International Journal of Legal Medicine

, Volume 121, Issue 3, pp 214–219 | Cite as

Aconitine involvement in an unusual homicide case

  • An A. Van Landeghem
  • Els A. De Letter
  • Willy E. Lambert
  • Carlos H. Van Peteghem
  • Michel H. A. Piette
Case Report


We describe a homicide complicated by an aconitine poisoning, which was initially thought to be a strangulation case. Routine toxicological analyses demonstrated only a small amount of alcohol in the blood and the urine. The case could not be clarified until 5 years after the event. A new element in the investigation made the wife the prime suspect, and finally, after thorough interrogation, she confessed her crime. She had mixed a decoction of three plants of Aconitum with red wine. Additional toxicological analyses, using the liquid chromatography–tandem mass spectrometry (LC-MS-MS) technique demonstrated 810 ng/ml of aconitine in urine, 6.5 ng/g in liver and 1.3 ng/g in the kidneys. Even though aconitine poisoning is still rare in Europe, it should be taken into account in suicides and homicides, particularly in unclarified cases.


Aconitine Intoxication Homicide Strangulation LC-MS-MS 



The authors gratefully thank Mr. Ben Claes and Mr. Peter Clauwaert of the Belgian Federal Police (Department of Technical and Scientific Police-Forensic Facial Imaging) for the drawing presented in Fig. 2. The authors would also like to thank Mr. Etienne Vandeventer for the pictures presented in Fig. 1. Finally, the authors render thanks to Mrs. Thérèse De Vuyst and Mrs. Isabelle Cornelis for their assistance in preparing the manuscript.


