Trailing White Monkshood (Aconitum reclinatum)

Description

Aconitum reclinatum is described by Asa Gray. Aconitum reclinatum included in the genus aconite, and family Buttercup. No subspecies are listed in the Catalog of Life. The dark green leaves of Aconitum species lack stipules. They are palmate or deeply palmately lobed with five to seven segments. Each segment again is trilobed with coarse sharp teeth. The leaves have a spiral (alternate) arrangement. The lower leaves have long petioles. Aconitum, commonly known as aconite, monkshood, wolfsbane, leopard's bane, mousebane, women's bane, devil's helmet, queen of poisons, or blue rocket, is a genus of over 250 species of flowering plants belonging to the family Ranunculaceae. These herbaceous perennial plants are chiefly native to the mountainous parts of the Northern Hemisphere, growing in the moisture-retentive but well-draining soils of mountain meadows. Most species are extremely poisonous and must be dealt with very carefully.Monkshood and other members of the genus Aconitum contain substantial amounts of the highly toxic aconitine and related alkoloids, especially in their roots and tubers. Aconitine is a potent neurotoxin and cardiotoxin that causes persistent depolarization of neuronal sodium channels in tetrodotoxin-sensitive tissues. The influx of sodium through these channels and the delay in their repolarization increases their excitability and may lead to diarrhea, convlusions, ventricular arrhythmia and death.Marked symptoms may appear almost immediately, usually not later than one hour, and "with large doses death is almost instantaneous". Death usually occurs within two to six hours in fatal poisoning (20 to 40 ml of tincture may prove fatal). The initial signs are gastrointestinal, including nausea, vomiting, and diarrhea. This is followed by a sensation of burning, tingling, and numbness in the mouth and face, and of burning in the abdomen. In severe poisonings, pronounced motor weakness occurs and cutaneous sensations of tingling and numbness spread to the limbs. Cardiovascular features include hypotension, sinus bradycardia, and ventricular arrhythmias. Other features may include sweating, dizziness, difficulty in breathing, headache, and confusion. The main causes of death are ventricular arrhythmias and asystole, or paralysis of the heart or respiratory center. The only post mortem signs are those of asphyxia.Treatment of poisoning is mainly supportive. All patients require close monitoring of blood pressure and cardiac rhythm. Gastrointestinal decontamination with activated charcoal can be used if given within one hour of ingestion. The major physiological antidote is atropine, which is used to treat bradycardia. Other drugs used for ventricular arrhythmia include lidocaine, amiodarone, bretylium, flecainide, procainamide, and mexiletine. Cardiopulmonary bypass is used if symptoms are refractory to treatment with these drugs. Successful use of charcoal hemoperfusion has been claimed in patients with severe aconitine poisoning.Severe toxicity is not expected from skin contact; however paraesthesia has been reported, as has mild toxicity (headache, nausea and palpitations).