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Dose, 5 to 30 m. ; .30 to 2.00 c.c.

2. Oleoresina Lupulini. Oleoresin of Lupulin. Lupulin, loo ;
by percolation with Ether and evaporation.
Dose, i to 5 gr. ; .06 to .30 gm.]

ACTION OF HOPS.

The volatile oil is stomachic and carminative like other
volatile oils. [To a slight extent it reflexly excites the circula-
tion.] The bitter principle aids the stomachic influence. Hops
are decidedly soporific. Probably it is the volatile oil that
produces this effect.

THERAPEUTICS OF HOPS.

The pharmacopoeial preparations of hops are not much used,
but good beer, because of the hops contained in it, may with
some persons aid digestion, and for this purpose is often given

24



3/O ORGANIC MATERIA MEDICA.

with meals to those whose digestion is feeble after a long illness,
or from any other cause. [The alcohol in the beer increases this
effect.] Many people find the soporific influence of beer very
well marked. [Lupulin has been used in nervous tremors, wake-
fulness and in the delirium of drunkards.]

LACTUCARIUM.

[LACTUCARIUM. The concrete milk-juice of Lactuca virosa LinnS
(nat. ord. Composites). Synonym. Lettuce. Habitat. Southern and Central
Europe.

CHARACTERS. In sections of plano-convex, circular cakes, or in irregu-
lar, angular pieces, externally grayish-brown or dull reddish-brown, internally
whitish or yellowish, of a waxy lustre ; odor heavy, somewhat narcotic ; taste
bitter.

COMPOSITION. The chief constituents of Lactucarium are (i) Lactu-
cerin or Lactucone, C 16 H 26 O, about 50 per cent., a crystalline principle. (2)
Lactucin, C U H 12 O 3 -|-H 2 O, resembling mannit. (3) Lactucic Acid.

Dose, 5 to 60 gr. ; .30 to 4.00 gm.

Preparations.

1. Tinctura Lactucarii. Tincture of Lactucarium. Lactucarium,
500 ; Glycerin, 250 ; by treatment with Benzin and drying, then
macerate and percolate with water, and Alcohol ; evaporate, filter and
add diluted Alcohol to 1000.

Dose, X to 2 fl - dr - > * to 8 - c - c -

2. Syrupus Lactucarii. Syrup of Lactucarium. Tincture of
Lactucarium, loo ; Sugar, 50 ; Precipitated Calcium Phosphate, 50 ;
triturated together with water, filter, dissolve Sugar, 700 ; and add
water to looo.

Dose, i to 4 fl. dr. ; 4. to 15. c.c.

ACTION AND THERAPEUTICS OF LACTUCARIUM.

Lactucarium has been credited with mild hypnotic powers.
Large doses of the green extract may cause mental derangement,
and will dilate the pupil.]

[PELLOTINUM.

PELLOTINE (Not official). C,,H. il NCy=238. 50. An alkaloid ob-
tained from the Anhalonium Williamsii (nat. ord. Cactacece). Habitat.
Mexico.

CHARACTERS. The hydrochloride, which is to be found in the shops,



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM.



occurs as a colorless, amorphous, intensely bitter powder. Solubility. Readily
in water.

Dose, l / 2 to i gr. ; .03 to .06 gm. (Hypodermatically.)

ACTION OF PELLOTINE.

Slight narcosis follows its injection in from ten to fifteen
minutes (frogs). The reflexes are somewhat diminished. After
twenty to thirty minutes there comes a distinct increase of reflex
irritability, followed by spasms, resembling strychnine poisoning.
If large doses are administered this condition may pass into one
of complete paralysis. The pulse rate is slightly diminished,
drowsiness and sleep supervene after its administration to man.
The drug is probably excreted by the kidneys.

THERAPEUTICS OF PELLOTINE.

Pellotine has been recently introduced as a hypnotic which,
because it is unirritating, can be used hypodermatically. It
slows the pulse slightly, induces a feeling of weariness, weight of
eyelids and limbs, disinclination to mental and bodily exertion,
and a quiet sleep follows. The awakening is easy and usually
without untoward symptoms. In full doses, with the patient in
an upright position it may give rise to vertigo. It apparently
has no effect on the secretions.]

