Jaborandi

 Pilocarpus pinnatus. Natural order: Rutaceae сommon names: (Brazilian), Jaborandi. Note: This plant is used by the South American Indian as the special antidote to the bite of serpents of the Trigonocephalus group. Preparation: Tincture of the leaves.

 Confusion of mind. Disinclination to speak (in one case).

 Vertigo. A little vertigo (after fifteen minutes). In rare instances, there is slight vertigo, but this was observed in only two cases. General Head. Head feels empty (after one hour and a quarter). Uneasiness in the head (after minutes). Slight uneasiness in the head, which during the forenoon increased to a pain in the occiput, then extending to the forehead; this disappeared late in the afternoon (after one hour, sixth day). Headache (after three hours and a half),; (thirteenth day). Some headache (after one hour and ten minutes). (10). Headache came on towards dinner time (noon), but did not affect my appetite (fifteenth day). Headache had disappeared in the morning, but came on again during the day, and lasted until I went to bed (sixteenth day). Headache almost every day just about noon, for over two weeks after taking. Headache and suffocative feeling (forty fourth day). Headache, dull pain, mostly on the left side, during the soreness of throat (twelfth day). Headache returned about noon; dull aching pain same as before, hurried breathing, pressure on the chest, and great anxiety, with palpitation of the heart, with pain in region of heart. These symptoms lasted five days, becoming less severe each day (twenty fourth day). Forehead. Front and top of head have a dull throbbing ache, at 7. 30 P. M. (twelfth day). Suddenly a headache, throbbing pains in the forehead and top of the head; next came pains in chest and around the heart; pain in forehead became less, but increased in severity in the chest and about the heart (forty fifth day). Occiput. Pain in the lower part of occiput (fifteenth day). Aching pain in the lower part of the occiput, which increased in severity for two hours, when it gradually passed off (after one hour, seventh day). Dull pain on the left side of the head in the occiput, during the evening (eleventh day). Dull pain in lower part of occiput, extending over left side of head to the forehead. Great weakness, palpitation of the heart; pains in chest of a stitching character. These symptoms lasted all day. The weakness lasted for three days (after two hours, thirty seventh day). Heavy dull pain in the lower part of the occiput, worse on the left side (after two hours, nineteenth day).
 Eyes.
 Objective. This morning, also yesterday morning, noticed bright red spot upon cornea of right eye near the iris. In both eyes a vascular appearance, as from cold or overwork (fifth day). After waking, found the cornea injected with blood and quite red, at 5. 30 P. M. (seventh and ninth days). Lids. Eyelids stiff and heavy. Very heavy (thirteenth day). Lachrymal Apparatus. Augmentation of the lachrymal secretion (after ten minutes). Some lachrymation (after twenty minutes),; (after fifty minutes). вall. Eyeballs begin to feel very sore when he rolls them, at 7. 30 P. M. (twelfth day). Pupil. Pupils slightly dilated. сontraction of pupil (nineteen cases). Pupil contracted (after fifty minutes). Pupils slightly contracted (after one hour); additional contraction of pupils (after two hours and a half. Action of pupil rendered sluggish (eleven cases). Vision. Disturbance of vision. When the perspiration and flow of saliva were at their height sight became so dim that he could scarcely see a spittoon held near his mouth (after half an hour). Sight still dim; cannot distinguish objects brought close to his eyes (after one hour). Vision suddenly restored, quite spontaneously (after two hours). Sight became blurred; at the distance of four feet I could see my wife, but could not distinguish her eyes; the impaired vision continued, but it was only at a distance; near objects I could see distinctly enough (after three quarters of an hour). Mist before his eyes (after forty minutes); he could not see anything on the other side of the ward, a distance of about twenty five feet, but he could see any one standing by the side of his bed distinctly; the pupils were not altered from their normal condition (after one hour and ten minutes); no derangement of vision (after one hour and forty minutes). сlouds before the vision. Everything at a distance appeared hazy, and although he could read moderate size type at one foot, at two feet it was indistinct (similar disturbance of vision was noticed in several other cases). Swimming of distant objects, so that the patient does not recognize one entering the room until he comes close to the bed. During the sweating and salivation, appearance as of numerous white spots before the eyes like flakes of snow, but without dimness of vision (after twenty eight minutes). A sort of mist before the eyes; in spite of wiping the eyes and frequent winking, the sight remained dim and the appearance of snowflakes continued (after thirty minutes). Sight restored suddenly; no mist, but still some white points moving before the eyes (after forty minutes). Dimness of sight returns, with annoying pricking in the eyes, obliging him to wipe them hard (after fifty minutes). The state of the vision is constantly changing, becoming suddenly more or less dim every few moments (after one hour).
 Nose.
 Nasal discharge begins (after thirty five minutes).
 Face.
 Slight increase of color (after half an hour, ninth day). Redness and heat of face; feels throbbing of temporal arteries, and increased warmth in the face, but skin still dry (after fifteen minutes). Face and body very red (after twenty eight minutes). Flushing of the face (ten minutes),; (after half an hour), (after thirty five minutes. Flushing of the face, ears, and neck (after half an hour); flush of face had passed off (after one hour and three quarters). In those instances in which sweat ing took place the face became flushed, and was most marked when the perspiration was greatest; the flush involved the cheek and the ears, but soon passed away and was succeeded by pallor. Face covered with suffused flush (one case). Slight paleness, as the action of the medicine began to decline.

