176 DEPRESSANTS TO PERIPHERAL NERVES 



of its digestive elements, although it may diminish the watery ele- 

 ments by depressing the vagus endings. 



The bile is but little influenced, but Bastedo says that atropine 

 promotes the storing of glycogen in the liver by cutting off certain 

 nerve impulses which induce the change of glycogen to sugar. It 

 has on this account been recommended in diabetes and Forcheimer 

 says, "in a large number of cases glycosuria, and with it acetone 

 bodies have disappeared." On the other hand, Mosenthal, in careful 

 studies of two diabetics, found no benefit or influence on the carbo- 

 hydrate tolerance, although large doses were used. 



Peristalsis. Atropine diminishes but does not entirely suspend 

 the power of the vagus over the intestines, so that the cathartic 

 drugs which act by stimulation of the vagus, arecoline, eserine, etc., 

 may be checked, although atropine does not check peristalsis from 

 cathartics which are direct irritants to the intestinal wall. On the 

 other hand, atropine diminishes the so-called " tone waves " without 

 checking peristalis, and tends to overcome spasmodic contraction 

 with colicky pain caused by severe irritation or excessive vagus stimu^ 

 lation. 



It is necessary to understand the difference between normal 

 peristalsis and intestinal colic (which means any spasmodic painful 

 contraction of the intestines, (griping) to understand just how the 

 action of atropine upon the intestine is brought about. 



In normal peristalis, a wave of contraction precedes the stimu- 

 lating body for about one inch, while the bowel relaxes below the 

 stimulating body for a considerable distance. In other words 

 peristalsis is a coordinated purposeful action to propel the contents 

 of the intestines and bring them in contact with the digestive juices. 

 If, on the other hand, instead of this rythmic coordinated wave of 

 contraction and expansion, we have a spasmodic contraction upon 

 some offending body, which may even be gas or preceding a body 

 which cannot be moved, we have intestinal colic or cramp (gripe). 

 At the same time the contents are not expelled or propelled and con- 

 stipation may result. In such cases atropine may restore normal 

 peristalis by checking the spasm and, as a result, stop the cramp 

 and constipation. It is on account of this action that atropine is 

 added to irritant cathartics, because they sometimes produce this 

 kind of colic. Large doses diminish or check peristalsis. 



Circulatory System. Therapeutic or moderate doses of atro- 

 pine accelerate the heart by depressing or paralyzing the terminations 

 of the vagi in the heart. This action is so marked that a heart 

 under the influence of atropine cannot be stopped even by strongly 

 stimulating the vagus. Occasionally the heart is first slowed by 

 stimulation of the vagus center before it is accelerated, but this is 

 for but a short period and is unimportant. The force of the heart 

 is also increased by direct action on heart muscle, so that there is 



