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 and cure diseases, but if the wrong herbs are used or the methods of making, preserving and drinking are improper, it may lead to tragedy.
A few days ago, the hospital received a case. Mr. Wang, a citizen, lost consciousness due to sudden panic, chest tightness, numbness in his limbs after drinking alcohol, and was sent to the emergency department by "120", although he was rescued with all his might, his life still pressed the stop button. It turned out that the liquor that Mr. Wang drank 1 hour before admission to the hospital was not the liquor or rice wine commonly found in the market, but the homemade Chinese medicinal liquor. Friends who dined together escaped the disaster after being rescued by the hospital because of the relatively small amount of drinking and mild symptoms. After testing the medicinal liquor, it was found that the culprit responsible for the poisoning of the two people was aconitine.
Aconitine toxicity acts directly on the myocardium
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 the high stimulation of the myocardium, the heart will suddenly beat faster, and the heart rhythm disorder will soon appear after the cardiac contractility is strengthened, the heart contractility is weakened, and the heart beat is stopped. To summarize simply, the toxicity of aconitine acts directly on the myocardium, first excitatory, then inhibited.
Its clinical manifestations mainly include: lip, tongue, face, limb numbness, salivation, palpitation, dizziness, irritability, vomiting, sweating, wet and cold skin, malignant arrhythmia, blood pressure drop, early pupil reduction, late 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.
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, dispel wind and relieve 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, bruises 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. On its toxicity, the snow on a branch of Artemisia is the most toxic, is dozens of times the Chuanwu, grass Wu, clinically explicitly prohibited internal use, can only be used externally, if the internal use must be strictly controlled under the guidance of professional doctors. The toxicity of grass wu is greater than that of Chuan Wu, and the appendage is the processed root of Chuan Wu, and the toxicity is the smallest among these medicinal materials.
Principles of treatment for aconitine poisoning
Reduces toxin absorption and promotes toxic excretion. Timely and thorough gastric lavage, diarrhea, diuresis.
Timely, early, correct, and rational use of atropine for toxic confrontation; lidocaine, amiodarone, etc. 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.
Prevention of infection, maintenance of the balance of acid-base water electrolytes, treatment of complications.
If the conditions of the poisoned person permit, hemoperfusion therapy is carried out as soon as possible to further promote the discharge of toxins.
If there are uncomfortable symptoms such as numbness in the lips, face, limbs, panic, dizziness, sweating, wet and cold skin after drinking medicinal liquor or other alcohol of unknown ingredients, if conditions permit, the alcohol that has been drunk is retained so that the type of poison can be sent for testing to determine the type of poison.
While waiting for the "120" to arrive, you can also do the following points to win valuable treatment time for the poisoned, which is divided into two situations:
1. The poisoned person has clear consciousness and can cooperate with the treatment: timely help the poisoned person to repeatedly induce vomiting, 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 perform effective cardiopulmonary resuscitation in time to fight for the golden time for the subsequent "120" to come to the scene.
Once again, 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 the health prescription of a regular legal medical institution, and strictly use and usage under the guidance of a doctor.
Author: Li Xiaoxin (Nurse, Department of Emergency and Critical Care Medicine, Shanghai Pudong New Area People's Hospital)
Edit: Wang Xing
Editor-in-charge: Gu Jun
*Wenhui exclusive manuscript, please indicate the source when reprinting. Photo: Visual China