The leaves of Pilocarpus pennatifolius.—Brazil.
Preparations.—An infusion of the leaves. Tincture of Pilocarpus. Pilocarpin.
Dose.—An infusion of ʒiss. to ℥iv. of hot water may be taken in tablespoonful doses every ten minutes, to produce the full effect of the remedy. The tincture may be given in doses of gtt. x. to gtt. xxx. in hot water. The dose of Pilocarpin is one-half grain; it may be used by hypodermic injection in doses of one-eighth to one quarter of a grain.
Therapeutic Action.—Jaborandi is the most powerful diaphoretic known, and should only be employed when there is need for a prompt and efficient action upon the skin. The old word "sudorific" expresses the quality of the action, which resembles that obtained by the spirit vapor bath, with the use of the compound tincture of Serpentaria. The first influence of the remedy noticed (when taken in full doses) is a flushing of the face, and sometimes of the entire trunk, with increased fullness of the pulse, and occasionally pressure on the brain. Then perspiration breaks out in drops, and soon the patient is sweating from every pore.
It has been employed in commencing uraemia from scanty secretion of urine; in acute albuminuria; in puerperal convulsions; in tardy appearance or retrocession of the eruption in the eruptive fevers; in pulmonary apoplexy; in dropsy of the cavities, especially in hydropericardium, and hydrothorax.
The advantage of a powerful remedy like Pilocarpin, which may be held in solution and used by hypodermic injection, is, that it offers a powerful means of acting upon the skin, and providing revulsion, when the patient is unconscious, and can not take the ordinary remedies.
It has not been named as a remedy for Asiatic cholera, and possibly has not been tested in this disease. Yet I should think, from the influence it exerts upon the circulation, and upon the skin, that it might prove curative. I will be sure to test it if I see another epidemic of this disease.
Jaborandi is thought to be a true galactagoguc, increasing the secretion of milk, in doses short of diaphoresis. When studied in small doses, it will probably serve other useful purposes in the practice of medicine.