[B. Cerebral Excitants.]

BELLADONNA.

BELLADONN/E FOLIA. Belladonna Leaves. [The leaves of
Atropa Belladonna Linne (nat. ord. Solanaceez). Synonym. Deadly Night-
shade. Habitat. Europe and Asia Minor.

CHARACTERS. Leaves from 10 to 15 cm. long, from 5 to 10 cm. broad,
broadly ovate, equilaterally narrowed into a petiole, tapering at the apex,
entire on the margin, smooth, thin, the upper surface brownish-green, the
lower surface grayish-green, both surfaces whitish, punctate ; odor slight,
bitterish, disagreeable.] Resembling Belladonna leaves. Stramonium leaves,
more wrinkled ; hyoscyamus leaves, hairy.

COMPOSITION. The chief constituents are (I) Atropine (see p. 373), [(2)
so-called Belladonnine, a yellowish powder, is probably identical with Hyos-
cyamine (see p. 384).] It has been stated that atropine does not exist in Bel-
ladonna in the natural state, but that it is a conversion product of hyoscyamine,



3/2 ORGANIC MATERIA MEDICA.

which is the natural alkaloid of Belladonna. [Atropine, hyoscine, (see p. 384),
daturine, (see p. 382), duboisine and scopolamine, all derived from atropaceous
plants, are nearly identical, and exist as malates in the plant.]
Dose, i to 5 gr. ; [.06 to .30 gm.]

Preparations.

1. [Extractum Belladonnae Foliorum Alcoholicum. Alco-
holic Extract of Belladonna Leaves. By percolation with Alcohol and
water, and evaporation.

Alcoholic Extract of Belladonna Leaves is used to make Emplas-
trum Belladonnas and Unguentum Belladonnae.
Dose, ^ to y z gr. ; .008 to .03 gm.

2. Tinctura Belladonnas Foliorum. Tincture of Belladonna
Leaves. Belladonna Leaves, 150; Diluted Alcohol, to 1000. By
maceration and percolation.

Dose, 5 to 30 m. ; .30 to 2.00 c.c.

3. Unguentum Belladonnae. Belladonna Ointment. Alcoholic
Extract of Belladonna Leaves, 10; Diluted Alcohol, 5; Benzoinated
Lard, 8$.

4. Emplastrum Belladonnae. Belladonna Plaster. Alcoholic
Extract of Belladonna Leaves, 200 ; Resin Plaster, 400 ; Soap Plaster,
400. Melt the plaster on a water-bath ; then add the extract of bella-
donna leaves and continue the heat, stirring constantly, until a homo-
geneous mass results. ]

BELLADONNA RADIX. Belladonna Root. The root of Atropa
Belladonna [LinnS (nat. ord. Solanacea). Habitat. Central and Southern
Europe, in woods.

CHARACTERS. In cylindrical, somewhat tapering, longitudinally wrinkled
pieces, 10 to 25 mm. or more in thickness ; externally brownish-gray, inter-
nally whitish ; fracture nearly smooth and mealy, not radiating or showing
medullary rays in the thicker roots, only in the layer near the bark ; nearly
inodorous ; taste sweetish, afterwards bitterish and strongly acrid.]

COMPOSITION. As of the leaves. Usually contains 0.2 to 0.6 per cent,
of alkaloids.

Preparations.

1. [Extractum Belladonnae Radicis Fluidum. Fluid Extract
of Belladonna Root. By percolation with Alcohol and Water, and
evaporation.

Dose, i to 3 m. ; .06 to .20 c.c.

2. Linimentum Belladonnae. Belladonna Liniment. Fluid
Extract of Belladonna Root, 950 ; Camphor, 50.]



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 3/3

ATROPINA. Atropine. C 17 H 23 NO 3 [=288.38. An Alkaloid obtained
from Belladonna, which it contains in .06 to .3 percent. As it occurs in com-
merce, it is always accompanied by a small proportion of hyoscyamine ex-
tracted along with it, from which it cannot be readily separated.