 Tongue. Tongue covered with a light fur (took china, at 10 A.M)., (thirteenth day). General Mouth. Great dryness of the mouth (after twelve and twenty four hours). Heat in mouth (after fifteen minutes). Saliva. Secretion of saliva began to increase (after five minutes). Secretion of saliva above the normal (in one case); very profuse (in second case). Secretion of saliva began to increase (after five minutes); the saliva for a time required almost constant ejection; the secretion of this from the glands in the cheeks caused a kind of collapsed feeling in the; saliva distinctly alkaline, measured 16 ounces in addition to that which flowed on the pillow while I slept. Profuse secretion of saliva. Salivation sets in (after fifteen minutes). Salivation commences (after twenty minutes), and in a few minutes after, the mouth is literally flowing with water; this continues for four or five hours, and during that period from 10 to 16 ounces of fluid may be easily collected. (60). сommencement of salivation (after fifteen minutes); increased salivation (after twenty minutes); salivation has been diminishing for ten minutes (after one hour and fifty five minutes); no salivation (after three hours and five minutes). Salivation begins (after fifteen minutes); flow of saliva decidedly set in (after twenty minutes); salivation at its height; spits fifteen times a minute (after thirty five minutes); salivation less (after one hour and a quarter), still some salivation (after one hour and fifty five minutes). Free salivation, with profuse sweating (after three quarters of an hour). Profuse salivation (after ten minutes). Salivation profuse (after thirty five minutes, and one hour and a half); action of salivary glands still continuing (after three hours and a half); total amount of saliva 13 fluid ounces. Salivation and perspiration continued to be profuse until my sight became blurred. There was some salivation in all the experiments, and in two cases it was profuse; but in the lad on whom two observations were made the effect on the salivary glands was very slight. The salivation was much more profuse in the lad whose skin remained dry. The salivation, when it occurred to a marked extent, began simultaneously with the sweating, was greatest when the sweating was most profuse, and lasted as long as the sweating. When the increase of the saliva was but slight, it was difficult to tell when the increase began, or how long it lasted. In the case of the lad who failed to perspire, the salivation became profuse in fifteen minutes, and so continued during three hours and a quarter, and then in a less degree for seven hours. Flow of saliva (after ten minutes). Saliva collecting in the mouth (after half an hour); saliva 3 fluid ounces (after one hour); increased to 6 fluid ounces (after one hour and a half); amounts to 8 fluid ounces (after two hours); 10 ounces (after two hours and a half); saliva 12 fluid ounces (after three hours); thirteen fluid ounces (after three hours and a half); 14 fluid ounces (after four hours); salivation had ceased (after four hours and a half). Mouth began to fill with saliva (soon after half an hour); salivation quite abundant (after one hour and a half); very free (after two hours); much diminished (after two hours and a half); saliva 12 ounces. (70). сomplained that his mouth was filling with water (after forty minutes); salivation continued (after one hour and ten minutes); no salivation (after one hour and forty minutes). The quantity of saliva amounted to above 250 c. c.. сonstant spitting of very alkaline saliva (after twenty five minutes). Salivary secretion extremely active; submaxillary gland especially enlarged; on pressing it there is a gush of saliva under the tongue (after thirty five minutes). On rising, felt weak; skin still moist, with some flow of saliva. Sat with forehead resting on edge of table, and let saliva run into a vessel on the floor. Remained in this position, the saliva flowing constantly, for an hour and a half (after two hours and five minutes). Tried to sleep, but had to clear the mouth of saliva every two or three minutes (after four hours and five minutes). Flow of saliva entirely ceased (after four hours and thirty five minutes). Total amount of saliva, 750 cubic centimeters, stringy, but not very viscid. Urea in notable quantity found in the saliva. Taste. Mawkish bitter taste (to the infusion). Speech. Speech. Speech so affected that articulation was both difficult and indistinct.
 Throat.
 Dryness of back of throat (after fifty minutes). During the forenoon my throat felt dry and inflamed; everything swallowed caused a scraping sensation; in the afternoon the inflammation increased; the tonsils were slightly swollen and the jaws a little stiff; this soreness lasted for two days (seventh day). Quite a sore throat, smarting pain; headache, dull pain, mostly on the left side; breathing hurried; the sore throat and headache lasted all day and evening till I went to bed (twelfth day); the next morning the headache had gone, but my throat felt so sore that for a time I seriously feared an attack of diphtheria; it gradually wore off, however, during the day, and the next day I was quite well. External Throat. Moderate swelling of the submaxillary glands (after twelve and twenty four hours). Pain in the submaxillary glands (second day).

