HUMULUS.

What are the effects, uses, preparations, and doses of humu

lus?

Humulus is the strobiles of H. lupulus or hop vine (Nat. Ord. Urticaceae). Lupulin is a yellow powder found near the base of the strobiles. It contains a volatile oil, choline (formerly called lupuline, a strongly alkaline liquid), lupamaric acid (a bitter principle), resin, etc.

Hops are tonic, very feebly narcotic, anaphrodisiac, and diuretic. They are used as a hypnotic in mild forms of delirium tremens, and in restlessness and sleeplessness from overwork; as an anaphrodisiac in priapism, chordee, nymphomania, and satyriasis; as an antispasmodic and sedative in hysteria and neurasthenia; as a diuretic and anodyne in irritation of the bladder, and locally as an anodyne poultice, and as a sedative injection in acute vaginitis.

Hop pillows are a popular remedy for sleeplessness due to nerv

ousness.

TINCTURA HUMULI (tincture of humulus), dose f3j-iv (4.0–15.0)

or more.

LUPULINUM (lupulin), dose gr. v-x (0.324–0.648), but not much used in this form.

EXTRACTUM LUPULINI FLUIDUM (fluid extract of lupulin), dose f3ss-ij (2.0–8.0).

OLEORESINA LUPULINI (oleoresin of lupulin), dose mx-xxx (0.61-2.0).

LACTUCARIUM.

What are the effects, uses, and preparations of lactucarium? Lactucarium is the concrete milk-juice of Lactuca verosa, the garden lettuce (Nat. Ord. Compositae), and contains lactucin, which is said to be even more feebly hypnotic than the crude drug. Lactucarium is supposed to possess anodyne and hypnotic powers, and has been used as a substitute for opium when the latter is indicated, but cannot, for any reason, be given. Its action, if any, is very mild. TINCTURA LACTUCARII (tincture of lactucarium), dose mx-f3j (0.6-3.6).

SYRUPUS LACTUCARII (syrup of lactucarium), dose f3ij-iv (8.0

ORDER II.-MYDRIATIC ANODYNES.

What are the mydriatic anodynes?

The mydriatic anodynes are remedies employed as analgesics and antispasmodics, which possess no hypnotic effect, but cause dilatation of the pupil and, in large doses, a restless delirium.

What medicines are included under this head?

Belladonna, stramonium, hyoscyamus, duboisa, coca, and their alkaloids, and antipyrine.

What is belladonna ?

BELLADONNA.

Belladonna is the leaves and root of Atropa Belladonna or deadly nightshade (Nat. Ord. Solanaceae), a European plant, cultivated in this country.

What are the chemical constituents of belladonna?

Its properties depend upon an alkaloid called atropine, which exists in the plant as a malate. Both the leaves and the root also contain belladonine (probably oxyatropine), hyoscyamine (sometimes the predominating alkaloid in the leaves and often the only alkaloid in young roots), and atropamine.

What are the tests for atropine?

A delicate test is the addition of hydrobromic acid, which produces a yellow, amorphous precipitate, soon becoming crystalline. The physiological test (viz., the dilatation of the pupil in the lower animals after the local application of the suspected solution) should always be resorted to.

What are the physiological effects of belladonna and its alkaloid?

Applied locally to the skin, it is absorbed, lessens the sensibility of the sensory nerves, and produces constitutional effects. Small doses, administered internally, cause dryness of the mouth and throat, with some headache; after larger amounts, there is difficulty in swallowing, from arrest of the mucous and salivary secretions, the pupils dilate widely, the skin becomes dry and a scarlatinoid rash appears, the cardiac action is accelerated, and an active delirium occurs. In moderate doses, they act as cerebral excitants; larger

doses produce hallucinations and impair the excitability of the motor and sensory nerves, thus producing a peculiar delirium in which there is a great desire for constant motion associated with lassitude. The spinal reflex centres are first stimulated, afterward paralyzed, if the amount taken be sufficiently large. It paralyzes the 3d nerves and stimulates the end organs of the sympathetic, thus dilating the pupil whether used locally or internally; the power of accommodation is also paralyzed, and after large doses the intraocular tension is lessened.

The cardiac action is at first slowed, if the dose be small (from stimulation of the inhibitory centre), but is soon much quickened (from progressive paralysis of the peripheral filaments of the vagus and stimulation of the cardio-accelerator centres or nerves). Large doses paralyze the cardiac muscle. Atropine stimulates the vasomotor centres and raises the arterial pressure, but after toxic doses the arterioles dilate, from paralysis of their muscular walls, and the blood pressure falls. It first stimulates and then paralyzes the respiratory centre. The temperature rises after moderate doses, probably from stimulation of the thermo-genetic spinal centres; but after toxic amounts have been taken a decided fall of temperature occurs, probably from vaso-motor paralysis. Small doses probably increase intestinal peristalsis, by depressing the inhibitory fibres of the splanchnics, while large doses paralyze the non-striated muscular fibres of the intestines and bladder. It arrests the secretions of the skin, mammary, salivary and muciparous glands, and probably of the liver and pancreas, by paralyzing the terminal filaments of the secretory nerves. The intestinal secretions are probably increased, as is that of the kidneys (usually). After large doses, the urine may be entirely suppressed.