SOURCE. Atropine is made from the root thus : (i ) Make a tincture of
the root by maceration and percolation with Alcohol. (2) Add slaked lime ;
this splits up the Atropine Malate, Lime Malate being precipitated. (3) Fil-
ter, and add Sulphuric Acid to precipitate the excess of Lime. (4) Filter, con-
centrate by distillation, partially evaporate, add Potassium Carbonate ; after
six hours much coloring matter is precipitated. ( 5 ) Filter, add more Potas-
sium Carbonate ; this sets free the Atropine. (6) Shake up with Chloroform,
which takes up the Atropine in solution. (7) Withdraw the Chloroform,
evaporate, and Atropine is left. It is purified by digestion with warm Alco-
hol and Animal Charcoal.]

CHARACTERS. [White, acicular crystals, or a more or less amorphous,
white powder, without odor, having a bitter, acrid taste, and gradually assum-
ing a yellowish tint on exposure to air. Solubility. In 130 parts of water, 3
parts of Alcohol, 16 parts of Ether, 4 parts of Chloroform, and about 50 parts
of Glycerin.] It can be decomposed into Tropine and Tropic Acid, and re-
constructed by their synthesis. It is distinguished from hyoscyamine, with
which it is isomeric, by its melting-point, optical properties and molecular con-
stitution.

I NCOMPATIBLES. Caustic alkalies decompose it.

Dose, T ^ to fa gr. ; [.0005 to .001 gm.]

ATROPINE SULPHAS. Atropine Sulphate. [(C 17 H 23 NO,) 2 H 2

S0<=6 4 7.58.

SOURCE. Dissolve Atropine in Diluted Sulphuric Acid, treat with Ether,
the insoluble Sulphate is deposited.

CHARACTERS. A white, indistinctly crystalline powder, having a very
bitter nauseating taste. Solubility. In 0.4 part of water ; in 6.2 parts of
Alcohol.]

Dose, T ^ to -fa gr. ; [.0005 to .003 gm.]

ACTION OF BELLADONNA.

The action of belladonna and atropine is the same.

External. Atropine placed by itself upon the unbroken
skin cannot be absorbed, but rubbed in with substances which
are absorbed, such as alcohol, glycerin, camphor, etc., or applied
to a broken surface, it paralyzes the terminations of the sensory
nerves, especially if pain is present. It is thus a local anaes-
thetic and an anodyne. These are its chief actions, but to a
much less extent it locally paralyzes the terminations of the



374 ORGANIC MATERIA MEDICA.

motor nerves, first contracts and then dilates the vessels, and
renders the secretions of the skin less active.

Internal. Gastro-intestinal tract. It will be convenient to
describe the effects of belladonna on all secretions when speaking
of its action on nerves, and we need not mention here its influ-
ence on the muscular coat of the intestine, for that is secondary
to its action on the nervous system.

Blood. Atropine is quickly absorbed, but does not affect the
blood. Its main action is on the nervous system, and that must
be considered in detail.

Secretory nerves. The activity of the peripheral termina-:
tions of all the secretory nerves in the body is, as far as
we know, depressed. These nerves fall under the following
headings :

^ (0) Mouth. Even small doses of atropine make the mouth
dry from lack of saliva and mucus. In health, secretion of sub-
maxillary saliva always follows stimulation of the chorda tympani
nerve, and, as is well known, this is due to the fact that this
nerve is the secretory nerve for this gland, and not to any vascu-
lar dilatation. If atropine be given to an animal, stimulation of
the chorda no longer causes an increased flow of saliva, however
close to the gland the nerve is excited, the reason being that
atropine has paralyzed the terminations of the chorda tympani.
In the same way the terminations of the secretory nerves of the
other salivary glands and the mucous glands are paralyzed, and
hence the mouth is dry, because normal impulses cannot reach
the cells of the glands.

Stomach, liver, and intestines. We do not know what influ-
ence atropine has on the secretions of these organs.

