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administered boldly ; the extract has often been given, but it is
better to inject physostigmine sulphate under the skin. Doses
f Vis g r -> [-002 gm.], frequently repeated, may be employed,
but the patient must be carefully watched. Physostigmine has
been given as an antidote for strychnine poisoning.

Eye. [A solution of physostigmine salicylate i or 2, to
water, 480 ; is dropped] in the eye to break up adhesions of the
iris, to diminish intra-ocular tension, and to prevent prolapse of
the iris after wounds,or ulcers of the cornea. It is also em-
ployed in glaucoma, in paralysis of the iris and ciliary muscles,
and to prevent the entrance of light into the eye in photophobia.

ANTAGONISM.

It will be observed that in its actions on the pupil, on secretion, on the
heart, and on respiration, physostigmine is antagonistic to atropine. In its
action on the spinal cord and respiratory centre it is antagonistic to strychnine.

[MUSCARINA.

MUSCARINE. (Not official). C 6 H 15 NO,= I36. 74. An alkaloid ob-
tained from Amanita Musearia, Fly Fungus. Habitat. Russia and North-
ern Europe.

CHARACTERS. A liquid of the consistence of syrup, without odor or taste.
Solubility. Nearly in water and Alcohol ; insoluble in Ether and Chloroform.

Dose, ^ to 2 m. ; .008 to .12 c.c.



DRUGS ACTING f HIEFLY ON THE NERVOUS SYSTEM. 403

ACTION AND USES OF MUSCARINE.

Muscarine in its action somewhat resembles Calabar bean, and
it is antagonistic to atropine. It produces free salivation, abun-
dant perspiration, diminution of the force and frequency of the
pulse, dyspnoea, paralysis and finally death. The pupil is con-
tracted ; dilating, however, before death. The cardiac diastole
is prolonged, due to action upon the inhibitory nerves. The
muscles of the intestines and bladder are markedly contracted.
The abdominal secretions are increased. Although it has been
but little used in medicine, it is likely to be useful in intestinal
torpor, duodenal catarrh, and in inflammatory effusions and exu-
dations. As it produces contraction of pulmonary capillaries, it
is indicated in pulmonary haemorrhage and incipient pulmonary
congestion.]

GELSEMIUM.

GELSEMIUM. Synonym. Yellow Jasmine. [The rhizome and roots
of Gelsemium sempervirens (Linne) Persoon (nat. ord. Loganiaceez). Habitat.
Southern United States.

CHARACTERS. Cylindrical, long, or cut in sections, mostly from 5 to 15
mm. and occasionally 3 cm. thick, the roots much thinner ; externally light
yellowish-brown, with purplish-brown, longitudinal lines ; tough ; fracture
splintery ; bark thin, with silky bast-fibres, closely adhering to the pale yel-
lowish, porous wood, which has fine, medullary rays, and in the rhizome a
thin pith ; odor, aromatic, heavy ; taste bitter.]

COMPOSITION. The chief constituents are (l) Gelsemine, [C^H^N^,,
a colorless, with difficulty crystallizable, bitter alkaloid, soluble in Alcohol and
Ether, sparingly in water. (2) Gelseminine, a brown, amorphous, bitter alka-
loid, very poisonous. (3) Gelseminic Acid. (4) A volatile oil.

Dose, 5 to 10 gr. ; .30 to .60 gm. Of Gelsemine hydrochlorate (not
official), ^ to ^ gr. ; .001 to .003 gm.

Preparations.

1. Extractum Gelsemii Fluidum. Fluid Extract of Gelsemium.
By maceration and percolation with Alcohol and evaporation.

Dose, 5 to 10 m. ; .30 to .60 c.c.

2. Tinctura Gelsemii. Tincture of Gelsemium. Gelsemium,
150 ; by maceration and percolation with Alcohol, to looo.

Dose, ]^ to i fl. dr. ; i. to 4. c.c.]



404 ORGANIC MATERIA MEDICA.

ACTION OF GELSEMIUM.

External. None.

Internal. Gelsemium produces no effect on the stomach or
intestines. Its powerful general physiological effects are due to
the gelseminirie in it.