Atropine is eliminated principally by the kidneys.

What are the symptoms and treatment of atropine poisoning?

The pupils dilate so widely that the iris can scarcely be seen; swallowing is impossible, from dryness of the throat and mouth; the muscular system is relaxed; maniacal delirium occurs, with impaired sensation, failing pulse, quickened followed by failing respiration, stupor, coma, sometimes convulsions, diminished body heat, and death usually from asphyxia. The treatment consists of: (1)

evacuation of the contents of the stomach (by emetics or stomach pump), bowels (by cathartics) and bladder (by the catheter), to prevent further absorption of the poison; (2) giving tannic acid freely as a chemical antidote; (3) giving pilocarpine, physostigmine or morphine hypodermically, as partial physiological antagonists, and (4) maintaining the circulation and respiration by electricity and artificial respiration.

What are the medicinal uses of belladonna and atropine?

As an anodyne in the various neuralgia, either locally or given by the mouth, rectum or subcutaneously, it is of value, and is often combined with morphine. In muscular rheumatism and in myalgia it is also of service. In conjunctivitis and in iritis it is used locally, not only to dilate the pupil but to lessen pain.

As an antispasmodic it is used to relax spasm and allay pain in lead colic, spasmodic dysmenorrhoea, and cramps of the bowel, bladder and urethra; also to relax the rigid cervix uteri in labor. In asthma, in laryngysmus stridulus and whooping cough it often proves of use. In habitual constipation, a small amount combined with purgatives increases their action by relaxing spasm of the intestinal muscular layer and stimulating peristalsis. It is a valuable remedy in the treatment of incontinence of urine in children when given in doses sufficient to produce some constitutional effect.

As a cardiac and vaso-motor stimulant in all cases of threatened collapse from heart failure it is advantageously employed, and has been highly recommended to contract the blood-vessels in acute inflammatory affections generally. To check excessive secretion, as in salivation, excessive sweating, especially the night-sweats of phthisis, and in colliquative diarrhoea, it is of great value, and is a well-known galactafuge, being used internally and applied locally for this purpose. As a respiratory stimulant in opium poisoning atropine is of great service, and may be used in cases of poisoning by other substances attended with failure of respiration.

Locally, belladonna is used as an ointment, liniment or plaster for the relief of pain in neuralgia, myalgia and muscular rheumatism; to allay cardiac palpitation; to relax spasmodic stricture of the urethra (applied on a bougie or given by suppository), and as a galactafuge. In ophthalmic practice a solution of atropine (gr. 26-iv

(0.003-0.25) to water f3j (4.0)) may be dropped into the conjunctival sac to dilate the pupil and to paralyze accommodation, so that an examination can be readily performed or the refraction of the eye determined. In various inflammations of the ocular apparatus, as conjunctivitis, keratitis, iritis, etc., it is used to lessen pain and diminish the blood-supply to the inflamed parts.

What are the preparations and doses of belladonna?

EXTRACTUM BELLADONNE FOLIORUM ALCOHOLICUM (alcoholic extract of belladonna leaves), dose gr. -ss (0.008-0.032) in pill or suppository.

EXTRACTUM BELLADONNE RADICIS FLUIDUM (fluid extract of belladonna root), dose mj-ij (0.061–0.12).

TINCTURA BELLADONNÆ (tincture of belladonna), dose mv-XXX (0.3-2.0).

LINIMENTUM BELLADONNÆ (liniment of belladonna) contains 95 per cent. of the fluid extract and 5 per cent. of camphor.

UNGUENTUM BELLADONNA (ointment of belladonna) contains 10 per cent. of fluid extract.

EMPLASTRUM BELLADONNÆ (plaster of belladonna).

ATROPINA (atropine), usually employed in the more soluble form of ATROPINÆ SULPHAS (atropine sulphate), dose gr. 120-60 (0.0005-0.001).

What substances are incompatible with belladonna?

Alkalies precipitate atropine from solutions of belladonna, and tannic acid forms with it atropine tannate, a less soluble salt.

What is homatropine hydrobromate?

It is a non-official salt of an alkaloid derived artificially from atropine. It differs from atropine in dilating the pupil more rapidly and much more transiently, in not causing much constitutional disturbance when used locally for this purpose, and in slowing, not accelerating, the heart's action. It is used as a substitute for atropine in ocular therapeutics.