Sweat glands. Atropine paralyzes the terminations of the
nerves in the sudoriparous glands. Thus it causes the skin to
become dry.

Kidneys. The effect of atropine on the amount of urine
secreted is necessarily uncertain, as the urinary flow depends so
much on the secretion of sweat.

Bronchial mucous membrane. The secretion of bronchial
and tracheal mucus, like that of the mouth, is diminished.



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 3/5

Mammary gland. The activity of the peripheral terminations
of the secretory nerves in the cells of the mammary gland is in-
hibited, hence the flow of milk, if any is present, is arrested,
and belladonna is called an antigalactagogue.

Sensory nerves. It has already been mentioned that bella-
donna rubbed into the skin depresses the function of the termi-
nations of the sensory nerves. It does the same when given by
the mouth, but its action on sensory nerves that is to say, its
anaesthetic and anodyne action is very inferior to that on the
secretory nerves, and is not powerful enough for atropine to
relieve pain when given internally. It is only used as a local
anodyne.

Voluntary muscles and their nerves. Voluntary muscles are
quite unaffected even by toxic doses of atropine ; towards the end
of a case of belladonna poisoning the motor nerves are slightly
paralyzed.

Involuntary muscles and their nerves. The splanchnics are
the inhibitory nerves of the intestinal movements, and if they are
stimulated, the peristaltic movements stop ; impulses are constantly
descending these nerves to restrain these movements. If atropine
in small doses is given to animals, it is observed that the bowels
are relaxed, because intestinal peristalsis is much increased,
and that stimulation of the splanchnics is powerless to arrest it ;
clearly the drug has paralyzed the terminations of the splanchnics
in the involuntary muscles of the intestine. Larger doses stop
peristalsis.

All involuntary nerve terminations, as those of the muscles of
the bladder, ureters, urethra, vesiculae seminales, uterus and
vagina are paralyzed like those in the intestinal muscles.

The eye and its nerves. Atropine acts only on the termina-
tions of the nerves in the involuntary muscles of the eye. If it
be dropped into the eye or given by the mouth the pupil dilates
widely, and cannot be made to contract by stimulation of the
third nerve. That this dilatation is not due to any marked action
on the muscular fibres of the iris themselves is shown by the fact
that the atropinized pupil will contract if the muscle itself be
stimulated. Therefore it must be that the terminations of



3/6 ORGANIC MATERIA MEDICA.

the third nerve in the iris are paralyzed. The ending of
this nerve in the ciliary muscle is affected in the same way, and
consequently accommodation is paralyzed. It is certain
that this mydriasis and defective accommodation is in no part
central, as is the contraction of the pupil produced by opium.
So strong is the local action of belladonna that if atropine
be dropped into the recently excised eye the pupil will dilate.
When the third nerve is cut the pupil dilates, and if, after this,
atropine be dropped into the eye it dilates still further. Some
have concluded, from this and other reasons, that atropine also
stimulates the terminations of the sympathetic in the iris ; but
this action is slight. [The pupil dilates because the elastic fibres
in the iris have an opportunity to act.] The intra-ocular tension
is increased by large doses. There is, as a result of the paralysis
of the ciliary muscle, disturbance of vision. Atropine does not
act on the pupils of birds.

The heart and its nerves. The main action of atropine is to
paralyze the terminations of the vagus in the heart, and
consequently the pulse is rendered more rapid, and cannot
be slowed by strongly stimulating the vagus. If the rate of the
heart has been lowered by [muscarine], which can be shown to
have a local stimulating influence on the termination of the vagus
in the heart, the application of atropine renders the heart quick
again, the two drugs being, in their effect on the heart, exactly
antagonistic. This quickening of the pulse from inhibition of the
vagal cardiac terminal filaments is the chief action of atropine on
the heart, but the following minor actions must be noticed. The
vagus centre and the trunk of the nerve are also depressed, but
to a much less extent. Before the pulse is quickened it is occa-
sionally slowed for a short time by atropine ; this is probably
owing to a brief excitation of the vagus centre. Some authori-
ties believe that part of the quickening of the pulse is due to a
slight stimulation of the cardiac accelerator nerves, just as we
have seen that some consider that the sympathetic fibres in the
iris are excited ; but if the accelerator nerves are stimulated, the
stimulation is quite subsidiary to the important paralysis of the
vagal terminations. Although the pulse is quickened by bella-



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 3/7

donna, its force is not diminished. Toxic doses abolish
the function of the cardiac muscle, and the heart stops in
diastole.