Brain. In poisoning by gelsemium consciousness is main-
tained till the end ; the drug, therefore, has no power on the
higher cerebral centres.

Spinal cord. The most marked symptom produced by gelse-
mium is paralysis of all the muscles of the body ; and by a
series of experiments, like those used for strychnine, this can be
shown to be due to depression of the activity of the ante-
rior cornua of the spinal cord. This is said to be followed by
a depression of the sensory part of the cord, with consequent
anaesthesia. The motor nerves are quite unaffected till just
before death, when the end-plates are paralyzed. The result of
the action on the cord is that the patient may be unable to walk,
or, if he can, the gait is staggering ; his general sensibility is
much impaired. Convulsions may be produced. The cause of
these cannot be made out, for they appear to be neither cerebral,
spinal, nor peripheral.

Eye. Gelsemium soon causes disturbance of vision, then
follows diplopia, due to paralysis of the ocular muscles,
and from the same cause the upper lid drops. The pupil is
dilated. All these symptoms are probably owing to the paralysis
of the motor centres in the floor of the fourth ventricle and the
aqueduct of Sylvius, for these are the continuation upwards of
the anterior cornua.

Circulation. The action of moderate doses is not marked.
Toxic doses are powerfully depressant ; the force and rate of the
pulse and the blood-pressure fall; This is owing to a direct ac-
tion on the ends of the vagus. How far these effects are due
also to affection of the medullary and spinal centres is not
known.

Respiration. Soon after the administration of gelsemium the
respiration becomes slower and more feeble ; ultimately it stops,
death taking place by asphyxia. This is due to paralysis of



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 40$

the respiratory centres in the cord and medulla. Before death
the temperature falls, and the skin is bathed in a cold sweat.

THERAPEUTICS OF GELSEMIUM.

Gelsemium was formerly given [as a circulatory depressant,
but it is not now used, as its other effects are so harmful. Nor
is it any longer prescribed for convulsive diseases, as tetanus,
whooping-cough, chorea, etc., as it was not found to do any
good. It is often successfully used for neuralgia and migraine ;
how it acts is quite uncertain.] A good combination for neuralgia
and migraine is gelsemine hydrochlorate -Z&G gr. [-0003 gm.jwith
butyl chloral hydrate, 3 gr. [.20 gm.] made into a pill with mu-
cilage, and given every two hours until pain is relieved. Some-
times it is employed to dilate the pupil and paralyze accommo-
dation. It will do this when applied locally, for it is quickly
absorbed from the eye. [It has the advantage that its influence
passes off rapidly.] Discs [of gelatin], each containing ^5 gr.
[.00013 gm.] gelsemine (not official), are made for application
to the eye.

CLASS III. DRUGS ACTING CHIEFLY ON THE NERVES.
[A. The following depress the motor nerves.]

CONIUM.

CONIUM. Synonym. [Spotted Hemlock. The full grown fruit of
Conium Maculatum, Linn6 (nat. ord. Umbellifera:')^ gathered while yet green.
Habitat. Europe and Asia ; naturalized in North America.

CHARACTERS. About 3 mm. long ; broadly ovate, laterally compressed ;
grayish-green ; often divided into the two mericarps, each with five crenate
ribs, without oil-tubes, and containing a seed which is grooved on the face ;
odor and taste slight.] Resembling conium fruit. Caraway, anise, dill, all
known by having viitffi [oil-tubes].

COMPOSITION. [The chief constituents are (I) Coniine, C 8 H, 7 N, the
active principle ; a colorless, oily, volatile alkaloid, of a disagreeable odor
and acrid taste.] Solubility. In 100 parts of water. It is easily obtained
from the plant by distillation with alkalies. It is readily decomposed by light
and heat, and the preparations of Conium are therefore of very varying
strengths. Its salts are much more stable. (2) Methyl-coniine, C 8 H 19 CN. A



406 ORGANIC MATERIA MEDICA.

colorless, liquid alkaloid. (3) ConhyJrine, a nearly inert crystallizable alka-
loid.

INCOMPATIBLE^. Caustic alkalies, vegetable acids and astringents.

