PILOCARPUS^PILOC
   The dried leaflets of (1) Pilocarpus Jaborandi, Holmes; or (2) Pilocarpus microphyllus, Stapf (Nat. Ord. Rutaceae). Brazil and Paraguay. Dose, 20 to 60 grains. Common Names: Jaborandi, (1) Pernambuco Jaborandi, (2) Maranham Jaborandi. Principal Constituents.—The powerful liquid alkaloid pilocarpine (C11H16N2O2); a colorless, viscid oil, isopilocarpine; a volatile oil chiefly pilocarpene (C10H16); and pilocarpidine (C10H14N2O2) in Pilocarpus Jaborandi only. Preparation.—Specific Medicine Jaborandi. Dose, 1 to 60 drops. Derivatives.—Pilocarpina Hydrochloridum, Pilocarpine Hydrochloride. Translucent, colorless and odorless crystals of a feebly bitter taste; hygroscopic in the air. Very soluble in water and alcohol, less soluble in chloroform, and not at all in ether. Dose, 1/12 to 1/6 grain by mouth; 1/24 to 1/8 grain (hypodermatically). Pilocarpinae Nitras, Pilocarpine Nitrate. Permanent, shining, odorless crystals, very soluble in water and less so in alcohol; insoluble in chloroform and ether. Dose, 1/12 to 1/4 grain (by mouth); 1/24 to 1/8 grain (hypodermatically). Specific Indications.—Deficient secretion; marked dryness and heat of skin and mucosa; muscular pain; muscular spasms; pain with puffiness of tissues; urinal suppression, the urine being of high specific gravity and deep color; pulse full, hard, sharp and strong, with deficient secretion; increased temperature with dry skin and membranes; sthenic forms of fever; marked restlessness due to lack of secretion; ptyalism, with stomatitis; inflammatory rheumatism, with swollen and painful parts, and dry membranes and skin; soreness and stiffness of joints in subacute rheumatism; dry, harsh cough; tenacious sputum; renal dropsy with deficiency of urine; uremia; uremic poisoning, with convulsions; itching, with jaundice; increased ocular tension; deafness due to deficient aural secretion; alopecia; poisoning by atropine or belladonna; colliquative sweating (minute dose). Action and Toxicology.—Jaborandi and its alkaloid, pilocarpine, are the most powerful excitants of the secretions of the peripheral secretory glands known. In full doses they cause an enormous outpouring of sweat and saliva, and to a lesser degree stimulate the lachrymal, nasal, faucial, and bronchial secretory apparatus, and to a still lesser extent those of the stomach and intestines. Even the modified secretory organs of the aural canal are indirectly affected by them and the quantity of cerumen increased. The growth of hair and intensification of its color are stimulated by their internal action as well as when locally applied. By most pharmacologists the effect of these drugs upon peripheral secretion is attributed to the direct action upon the terminals of the peripheral nerves and not to any impression per se upon the epithelial secretory cells. This they prove by completely checking them with atropine, known to act upon the same parts but in exactly an opposite manner. Cushny declares that both act upon an intermediary receptor interposed between the nerve and cells at the myocellular junction, and that neither the nerve nor the cells are directly impressed. These bodies are stimulated by pilocarpine and muscarine (agaricine) and depressed or paralyzed by atropine. It is generally conceded that while atropine is the complete antagonist of pilocarpine, which chiefly acts in the manner described and to a very limited extent upon the central nervous system, on the other hand pilocarpine is, therefore, not a complete antagonist of atropine. The action of pilocarpine upon the involuntary muscles is caused in the same manner as upon the sudoriferous glands—by impressing the myo-neural receptors. Moderate doses of these drugs have scarcely any effect upon the central nervous system, and pilocarpine is less apt than jaborandi to cause gastric and intestinal discomfort. Both, however, appear to increase peristalsis and in full doses may cause a persistent watery diarrhea, with straining or tormina after the diarrhea ceases. Upon the eye myosis is produced by both the local and internal use of them, and spasm of the accommodation also occurs. In large doses they are cardiac depressants, probably affecting the heart muscle and to some degree vagal inhibition. The extent to which the vaso-motor system participates in first causing increased and then lowered blood pressure is not satisfactorily known. Full doses cause cardiac arrythmia, and increase the number of heartbeats greatly, but render them weaker. The uterus, spleen, and bronchi contract under the influence of these drugs. Temperature, though at first considerably increased, falls when sweating has become well established. This action is more marked during fevers than in health. After the termination of sweating temperature regains its normal status, usually at once, but is sometimes delayed for several hours. As a rule, the secretion of milk is believed to be unaffected by pilocarpine, but contrary to what might be anticipated, where there is a diminished lacteal secretion, it apparently increases the supply. One or two drachms of powdered jaborandi infused in a cupful of boiling water and taken at one dose will in about ten to twenty minutes cause a tingling of the skin with marked redness of the surface. This sensation is first experienced in the face, but soon extends to the whole surface of the body, and is quickly followed by an abundant perspiration, which is apt to last for four or five hours. Almost simultaneously with the sweating the secretion of saliva increases to such an extent as to greatly embarrass speech, the person being obliged to assume an inclined position that the escape of saliva may be facilitated. During this stage from one to two pints of saliva and even more may be secreted, and usually there will be in addition an augmentation of the bronchial and lachrimal flow. The saliva contains an abundance of ptyalin and salts and readily converts starch into sugar. At times the mucous ¹