Vaso-moto r system and its nerves. After a considerable dose
of belladonna the skin is flushed, and a scarlatiniform erythe-
matous rash may be present in belladonna poisoning. It is thus
obvious that such a dose of belladonna relaxes the peripheral
vessels. The exact cause of this has not definitely been made
out, but it is extremely probable that it is largely a peripheral
action, quite harmonizing with the peripheral action we have
seen atropine to have on the involuntary muscles of the intestines,
eye and heart ; that is to say, the vaso-constrictor nerve-filaments
supplying the arterioles are paralyzed, and consequently the ves-
sels dilate. The action of atropine on the medullary vaso-motor
centre is more marked than that on the cardiac medullary centre ;
but it is the same, the centre first- being stimulated, and then
depressed. The primary stimulation is sufficient to overcome the
tendency of the peripheral vessels to dilate, so that belladonna
at first contracts them ; and as this stage of contraction lasts well
into the period during which, owing to paralysis of the vagal
terminations, the heart is accelerated, the blood-pressure rises
considerably ; subsequently it falls, the fall being due to the
depression of the vaso-motor centre and the peripheral action of
belladonna on the vessels, causing their wide dilatation. Ulti-
mately, when the heart itself is paralyzed, the blood-pressure is
very low. The spinal vaso-motor centres are acted on as power-
fully and in the same way as the medullary centre.

Respiration and its nerves. Here also belladonna paralyzes
peripheral nerve-filaments, in this case those of the vagus
in the bronchial tubes. Both the afferent and efferent pulmo-
nary vagal fibres are effected. The result is that the muscular
coat of the bronchial tube is relaxed, and that the secretions
(the activity of the afferent fibres being depressed) do not irritate
the nerves so much as before, and therefore cough is lessened.
It will be remembered that the quantity of bronchial secretion is
diminished. The medullary and spinal respiratory centres are
influenced precisely as the vaso-motor, that is to say, they are



3/8 ORGANIC MATERIA MEDICA.

first stimulated, and so the respirations are quicker and deeper,
then large doses paralyze them, and the breathing is slow and
shallow. The patient becomes asphyxiated, and this contributes
to the result in a fatal case.

Temperature. This is decidedly raised by toxic doses of
belladonna (it may be 4 [F., about 2 C.] or more). This rise
is independent of the blood -pressure and of the diminution of
perspiration. It is said that heat-production is greatly exag-
gerated. The heat-loss is also increased, probably because the
flushing of the skin leads to a greater loss by radiation.

Spinal cord. Except for the action on the vaso-motor and
respiratory spinal centres, belladonna has little influence on the
spinal cord in man, but has a well-marked tetanizing effect in
frogs. It is said slightly to increase and afterwards diminish
general reflex excitability.

Cerebrum. A considerable dose of belladonna causes delir-
ium, showing that the higher centres are stimulated. Gener-
ally the stimulation takes place inco-ordinately. That it is pow-
erful is indicated by the fact that in poisoning by belladonna
the delirium will last for a long while. The subsequent quietude
is not more than the exhaustion of the cerebrum from the con-
tinued delirium will explain. Belladonna rarely, if ever, pro-
duces genuine coma. Other symptoms that may be observed
with large doses, and which are probably due to disorder of
the brain, are staggering gait, giddiness and occasionally convul-
sions.

Elimination. Atropine is probably eliminated entirely by the
kidneys.

It will be seen that the dominant action of belladonna is
to depress the activity of the terminations of nearly all varie-
ties of nerves. In addition, it first stimulates and then
depresses the three great medullary centres, and it is a
deliriant. A summary of its effects on man will be given under
the heading of Toxicology.