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

Preparations.

1. [Extractum Conii. Extract of Conium. By maceration and
percolation with Diluted Alcohol and Acetic Acid, and evaporation.

Dose, y$ to i gr. ; .02 to .06 gm.

2. Extractum Conii Fluidum. Fluid Extract of Conium. By
maceration and percolation with Diluted Alcohol and Acetic Acid, and
evaporation.

Dose, i to 5 m. ; .12 to .30 c.c.]

ACTION OF CONIUM.

External. Coniine probably has no influence on the un-
broken skin, but it has been thought to be anaesthetic when ap-
plied to painful broken surfaces. This is doubtful, for, in the
first place, we have no proof that it can be absorbed from sores ;
and, secondly, experiments show that large doses have to be given
to depress the activity of sensory nerves.

Internal. Gastro-intestinal tract. It has no special action
here, but it may occasionally give rise to vomiting and diarrhoea.

Circulation. Coniine is absorbed into the blood, and circu-
lates unchanged. Probably it paralyzes the terminations of the
vagus and so increases the rapidity of the cardiac beat. The
heart beats long after breathing has ceased.

Respiration. Owing to the profound paralysis of all motor
nerves, and the later depression of the respiratory centre and
motor part of the cord, death takes place from enfeeblement of
respiration and consequent asphyxia.

Nervous system. Nerves. Coniine powerfully depresses
all the motor nerves. This depression begins at the periph-
ery, and gradually ascends till the whole nerve, up to the spinal
cord, is incapable of responding to stimuli. This leads to paral-
ysis of all the muscles of the body so far as voluntary and reflex
motion is concerned, but they themselves are unaffected, retain-
ing their irritability to local stimuli. The sensory nerves are not



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 407

implicated unless the dose is very large ; then their conducting
power is slightly impaired. The effects on nerves are well illus-
trated in the death of Socrates, for he was directed to walk about
until his legs felt heavy (motor paralysis), and later, when his
foot was pressed he could not feel.

Spinal cord. This remains uninfluenced till quite late ; then,
if poisonous doses have been given, the function of its motor
cornua is feebly depressed, as is also that of the respiratory centre
in the medulla. These actions are probably due to the methyl-
coniine. As the amount of this is variable in the different spec-
imens, the exact period at which these effects come on varies
with different preparations. In some animals asphyxial convul-
sions are very marked.

Brain. Except for the respiratory centre the whole of th*
brain is unaffected by coniine. Consciousness is preserved until
the stage of asphyxia.

Eye. Coniine, when dropped into the eye, causes immediate
contraction of the pupil reflexly from the conjunctival irritation.
But soon the pupil dilates, and accommodation is paralyzed;
the same usually happens when the drug is given internally.
Probably these results are owing to paralysis of the terminal por-
tions of the third nerve, for well-marked ptosis v which is due
to this cause, is present.

Coniine is excreted unchanged, chiefly in the urine.

THERAPEUTICS OF CONIUM.

External. Conium has been applied to gainful ulcers and
sores, but it is, for the reasons already given, doubtful whether
it produces any good effect. It has also been employed for
myalgia and rheumatism, but it is quite useless.

Internal. Conium is rarely given as a medicine, for (#) the
amount of coniine extracted by any preparation is very variable ;
() the amount in the same part of different plants is incon-
stant ; (t~) the amount of methyl-coniine present is also very un-
certain ; (V) coniine is very volatile ; (e) it is unstable, light
and air making it inert. For these reasons it is probable that



408 ORGANIC MATERIA MEDICA.

often the pharmacopoeial preparations contain no coniine at all.
Ounces of the succus [B. P., which is the expressed juice of the
leaves and young branches, to which 25 per cent, of alcohol has
been added], and which is believed to be the most reliable
preparation, have frequently been swallowed without producing
any effects. The preparations of the fruit are said by some to be
more reliable than those of the leaves. Conium has been given
in spasmodic diseases, as whooping-cough, in chorea, tetanus,
asthma, and epilepsy, but in all it does little or no good.

TOXICOLOGY.

