bined sedative and sudorific effect. In this group also should be placed SALICYLIC ACID and other ANTIPYRETICS (q. v.) which produce more or less profuse perspiration.

SALINE DIAPHORETICS.

What are the saline diaphoretics?

While some of the saline diaphoretics have a sedative effect upon the circulation, which is not, however, as marked as the remedies of the preceding group, they have no tendency to nauseate even when given in large doses, on the contrary, they are acceptable to the stomach, and form the basis of most fever mixtures.

POTASSIUM CITRATE and its preparations have been noticed among the Diuretics.'

LIQUOR AMMONII ACETATIS-SOLUTION OF AMMONIUM ACETATE. What is the solution of ammonium acetate?

The solution of ammonium acetate or spirit of mindererus is a mild stimulant, diaphoretic and diuretic, often employed in febrile and inflammatory affections combined with other remedies. f3ss-j (15.0-30.0)

Dose

SPIRITUS ETHERIS NITROSI-SPIRIT OF NITROUS ETHER.

What is this substance?

Spirit of nitrous ether, or sweet spirit of nitre, is a solution of about 4 per cent. of nitrous ether (ethyl nitrite) in alcohol. In small doses it is a diaphoretic and stimulant, in larger doses an antispasmodic, and (if the skin be kept cool) diuretic; in excessive doses, either internally or when inhaled, it is a depresso-motor, acting similarly to the other nitrites (q. v.) and capable of causing death. It is much used as a diaphoretic in fevers, and occasionally as a diuretic (q. v.) and antispasmodic in nervous children. Dose for an adult f3j-iv (4.0-15.0). It is given as a diaphoretic in minute doses, frequently repeated and largely diluted, the body being kept

warm.

What is pilocarpus ?

SPECIAL DIAPHORETICS.

PILOCARPUS.

Pilocarpus or Jaborandi is the leaflets of P. Selloanus (Rio de Jañeiro Jaborandi) and of P. Jaborandi (Pernambuco Jaborandi) (Nat. Ord. Rutacea), a Brazilian shrub.

What are its chief chemical constituents?

It contains an alkaloid, pilocarpine, and a volatile oil; a second alkaloid, jaborine, probably a derivative of pilocarpine, has been isolated, and lately two other derivative alkaloids pilocarpidine and jaborandine have been described.

What are the physiological effects of these substances?

In medicinal doses pilocarpus or pilocarpine produces profuse diaphoresis and salivation, sometimes copious, with flushed face and quickened circulation and respiration. Sometimes the mucous secretions are increased also, and nausea, even vomiting, may occur. It increases both the watery portion and the solids (especially urea) of the perspiration by a direct influence on the nerve endings governing its secretion, and probably increases the secretion of the gastric juices and bronchial mucus in the same manner. It appears to act directly as a stimulant upon the cells of the salivary glands. There seems to be some relation between its influence over the secretions of perspiration and saliva, the one being more profuse when the other is scanty, and vice versa. In small doses frequently repeated it proves diuretic. It seems to stimulate the nutrition of the hair. The cardiac action is at first quickened, but soon slowed, and the arterial tension is elevated. Applied to the eye it contracts the pupil (by peripheral action) and increases the tension of accommodation. locarpine and atropine are antagonists as regards their action on the heart, intestines and pupil, and on the secretions of perspiration and saliva. Jaborine acts upon the heart, pupil, intestines and salivary glands like atropine. Pilocarpidine causes profuse diaphoresis, salivation, vomiting and purging; while jaborandine resembles atropine in its cardiac effects.

Pi

What are the medicinal uses of pilocarpus and its alkaloid? Pilocarpus or pilocarpine is used as a diaphoretic to abort disease

in incipient catarrh and at the onset of a paroxysm of malarial fever; in various forms of dropsy, to aid in removal of the fluid, especially hydrothorax, and in pulmonary adema; in uramia, to eliminate the poison from the blood, it is of great value, and similarly in acute or chronic Bright's disease, to relieve the kidneys of some of their work, it is very useful. It is also employed in subacute and muscular rheumatism.

As a diuretic, minute doses (pilocarpine gr. 12 (0.005), are given in acute suppression of urine, but when thus used in the early stages of acute desquamative nephritis it must be employed with great caution. As an expectorant it has been given in bronchitis and asthma and, with varying success, in croup and diphtheria. To stimulate the growth of hair in alopecia, pilocarpine may be administered internally or hypodermically, and applied locally as well, and it has been employed hypodermically with success to arrest severe and prolonged hiccough.

