The Toxicological Studies and Autopsy Findings of Aconitine Poisoning

Korean J Leg Med. 2010 May;34(1):15-19. English.

Division of Forensic Toxicology National Institute of Scientific Investigation, Seoul, Korea

Division of Forensic Medicine National Institute of Scientific Investigation, Seoul, Korea

Department of Medical Humanities and Social Sciences University of Ulsan College of Medicine, Seoul, Korea. jhk@amc.seoul.kr

Background: Aconitium species have been used for a material of oriental herb medicine for analgesic and anti-inflammatory effects. But Aconitium species were known to have the potent poisons like aconitine, mesaconitine and hypaconitine which are of C19 diterpenoid alkaloids. The intoxication symptoms are nausea, vomiting, discomfort and cardiac arrhythmias which are well known as a main cause of death. Method and Materials: We obtained the specimens from the five poisoned cases and analyzed those specimens by GC/MS-SIM for 2002-2004. These cases were divided into two groups. The first group was the victims who ingested raw Aconitium roots and leaves and were all dead. The second was those who ingested processed Aconitium roots. One of them drank Aconitium root-submersed alcohol (root wine) and died. Another victim had ingested some liquid extract of herb medicine for three months but the person’s symptom was manifested by jaundice and hematuria without fatality. Results: Autopsy pathology on the cases of raw Aconitium ingestion and root wine drinking revealed similar gross and microscopic feature. The benzoylaconine analogues were detected in root wine (dead case) and hypaconitine, benzoylmesaconine and benzoylhypaconine were detected in herb liquid (living case). The aconitine analogues are hydrolyzed to make less toxic benzoylaconine analogues but the toxicity of hydrolyzed products and the methods of detoxification are still in controversy. Conclusion: We could conclude that benzoylaconine is relatively more toxic than benzoylmesaconine and benzoylhypaconitine. And the hypaconitine is relatively less toxic than aconitine and mesaconitine.

Key words : aconitine, autopsy pathology, benzoylaconine, gas chromatography, mass spectrometry, selected ion monitoring

Original article