The action of aconitine on the circulation is due to an initial stimulation of the cardio-inhibitory centre in the medulla oblongata (at the root of the vagus nerves), and later to a directly toxic influence on the nerve-ganglia and muscular fibres of the heart itself.
The final arrest is due to paralysis of the respiratory centre in the medulla oblongata, hastened by a quasi-asthmatic contraction of the non-striped muscular tissue in the bronchial tubes, and by a "water-logging" of the lungs due to an increase in the amount of bronchial secretion.
The cerebral convolutions remain unaffected, but the important centres of the medulla oblongata are stimulated.
As the vaso-motor centre in the medulla oblongata is also stimulated, as well as the contractions of the heart, there is thus trebly caused a very great rise in the blood-pressure.
Whether effected entirely by action on the nerve terminals, or by an additional influence upon the vaso-motor centre in the medulla oblongata, atropine certainly causes extreme dilatation of the blood-vessels, so much so that the skin becomes flushed and there may appear, after large doses, an erythematous rash, which must be carefully distinguished, in cases of supposed belladonna poisoning, from that of scarlet fever: more especially as the temperature may be elevated and the pulse is very rapid in both conditions.