 Abdomen.
 Empty, gone feeling in the bowels (twelfth day).
 Stool.
 Diarrhoea. Stool at 6. 30 p.m very loose, came with a gush; stool at 7. 30 p.m, stool at 8 p.m, all thin, watery, yellow, and came with a gush; at 9. 30 p.m, another stool; at 10. 30 p.m another; at 11. 30 p.m, another; at 1 P. M.; the eighth stool; has felt a goneness, an emptiness, from the diarrhoea, but no pain whatever; at 3. 25 P. M., another stool, which came with a gush, yellow, watery, undigested, no pains; at 5. 25, stool like the last; at 6 P. M., stool; felt a little weak at night, having had eleven copious, watery, undigested stools since 7 p.m (twelfth day). сontinues to have from five to ten stools a day, of a yellow color, and watery, painless. Took two small doses of Gummi gutt., 3D trit., which cured the diarrhoea), (sixteenth day). Five painless stools during the day yellow, thin, watery, better digested (fourteenth day). Three stools during the day (his usual number); the last one, at 8. 30 P. M., somewhat harder, constipated (second day). Two stools during the day (eighth day). Two movements during the day, more papescent (seventh day). Two stools only during the day, the first at 7 p.m, more papescent than three days before; the second at 9 p.m, thin and yellow (tenth day). Stool at 7 p.m, papescent and very large (ninth day). Stool thin, better digested, with more control over sphincter ani, at 9 P. M. (twelfth day). Stool yellow, better digested, but came with a gush, at 2 P. M. (thirteenth day). вowels moved at 7. 30 p.m, with this difference, the discharges were less papescent than heretofore; the first portion of the evacuation was 5/8 of an inch in diameter and about 5 inches in length; the latter portion was papescent, color dark brown (fourth day). сonstipation. сonstipated; two motions in the day instead of three, as usual (fifth day). Stool at 7 p.m, and again at 7 P. M., both exceedingly difficult to evacuate, consisting of long, large, and very dark faeces (eleventh day).

