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It may be given internally as in the form of a suppository, or
applied as a plaster to the perinaeum.

It has been tried in many nervous diseases, but without any
good results.

TOXICOLOGY.

[Symptoms.] If a person takes a moderate dose of belladonna he soon ex-
periences dryness of the mouth and throat, and as the food, therefore, cannot be
properly lubricated, there is difficulty of swallowing ; the pulse may at first be a
little slower than usual. The pupil is dilated ; accommodation is defective, and
vision confused. The skin feels dry. If the dose has been a large one, these



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 381

symptoms all come on quickly ; the conjunctivae and face, and perhaps other
parts of the skin are flushed, and the rate of the pulse is greatly increased, it
may even be doubled. The patient staggers, feels giddy, and reels when he
walks ; the throat soon becomes very hot, the skin still more flushed, the eye-
lids swell, and there may be a uniform erythematous rash. The temperature
is often raised, the respirations are slow and deep. The pupils are very widely
dilated. By this time the patient is quite delirious. There may be purging,
but this is not common ; and sometimes he complains of a frequent desire to
micturate, although he is unable to pass any urine. Death takes place from
cardiac failure combined with asphyxia. Post-mortem. The organs are all in
a state of venous congestion, which is due to the asphyxia. If recovery takes
place the patient may have no recollection of his illness.

Treatment. Give emetics (see p. 139) or wash out the stomach. Inject
pilocarpine and stimulants subcutaneously. Employ artificial respiration and
hot bottles, and give strong coffee per rectum.

ANTAGONISM.

The antagonism between atropine and morphine has already been dis-
cussed (see, p. 365). It is clear that as pilocarpine stimulates the terminations
of the secretory nerves in the salivary and sweat glands, and also excites the
terminations of the third nerve in the iris and ciliary muscle, it is a diaphoretic,
a sialagogue, and a myotic, and is in these respects antagonistic to atropine.
Physostigmine also causes contraction of the pupil and spasm of the ciliary
muscle by stimulation of the terminations of the third nerve, and it depresses
the respiratory centre almost from the beginning. In these points it is an
antagonist to atropine.

[HOMATROPIN^E HYDROBROMAS. Homatropine Hydro-

bromate^ B. P., not official.] C 16 H 21 NO 3 HBr[=355.l7]. The hydrobro-
mate of an alkaloid prepared from Tropine. [Homatropine is really Oxytoluyl-
tropine. ]

SOURCE. [( i) Tropine, C 8 H 15 NO, a derivative of Atropine, is heated with
Oxytoluic Acid in the presence of Hydrochloric Acid ; (2) Ammonia is added,
and pure Homatropine shaken out with Chloroform ; (3) the Chloroformic
solution is evaporated ; (4) the Homatropine is neutralized with Hydrobromic
Acid.

CHARACTERS. Small prismatic white crystals. Solubility. In 10 parts
of water ; in 133 parts of Alcohol.]

Dose, Y!^ to sV S T - > [-0005 to .003 gm.] subcutaneously.

ACTION AND THERAPEUTICS OF HOMATROPINE HYDROBROMATE.

Homatropine [hydrobromate] has an action exactly similar,
so far as we know, to that of atropine. It is only used to dilate



382 ORGANIC MATERIA MEDIC A.

the pupil in ophthalmic practice, the advantage over atropine
being that the dilatation produced by homatropine passes off in a
quarter of the time. It may be applied as a solution, [i in]
distilled water [120.] Sometimes a solution in castor oil is used,
for it is less likely to be washed out by the tears, but it may be
rather irritating.

STRAMONIUM.

STRAMONII SEMEN. Stramonium Seed. [The seed of Datura
Stramonium Linn6 (nat. ord. Solanacea). Synonyms. Thorn apple. Stink :
weed. Jamestown Weed. Habitat. Asia ; naturalized in most countries.

CHARACTERS. About 4 mm. long, reniform, flattened, pitted and wrinkled ;
testa dull, brownish- black, hard, inclosing a cylindrical, curved embryo, im-
bedded in a whitish, oily perisperm ; of an unpleasant odor when bruised, and
of an oily and bitter taste. ]

COMPOSITION. The chief constituents are (i) Daturine (.02 to .03
per cent. ) which resembles Atropine but is [probably identical with] Hyoscya-
mine. Usually a little Atropine is present, and the term daturine is occasion-
ally applied to the total alkaloids of Stramonium. (2) [A fixed oil (25 per cent ),
which contains Daturic Acid, C 17 H J4 O 2 .]

