(Jaborandi.)

Origin. - The leaflets of Pilocarpus Jaborandi Holmes or of Pilocarpus micro-phyllus Stapf., yielding not less than 0.5 per cent. of alkaloids.

Description and Properties. - Pilocarpus contains a volatile oil and two alkaloids, pilocarpine and jaborine, the latter being thought to be chemically isomeric with the former.

Pilocarpidine, in many ways the equivalent of pilocarpine, has recently been isolated.

Dose. - 5-60 grains (0.3-4.0 Gm.).

Official Preparations

Fluidextractum Pilocarpi - Fluidextracti Pilocarpi - Fluidextract of Pilocarpus.Dose, 5-60 minims (0.3-4.0 Cc).

Pilocarpines Hydrochloridum - Pilocarpines Hydrochloridi - Pilocarpine Hydrochloride. - Origin. - The hydrochloride of an alkaloid obtained from pilocarpus.

Description and Properties. - Small, white crystals, odorless, and of a faintly bitter taste; deliquescent on exposure to damp air. Very soluble in water and in alcohol. It should be kept in small, well-stoppered bottles.

Dose-6 1/4 - 1/2. grain (0.001-0.03 Gm.).

Pilocarpinae Nitras - Pilocarpinae Nitratis - Pilocarpine Nitrate. - Definition. - The nitrate (C11Hl6N2O2.HN03) of an alkaloid obtained from pilocarpus.

Character. - In colorless, or white, shining crystals, odorless, and having a faintly bitter taste. It is permanent in the air, whereas the hydrochloride is deliquescent on exposure to the air. Soluble in water (1:4), alcohol (1: 60), warm alcohol (1:16).

Dose. - Average dose: i grain (0.010 Gm. = 10 milligrammes, U. S. P.

Antagonists and Incompatibles. - Atropine is a physiological antagonist to pilocarpine, being directly opposite in its action throughout its entire range, 1/100 grain (0.0006 Gm.) being sufficient to counteract 1/6 grain (0.01 Gm.) of pilocarpine. Morphine relieves the nausea.

The incompatibles are tannic acid, caustic alkalies, and the ferric and metallic salts.

Synergists. - The cardiac depressants, particularly aconite and veratrum viride, gelsemium, spirit of nitrous ether, and drugs which paralyze the vasomotor system.

Physiological Action. - Externally and Locally. - There is no action of importance.

Internally. - Digestive System. - The action of pilocarpine is here given, since the alkaloid fully represents the drug.

When pilocarpine is taken into the mouth, the ends of the chorda tympani and secretory nerves are stimulated, causing an increased secretion of saliva. Should large doses be taken, there is a feeling of tenderness in the mouth and severe salivation is produced. There is also a marked increase in the flow of tears.

The gastric glands are stimulated by the drug, their normal secretion being augmented. By stimulating the unstriped muscle-fibers pilocarpine increases peristalsis, both of the stomach and the intestines, in large doses acting as a cathartic. Immoderate amounts may also induce vomiting. The bile and pancreatic juice are not affected by moderate amounts of the drug.

Circulatory System. - At first the inhibitory fibers are stimulated, resulting in a slowed heart; but this soon gives over to rapid and palpitating heart action with raised blood-pressure.

Nervous System. - In medicinal amounts pilocarpine has no perceptible action on the central nervous system, although stimulating the nerve-terminations of involuntary muscles - i. e., those of the stomach, intestines, heart, spleen, bladder, uterus, etc.

Poisonous doses have produced (in the frog) tetanic convulsions, followed by paralysis, the result of depression of the muscles and spinal centers, the nerves apparently being unaffected.

Respiratory System. - The respiratory movements are unaffected by medicinal amounts, but the bronchial secretion is augmented.

Absorption and Elimination. - Pilocarpine is rapidly absorbed, and is eliminated principally by the skin, occasioning free, and under large doses excessive, diaphoresis.

The sweat is at first acid, then neutral, and finally alkaline in reaction. The diaphoresis produced by pilocarpine is due to stimulation of the secretory nerves supplying the glands.

The kidneys, under small doses, are stimulated, there being a slight increase in the urine, and the amount of urea is considerably augmented. This may be a result of the stimulation to leucocyto-sis caused by this drug on the blood-forming organs.

The drug is also eliminated by the salivary glands, there being frequently an enormous increase in the salivary secretion. Under the influence of pilocarpine there is an increase in the gastric, bronchial, and lacrymal secretions, even the secretion of milk being notably augmented. Cushny states that pilocarpine is not a galactagogue.

