182 DEPRESSANTS TO PERIPHERAL NERVES 



twice as strong as by atropine. The action of hyoscine or scopola- 

 mine is quite dilferent from hyoscy amine. Hyoscine depresses the 

 endings of the same nerves as atropine but with a more powerful, 

 prompt and less persistent action, depresses the cerebrum and pro- 

 duces sleep in man without a previous period of excitement. It also 

 differs from atropine and hyoscyamine in being a distinct depressant 

 to the vasomotor and respiratory centers instead of stimulating them, 

 and in several instances collapse has followed small doses. It is con- 

 sidered as a distinct hypnotic in man. 



Therapeutics. Hyoseyamus can be used in the same class of 

 cases as belladonna or atropine but is often considered superior as a 

 urinary sedative in the treatment of cystitis. It may prove more 

 efficient to relieve pain in colic or intestinal irritations and the griping 

 of purgatives. 



Hyoscyamine. The uses of this agent are the same as those of 

 atropine and belladonna but it cannot often be procured in a pure 

 form and is not in any way superior to atropine. 



Hyoscine. 1. Hypnotic. Good results are procured in man in 

 maniacal excitement and delirium tremens. In veterinary practice 

 it is used almost entirely as a hypnotic for canine patients in com- 

 bination with morphine for the relief of pain, as a preliminary to 

 general anesthesia or as a general anesthetic. 



2. As a mydriatic in 1 per cent, solution. 



Scopolamine-morphine anesthesia. 



Hyoscine has been used very extensively under the name scopo- 

 lamine, in combination with morphine, and it seems well to discuss it 

 here. The uses of the combination are : 1, As an anesthetic, and 

 2, as a preliminary to general anesthesia. 



1. As an anesthetic. In human practice about %oo gTain 

 (0.0003 gm.) of scopolamine hydrobromide and % gr. (0.008 gm.) 

 of morphine hydrobromide or sulphate, are injected hypodermically 

 two and a half hours and one and one-half hours before operating, and 

 will in many cases often result in the abolition of pain. This has 

 been recommended by different authors in surgery and obstetrics, yet 

 in a large per cent, of cases, the anesthesia has not been sufficient and 

 has had to be completed with ether. This is the combination which 

 has won much notoriety through the magazines as the " twilight 

 sleep " in human obstetrics. By some it is considered as entirely 

 safe, by others, as undesirable on account of its liability to apcident, 

 necessity of close attention, on account of nausea, vomiting, excite- 

 ment, delirium and collapse. The dose is not given sufficiently large 

 to produce sleep but to dull the memory, so that everything which 

 occurs during that period is forgotten. One company adds cactin, a 

 glucoside of Cactus grandiflora, to the usual mixture aiming to coun- 

 teract the action of morphine upon the heart, but Hatcher and others 



