Active Ingredients. - In 1875, MM. Byasson and Hardy both obtained from this plant an alkaloid which is now known as pilocarpia. It is probable that jaborandi also contains another alkaloid and a peculiar acid. Of pilocarpia several salts, especially the hydrochlorate and nitrate, have been prepared. The writer was the first, he believes, to prepare an iodohydrargyrate. This has since been prepared in much larger quantity by Chas. Rice, Ph.D., chemist to Bellevue Hospital, New York, who furnishes C23H30N4O4HI.HgI2 as its probable formula.

Physiological Action. - Jaborandi produces two most marked physiological effects - sweating and salivation, with a promptness and to a degree unequalled by any other known drug. If an infusion made of from one to two drachms of jaborandi leaves be administered to an adult, in from five to ten minutes the face will flush, and in a few moments more become covered with droplets of sweat. Soon the entire body becomes bathed in perspiration. Coincident with the sweating, free salivation occurs. These phenomena gradually disappear at the end of three to six hours. In some cases nausea and vomiting may occur. The face, at first flushed, afterwards becomes pale, and, according to Ringer, the temperature of the body falls from 4° to 1.4° F. The physiological effects resulting from continued use of the drug have not as yet been sufficiently studied; and it is by no means impossible that the violent perturbation of the system, which results in the profuse sweating and salivation, may seriously impair the functional and even organic integrity of important organs. The sweating is apparently not due to increased afflux of blood to the surface, but rather to a paralysis of the inhibitory influence of that portion of the nervous system that presides over the sudatory apparatus. The remarkable experiments of Adamkiewicz, in which he produced sweating at will by the faradization of certain nerves, should be considered in this connection.1

Therapeutic Action. - Like all new drugs possessing marked and decided action, jaborandi has been employed in almost every disease in which it seemed desirable for any reason to stimulate the perspiratory function. In this respect it is a marked example of the methods too much employed in so-called "physiological therapeutics." In a given case it seems desirable to fulfil a certain indication, and a drug capable of effecting this result when given in immense doses is brought into requisition, utterly regardless of the ulterior or even immediate effect which it may have on organs other than those which it is desired to influence. Instances of this are too numerous and too well known to need citation. With respect to jaborandi, the notes of warning are already being heard. In his seventh edition Ringer says: "I have used it in many cases" (of Bright's disease) "not only without benefit, but, I must confess, not without doing harm, for it has always much depressed the patient, has generally excited sickness, and the effects have been so disagreeable that in almost every case the patient has begged the discontinuance of the treatment." In a case of syphilis complicated with renal anasarca, under the writer's care, the administration of a teaspoonful of fluid extract of jaborandi was followed by diminution of the urine and rapid and marked increase of the oedema without sweating. More recently Dr. Fordyce Barker2 has called attention to certain dangers accompanying its use in puerperal albuminuria. When first introduced, it was, so to speak, "warranted safe;" but its inconveniences are now beginning to come to the surface. In the spring of 1877 the writer employed the hydrochlorates of pilocarpia in a case of severe ichthyosis. A daily dose for two weeks entirely removed the scales, but the patient preferred the disease to the remedy, and discontinued the treatment. It has been employed by others in different cutaneous affections, but so far, as we are aware, with but exceptional benefit.

Ringer makes the statement that to many may seem extraordinary that "pilocarpine, in doses of 1/20 grain, given thrice daily, will check profuse perspiration." In the spring of 1878 a case of mild mercurial salivation occurred in one of the writer's wards at the Charity Hospital; a few weeks later a case of severe salivation occurred in connection with his dispensary service. In the first case pilocarpia, and in the other jaborandi in small doses, was employed. In both immediate improvement and rapid recovery ensued. With the exception of the class of cases just referred to, we are unable at present to specify any diseases in which jaborandi can unreservedly be recommended, and are forced to conclude, with Ringer, that "though of great physiological interest, jaborandi has not yet proved very serviceable in the treatment of disease." The iodohydrargyrate of pilocarpia, already alluded to, suggested itself to the writer as a theoretical substitute for Zittmann's decoction in the treatment of syphilis. We have not, however, as yet had sufficient experience with it to hazard any conclusions concerning its practical utility.

1 Die Secretion des Schweisses, Berlin, 1878. 2 Medical Record, 1878.

Preparations And Dose. - Non-officinal. To procure suda-tion, an infusion or a decoction of one to two drachms of the leaves, or an equivalent amount of the fluid extract, may be employed. The corresponding dose of hydrochlorate of pilocarpia is about gr. 1/4 - 1/2.)