INCOMPATIBLE. Caustic alkalies, metallic salts, and mineral acids.

Dose, i to 3 gr. ; [.06 to .20 gm.]

Preparations.

1. Extractum Stramonii [Seminis. Extract of Stramonium
Seed. By maceration and percolation with Diluted Alcohol, and evap-
oration.

Extract of Stramonium Seed is used to prepare Unguentum
Stramonii.

Dose, X t Y* S T - ', -015 to .03 gm.

2. Extractum Stramonii Seminis Fluidum. Fluid Extract of
Stramonium Seed. By maceration and percolation with Alcohol and
Water, and evaporation.

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

3. Tinctura Stramonii Seminis. Tinctura of Stramonium Seed.
Stramonium Seed, 150; Diluted Alcohol, by maceration and percola-
tion to looo.

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

4. Unguentum Stramonii. Stramonium Ointment. Extract of
Stramonium Seed, 10; Diluted Alcohol, 5 ; Benzoinated Lard, 85.]



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 383

STRAMONII FOLIA. Stramonium Leaves. [The leaves of Datura
Stramonium Linne (nat. ord. Solanacece).

CHARACTERS. About 15 cm. long, petiolate, dark-green, smooth, ovate,
pointed, unequal, especially at the base, coarsely and sinuately toothed ; thin,
brittle, and nearly inodorous ; taste unpleasant, bitter and nauseous. ] Resem-
bling Stramonium Leaves. Belladonna leaves, but less wrinkled ; hyoscyamus
leaves, hairy.

COMPOSITION. As of the seeds ; the proportion of alkaloids is very in-
constant.

Dose, i to 5 gr. ; .06 to .30 gm.]

ACTION OF STRAMONIUM.

The physiological action of stramonium is precisely that of
belladonna ; the difference being that stramonium relaxes the
muscular coat of the bronchial tubes more powerfully than bella-
donna, and it may cause the heart to be a little irregular, and
is generally thought to be more active than belladonna.

THERAPEUTICS OF STRAMONIUM.

There is no reason why stramonium should not be employed
for the same purposes as belladonna, but it is rarely used, except
in cases of [the existence of the symptom] asthma, to relieve
the spasm of the bronchial tubes. For this it is very valuable.
Cigarettes of the leaves may be smoked, or the drug may be
given internally. The following powder, which gives off dense
fumes if burnt, is said to afford great relief for asthma : Leaves
of Datura Stramonium, Datura Tatula [not official], Cannabis
Indica, and Lobelia Inflata, all in powder, of each 12 ; nitre in
powder, 16 ; oil of eucalyptus, i. Mix thoroughly. Himrod's,
Bliss', and other "cures" for asthma are of similar composi-
tion.

HYOSCYAMUS.

HYOSCYAMUS. {Synonym. Henbane. The leaves and flowering
tops of Hyoscyamus Niger Linne (nat. ord. Solanacece^ collected from plants
of the second year's growth. Habitat., Europe and Asia; naturalized in
some parts of North America.

CHARACTERS. Leaves ovate, or ovate-oblong, up to 25 cm. long and 10
cm. broad ; sinuate-toothed, the teeth large, oblong or triangular ; grayish-
green and, particularly on the lower surface, glandular-hairy; midrib promi-



384 ORGANIC MATERIA MEDICA.

nent; flowers nearly sessile, with an urn-shaped, five toothed calyx, and a
light yellow purple- veined corolla ; odor heavy, narcotic ; taste bitter and
somewhat acrid.]

COMPOSITION. The chief constituents are (i ) Hyoscyamine, C^H^NOj,
an alkaloid. It is very closely allied to the active alkaloids of belladonna and
stramonium (see p. 382) and is also contained in many plants of the natural
order Solanace<z. It, like Atropine, with which it is isomeric, consists of
Tropic Acid and Tropine. There is in commerce an amorphous impure Hy-
oscyamine, which is a dark brown extract-like fluid having a disagreeable
odor. As it is much cheaper than the crystalline alkaloid, it is often used,
[but this as well as other specimens should be proscribed.] (2) Hyoscine [see
p. 385], a white crystalline alkaloid. It is [stated to be] the same as Scopola-
minf, an alkaloid isomeric with cocaine. Only its salts are used.