  1. 1.
    Ameri A (1998) The effects of Aconitum alkaloids on the central nervous system. Prog Neurobiol 56:211–235PubMedCrossRefGoogle Scholar
  2. 2.
    Baselt RC (2004) Disposition of toxic drugs and chemicals in man, (7th edn). Biomedical publications, Foster City, California, pp 22–23Google Scholar
  3. 3.
    Beike J, Frommherz L, Wood M, Brinkmann B, Köhler H (2004) Determination of aconitine in body fluids by LC-MS–MS. Int J Legal Med 118:289–293PubMedCrossRefGoogle Scholar
  4. 4.
    Camps FE (ed) (1976) Gradwohl’s legal medicine, 3rd edn, John Wright, Bristol, p 601Google Scholar
  5. 5.
    Chan TYK (2002) Incidence of herb-induced aconitine poisoning in Hong Kong—impact of publicity measures to promote awareness among the herbalists and the public. Drug Safety 25:823–828PubMedCrossRefGoogle Scholar
  6. 6.
    Chan TYK, Critchley JAJH (1996) Usage and adverse effects of Chinese herbal medicines. Hum Exp Toxicol 15:5–12PubMedGoogle Scholar
  7. 7.
    Chan TYK, Tomlinson B, Critchley JAJH (1993) Aconitine poisoning following the ingestion of Chinese herbal medicines: a report of eight cases. Aust NZ J Med 23:268–271Google Scholar
  8. 8.
    Chan TYK, Chan JCN, Tomlinson B, Critchley JAJH (1994) Poisoning by Chinese herbal medicines in Hong Kong: a hospital-based study. Vet Hum Toxicol 36:546–547PubMedGoogle Scholar
  9. 9.
    Chan TYK, Tomlinson B, Tse LKK, Chan JCN, Chan WWM, Critchley JAJH (1994) Aconitine poisoning due to Chinese herbal medicines: a review. Vet Hum Toxicol 36:452–455PubMedGoogle Scholar
  10. 10.
    Chan TYK, Tam HP, Lai CK, Chan AYW (2005) A multidisciplinary approach to the toxicologic problems associated with the use of herbal medicines. Ther Drug Monit 27:53–57PubMedCrossRefGoogle Scholar
  11. 11.
    Dechelotte MJ (1964) Un cas d’intoxication par l’aconitine avec troubles cardiaques. Bull Mens Soc Med Mil Fr 58:302–309PubMedGoogle Scholar
  12. 12.
    Dobbelstein H (2000) Hintergrund eines toxikologischen Notfalls: Mordversuch mit Eisenhut. MMW Fortschr Med 142:46–47PubMedGoogle Scholar
  13. 13.
    Elliott SP (2002) A case of fatal poisoning with the aconite plant: quantitative analysis in biological fluid. Sci Justice 42:111–115PubMedCrossRefGoogle Scholar
  14. 14.
    Ernst E (2003) Cardiovascular adverse effects of herbal medicines: a systematic review of the recent literature. Can J Cardiol 19:818–827PubMedGoogle Scholar
  15. 15.
    Feldkamp A, Köster B, Weber H-P (1991) Tödliche Vergiftung durch Blauen Eisenhut (Aconitum napellus). Monatsschr Kinderheilkd 139:366–367PubMedGoogle Scholar
  16. 16.
    Friese J, Gleitz J, Gutser UT, Heubach JF, Matthiesen T, Wilffert B, Selve N (1997) Aconitum sp. alkaloids: the modulation of voltage-dependent Na+-channels, toxicity and antinociceptive properties. Eur J Pharmacol 337:165–174PubMedCrossRefGoogle Scholar
  17. 17.
    Frketi J (1956) Ein fall medizinaler Vergiftung mit Aconitin. Arch Toxikol 16:18–20CrossRefGoogle Scholar
  18. 18.
    Frommherz L, Kintz P, Kijewski H, Köhler H, Lehr M, Brinkmann B, Beike J (2006) Quantitative determination of taxine B in body fluids by LC-MS–MS. Int J Legal Med (in press)Google Scholar
  19. 19.
    Hikino H, Konno C, Watanabe H, Ishikawa O (1981) Determination of aconitine alkaloids by high-performance liquid chromatography. J Chromatogr 211:123–128CrossRefGoogle Scholar
  20. 20.
    Ito K, Tanaka S, Funayama M, Mizugaki M (2000) Distribution of Aconitum alkaloids in body fluids and tissues in a suicidal case of aconite ingestion. J Anal Toxicol 24:348–353PubMedGoogle Scholar
  21. 21.
    Kämpf W (1954) Über eine acute tödliche Aconitinvergiftung. Arch Toxikol 14:445–450PubMedCrossRefGoogle Scholar
  22. 22.
    Kinnell HG (2000) Serial homicide by doctors: Shipman in perspective. BMJ 321:1594–1597PubMedCrossRefGoogle Scholar
  23. 23.
    Kolev ST, Leman P, Kite GC, Stevenson PC, Shaw D, Murray VSG (1996) Toxicity following accidental ingestion of Aconitum containing Chinese remedy. Hum Exp Toxicol 15:839–842PubMedCrossRefGoogle Scholar
  24. 24.
    Lin C-C, Chan TYK, Deng J-F (2004) Clinical features and management of herb-induced aconitine poisoning. Ann Emerg Med 43:574–579PubMedCrossRefGoogle Scholar
  25. 25.
    Lowe L, Matteucci MJ, Schneir AB (2005) Herbal aconite tea and refractory ventricular tachycardia. N Engl J Med 353:1532PubMedCrossRefGoogle Scholar
  26. 26.
    Maresch W, Udermann H (1973) Aconitvergiftung. Beitr Gerichtl Med 30:297–300PubMedGoogle Scholar
  27. 27.
    Mizugaki M, Ito K (2005) Aconite toxins. In: Suzuki O, Watanabe K (eds) Drugs and poisons in humans. A handbook of practical analysis. Springer, Berlin Heidelberg New York, pp 455–467CrossRefGoogle Scholar
  28. 28.
    Mizugaki M, Ito K, Ohyama Y, Konishi Y, Tanaka S, Kurasawa K (1998) Quantitative analysis of Aconitum alkaloids in the urine and serum of a male attempting suicide by oral intake of aconite extract. J Anal Toxicol 22:336–340PubMedGoogle Scholar
  29. 29.
    Moog FP, Karenberg A (2002) Toxicology in the Old Testament. Did the High Priest Alcimus die of acute aconitine poisoning? Adv Drug React Toxicol Rev 21:151–156Google Scholar
  30. 30.
    Nicolas G, Desjars PH, Godin JF, Rozo L (1978) Intoxication par l’Aconitine (à propos d’une observation). Toxicol Eur Res 1:45–49PubMedGoogle Scholar
  31. 31.
    Pietsch J, Oertel R, Trautmann S, Schulz K, Kopp B, Dreßler J (2005) A non-fatal oleander poisoning. Int J Legal Med 119:236–240PubMedCrossRefGoogle Scholar
  32. 32.
    Saukko P, Knight B (2004) Knight’s forensic pathology, (3rd edn). Arnold, London, pp 149–150Google Scholar
  33. 33.
    Smith S (1934) Taylor’s principles and practice of medical jurisprudence, (9th edn). Vol 2, Churchill, London, pp 733–742Google Scholar
  34. 34.
    Smith SW, Shah RR, Hunt JL, Herzog CA (2005) Bidirectional ventricular tachycardia resulting from herbal aconite poisoning. Ann Emerg Med 45:100–101PubMedCrossRefGoogle Scholar
  35. 35.
    Tai Y-T, But PP-H, Young K, Lau CP (1992) Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 340:1254–1256PubMedCrossRefGoogle Scholar
  36. 36.
    Wada K, Nihira M, Hayakawa H, Tomita Y, Hayashida M, Ohno Y (2005) Effects of long-term administrations of aconitine on electrocardiogram and tissue concentrations of aconitine and its metabolites in mice. Forensic Sci Int 148:21–29PubMedCrossRefGoogle Scholar
  37. 37.
    Wang Y, Liu Z, Song F, Liu S (2002) Electrospray ionization tandem mass spectrometric study of the aconitines in the roots of aconite. Rapid Commun Mass Spectrom 16:2075–2082PubMedCrossRefGoogle Scholar
  38. 38.
    Watson JT (1990) Selected-ion measurements. In: McCloskey JA (ed) Methods in enzymology, vol.193. Academic, San Diego, pp 86–106Google Scholar
  39. 39.
    Xu Q, Zhang F, Xiao H, Liang X, Kettrup A (2005) Study on detoxification of main alkaloids in Aconitum by high performance liquid chromatography—atmospheric pressure chemical ionization mass spectrometry. Fresen Environ Bull 14:194–198Google Scholar
  40. 40.
    Yeih D-F, Chiang F-T, Huang SKS (2000) Successful treatment of aconitine induced life threatening ventricular tachyarrhythmia with amiodarone. Heart 84:e8PubMedCrossRefGoogle Scholar
  41. 41.
    Yoshioka N, Gonmori K, Tagashira A, Boonhooi O, Hayashi M, Saito Y, Mizugaki M (1996) A case of aconitine poisoning with analysis of aconitine alkaloids by GC/SIM. Forensic Sci Int 81:117–123PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • An A. Van Landeghem
    • 1
  • Els A. De Letter
    • 1
  • Willy E. Lambert
    • 2
  • Carlos H. Van Peteghem
    • 2
  • Michel H. A. Piette
    • 1
  1. 1.Department of Forensic MedicineGhent UniversityGentBelgium
  2. 2.Laboratory of ToxicologyGhent UniversityGentBelgium

Personalised recommendations