 Appetite. When I took the drug I felt quite hungry, but soon after taking it the hunger left me, and on sitting down to breakfast I could not eat; about two hours afterwards became very hungry (fifteenth day). Thirst. Urgent thirst (after three hours and thirty five minutes). Eructations and Hiccough. Eructations and vomiting. Hiccough. Nausea and Vomiting. Felt squeamish, although I was able to attend to business (second day). Sickness (in both cases). Sickness of the stomach (after three hours and a half). Was sick and vomited a quantity of saliva which I had swallowed (after one hour and a half); putting my finger into my mouth vomiting was further excited, until a portion of the Jaborandi returned. They were a little sick, faint, and prostrate. Vomited half an hour after eating supper. In some cases vomiting is produced, either at the beginning or end of the effect. The lad who failed to perspire vomited; the vomiting came on suddenly and was not repeated. Stomach. Distress at the stomach (which may be owing to the alcohol in the tincture, ore than to the jaborandi); it is a burning pain, not that dyspeptic ache experienced yesterday (fifth day). сonsiderable distress, both in the stomach and lower half of oesophagus, especially the latter feels constricted, aching heavily (took Pulsatilla 1st, at 3 P. M., which completely controlled the dyspeptic distress), (thirteenth day). Dull, heavy distress in the pyloric portion of the stomach, as though some hard indigestible substance was lying there, relieved by eating a full meal, at dinner time (fourth day). сonstrictive feeling in the stomach, as though the rugae were puckered up (probably owing to the alcohol of the tincture, as it was taken clear), (seventh day).

 Burning in the urethra in two cases, with urging to urinate. Secretion of urine increased (750 c. c. during the perspiration). When administered in fractional doses, jaborandi does not produce either perspiration or salivation, but becomes a powerful diuretic. The quantity of urine diminished in a very noticeable manner on the day the remedy is administered, but on the next day there is sometimes a slight augmentation, sometimes the usual amount. Urine dark colored. The urea diminishes on the day the Jaborandi is given, increases slightly again on the next day, and then falls to the normal amount. сhlorine and the chlorides, as well as the uric acid, also undergo the same quantitative changes, and diminish on the first day only to in crease on the second. Augmentation of the bronchial secretions (after ten minutes). We noticed an increase of the bronchial secretion, indicated by a loose cough, only in the lad previously quite free from catarrhal symptoms, on whom two observations were made, and in whom but a slight increase of salivary secretion occurred; the bronchial secretion was much abundant in the first than in the second observation; indeed, in the second there was very little cough. Hurried breathing (after two hours, nineteenth day). вreathing hurried, during the soreness of throat (twelfth day).

 Pains in chest and around the heart (forty fifth day). сould not get to sleep for two hours after going to bed, on account of anxious and oppressed feeling in the chest (eleventh day). Pressure on chest, and great anxiety, with palpitation of heart, and pain in region of heart (twenty fourth day). Sense of heavy pressure on the chest, hurried beating, and great prostration; symptoms became so bad that I was obliged to go to bed; for half an hour after going to bed could only breathe with great difficulty (forty fifth day). Pains in chest, of a stitching character (after two hours, thirty seventh day).

