possesses a mild pilocarpine effect. 11.
A. 1). dowett (Trans. Chem. soe., 1900; Brit. Nied. 19, mon.
Physiological Action. — A medicinal dose of jaborandi causes flushing of the face and neck, followed by profuse sweat ing of the entire surface, marked saliva tion, and occasionally nausea. In some subjects, and particularly in children, even large doses produce no effect.
Toxic doses cause depression of the nerve-centres, but normal doses seem to slightly, if at all, influence the nervous system. The pulse of animals is slowed by jaborandi; but this does not seem to be the case in man, in which, on the con trary, the pulsations are increased in number. The temperature is markedly lowered after a rise of short duration.
Pilocarpine, according to Reichert, first increases and then decreases bodily temperature. Heat-production and heat dissipation are first increased and then ' diminished. The alterations in tempera- , ture are dependent essentially upon the , actions on heat-production, but may be affected by sweating, and, after very large doses, by alterations in heat-dissipa tion. The primary increase of tempera ture is due at first to an increase of heat production, but after very large doses this increase may be exaggerated and continued by a diminution of heat-dis sipation which is greater than the depres sion of heat-production. The actions on the process of heat-production are so much more potent in their effects on temperature than those on the sweat glands that it is doubtful if the latter ever play an important part in the tem perature-alterations. Bodily tempera ture may be increased during the stage of diminished heat-production, owing to the great depression of heat-dissipation. The amount of increase and decrease of temperature and the duration of each of these periods are essentially in direct relation to the dose.
Horbaczewski found that pilocarpine caused an increase in the number of len cocytes in the blood and a correlative in crease in the quantity of uric acid. The excretion of urea is markedly increased.
The influence of jaborandi upon the , renal system dilTers with the dose admin istered. Lare doses, by diminishing the body-licinids through the profuse sweat . ing induced, decrease the quantity of urine; small doses increase the flow.
As to the direct cause of the sweating, . it is thought to depend upon stimulation of nerve-ends of the sweat-glands and upon paralysis of the vasomotor nerves, as would naturally be inferred.
Poisoning by Jaborandi or Pilocar pine.—Serious and even fatal results have followed the injection of medicinal doses of pilocarpine; 1/, grain of pilo carpine has caused profuse diaphoresis, salivation, lacrymation, a discharge from the nose, sickness of the stomach, diffi culty in breathing, and a sense of car diac oppression. Remy mentions a case in which the remedy induced a series of epileptic attacks. In another case the patient suddenly expired directly after an injection had been made. The use of lethal doses is usually followed by copi ous sweating, dizziness, salivation and swelling of the salivary glands and ton sils, lacrymation, discharge from the nose, hiccough and strangling,, vomiting, diarrhoea, a tearing pain in the eyeballs, myopia, dimness of vision, strongly-con tracted pupils, dyspnon, and more or less cardiac oppression, and sometimes bloody leucorrinna is seen. These efrects and the report of occasional cases of accident following the administrations of medic inal doses should teach caution in the use of the remedy.
Caution advised in the use of what may prove a dangerous drug, as fatal or alarming symptoms may be produced by pilocarpine. Lanphear (Kansas City Med. Index, Nov., 'SS).
Treatment of Poisoning by Jaborandi. —The untoward symptoms of poisoning by jaborandi indicate the use of active external and internal stimulation. If taken by the mouth, use emetics or a stomach-siphon to wash out any portion of the drug that may be present in the stomach. Atropine or any preparation of belladonna may be used as a physio logical antidote. Ammonia and brandy should be given freely. The vomiting may be controlled by morphine.
Therapeutics. — The therapeutics of jaborandi accord strictly with its physio logical action, for it is mainly employed for its property of producing sweating. As it is the most powerful remedy we possess for this purpose, it should be used with great caution, as it is much more depressing than the use of the hot-air bath, water packs, etc.; it should not be used in cases of asthenia or adynamia, or in pronounced embarrassment from organic diseases, pulmonary congestion or oedema, threatening or existing, or in irritation or inflammation of the ali inentary canal.