INCOMPATIBLE^. Vegetable acids, silver nitrate, lead acetate, and
alkalies.

Dose, 5 to 15 gr. ; [.30 to i.oo gm.]

Preparations.

1. Extractum Hyoscyami. [Extract of Hyoscyamus. By
maceration and percolation with diluted Alcohol and evaporation.

Dose, y 2 to 2 gr. ; .03 to .12 gm.]

2. Extractum Hyoscyami Fluidum. [Fluid Extract of Hyoscy-
amus. By maceration and percolation with Alcohol and water, and
evaporation.

Dose, 5 to 15 m. ; .30 to i.oo c.c.]

3. Tinctura Hyoscyami. [Tincture of Hyoscyamus. Hyoscy-
amus, 150 ; diluted Alcohol to 1000. By maceration and percolation.

Dose i c.c.



[HYOSCYAMINE SULPHAS. Hyoscyamine Sulphate. (C,,^
NOj)jH.,SO 4 =674.58. The neutral sulphate of an alkaloid prepared from
Hyoscyamus.

SOURCE. Hyoscyamus is treated with Ether, to remove fat, then with
Alcohol acidulated with Sulphuric Acid and distilled. The aqueous residue
is neutralized with Soda, and the liquid precipitated with Tannic Acid, the
precipitate mixed with Lime, then exhausted by strong Alcohol. The Alco-
holic solution is treated with Sulphuric Acid, then with Soda, and finally with
Ether, which dissolves the alkaloid, which is obtained from it by distillation.

CHARACTERS. White, indistinct crystals, or a white powder, without
odor, and having a bitter, acrid taste ; deliquescent in damp air. Solubility.
In 0.5 part of water, and in 2.5 parts of Alcohol ; very slightly soluble in
Ether or Chloroform.

Dose, ^3 to 3*5 gr. ; .001 to .002 gm.



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 385

HYOSCYAMINE HYDROBROMAS. Hyoscyamine Hydrobro-
mate. C 17 H 23 NO 3 HBr=369. 14. The hydrobromate of an alkaloid obtained
from Hyoscyamus.

CHARACTERS. A yellowish- white, amorphous, resin- like mass, or pris-
matic crystals, having, particularly when damp, a tobacco-like odor, and an
acrid, nauseous, and bitter taste ; deliquescent on exposure to air. Solubility.
In about 0.3 part of water, 2 parts of Alcohol, 3000 parts of Ether, or 250
parts of Chloroform.

Dose, ^ to jg ? ', > to .002 gm.

HYOSCIN^E HYDROBROMAS. Hyoscine Hydrobromate. C 1T
H 21 NO 4 HBr-(-3H 2 O=436.98. The Hydrobromate of an alkaloid obtained
from Hyoscyamus.

CHARACTERS. Colorless, transparent, rhombic crystals, odorless, and
having an acrid, slightly bitter taste ; permanent in the air. Solubility. In
1.9 parts of water, and in 13 parts of Alcohol; very slightly soluble in Ether
or Chloroform.

Dose, T ^j to T fo gr. ; .0004 to .0006 gm.]

ACTION OF HYOSCYAMUS.

That the action of hyoscyamus is almost identical with that
of belladonna and stramonium is not surprising when we re-
member the close resemblance in alkaloidal composition. The
following are the chief points of difference : (i) Hyoscyamus
contains hyoscine in minute quantities. This is a powerful
cerebral and spinal sedative, and therefore the excitation
and delirium occasioned by the atropine in belladonna are not
so evident when hyoscyamus is given ; indeed, that may, owing
to the hyoscine in it, distinctly depress the higher functions of
the brain. The heart is not quite so powerfully affected by hy-
oscyamus as by belladonna, for hyoscine has a comparatively
feeble cardiac influence. Still it is, of course, affected by the
hyoscyamine, which acts like atropine. (2) Hyoscyamus
increases the peristaltic contractions of the intestines
more powerfully than belladonna, and at the same time it is
more efficient in relieving the griping of other purgatives.
(3) Hyoscyamus has a more markedly sedative action on
the urinary unstriped muscle than belladonna. (4) Hyos-
cine diminishes intra-ocular tension, therefore hyoscyamus does
not affect this so much as belladonna.

