Medicinal liquor is to soak the drug in wine, so that the active ingredients in the medicine are dissolved in the wine, the purpose is to use the spicy temperature of the wine to disperse, in order to activate the meridians.
Proper consumption of medicinal liquor can strengthen the body and prevent diseases and cure diseases, but if the wrong herbs are used or improperly prepared or preserved or drunk, it may lead to tragedy.
A few days ago, citizen Wang Gang (pseudonym) suddenly panicked after drinking, chest tightness, numbness in his limbs... He immediately lost consciousness and was sent to the emergency department of Pudong New Area People's Hospital by 120, but although he was rescued with all his might, his life still pressed the stop button.
It turned out that the wine That Wang Gang drank 1 hour before he was admitted to the hospital was not a common liquor or rice wine, but a homemade Chinese medicine liquor.
Because the friends who dined together drank relatively little and the symptoms were mild, they opened the green channel for rescue through the general coordination of the medical department, urgently carried out the MDT consultation of the whole hospital, and escaped the disaster under the full rescue and treatment of the emergency department, intensive care unit and other departments, but the whole treatment process was still abnormally thrilling.
After testing the medicinal liquor, the culprit responsible for the poisoning of the two people was aconitine.
Since it has been clear that the toxic substance is aconitine
Let's take a look at it first
Aconitine is a diester alkaloid that mainly excites the vagus nerve and damages peripheral nerves.
Symptoms of intoxication are predominantly the circulatory system and nervous system, followed by the digestive system.
The toxic effect of aconitine on the heart initially slows down the heart rhythm, and then due to high stimulation of the myocardium, the heart suddenly beats faster and the contractility of the heart strengthens, but soon there is a heart rhythm disorder, the contractility of the heart is weakened, and finally the heart stops.
The simple summary is that the toxicity of aconitine acts directly on the myocardium, first excitatory, then inhibited.
Its clinical manifestations mainly include: lips, tongue, face, limb numbness, squalor, palpitation, palpitation, dizziness, irritability, vomiting, sweating drip, wet and cold skin, malignant arrhythmia, decreased blood pressure, early pupil reduction, later enlargement, respiratory spasm, etc.
Aconitine is a highly toxic alkaloid, which is extremely toxic when inhaled or taken orally, and can also cause poisoning in direct contact with the skin. Oral administration of pure aconitine 0.2 mg can be poisoned, 3-5 mg is fatal.
Which Chinese herbal medicines contain aconitine?
And which Chinese herbal medicines containing aconitine are mostly used in the brewing of medicinal liquor?
Chinese medicinal herbs containing aconitine ingredients include Chuan Wu, Cao Wu, Zhi Zi, Falling Money, Snow Artemisia, Iron Rod Hammer and so on.
Among them, Chuan Wu, Cao Wu, Zhi Zi, and Xue Shang Yi Zhi Artemisia are the most commonly used medicinal herbs.
Chuanwu and caowu are mainly warm and cold, dispelling wind and relieving pain; appendages can return to the yang to save the rebellion, replenish the fire and help the yang; a branch of artemisia on the snow has a significant effect on the treatment of rheumatic bone pain, fall and swelling pain. Therefore, most of the medicinal liquor secret recipes that are popular in the folk are brewed from these types of Chinese medicinal materials.
However, in terms of its toxicity, the most severe toxicity of artemisia sprigs on the snow, is dozens of times that of Chuanwu and Caowu, clinically it is explicitly prohibited to take internally, it can only be used externally, if the internal use must be strictly controlled under the guidance of a professional doctor; the toxicity of Caowu is greater than that of Chuanwu; the appendage is the sub-root processed product of Chuanwu, and the toxicity is the smallest among these medicinal materials.
Principles of treatment for aconitine poisoning:
◆ Reduces toxin absorption and promotes the discharge of poisons. Timely and thorough gastric lavage, diarrhea, diuresis.
◆ Timely, early, correct, rational use of atropine for toxic confrontation; lidocaine, amiodarone, etc. to correct arrhythmias.
◆ Maintain effective life support. Maintain airway patency, endotracheal intubation if necessary, mechanically assisted ventilation, and timely cardiopulmonary resuscitation and electrical defibrillation are given in the presence of malignant arrhythmias such as ventricular fibrillation.
◆ Prevent infection, maintain the balance of acid-base water electrolytes, and treat complications.
◆ If the conditions of the poisoned person permit, hemoperfusion treatment is carried out as soon as possible to further promote the discharge of toxins.
Encounter aconitine poisoning in daily life
What should we do in the event of other similar poisoning incidents?
If there are discomfort symptoms such as lip, face, limb numbness, palpitation, dizziness, sweating, wet and cold skin after drinking medicinal liquor or other unknown ingredients, (here, draw a key point, different from ordinary alcoholism, ordinary alcoholism shows symptoms that rarely appear lip, face, limb numbness, and wet and cold skin!) Please do not hesitate, immediately call the first aid 120, this is likely to be an acute poisoning disease that needs to be treated in the hospital, it is impossible to lie down!
If conditions permit, keep the alcohol you have drunk so that you can send it for testing to determine the type of poison.
While waiting for 120 to arrive, we can also do the following points to win valuable treatment time for the poisoned,
There are two cases here:
1. The poisoned person is clear in consciousness and can cooperate with the treatment: timely help the poisoned person to repeatedly induce vomiting, and spit out as much stomach contents as possible, thereby reducing the absorption of toxins. It can prompt the patient to drink a lot of water, use objects such as spoons or chopsticks, press the root of the tongue, and stimulate the patient to vomit. Place the patient in a ventilated environment and pay close attention to the development of his consciousness and symptoms so that useful information can be fed back to the health care staff after arriving at the hospital.
2. The poisoned person's consciousness is not clear: immediately lie the poisoned person flat in the ventilation place, untie the collar, and pay attention to keep warm. Tilt the head to one side to keep the airway open and prevent vomit from aspiration and suffocation. If the heartbeat stops, those with cardiopulmonary resuscitation experience can perform effective CPR in a timely manner, which can win the golden time for rescue for the subsequent arrival of 120 and the treatment hospital.
How to avoid poisoning?
If the body is unwell, you should seek medical treatment as soon as possible, and you must not blindly listen to rumors such as the so-called medicine and wine treatment; if you want to strengthen your body, you should seek a health prescription from a regular legal medical institution, and strictly use and usage under the guidance of a doctor.
Remember: you must not brew your own pharmaceutical liquor according to the so-called jianghu folk remedies, and you cannot believe in the folk "jianghu langzhong".
Author: Li Xiaoxin (Nurse, Department of Emergency and Critical Care Medicine, Pudong New Area People's Hospital)
Editor: Li Chenyan
Image source: Wen Wei Po data photo