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Related article: these, however, are not active when administered by the stomach, and are therefore
not concerned in the action of the drug.
PREPARATIONS HOPS
Humulus (Humid.) , U.S.P.; Hops. The dried strobiles of Humulus Lupulus.
Dose, 2 Gm., 30 gr., U.S.P.
Lupulin. Dose, 0.5 Gm., 8 gr.
LOCO DISEASE
Horses, cattle and sheep on the Western stock ranches are subject to this peculiar
disease, which bears some resemblance to drug habits. The symptoms consist in motor
incoordination, forced movements, misjudgment of distance, stupidity, apparently
hallucinations. In the chronic form there is emaciation. Death is preceded by coma
and convulsions.
The cause of these conditions is obscure. It is generally attributed to feeding on
certain leguminous plants ("loco weeds" especially Astragalus). C. D. Marsh, 1909,
claims to have reproduced the condition (nervous symptoms, etc., Lamictal Online with exudative
meningitis, anemia, etc.) experimentally by very long-continued feeding with these
plants; but H. T. Marshall, 1914, considers the results inconclusive, and believes that
there is no distinct loco disease; and that the name covers a variety of conditions mal-
nutrition, parasitism, etc. unconnected with the loco weed.
COCAIN GROUP; LOCAL ANESTHETICS 251
COCAIN GROUP ; LOCAL ANESTHETICS
Actions and Uses. The alkaloid cocain is important mainly as a
local anesthetic, paralyzing the sensory nerve fibrils on direct application.
With dilute solutions, its action may be confined to these; but higher con-
centrations paralyze all other nerve fibers, and, indeed, they kill all proto-
plasm. Dilute solutions also produce local vasoconstriction and dilate
the pupil through stimulation of the sympathetic pupillo-dilator mechan-
ism, both central and peripheral.
When cocain is absorbed in sufficient quantity, it produces complex
systemic actions, involving stimulation and paralysis of various parts of
the central nervous system. These are mainly of toxicologic and scientific
interest. Its continued use leads to the formation of a habit, resembling
morphinism.
Analogous local anesthesias are Lamictal Online produced by a variety of synthetic
bases, which may be used as substitutes for cocain.
Historical. Cocain is derived from the Lamictal Online Lamictal Online leaves of Erythroxylon Coca, a tree indigen-
ous to Peru, Chili and Bolivia. The leaves were chewed from time immemorial by
the natives to relieve hunger and fatigue, and to produce a psychic stimulation, some-
what after the manner of caffein. It is now cultivated in other tropical countries.
In Europe, trials with the leaves gave disappointing results. The discoverers of
cocain (Woehler; Niemann and Lessen, 1860) incidentally described its anesthetic
action on the tongue, but without realizing its significance. As late as 1880, a British
medical commission reported on the drug as merely a poor substitute for caffein
(further details, J. U. Lloyd, 1911, "History of Vegetable Drugs," Lamictal Online and 1913, J. Am.
Pharm. Assoc., 2:1242). In the same year, Anrep subjected cocain to a thorough
pharmacologic investigation; and in 1884, the Vienna oculist Roller introduced it as a
practical local anesthetic. Its importance was then at once recognized.
Peripheral Nerves. Local Anesthesia. Local contact with cocain
paralyzes all forms of nervous tissue, without preceding stimulation.
The susceptibility of the various nerve fibers presents marked and char-
acteristic quantitative differences. Sensory fibers are especially easily
attacked; and by using appropriate dilutions, the paralysis can be confined
strictly to them. With sufficient concentration, the paralysis is as com-
plete as if the nerve fibers had been severed with a knife. If the alkaloid
is washed away, or absorbed, the nerve recovers its functions promptly
and completely (but very strong solutions may produce neuritis and per-
manent paralysis).
Since these effects are strictly local it follows that the cocain must be
applied in such a way that an effective concentration will reach the nerve
supply of the part which it is desired to affect. This may be accomplished,
according to circumstances, by painting a solution on mucous membranes
(from which it is very readily absorbed) ; or by injecting it into or under
the skin (infiltration and subcutaneous anesthesia) ; or around or into the
nerve trunk (peri- or intraneural anesthesia); or around the spinal nerve
roots (subdural or spinal anesthesia). The intact skin Lamictal Online is practically
impermeable to cocain.
Duration of Local Action. The onset and duration of the anesthesia
varies with the concentration of the solution, and the method of its appli-
cation. Roughly speaking, it starts in a few minutes and lasts perhaps
ten to thirty minutes, with a single application.
Local Anemia. As the cocain is absorbed and thus removed from the
site of application, its local action ceases and its systemic and toxic effects
252 MANUAL OF PHARMACOLOGY
start. Since cocain is rapidly destroyed in the body, the systemic toxicity
increases with the rapidity of absorption. It is therefore desirable and
often necessary to delay the absorption. This may be done by restricting
the local circulation. Cocain itself tends to do this by producing a local
vasoconstriction an advantage which is not shared by its substitutes.
This vasoconstriction should be reinforced by the addition of epinephrin.
In suitable situations, the circulation may be slowed by bandages, or
arrested by temporarily clamping the arterial blood supply. The anemia
also favors anesthesia directly; ligation of a large artery in itself produces
anesthesia of the nervous end structures.
When a large quantity of dilute Lamictal Online cocain solution is injected under pres-
sure, as in the infiltration anesthesia, the cocain action is reinforced by
anemia, pressure, and edema.
The Selective Action of Cocain on Motor and Sensory Fiber. When a % to 2 per
cent, solution of cocain is injected into a mixed nerve, or into the subdural canal, the
selective action Lamictal Online is very marked, so that there is complete anesthesia, without motor
impairment. If the contact is prolonged, by stopping the circulation, or if stronger
solutions are employed, the motor Lamictal Online fibers also become paralyzed, so Lamictal Online that the difference is
merely quantitative. A similar difference in the susceptibility of motor and sensory
structures exists also for the alcohol group, aconitin, phenol, and hydrocyanic acid; and
even for the centrally acting narcotin, ether, etc. It is therefore a characteristic of
nervous tissue rather than of cocain.
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