 Precordium. Pain in region of heart (twenty fourth day). The pains about the heart were very severe, accompanied with severe palpitation; this condition lasted two hours in its severest form, then gradually abated (forty fifth day). Heart’s Action. Palpitation of heart (after two hours, nineteenth day). Pulse. Tracing № 1 represents the normal pulse of the subject; its general aspect is rectilinear, excepting a very slight curve corresponding to a respiratory movement; the ascending line is short and somewhat oblique; the descending line nearly horizontal; the natural dicrotism is well marked. At the commencement of sweat the pulse become more rapid, and the tracing assumes a different appearance; its general outline becomes a little crooked; the rising line is larger and more upright; the descending line, therefore, more oblique, with more of the diacrotic character. At the height of the sweating period, the general outline becomes strikingly irregular; moreover, the beats are no longer isochronous, some being shorter than others. When the morbid activity of the secretory organs has passed off, the general outline becomes regular again, but the ascending line is shorter and more oblique, the descending line longer and nearly horizontal, with hardly a trace of exaggerated dicrotism. Sphygmographic tracings, taken at different stages of the administration of this drug, showed almost complete asystole, with a very noticeable diminution of vascular tension during the sweating stage. Pulsation was quickened while the action of the medicine lasted (in both cases). In each experiment the pulse became considerably quicker, the increase varying from forty to fifty minutes; the pulse reached its quickest in twenty five to eighty minutes after administration; the quickened pulse continued more than four hours; no close relation existed between the rapidity of the pulse and the fall of temperature; in one lad whose pulse was intermittent, the medicine entirely removed this irregularity. At the moment the sweat was produced, there was an increase of the pulse and of temperature; then during the period of active sweating, it was sometimes noted that these two elements remained at the same point as at the outset of the experiment; sometimes there was a slight diminution; but after sweating, a very notable lowering of the pulse and of the temperature were observed, which sometimes lasted two days after the experiment (in thirty two experiments). Pulse rose from 88 to 120. Pulse rose from 12 to 20 beats during the first few hours (the reverse of temperature), and returned to its normal rate with the return of the normal temperature, but became soft and compressible. Pulse 108 (normal 80), (half an hour after 80 drops), (seventh day). Pulse 100 (temperature normal, at 6 P. M. (twelfth day). Pulse 94 (an increase of 14 from 150 drops of the tincture taken within an hour), (ninth day). (140). Pulse 96 (when first noted), 104 (afterwards); 88 on awaking (second morning), normally 80. Pulse 90 (before taking); 104 (after forty minutes); 96 (after one hour and ten minutes); 90 (after one hour and forty minutes); 96 (after two hours and a half). Pulse 80 (before taking); 96 (after thirty five minutes); 108 (after one hour and a half); 112 (after three hours and a half); 90 (five hours and a half); 88 at 10 p.m (second day). Pulse 78 (before taking); 84 (after fifteen minutes); 86 (after twenty two minutes); 87 (after forty minutes); 87 (after one hour and a quarter); 76 (after five hours and a half); 70 (second day). Pulse 75 (before taking); 90 (after half an hour); 108 (after one hour and a half); 100 (after two hours); 88 after two hours an a half); 80 (after three hours and a half); 78 at 10 p.m (second day). Pulse 77 (before taking); 90 (after one hour); 93 (after one hour and a half); 94 (after two hours); 92 (after two hours and a half); 90 (after three hours); 82 (after three hours and a half); 80 (after four hours and a half). Pulse 80 (before taking); 100 (after fifteen minutes); 96 (after twenty minutes); 100 after thirty five minutes); 104 (after fifty minutes); 100 (after one hour); 96 (after one hour and ten minutes); 88 (after one hour and thirty five minutes); 90 (after one hour and fifty five minutes); 76 (after two hours and five minutes); 78 (after three hours and five minutes). Pulse 78 (before taking); 100 (after fifteen minutes); 96 (after twenty minutes); 100 (after thirty five minutes); 104 (after fifty minutes); 100 (after one hour); 96 (after one hour and ten minutes); 96 (after one hour and a quarter); 90 (after one hour and fifty five minutes); 76 (after two hours and five minutes); 78 (second day).

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