Temperature. - Succeeding a very brief and slight elevation of temperature there is a decided diminution of bodily heat, resulting from the dilatation of cutaneous blood-vessels and the evaporation of the perspiration.

Eye. - Whether applied locally to the eye or taken internally, pilocarpine produces marked contraction of the pupil by stimulating the peripheral endings of the motor oculi nerves. The drug produces a primary increase of tension of the eyeball, followed by a more permanent diminution in tension.

Uterus. - There is authority for the statement that pilocarpine stimulates the gravid uterus, inducing uterine contractions or increasing the energy of those already established.

The effect of the drug upon the uterus, however, is more pronounced and apparent in cases of eclampsia, seeming to prove the fallacy of the statement that pilocarpine is a true ecbolic.

Untoward Action. - Nausea and vomiting are of quite frequent occurrence, the vomiting being preceded by long and distressing nausea. Occasionally the patient complains of severe pain in the urethra and in the lumbar region, with frequent desire to micturate.

There have often been present headache, vertigo, hiccough, dimness of vision, gastric and abdominal pains, stupor, and chilliness. Collapse may occur.

Poisoning. - The symptoms produced by poisonous doses of pilocarpine are exaggerations of those already described, together with diarrhea, exhausting and excessive sweating and salivation, marked cardiac and respiratory depression, and collapse.

Treatment of Poisoning. - If the drug has been ingested, the stomach should be immediately cleansed with a solution of tannic acid.

To counteract the untoward effects of pilocarpine, whether the drug has been ingested or given by subcutaneous injection, atropine is undoubtedly the most complete physiological antagonist, and should be given hypodermically. Morphine is indicated to control the nausea and vomiting, while some of the cardiac stimulants may be required to counteract cardiac depression.

Therapeutics. - Externally and Locally. - Pilocarpine, or the fluidextract of jaborandi, has been highly recommended for alopecia. By the use of pilocarpine the hair becomes darker. The fluidextract of pilocarpus has been employed as a local application in erysipelas and eczema.

Lozenges containing 1/40 grain (0.01 Gm.) of pilocarpine are efficient in relieving dryness of the throat. As a myotic, pilocarpine is used in many diseases of the eye.

Internally. - The principal internal use of pilocarpine is as a diaphoretic in Brighfs disease. It eliminates through the skin many products, particularly fluids, that otherwise must be eliminated by an overtaxed kidney. In cardiac dropsy it is not a safe remedy, because of its depressing influence upon the heart.

The drug is very efficient in removing pleuritic effusion, while in uremic poisoning it is unquestionably a valuable remedy.

The hypodermic injection of small doses of pilocarpine has been highly recommended as an efficient remedy in erysipelas, particularly during the first stages of the disease.

The drug has proved beneficial in tobacco and alcoholic amblyopia.

Pilocarpine has been found useful in humid asthma, bronchor-rhea, and hiccough, and, in small doses, in arresting the sweating of phthisis and for the relief of ptyalism. The drug is an efficient galactogogue, and has been used with success in mumps, chronic enlargement of the cervical glands, and adenitis of the inguinal glands.

Pilocarpine materially lessens the flow of urine in diabetes insipidus, and in many diseases of the eye and ear the internal use of the drug serves a useful purpose.

The property possessed by pilocarpine of stimulating the glands of the skin renders this remedy of great service in many chronic diseases of the skin characterized by a dry, scaly condition. It is a peculiarly valuable agent in phthiriasis, psoriasis, certain forms of eczema, pruritus senilis, etc. Pilocarpine or fluidex-tract of jaborandi may be useful in breaking up a cold.

Finally, pilocarpine has been highly recommended in catarrhal jaundice, and is one of the most efficient antidotes to belladonna-poisoning.

Contraindications. - The drug should never be employed when the heart is weak from thinning and atrophy of its walls or from fatty degeneration, nor where there is a tendency to pulmonary congestion and edema. The drug is also contraindicated in asthenic fevers, such as typhoid fever, etc.

Administration. - Pilocarpine is superior to the crude drug, being far more reliable in its action and less liable to produce nausea and vomiting. Pilocarpine is usually given hypodermically, although it is frequently administered by the mouth, in solution, or in troches.

Of all the preparations of the crude drug, the fluidextract and infusion are commonly employed, the latter being less apt to cause profuse salivation. An elixir of pilocarpus is prescribed considerably.

Should preparations of jaborandi be given upon an empty stomach, they are less apt to occasion nausea. This inconvenience may be also avoided by giving an infusion by the rectum.