632 TRANSACTIONS OF SECTION T. 
Brodie and Crouch,’ J. Harley,” Dastre,* Pitha,* Fraser,* Brown-Sequard,° 
Dastre and Morat,’ Schafer,* Schafer and Scharlieb,? Hewitt.'° Some 
of these question the great danger of primary inhibition of the heart 
through excitation of the vagus, and also the benefit supposed to be derived 
from a preliminary dose of atropine. 
The dose required to eliminate vagus action in dogs varies greatly 
per kg. of body weight in different individuals. This variability, we 
know, exists to as great an extent in the human subject; it follows that 
after administering a dose of atropine previously determined upon, we 
are in the dark as to whether we have obtained the desired effect. Should 
we inveriably give a large dose, disagreeable and possibly fatal results 
might ensue; numerous cases have been recorded where small doses have 
produced ill effects. 
Harley advocates 0°01 to 0°025 grain, and Dastre 00015 gramme 
(0°023 grain). Schafer,"’ in a paper read last year at Chicago, advocates 
the use of 1/50 gr. of atropine before all cases of anesthesia. These 
doses would certainly cause serious symptoms .in some subjects, and would 
probably cause discomfort in nearly all, and, in spite of their size, we have 
no guarantee that the quantity is sufficient to abolish vagus action. 
Tested upon myself, 0°01 grain administered hypodermically to deter- 
mine the effect on blood-pressure produced very disagreeable results—head- 
ache, defective vision, dryness of the fauces, and a slight inco-ordination 
of the muscles, particularly of the lower limbs, being the prominent 
symptoms. The blood-pressure, which was taken previously for three con- 
secutive days at the same hour with Janeway’s instrument, was recorded 
at first every five minutes after the injection, then later every ten minutes. 
It showed a gradual fall until it was reduced by 20 mm. of mercury. 
Dr. , who was treated in the same manner, but only took 0°0067 grain 
of atropine, had less pronounced symptoms, but still sufficient to cause 
considerable discomfort and a very slight change of blood-pressure, which 
was lowered by 10 mm. of mercury. 
So far as I can conclude from my experiments, adrenalin would be of 
distinctly more benefit than atropine, though, since its effect is transitory, 
as a rule frequent small doses must be administered in order to be of 
use. If the heart has not completely stopped, adrenalin causes more 
active contractions '* and consequent rise of blood-pressure, which a few 
doses at short intervals may make permanent. If the heart has ceased abso- 
lutely, I have never obtained any result. This restoration of the heart 
may be obtained after the heart movements can no longer be felt through 
the chest wall, but when, if the chest wall is opened, small movements can 
still be observed. 
Summary. 
1. In dogs atropine, hyoscine, hyoscyamine, scopolamine, duboisine, 
and daturine produce, whether in small or large doses, a lowering of blood- 
pressure. 
Trans. Soc. Anesth., vol. vi. pp. 70 and 81, 1903. 
* Brit. Med. Jour., vol. ii., p. 320, 1868. 
8 Soc. Biol., p. 242, 1883. 
* Pitha, 1861. Quoted by Schafer from Dastre. 
5 Brit. Med. Jour., vol. ii. p. 715, 1880. 
° Brown-Sequard (C’. 7. Soc. Biol., p. 289, 1883). 
7 Dastre and Morat (Lyon Med., 1882, and C. r. Soc. Biol., pp. 242 and 259, 
1883). 
® Schafer, Brit. Med. Jour. vol. ii. p. 620, 1880. 
* Trans. Royal Soc. Edin., p. 333, 1904. 
10 Anesthetics and their Administration, pp. 230, 259, 503, 1907. 
Jour. Am. Med. Assn., September 8, 1998, vol. li. p. 863. 
2 The rise with adrenalin is due also to stimulation of vaso-motor nerve: 
endings in various parts of the body. 
