-
tique.