25



386 ORGANIC MATERIA MEDICA.

THERAPEUTICS OF HYOSCYAMUS.

Hyoscyamus might be used for the same purpose as bella-
donna, but is chiefly employed in combination with purgatives
to diminish their griping action. It is also largely given to re-
lieve vesical spasm in calculus, cystitis, and prostatitis, usually
in conjunction with other urinary sedatives, as buchu, uva ursi,
or benzoic acid if the urine is alkaline. It will be noticed that
the doses of the preparations of hyoscyamus are larger than those
of the corresponding preparations of belladonna.

Hyoscine and hyoscyamine may, if given cautiously, be em-
ployed as cerebral depressants, and are used in acute mania, de-
lirium tremens, febrile delirium, and insomnia, sometimes with
good results. They are mostly given in asylum practice. Hy-
oscine is most used, and is usually given subcutaneously.
Chorea, paralysis ag'tans, and other convulsive diseases have
been treated with them, but the convulsions always recur when
these drugs are discontinued. They must be given very care-
fully, as the activity of different specimens varies, and fatal re-
sults have followed their use. They should never be employed
if the patient is weak.

DUBOISIN^E SULPHAS. Duboisine Sulphate. (Not official.)
The Sulphate of the alkaloid Duboisine obtained from the leaves of Duboisia
myoporoides, [nat. ord. Solanace<e\. Duboisine is probably identical with
Hyoscyamine (see p. 384).

ACTION AND THERAPEUTICS OF DUBOISINE.

The action of duboisine is like that of atropine, and ophthal-
mic discs containing ^nr of a grain [.000013 & m -] are use d to
dilate the pupil.

CANNABIS INDICA.

[INDIAN CANNABIS. Synonym. Indian Hemp. The flowering
tops of the female plant of Cannabis saliva Linne (nat. ord. Urticacece), grown
in the East Indies. Habitat. Asia ; collected in India.

CHARACTERS. Branching, compressed, brittle, about 5 cm. or more long,
with a few digitate leaves, having linear-lanceolate leaflets and numerous,
sheathing, pointed bracts, each containing two small, pistillate flowers, some-
times with the nearly ripe fruit, the whole more or less agglutinated with a



DRUGS ACTING CHJEFLY ON THE NERVOUS SYSTEM. 387

resinous exudation. It has a brownish green color, a peculiar, narcotic odor,
and slightly acrid taste. ]

COMPOSITION. [The chief constituents are (I) Cannabinon, a soft resin.
(2) Choline, C 5 H J5 NO 2 , which is contained in (3) Tetanocannabine, and with
alkalies gives (4) Cannabinine. (5) Cannabin, a brown, amorphous resin,
said to be very active. ]

INCOMPATIBLE. Water, which precipitates the resin.

Dose, 2 to 5 gr. ; [.12 to .30 gm.]

Prepa rations.

1. Extractum Cannabis Indicae. [Extract of Indian Cannabis.
By maceration and percolation with Alcohol, and evaporation.

Dose, \ to % gr. ; .01 to .045 gm.

2. Extractum Cannabis Indicae Fluidum. Fluid Extract of
Indian Cannabis. By maceration, percolation with Alcohol, which is
distilled off, and evaporation.

Dose, 2 to 5 m. ; .12 to .30 c.c.

3. Tinctura Cannabis Indicae. Tincture of Indian Cannabis.
Indian Cannabis, 5 ', Alcohol, by maceration and percolation, to 1000.

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

Synonyms. Haschisch is a confection of the drug. Gunjah, or Ganga, is
the dried flowering tops of the cultivated female plants which are coated with
resin. Churrus or Charas is the resin scraped off the leaves. Bhang [or
Siddhi] is the dried leaves [and stalks made with preserved fruits into a con-
fection]. In some provinces it means powdered Ganga made into a drink.
Ganga and Charas are often smoked like tobacco.

ACTION OF CANNABIS INDICA.

External. None is known.

