Intentional ingestion of aconite: Two cases of suicide

Abstract Aconitum plants have long played a major role in traditional Asian medicine and cuisine. The roots are often eaten or used to prepare a soup for culinary or traditional medicinal reasons. Thus, many cases of aconitine poisoning have been reported in China and nearby countries. However, only few cases have been described in Europe. We present two unrelated cases of aconitine poisoning. A 44 year and a 56 year old man were found dead in their beds. In both cases, residual plant material was found in close proximity to the body. The autopsies revealed gastric contents interspersed with plant components, blood congestion, hemorrhages in the lung tissue, lung edema and brain edema. Additionally, we found fine-vacuolar fat-negative intracytoplasmatic transformation of hepatocytes. Aconitine was detected in all analyzed samples (blood, urine, gastric content and kidney) and quantified in femoral blood with 86.2 µg/L (case 1) and 2.3 µg/L (case 2), respectively. In both forensic cases, the scenery suggested a suicidal ingestion of Aconitum plant material.