Pilocarpus pinnatifolius. *N.O. Rutaceae. Tincture of fresh leaves. Tincture of dried leaves and stems. (The alkaloid, Pilocarpine, has been experimented with independently and is dealt with in a separate article.).
Clinical
Alopecia. Asthenopia. Bronchitis. Burns. Cataract. Ciliary spasm. *Consumption. Diarrhoea. Dysmenorrhoea. Erysipelas. Eyes: tension in, hyperopia, affections of, operations on. Flushings, climacteric. Hair, affections of. Heart, affections of. Hypermetropia. Leucorrhoea. *Miliaria. Mumps. *Perspiration, excessive. Pregnancy, salivation of. Salivation.* Scalds. Strabismus. Worms.
Relations
*Compare: Amyl. nit. (flushings), Atrop., Physost., Sepia, and Lilium T. (eyes), Hepar (increased bronchial secretion). Compare also Pilocarpinum and the Rutaceae.
Characteristics
*Jaborandi is a South American tree growing to the height of twenty feet. It is used by South American Indians as an antidote to the bite of serpents of the Trigonocephalous group. The drug has been extensively used in ophthalmic practice for its mydriatic properties. Incidentally its action on the skin and salivary glands was observed and led to extensive provings being made. Robin (*C.D.P.) sums up the effects of the drug in doses of 6 grammes of the powdered leaves in infusion: Very soon face becomes red, temporal arteries throb more strongly, then there is a peculiar feeling of heat in the mouth and on the face and the flow of saliva begins. Soon the forehead becomes moist and the face more red, then beads of perspiration appear on the forehead, cheeks, and temples. The flow of saliva increases, all the salivary glands contributing. The mouth is filled with immense quantities of fluid and expectoration is incessant. At the same time perspiration covers face and neck, then the whole body became red and moist, and a pleasant warmth is experienced, in a few minutes perspiration breaks out over entire surface and soon runs down on all sides. Meantime other symptoms have supervened. The eyelids first become moist, then tears increase, collect in canthi, then roll down the cheeks, at the same time there is increased secretion of Schneiderian membrane, and increased activity of mucous glands of pharynx, trachea, and bronchi. These effects reach the maximum intensity forty-five minutes after taking the drug and last thirty or forty minutes more. Salivary glands enlarge. Thirst in intense. Pupils slightly contracted. When perspiration and salivation have ceased the subject is prostrated and drowsy, and the parts which secreted excessively become abnormally dry. In addition to these symptoms noted by Robin others have observed: vomiting, diarrhoea, pains in abdomen, especially hypogastric region and pubes, pains in bladder and urging to urinate. Dudgeon has recorded the following interesting case: A gentleman, 45, rose at an early hour and went to the other side of his bedroom to get a dose of *Nux 3 for some fancied derangement of his stomach. On coming back to bed he was seized with sudden violent crimson flushing of the face followed almost immediately by profuse perspiration, beginning in the face and head and extending all over the body. This was followed by extreme coldness of the extremities and sickness terminating in the vomiting chiefly of sour mucus. The attacks recurred every quarter of an hour throughout the day. Not only was he unable to get out of bed, he could not raise himself up in bed, or lie otherwise than on his right side without the most distressing giddiness and a feeling “as if he should die.” Pulse 60, regular and strong, temperature below normal. Ten drops of *Jaborandi 1 were mixed in half a tumbler of water, and a dessert spoonful given immediately and repeated every half hour. After the second dose the attacks ceased and he was able to take bread and milk without sickness. He had a good night’s rest and was perfectly well the next day (*M.H.R., October, 1888). Hale commends its use in women or young girls who have always a dry skin, scanty menses, and tendency of blood to the head. Duncan (H. W., xxxii. 189) has aborted erysipelas by painting the tincture on the part four to five times daily. A sharp smarting is the first effect, followed by a more agreeable, soothing sensation. In burns, scalds and some forms of eczema and psoriasis the same use has given excellent results. The action of the drug o the eyes is very pronounced and it has been found useful in many conditions of eye weakness, especially hypermetropia, ciliary spasm, convergent strabismus, and after operations for strabismus. Sandesberg (*B.J.H.., xl. 201) noticed that the internal use of *Jaborandi and *Pilocarpin in cases of detachment of retina and