Internal. The effects of cannabis indica vary very much
on different people. This is partly due to the uncertain strength
of the preparations of the drug, and partly to individual pecu-
liarities, but generally the symptoms are somewhat as follows.
After some time, usually from half an hour to two or three hours,
there is a pleasurable sensation of mild intoxication ; the patient
is particularly gay, joyous, and pleased with everything ; he will
laugh and smile on the slightest provocation, and is himself able
to say sharp, witty things. Pleasant ideas flit through his mind
with wonderful rapidity, so that time seems to him much [pro-
longed ; space also seems to be extended] . Generally the ideas



388 ORGANIC MATERIA MEDICA.

are quickly forgotten, but sometimes the memory of them re-
mains after recovery. The eyes are bright, the pupils may be
dilated. The limbs feel heavy, and there is a marked lowering
of general sensibility, so that he scarcely feels a severe pinch ;
this may pass on to complete anaesthesia. There may be head-
ache. After a time sleep, which is often accompanied by de-
lightful dreams, comes on. [On awakening the sense of hunger
is acute.] The drug is frequently taken in the East to produce
the early pleasurable symptoms, and, in moderation, it causes no
harm. Very few take it to excess, but in them it leads to loss
of appetite and strength, trembling and much weakness. Can-
nabis indica is reputed to occasionally produce sexual excite-
ment, but this is incorrect. Large doses given to a dog only
made him sleepy, and uncertain on his legs, but he appeared
contented and pleased. Much the same results followed when a
monkey was made to inhale the smoke daily for six months.

THERAPEUTICS OF CANNABIS INDICA.

It has been given with success in migraine and neuralgia, but
it very often fails to afford relief. Its use as an hypnotic has
been discarded. The tincture is very difficult to prescribe, be-
cause of the voluminous precipitate of resin which falls on the
addition of water. Mucilage must be used to suspend it, and
the taste should be covered with spirit of chloroform.

CAFFEINA.

CAFFEINE. C 8 H 10 N 4 O,-f-H,O=2i i. 68. Synonyms. Theine. Guar-
anine. [A feebly basic, proximate principle, obtained from the dried leaves
of Thea sinensis Linn6 (nat. ord. Ternstrccmiacetf], or from the dried seed of
Coffea arabiea Linne (nat ord. Rubiacea), and found also in other plants.
Habitat. Tropical Africa ; cultivated in tropical countries.

SOURCE. Exhaust bruised coffee by successive portions of boiling water,
precipitate with Lead Acetate, decompose the excess of Lead Acetate in the
filtrate by Hydrogen Sulphide, concentrate by evaporation, neutralize with
Ammonia. The Caffeine crystallizes on cooling, and is purified by re-dissolving
in water, treating with Animal Charcoal, and evaporation.

CHARACTERS. Fleecy masses of long, flexible, white crystals, possessing
a silky lustre, without odor, having a bitter taste, and permanent in the air.
Solubility. In 80 parts of water, 33 parts of Alcohol, 555 parts of Ether, or



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 389

7 parts of Chloroform.] Tea contains 3 to 5 per cent, (hence the name Theine),
Coffee, 1.3 per cent, (coffee leaves contain much more). Guarana (the seeds of
Paullinia [Cupana]), [4 to] 5 per cent, (hence the name Guaranine). Mate
(Paraguay tea, the leaves of Ilex paraguayensis), 1.2 per cent. Kola nut
(which is used as a beverage in Africa), 3 per cent. ; this is the fruit of Sier-
culia acuminata. Caffeine is trimethyl-xanthine, theobromine is dimethyl-
xanthine, and both can be prepared synthetically from xanthine.

[Strictly speaking, Theine is the alkaloid of tea-leaves. It differs from
caffeine in that it is analgesic and constipates. Much of the caffeine in the
market is really theine and is made from the sweepings of tea- warehouses. ]

INCOMPATIBLES. Potassium iodide, mercury salts, and tannic acid.

Dose, i to 5 gr. ; [.06 to .30 gm.]

Preparations.

[i. Caffeina Citrata. Citrated Caffeine. Dissolve Citric Acid,
50, in hot Distilled Water, 100 ; add the Caffeine, 50, and evaporate the
resulting solution on a water-bath to dryness, constantly stirring towards
the end of the operation. Reduce the product to a fine powder.

CHARACTERS. A white powder, odorless, having a purely acid
taste and an acid reaction. Solubility. One part of Citrated Caffeine
forms a clear, syrupy solution with about 3 parts of water.

