Aconite

Raw aconite contains diterpene alkaloids (aconitine, mesaconitine, hypaconitine) that bind sodium channels and can cause potentially fatal cardiac arrhythmias, neurological effects, and gastrointestinal toxicity. Traditional 'curing' processes (paozhi) — soaking, boiling, and steaming — hydrolyze the toxic diester alkaloids to less toxic monoester forms. Processed aconite (zhi fu zi) is used in TCM for 'rescuing yang,' cold-pattern conditions, joint pain, and cardiac weakness. Some clinical use exists in China under medical supervision, but the therapeutic window is narrow. Aconite poisoning, including from improperly processed herbal products, is a recognized cause of severe toxicity and death. Western herbal use is extremely uncommon and not recommended for self-administration.

Dose depends entirely on processing and preparation. TCM practitioners use 3 to 15 grams of properly processed aconite, decocted for extended periods (often hours) to further reduce toxicity. Self-dosing is unsafe.

Only used under expert TCM supervision. Self-dosing is unsafe at any time.

Highly toxic. Aconite is one of the most dangerous medicinal plants. Even small amounts of inadequately processed material can cause severe poisoning: cardiac arrhythmias, paresthesias, hypotension, respiratory failure, and death. Documented fatalities continue to occur.

Potentially fatal interactions with cardiac medications, antiarrhythmics, beta-blockers, calcium channel blockers, and any drugs affecting sodium channels. Should not be combined with other herbs or supplements without expert TCM supervision.