It should not be given in diseases of the gastro-intestinal mucous membrane, nor in weak heart due to cardiac disease.

What are the officinal preparations of pilocarpus and their doses?

EXTRACTUM PILOCARPI FLUIDUM (fluid extract of pilocarpus), Jose f3ss-j (2.0-4.0).

PILOCARPINE HYDROCHLORAS (pilocarpine hydrochlorate), dose gr. -ss (0.008-0.032). It is well adapted to hypodermic use.

ORDER III.-EXPECTORANTS.

What are expectorants?

Expectorants are remedies which are given to modify the secretions of, and promote their expulsion from, the air passages.

How may they be classified?

They are divided into sedative and stimulating expectorants?

SEDATIVE EXPECTORANTS.

What are sedative expectorants?

They are remedies which increase the secretion and at the same

time tend to lower the blood pressure, cause nausea and, if frequently repeated, vomiting.

Name the sedative expectorants.

Ipecac, apomorphine, tartar emetic, pilocarpine, lobelia and grindelia. Of these ipecac and apomorphine have been discussed with the "emetics," tartar emetic with the "sedatives," pilocarpine with the "diaphoretics," and lobelia with the "depresso-motors."

What is grindelia?

GRINDELIA.

Grindelia is the leaves and flowering tops of G. robusta and G. squarrosa (Nat. Ord. Compositæ). It appears to depress the motor nerves and muscles, and in large doses to slow the heart and reduce the blood-pressure. Toxic doses produce narcosis with dilated pupils. It is eliminated by the kidneys, increasing the flow of urine, and to some extent by the broncho-pulmonary mucous membrane. It has been highly recommended in spasmodic and cardiac asthma, in hay asthma and hay fever, in whooping-cough and in acute and chronic bronchitis. In chronic cystitis it has been advantageously employed, and as a local application in vaginitis and in poisoning by rhus toxicodendron has met with some success. Dose of the fluid extract (extractum grindeliæ fuidum) mx-f3j (0.6-4.0).

STIMULATING EXPECTORANTS.

What are stimulating expectorants?

They are remedies which probably modify the secretion by toning up the broncho-pulmonary mucous membrane through which they are eliminated. Most of them seem to exert an alterative effect in passing through the membrane, and many of them elevate the arterial tension.

Name the stimulating expectorants.

Ammonium chloride, senega, quillaja, quebracho, asclepias, eriodictyon, garlic, sanguinaria, ammoniac, benzoin, Peruvian balsam, balsam of Tolu, squill, eucalyptus, serpentaria, turpentine, tar, terpin hydrate, and terebene,

AMMONII CHLORIDUM-AMMONIUM CHLORIDE.

What is ammonium chloride?

Ammonium chloride, called also ammonium muriate or sal ammoniac, is a crystalline salt obtained from gas liquor.

What are its effects and uses?

Locally it is irritant. In medicinal doses it is believed to influence especially the mucous membranes, promoting very decidedly nutritive changes and hastening epithelial exfoliation. When given continuously for a length of time it diminishes the solids of the blood and stimulates the secretions. It is supposed to stimulate the hepatic functions, for the amount of urea excreted is greatly increased, as are all the other solids of the urine except uric acid. Large doses are purgative. It is used as a stimulating and alterative expectorant in the moist stage of acute and in chronic bronchitis, in pneumonia and the various catarrhs of children. Abroad it is employed also in gastric and intestinal catarrhs, in chronic hepatitis and in the early stages of hepatic cirrhosis. In cases of albuminoid liver, spleen or kidneys it is very useful. In subacute muscular rheumatism and in neuralgia, especially ovarian, it is advantageous, and it has been used internally as an alterative and employed locally as a sorbefacient in scrofulous adenitis of the cervical glands, and uterine fibroid

tumors.

Dose gr. x-xxx (0.6-2.0). The unpleasant taste may be partially disguised by liquorice. The troches (trochisci ammoni chloride) each contain about gr. ij (0.1) of the salt.

Senega is the root of Polygala Senega or senega snake-root (Nat. Ord. Polygalea) and contains polygalic acid or senegin, a glucoside identical with saponin.

What are its effects and uses?

Locally, it is an irritant. Internally, it stimulates the mucous membranes, and in large doses is emetic and cathartic. It is given as a stimulating expectorant in the latter stages of acute and in subacute and chronic bronchitis, especially when the mucous membranes are wanting in tone. It has also been used as an emmenagogue in