Dose, 2 to 8 gr. ; .12 to .50 gm.

2. Caffeina Citrata Effervescens. Effervescent Citrated Caf-
feine. Caffeine, 10 ; Citric Acid, 10 ; Sodium Bicarbonate, 330 ; Tar-
taric Acid, 300 ; Sugar, 350 ; Alcohol, to make looo. Triturate the
solid ingredients, separately well dried, to a fine uniform powder. Mix
this with Alcohol to a soft paste and rub it through a sieve. Then dry
it, and reduce it to a coarse, granular powder.

Dose, i to 4 dr. ; 4. to 15. gm.]

ACTION OF CAFFEINE.

External. None.

Internal. Alimentary canal. Excessive tea-drinking may
cause indigestion, but this is probably induced by the tannic acid
in the tea, and not by the caffeine. The teeth of tea tasters are
very liable to decay. Coffee is, with some persons, slightly lax-
ative ; it is not known to what ingredient this is due.

Circulation. Caffeine is freely absorbed. It produces no
change in the blood. Moderate doses increase the force of
the cardiac contraction and the duration of the systole,
the diastolic period being shortened ; as a consequence of this



39 ORGANIC MATERIA MEDICA.

the blood -pressure rises. The pulse is usually slowed. Toxic
doses paralyze the heart. These effects are largely due to the
direct action of caffeine on the cardiac muscle, but also to an
action on the inhibitory centres.

Vessels. Caffeine causes first a constriction and then a dilata-
tion of the arterioles of the body, and this is due principally to
its action on the muscular coat and slightly to its action on vaso-
motor centres.

Respiration. In animals the rate of breathing is increased by
caffeine. Medicinal doses are said to excite and toxic doses to
depress it.

Nervous system. It is well known that tea and coffee stimu-
late the cerebrum. This is due to the caffeine in them. The
patient becomes wakeful, the mental activity and capability for
work are increased, the reasoning powers being quite as much
affected as the imagination. In this respect the cerebral stimu-
lation of caffeine differs from that of opium, and also in that the
excitation is not inco-ordinate, nor is it soon replaced by sleep.
Very excessive tea-drinking causes trembling of all the muscles
of the body, and makes the patient extremely "nervous."

In man the spinal cord and muscles are very little affected by
caffeine, but in some frogs the spinal cord is decidedly stimu-
lated, and convulsions occur ; in other species the muscles are
thrown into a state of rigidity, which is clearly due to an action
on the muscles themselves, for it follows the application of caf-
feine to an isolated muscle. Sometimes the muscle curve is
altered in character. It is believed that in man the powers of
muscular endurance are increased by caffeine. Motor and sen-
sory nerves are uninfluenced in all animals.

Kidneys. As caffeine first causes a contraction of arterioles
there is decrease in the urinary flow ; but soon the renal vessels
dilate, the renal cells are stimulated and the flow of urine is in-
creased. Thus caffeine is a good local diuretic.

Metabolism. Many elaborate experiments have been made
upon the action of caffeine on tissue waste ; they are all of them
inconclusive, [probably] because it has no effect. It increases
the excretion of xanthin in the urine ; probably this xanthin is



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 39!

derived directly from it, and the increased urea said to be ex-
creted may also proceed directly from the caffeine. Toxic doses
may cause a slight rise of temperature.

THERAPEUTICS OF CAFFEINE.

Heart. Caffeine has been most used in heart disease. It is
given when, as in aortic or mitral obstruction, a purely stimulant
effect is desired ; large doses, 3 or 8 gr. [.20 to .50 gm.] a day
of the [citrated, or 2 to 6 dr., 8. to 24. gm., of the effervescent
citrated] , are often easily borne, and may be combined with
strychnine. [These preparations are useful, when combined
with antipyrin or acetanilid derivatives, to counteract their de-
pressing influence upon the heart.] Caffeine will not replace
digitalis, for it does not slow the heart nor make it regular, and
it shortens the diastole. It is, on account of its diuretic action,
especially valuable in cardiac cases in which there is dropsy.
Tea and coffee are, in some persons, liable to produce irregularity
of the heart.

Kidney. Small doses of caffeine are powerfully diuretic, and
are therefore used in heart disease, ascites, pleuritic effusion, etc.



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