Symptoms. The symptoms produced by a poisonous dose are in strict ac-
cordance with the physiological action. The sufferer feels his legs to be
heavy ; on attempting to walk he staggers, and finds he can hardly move them,
and finally he has to lie down because he has no power over them. The arms
become powerless, and lie motionless at his side. There is ptosis, and dim-
ness of vision from paralysis of accommodation ; the eyes are fixed, the pupil
is dilated. Swallowing becomes difficult. Respiration is labored, the voice
is lost, and death takes place from asphyxia. Post-mortem. The organs are
found congested with venous blood.

Treatment. Emetics (see p. 139), and wash out the stomach. Give tan-
nic acid and again wash it out. Stimulants subcutaneously, warmth to the
feet, and artificial respiration [are necessary].

TABACUM.

[TOBACCO. The commercial dried leaves of Nicotiana Tabacum (nat.
ord. Solanacete). Habitat. Tropical America ; cultivated.

CHARACTERS. Up to 50 cm. long, oval or ovate-lanceolate, acute, entire,
brown, friable, glandular-hairy, of a heavy, peculiar odor, and a nauseous,
bitter, and acrid taste.]

COMPOSITION. The chief constituent is (i) Nicotine, [C 10 H 14 N.,(o.7 to
5, sometimes n per cent.)]. A colorless, volatile, oily alkaloid, smelling and
tasting like Tobacco leaves, darkening with age. Solubility. Soluble in
water, more so in Alcohol and Ether. Turkish Tobacco contains hardly any.
(2) Nicotianine. (3) Salts and flavoring agents.

[Nicotine is decomposed by heat, consequently Tobacco smoke contains
none(Binz), but consists of small quantities of various Pyridine compounds, as
Pyridine C 5 H 5 N, Picoline C 6 H 7 N, Lutidine C T H 9 N, Collidine C 8 H,,N,
Parvoline C B H, 3 N, Coridine C 10 H 15 N, Rubidine C,,H 17 N, and small amounts
of Hydrocyanic and Acetic Acids, Creosote, Sulphur, and Carbon com-
pounds.]



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 409

ACTION OF TOBACCO.

Tobacco leaves, when taken internally, act entirely by virtue
of their nicotine, which is one of the most powerful and
rapid poisons known.

External. Nicotine is an antiseptic.

Internal. Gastro-intestinal tract. Nicotine in even minute
doses (^ gr. [.009 gm.]) promptly produces greatly increased
salivary flow, burning pain in the mouth, oesophagus and stomach,
horrible nausea, quickly succeeded owing to its action on the
gastro-intestinal muscle by vomiting and free purging. The
marked characteristic of this gastro-intestinal irritation is the
extreme collapse which accompanies it. Thus there is a
rapid, very feeble pulse, intense muscular weakness, labored
respiration, partial loss of consciousness, occasional convulsions,
icy extremities, and profound general collapse. A dose of nico-
tine has been known to kill in three minutes, but in both man
and animals a certain tolerance may be acquired.

Circulation. Nicotine disintegrates the red blood-corpuscles
of freshly-drawn blood, but has not this effect upon living blood,
although the spectrum of haemoglobin is altered, so that the
corpuscles must be in some way affected. The action on the
heart is obscure ; the muscle itself is unaffected, but the rapid-
running, feeble pulse shows that some part of the cardiac appa-
ratus is powerfully influenced. The blood-pressure falls rapidly ;
this is not entirely due to the action of nicotine on the heart,
but is in part due to its peripheral action on the vessels.

Respiration. This is at first accelerated and deepened ; ulti-
mately it is paralyzed from depression of the centre. Death is
partly due to asphyxia.

Nervous system. The higher faculties are depressed by large
doses of nicotine, for those poisoned by it become comatose
within even a minute or two of taking a large dose. The con-
vulsions occasionally observed in man, and always in the frog,
are due to spinal stimulation. All observers are agreed that ulti-
mately the function of the motor nerves is entirely
abolished. This explains the intense muscular weakness.
Probably the sensory nerves, and certainly the muscles, escape.



4IO ORGANIC MATERIA MEDICA.

