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Pianists

pilocarpus, poisoning and pupil

PIANISTS' CRAMP.—A form of occupation neurosis which occurs almost exclusively in professional pianists, and most frequently in young, weakly girl pupils of the conservatoires. It is characterised by pains in the arms, and by a sensation of fatigue, which compel the pianist to stop playing soon after having begun. Actual spasms may develop. The treat ment of the affection requires suspension of playing. At the same time massage and gymnastic exercises may be employed, depending largely upon the severity of the affection. After recovery has taken place, it is important to take sufficient rest between the times of practising, and to refrain for some time from playing pieces that require wide stretching of the fingers.

PILES.—See HEMORRHOIDS.

PILOCARPUS.—The leaves of several varieties of Pilocarpus, a tree growing in South America. It depends for its action on two alkaloids, pilocarpine and isopilocar pine. Physiologically, it acts much like muscarine, but is not as poisonous. The most noticeable effect of pilocarpus or its alkaloids is an increase in the amount of sweat secreted. It also contracts

the pupil of the eye, depresses the circulation and temperature, and slightly stimulates the kidneys. The most common use of pilocarpus is to produce free sweating when it is desired to reduce the amount of fluid in the system, as in dropsy or accumulations of fluid in any of the body cavities. Like physostigma, it is used in certain eye conditions to contract the pupil. Its free use is limited by its depressing effect. Poisoning by pilocarpus causes an increased secretion of sweat, saliva, and tears. There may be nausea and vomiting. The pupil is contracted, the breathing quick and difficult, and the pulse either fast or slow and irregular. Atropine is the antidote for poisoning by pilocarpus, and, conversely, pilocarpine is given for atropine poisoning. The preparation most frequently used is pilocarpine or some one of its salts, the dose ben* about one-eighth of a grain.

PIMPLES.—See SKIN BLOTCHES.