Seven cases of fatal aconite poisoning: Forensic experience in China

Faculty of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Hangkong Road 13#, Wuhan 430030, China.
Forensic science international (Impact Factor: 2.14). 06/2011; 212(1-3):e5-9. DOI: 10.1016/j.forsciint.2011.05.009
Source: PubMed


This paper presents seven fatal cases of aconite poisoning encountered in the Tongji Center for Medicolegal Expertise in Hubei (TCMEH), China, from 1999 to 2008 retrospectively. In six of the cases, deaths occurred after drinking homemade medicated liquor containing aconite, and in one case death was due to ingestion of traditional Chinese medication containing aconite. Forensic autopsy and pathological examinations ruled out the presence of physical trauma or life-threatening diseases. Diagnosis of aconite poisoning was made after postmortem toxicological analysis. Animal experiment was performed in one case demonstrating that the medicated liquor could cause death rapidly. We present the autopsy and histopathological findings, toxicological analysis, and results of animal experiment done on samples from those seven cases. As an important herbal Chinese medicine, Aconitum species deserve special attention, especially because it contains poisonous alkaloids.

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    • "These medicinal plants constitute important ingredients in some commonly used herbal preparations like Sini Tang, Fuzi Lizhong Wan, and Guifu Dihuang Wan for stroke and heart failure, diarrhea and diabetes, respectively (Chinese Pharmacopoeia Commission, 2010). Poisoning due to homemade medicated liquor containing aconite and traditional medicine containing A. carmichaeli were reported in China between 1999 and 2008 (Liu et al., 2011). Severe cases of cardiac toxicity from consumption of aconitine-containing herbal preparation manifesting as ventricular tachycardia and fibrillation and eventually leading to death have been reported (Tai et al., 1992; Fujita et al., 2007; Dhesi et al., 2010; Lin et al., 2011). "
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    ABSTRACT: Although proprietary medicines and decoction of processed aconite roots are the most widely used, tincture accounts for the great majority of aconite poisoning cases in China, indicating that it is much more toxic than other formulations. Aconite tincture is often self-prepared at home and raw aconite plants or roots are often used. Even if processed aconite roots were used to make the tincture, the amount of Aconitum alkaloids is highly variable, depending on the adequacy of processing and quality control. Aconitum alkaloids dissolve efficiently in alcohol. For these reasons, tincture contains very high concentrations of Aconitum alkaloids. Despite its high intrinsic toxicity, overdose of aconite tincture by the users has been common. Severe aconite poisoning can be complicated by fatal ventricular tachyarrhythmias and asystole. The public should be repeatedly warned of the danger of taking aconite tincture by mouth.
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