AGAR
   A dried substance of mucilaginous character abstracted from several species of sea weeds (marine algae) growing along the coast of Asia. Most of it comes from Japan. Dose, 1 to 4 drachms. Common Name: Agar-agar. Description.—Agglutinated membranous pieces, tough or brittle accordingly as it is damp or dry. The pulverulent form is most commonly used. It is a coarse, buffcolored granular powder, having practically no odor or taste. It swells to a soft magma in the presence of water. Action and Therapy.—Agar has no action upon the human body nor is it in turn affected by the digestive ferments or intestinal flora. It has the property of absorbing moisture and swelling to a soft mass, and for this purpose is given in constipation as a mechanical laxative; rendering the best service when intestinal secretion is scanty, and in consequence, the feces are abnormally dry. From one teaspoonful to two heaping tablespoonfuls may be given once or twice a day in dry form alone, or mixed with some cereal at meal-time. Biscuits, bread, and crackers are prepared from it and may be procured in the general trade. Agar is also used as a culture medium in making labaratory cultures. ¹

AGARICUS (Amanita muscaria)
   The fungus Amanita muscaria, Persoon; (Agaricus muscarius, Linné.) (Nat. Ord. Fungi.) An extremely poisonous fungus found in the pine forests of Europe. Common Name: Fly Agaric. Principal Constituents.—Muscarine, a deadly alkaloid, and pilzatropin, its physiologic opposite. Preparations.—1. Tinctura Agarici, Tincture of Agaricus (Fresh fungus, 1 ounce; strong alcohol, 16 fluidounces). Dose, 1/30 drop. 2. Muscarine. Dose, 1/30 to 1/12 grain. Action and Toxicology.—The chief toxic action of agaricus is probably due to muscarine, which produces ptyalism, weeping, vomiting, depressed circulation, difficult breathing, muscular weakness, minutely contracted pupils, tetanic contraction of the viscera with subsequent relaxation of the bowels, when violent peristalsis takes place, paralysis and death. Muscarine is the direct antagonist to atropine. Closely allied to Agaricus is Amanita phalloides, Fries or Death Cup. Common in the United States and the cause of many fatal poisonings. Gastro-enteritis with choleraic diarrhoea occurs, with death within two to four days. It contains muscarine and a toxalbumen phallin, both of which are deadly agents. While salt abstracts the latter, there is no known antidote after it has been absorbed. Therapy.—Agaricus is seldom used, but possesses undoubted power over the secretions and the nervous system. The chief uses that have been made of it, and for these even the muscarine sulphate or nitrate have been mostly employed, are in colliquative night-sweating from debilitating diseases, and profuse sweating in the daytime; and to restrain the excess of urine in polyuria, or so-called diabetes insipidus. Scudder suggested a tincture of the fresh fungus for “involuntary twitching of the muscles of the face, forehead, and even of the eyes, so that objects are not well seen because they seem to move; drawing of the tissues of the forehead and nose; pressing pain in the occiput and an inclination to fall backward.” Webster thought it useful in typhoid conditions and spinal irritation when there is “tremor, restlessness, and desire to get out of bed.” These indications are of homeopathic origin and have been but little followed by Eclectic practitioners. Muscarine is used in atropine and belladonna poisoning, sometimes being employed in place of eserine (physostigmine). ¹

BOLETUS
   The fungus Polyporus officinalis, Fries (Boletus laricis, jacquin). (Nat. Ord. Fungi.) Asia, Eastern Europe, and Central America. Common Names: White Agaric, Purging Agaric, Larch Agaric. Principal Constituents.—Agaric Acid (Agaricin) (C16 H30 O5+H2 O), resins, 79 per cent and agaricol. The purging constituent is a red resin (C15 H24 O4). Preparation.—Specific Medicine Boletus. Dose, 1/2 to 5 drops. Derivative: Agaricin. Dose, 1/10 to 1/3 grain. Specific Indications.—Ague with alternate chills and flushes of heat; impaired nutrition and feeble cerebral circulation; colliquative sweats. Action and Therapy.—This fungus is remarkable for the high per cent (79) of resins it contains. It is a decided nerve stimulant and antiperiodic. Boletus is but little used, but occasionally will be needed in irregular intermittents, not reached by quinine medication and presenting alternate chills and flashes of heat, accompanied by a heavy bearing down pain in the back. The patient perspires freely at night and has a yellow-coated tongue, bitter taste, capricious appetite, slight fever, and has for some time been experiencing a dull, languid feeling. It may also be used in cases of impaired nutrition with feeble cerebral circulation. To some extent it controls diarrhea, cough, hectic fever, rapid circulation, and the profuse night-sweats of phthisis. The dose for these purposes is from the fraction of a drop to 5 drops of the specific medicine. For the last named use that of controlling colliquative sweating, agaric acid or agaricin, as it is more commonly called, is one of the most effectual of antihydrotics. In 113 grain doses it controls the thirst, cough, and the excessive sweating of consumptives.¹

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