Eye. A toxic dose taken internally, or the local application
of nicotine to the eye, contracts the pupil of man and most
animals. This will occur in excised eyes, and is therefore a local
effect. With some animals nicotine is a mydriatic. We know
nothing of the details of its action.

Secretion. Nicotine first stimulates but ultimately paralyzes
the secretory structures of the salivary, sweat and lachrymal
glands.

Elimination. Nicotine is eliminated partly by the lungs, but
chiefly in the urine, the secretion of which it increases.

THERAPEUTICS OF TOBACCO.

Tobacco is never used therapeutically. [In non-smokers it is
useful to relieve the symptom asthma.] Formerly it was em-
ployed in the form of an enema of leaves to relax muscular
spasm, so as to facilitate the reduction of dislocations. This
enema was also sometimes given as a purgative. [Pyridine which
is found in tobacco, but commercially is obtained from other
sources, when administered by inhalation will frequently relieve
the paroxysms of asthma. For this purpose a fluid drachm ;
4. c.c., is necessary, placed in a dish, so that it may slowly
evaporate. Its persistent and abominable odor is a great obstacle
to its use.]

Tobacco smoking, in those who are unaccustomed to it, pro-
duces, to a greater or less degree, the symptoms of gastro-intes-
tinal irritation and collapse just mentioned. Even in those who
are used to it the smoke may produce catarrh of the pharynx.
Some persons find smoking after breakfast assists the daily action
of the bowels. With many people it has an obscure effect, espe-
cially among those who lead sedentary lives, in stimulating the
brain and. producing a peaceable, calm state of mind. Over-
indulgence in it may lead to loss of appetite, irregularity of the
heart, chronic laryngeal and pharyngeal catarrh, and retrobulbar
neuritis of the optic nerve. The effect of this is that the sufferer
complains that objects look misty, he has a central scotoma,
sometimes complete, often only for red and green, and finally
atrophy of his optic nerve.



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 4! I

[TOXICOLOGY.

Symptoms. The symptoms are those which we should expect from its
physiological action.

Treatment. Tannic acid followed by emetics (see p. 139). Strychnine is
the true physiological antidote. Alcohol and ammonia stimulate the heart.
The recumbent position must be maintained. Artificial respiration may be
necessary. ]

[B. The following depresses the motor end-plates.]

[CURARA.]

CURARE. (Not official.) Synonyms. Wourara. Ourari. Urari.
Wourali. The South American arrow poison, prepared from species of Strych-
nos and other plants.

CHARACTERS. A blackish-brown, dry extract, [brittle or hygroscopic, with
a bitter taste. Solubility. Almost completely in diluted Alcohol.]

COMPOSITION. It contains an extremely active poison, Curarina or Cura-
rine, [C 18 H 35 N,] a yellowish-brown powder intensely bitter.
Dose, ^ to Yi gr. ; [.0025 to .03 gm.]

The British Pharmaceutical Conference [proposes for hypodermatic injec-
tion of Curara :] Curare, I ; add distilled water to form a thin paste. Put in
a funnel plugged with absorbent wool, and gradually add more water until 12
parts are obtained. Of this the dose is I to 6 m. ; [.06 to .25 c.c.]

Lamellae or discs, each containing ^ gr. ; [.003 gm.] are also prepared.
They are dissolved in a few drops of water before injection subcutaneously.

ACTION AND THERAPEUTICS OF CURARE.

The physiological action of curare, by which it paralyzes the
end plates of the motor nerves of voluntary muscles, is well
known. It has been given successfully in tetanus, and is pro-
bably the most useful of all the drugs employed for this very
fatal disease.

[C. The following depress the sensory nerves.] //

COCA.

COCA. [Synonyms. Erythroxylon. Cuca. The leaves of Erythroxy-
lon Coca, Lamarck (nat. ord. Linea}. Habitat. Peru and Bolivia ; culti-
vated.

