DROPSY. — The main usefulness of apocynum, especially when the fluid ex tract is employed in doses of 7 to 8 drops, is in the treatment of dropsies. Such a dose, repeated at short intervals if nec essary, causes copious watery discharges from the bowels, the flow of urine being increased. As tolerance is established by continued use, it is necessary to increase the dose when given for a long time. (Richmond.) It is also possessed of diaphoretic powers, which exert an effect upon the dropsy.
Apocynum properly administered is a very remarkable diuretic. Doubtless it acts indirectly by increasing the arterial pressure, but it must also be a direct renal stimulant, and cause dilatation of the renal arterioles. So far as I know, this has not been demonstrated, but the effects point to such a mode of action.. Its influence is best seen in those general effusions that depend upon a want of vascular tone, and, whatever the reason, the empirical fact remains that most remarkable results have followed its use. A. A. Woodhull (Brit. Med. Jour., Dec. 11, '97).
Violent catharsis and emesis follow its abuse and not its intelligent use, and it is a really trustworthy and singularly efficacious hydragogue, especially in ana sarca. The true value of properly admin istered apocynum is as a diuretic. It doubtless acts indirectly by increasing the arterial pressure, but it must also be a direct renal stimulant, and cause dilatation of the renal arterioles. A. A. Woodhull (Brit. Med. Jour., Dec. 11, '97).
To assist in removing the solid oedema which often prevents the healing of vari cose ulcers in the aged, apocynum has proved more useful than any other drug. F. R. Millard (Med. and Surg. Reporter, Apr. 16, '9S).
Apocynum is excellent in cardiac dropsy if a good preparation is employed. Large doses are apt to disagree, and small ones are preferable for diuretic ac tion. One of its active principles—apo cynin—appears to resemble digitalin in its effect upon the heart; so that the diuresis produced is evidently cardio vascular in character, and it practically represents the diuretic principle of the drug. Apoeynum causes no cumulative
effects, and it will occasionally prove efficient in removing dropsical symptoms of cardiac insufficiency. T. B. McGee (Amer. Therapist, No. 10, 1900).
APOMORPHINE.—Apomorphine is a pseudo-alkaloid obtained by the action of on morphine in sealed tubes at a high temperature. The base can be obtained from the resulting hydrochlo rate of morphine by dissolving in water, adding excess of bicarbonate of soda, and extracting by means of ether or chloro form. It is soluble in hot or cold water and in alcohol. In powder it is white; but a watery solution, though at first colorless, soon turns black.
The salt generally employed, however, is the hydrochloride: made by adding a small quantity of hydrochloric acid to a solution of apomorphine. It occurs in grayish-white crystals, which are odor less and slightly bitter. It becomes green on exposure to light and air.
Dose. — For adults 1/15 to grain. Great care must be observed in using it in feeble persons. Death has been caused by 1/15 grain under such circumstances. For a child of 18 months, grain; 2 years, 1/4U grain; 3 years, grain; 5 years, grain; S years, grain. One-fifth of a grain should not be sur passed in any case when given hypoder mically, and grain when administered by the mouth.
The drug acts with more vigor in some individuals than in others. Its effects, therefore, should be watched.
Case of a drunkard in whom grain of apomorphine, hypodermically admin istered, followed in five minutes by an other grain, caused collapse, uncon sciousness, cold surface, and absence of pulse at the wrist. Westby (Brit. Med. Jour., Feb. 2, 'S9).
When administered on an empty stomach, apomorphine produces vomit ing much more readily than when ad ministered after meals. The rate of absorption has much to do with the entire effect. When given hypodermic ally, it is absorbed at once; when given on an empty stomach, it is absorbed more rapidly than when mixed with foods. Murrell (Brit. Med. Jour., Feb. 2S, '91).