Children can take considerable doses of belladonna without
any symptoms of poisoning. Pigeons and rodents are pecu-
liarly insusceptible to it.



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 3/9

THERAPEUTICS OF BELLADONNA.

Externally. Belladonna is used externally to relieve all
sorts of pain, for example, that of neuralgia, pleurodynia, and
chronic osteo-arthritis. Chloroformum Belladonnae (Brit. Pharm.
Conf.), the root being extracted with ammonia and chloroform,
diluted with a little olive oil, or the liniment is excellent for
these purposes. A glycerin preparation (made by rubbing [the
alcoholic] extract of belladonna [leaves], 4 ; with boiling water,
i ; and then adding gradually glycerin, 12), soothes the pain of
acute inflammations. This, or the plaster, or the ointment, is
very efficacious in preventing the secretion of milk in women
who do not for any reason nurse their infants. Pruritus and
local sweating of various parts of the body, especially the feet,
may sometimes be stopped by the application of belladonna lini-
ment. A solution of atropine sulphate, 4 ; boric acid, 5 ; in
water to 480 ; will dilate the pupil for ophthalmoscopic exami-
nation. Atropine is often used in ophthalmic practice to par-
alyze the movements of the iris and ciliary muscle, to break
down adhesions, and to prevent the formation of contractions
of the iris. [It must not be used if the patient is suffering from
glaucoma.] See also Homatropine [Hydrobromate, p. 381].

Internal. Alimentary canal. [Belladonna] has occasionally
been employed to check salivation, and some use it to overcome
constipation and colic. The alcoholic extract [of the leaves]
is then given, and is commonly combined with some purgative
in a pill. [This] extract in the form of a pill is often adminis-
tered with opium to patients suffering with appendicitis or peri-
tonitis ; as it is given several times a day a large amount is taken,
and this, as already explained, probably paralyzes intestinal
movements, and so aids the opium.

Skin. Atropine sulphate (y^j gr. ; .0006 gm.) injected sub-
cutaneously, or one or two minims [.06 to .12 c.c.] of the solu-
tion of atropine sulphate [i, in camphor water, 100.], by the
mouth will sometimes arrest sweating, .and this treatment may
succeed with the night-sweats of phthisis.

Circulation. There are many cases of heart disease in which
belladonna may advantageously be combined with other drugs.



380 ORGANIC MATERIA MEDICA.

Whenever we wish to empty the ventricle completely it is useful,
for it will be remembered that it increases the rapidity of the
heart without diminishing the force. But its greatest value is to
remove cardiac pain and distress, which it often does most effec-
tually. It may be conveniently applied as a plaster over the car-
diac region, or it may be given internally, usually as the tincture
[of the leaves] .

Respiration. As belladonna relaxes the muscular coat of the
bronchial tubes, it is of great value in spasmodic affections of
the respiratory passages. Thus, of all the numerous drugs that
have been given for whooping-cough, it is the best. It is also
very useful [to relieve the symptom] asthma, and in bronchitis
with asthma-like paroxysms ; in the last named [condition] its
powerful stimulation of the respiratory centre and its capability
of diminishing the secretion will, in properly chosen cases, ren-
der it particularly valuable. It is generally given as a tincture
[of the leaves], and combined with other drugs. A useful
linctus contains the tincture, 3 ; vinegar of squill, 5 ; syrup of
tolu, 10 ; glycerin to 60 parts.

Genito-urinary diseases. Belladonna is one of the favorite
remedies for the nocturnal incontinence of children, and it occa-
sionally overcomes this trouble in adults when it is not due to
organic diseases. [It relieves eneuresis because it has an anodyne
effect upon the centres in the cord and when excreted in the
urine anaesthetizes the neck of the bladder.] Its power of re-
lieving the spasm of involuntary muscle is well shown in the effec-
tual manner in which the very painful vesical spasm which accom-
panies -calculus, cystitis, and prostatitis may be benefited by it.



Online LibraryWilliam Hale-WhiteMateria medica, pharmacy, pharmacology and therapeutics → online text (page 33 of 67)