CHARACTERS. Varying between ovate, lanceolate, and obovate-oblong,
and from 2 to 5 or 7 cm. in length ; short-petiolate, entire, rather obtuse or
emarginate at the apex, slightly reticulate on both sides, with a prominent mid-



412 ORGANIC MATERIA MEDICA.

rib, and on each side of it a curved line running from base to apex ; odor slight
and tea-like ; taste somewhat aromatic and bitter. When chewed, it tempo-
rarily benumbs the lips and tongue.]

COMPOSITION. It contains at least three alkaloids, viz., (i) Cocaine, which
is methyl benzoyl ecgonine, 0.2 per cent. ; (2) Cocamine or isatrophyl cocaine ;
(3) Cinnamylcocaine. Also (4) Coca-tannic acid and (5) Coca-wax. Differ-
ent specimens vary very much in strength of Cocaine. Fresh specimens are
stronger than those that have been kept.

INCOMPATIBLE^. Mineral acids (decompose cocaine into benzoic acid and
ecgonine), sodium bromide, menthol, mercury salts and silver nitrate.

[Dose, I to 4 dr. ; 4. to 15. gm. of the leaves infused in hot water.]

Preparation.

Extractum Cocas [Fluidum. Fluid Extract of Coca. By ma-
ceration and percolation with Diluted Alcohol, and evaporation.
Dose, i to 4 fl. dr. ; 4. to 15. c.c.]

COCAINE HYDROCHLORAS. Cocaine Hydrochlorate. C 17 H 21
NOIIC1 [=338.71. The hydrochlorate of an Alkaloid obtained from Coca.

SOURCE. Agitate with Ether an aqueous solution of an acidulated Alco-
holic exlract, make alkaline with Sodium Carbonate ; separate and evaporate
the Ethereal liquid ; purify by repetition ; decolorize, neutralize with Hydro-
chloric Acid, and re-crystallize.

CHARACTERS. Colorless, transparent crystals, or a white, crystalline pow-
der, without odor ; of a saline, slightly bitter taste, and producing upon the
tongue a tingling sensation followed by numbness of some minutes' duration.
Permanent in the air. Solubility. In 0.48 part of water, and in 3.5 parts of
Alcohol ; also soluble in 2800 parts of Ether, or in 17 parts of Chloroform.

Dose, y$ to a gr. ; .008 to .12 gm.]

ACTION OF COCA.

External. Cocaine has little action on the unbroken skin,
but if injected subcutaneously or applied to mucous membranes
as, for example, those of the eye, nose, mouth, rectum, vagina
it produces complete local anaesthesia to pain, touch,
heat and cold, so that small operations can be performed without
the patient feeling them. A 5 to 10 per cent, solution of the
hydrochlorate is strong enough thus to paralyze the sensory
nerves. Much larger doses must be applied to motor nerves to
paralyze them.

Internal. Gastro-intestinal tract. Applied to the nose and
tongue cocaine abolishes smell and taste respectively, and when it



DRUGS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 413

is taken internally, the gastric mucous membrane experiences its
anaesthetic influence. Therefore the sensation of hunger is dead-
ened, and persons taking cocaine can go a long time without feeling
the want of food ; but the drug is not a food, for the body rap-
idly wastes. Because of its local anaesthetic effect it sometimes
stops vomiting. Very large doses may lead to diarrhoea.

Circulation. Large doses depress the vagus, and therefore the
pulse quickens, and as the vaso-motor centre is stimulated the
blood- pressure rises ; larger doses slow the pulse from stimulation
of the vagus. [Cocaine constricts the arterioles] .

Respiration. It acts upon the respiratory centre, first stimu-
lating it, so that the rapidity and depth of respiration are in-
creased ; but soon depression of the centre follows, the respira-
tory movements become feeble, and death takes place from
asphyxia.

Nenwus system. Cerebrum. Moderate doses greatly in-
crease the bodily and mental power, and give a sense of
calm and happiness, with abolition of bodily and mental fatigue.
This greater physical energy renders possible the performance of
long, exhausting muscular feats. For this, and for the extreme
sense of peace produced, coca leaves mixed with clay or ashes
are chewed by thousands of the inhabitants of Peru and the
neighboring countries. It is said that forty million pounds of
the leaves are annually harvested. A single large dose causes
mental excitement, delirium and ataxia, with subsequent head-



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