choroiditis seemed to occasion opacity of the crystalline lens. He treated a horse for iridochoroiditis and large opacities of the vitreous with infusion of *Jab. leaves and injections of *Pilo. The disease was quickly arrested, the vitreous cleared up completely, but during the first week the crystalline lens became opaque. Bell commends it in diarrhoea with gushing painless stools, flushed face, profuse salivation, intense thirst, urine dark, scanty (or profuse), profuse sweat. Cooper has seen a violent leucorrhoea caused by *Jabor., also the discharge of a quantity of threadworms. One patient, after having been injected with *Pilocarpine, complained of great sensitiveness to cold: constantly taking cold and in dread of bronchitis, the skin too became irritable. *Jabor. has a reputation in the old school as a stimulant of the mammary secretion, and a case is quoted from the *Lancet in ***C.D.P. in which a woman whose milk had ceased for a fortnight received gtt. x. of the fluid extract every four hours. The secretion of milk was re-established, but the patient began to suffer from extreme nervous excitement accompanied by a fixed idea that she should murder her family with a hatchet. The drug was stopped, and these symptoms disappeared and with them the activity of the mammary glands. The *Hom. News, February, 1900, quotes an incidental cure of dysmenorrhoea in a woman, age 23, who received five-drop doses of *Jabor. for increased eye-tension which rapidly disappeared. The patient noticed that she passed the next menstrual period without pain though she usually had to spend two to four days in bed. The drug was continued in smaller doses, and the improvement was maintained. “When the period begins with a feeling of coldness and faintness, and neuralgic throbbings i head and pelvis, with backache, a drop or two of *Jabor. in hot water will at once relieve” (Cooper). *Jabor. has been used as a remedy for baldness, and it forms the principal ingredient in some of the popular hair-restorers. In a number of patients who have been taking it white hair and blonde hair have been observed to turn black. *Jabor. acts more on left side. Sometimes the left side only is affected by sweating, the right side being quite dry. Headaches were more noticed on left side. Headache worse at noon every day. Eating better distress in stomach.
SYMPTOMS.
Mind
Confusion. Disinclination to speak. Extreme nervous excitement, has a fixed idea that she will murder her family with a hatchet.
Head
Headache every day about noon. Headache about noon, with hurried breathing, pressure on chest, anxiety, palpitation and pain in region of heart. Headache towards dinner-time (Noon), not affecting the appetite, worse left side, during sore throat, with suffocative feeling. Uneasiness, increasing in forenoon to pain in occiput, then extending to forehead, better late in afternoon. Empty feeling in head. Vertigo. Throbbing pain in vertex and front of head at 7:30 p.m. Pain in lower part of occiput, extending over left side of head to forehead, heavy, worse left side, pain in left side of occiput in evening. Baldness. Light hair turns black.
Eyes
Cornea red after waking at 5:30 p.m. Lachrymation. The lachrymal secretion is increased and there is a copious discharge from the Schneiderian membrane, also increased secretion of mucus from the pharynx, trachea and bronchi. Pupils contracted, and tension (spasm) of accommodative apparatus, with approximation of nearest and farthest points of distinct vision, amblyopic impairment of vision from diminished sensibility of retina. Pupils dilated, sluggish. Balls sore on rolling them at 7 p.m. Lids stiff and heavy. Vision disturbed. Spasm of accommodation, vision changing constantly, becoming more then less dim, then dim with pricking in eyes. Eyes tire easily, are irritable. Vision dim, restored suddenly. Blurred vision for distant objects. Swimming of distant objects. Clouds before vision. Vision of snowflakes during the sweat and salivation. Vision lost for distant objects. Hypermetropia. Asthenopia. Ciliary spasm. Cataract. Convergent strabismus.
Nose
Copious nasal discharge.
Face
Redness of face, and of ears and neck, and of body, involving cheeks and ears, worse when sweat was greatest, then pallor, with heat of face and throbbing of temporal arteries. Acts powerfully upon the salivary and perspiratory glands, producing irritation and excessive secretion, under its influence the face soon becomes red, the saliva begins to flow, and profuse perspiration sets in, lasting for hours though their maximum intensity is less than an hour.
