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Related post: vasomotor center, however, does not occur with therapeutic doses, but only as the con- vulsant effects are approached; and especially during the convulsions proper (Pilcher and Sollmann, 1915). Often the blood pressure is not changed by moderate doses. The most frequent result, according to Winterberg, 1903, and Liebmann, 1912, consists in persistent fall of blood pressure, occasionally preceded by a slight and short rise. The rise is attributed to central vasomotor stimulation; but the fall is produced by pe- ripheral action on the vessels. Heard and Brooks, 1913, obtained quite negative results. Liebmann finds that the pulmonary vessels dilate before the systemic. The widespread vasodilation results in lowering the pressure in the right heart. Frey, 1909, found no effect on pulmonary hemorrhage. The cerebral vessels are also dilated (Berezin, 1916). Clinical Effects on Circulation. Camphor is used clinically as a temporary cardiac stimulant. Opinions are divided as to its usefulness. The effects, if they occur, are inconstant and unreliable. However, its employment is harmless. CAMPHOR 415 In normal individuals and in cardiovascular disease, camphor (even up to 3 Gm. hypodermically Heard and Brooks, 1913) does not alter the blood pressure, or the rate or quality of the pulse. In collapse conditions, especially in febrile toxemias, most clinicians believe that hypodermic injections improve the volume, tension and regularity of the pulse temporarily. G. Schwartz, Buy Primidone 1906, generally found a rise of blood pressure of 10 to 20 mm., too slight to explain the improvement. It is possible but not certain that the weakened human heart responds better to camphor than experiments on animals would indicate. It is also conceivable that the stimulation is reflex, since the injections produce considerable local reaction (Heard and Brooks). The regulating influence on delirium cordis might be beneficial in auricular fibrillation, but the action would probably be too brief. Administration. The camphor is employed intramuscularly, dis- solved in sterile olive oil, i to 2 c.c. of the 10 per cent, solution being repeated in ten- to fifteen-minute intervals as needed. In babies of one year, A. Jacobi advises J^LO to % grain every two hours. Intravenous injection (250 to 350 c.c. of o.i per cent, in saline) is safe, but less effective (Weintraud, 1913). Other Uses. Camphor Spirit is a household remedy in colds, bronchitis, etc. It is probably somewhat expectorant, diaphoretic and antipyretic (Binz, 1875 and 1877). The skin vessels are dilated. It was also advised in tuberculosis, but has not found much support. Camphor has also been used as a nervous depressant in hysteria, epilepsy, chorea, and con- vulsions, and as an anaphrodisiac. This rests on no rational basis. Respiration. The effects of non-convulsant doses are very slight and inconstant, practically negative. Edsall and Means, 1914, and Higgins and Means, 1915, studied the effects on man, using 0.4 to 0.5 Gm. hypodermically. They found the center sometimes slightly stimu- lated by bronchodilation and slight increase of carbon metabolism. The rate was often slowed; the volume, single or minute, was unchanged. In animals, the respiration is somewhat slowed but deepened, so that the minute volume is increased. Wieland, 1915, claims lowering of the threshold for CGv Isaac found it especially effective after morphin. TOXIC EFFECTS These are similar in man and animals, consisting in stimulation and then depression Buy Primidone Online and paralysis of the central nervous system. The treatment would consist Generic Primidone in evacuation and stimulation. Alcohol and oils should be avoided since they favor absorption. Symptoms in Man. These consist in nausea, vomiting, colic, vertigo, disturbed vision, tipsiness, excitement, impulsive movements, delirium, loss of consciousness, face flushed, then pale.; epileptiform convulsions are a constant feature in animals, and some- times occur m man (after 1.5 Gm.; Austragesillo, 1915); often anuria (illustrative reports, Stanley, 1903; F. Barker, 1910; Koppang, 1912). Death is rare in man, occur- ring by asphyxia and collapse. Convalescence may last several days or weeks; the gastric disturbance is especially persistent. Convulsions. In mammals, these are located mainly in the hemispheres; for removal of the hemispheres with section below the optic thalami diminishes (Albertoni, 1882) or abolishes (Morita, 1915) the convulsions. The spinal cord also shows some stimulation, and finally paralysis, but this does not come on until late, and is not important in mammals. In frogs, on the other hand, the action on the spinal cord is very pronounced, and consists in a paralysis. This entirely obscures any action which the drug may have higher up in the nervous system in these animals. It appears that the path for reflex impulses is blocked before that for impulses coming from the higher brain (Wiedemann, 1877; Binz, 1878). The symptoms are described by Grove, 1910. Toxic Dose. This varies greatly: 0.7 to i Gm. has been fatal to children and toxic to adults; 2 Gm. generally produced dangerous effects; but 15 Gm. have been survived (Koppang) ; and in an infant of eighteen months, i Gm. produced little if any symptoms (Miller, 1914). 416 MANUAL OF PHARMACOLOGY Solvent and Place of Administration on Toxicity. Cairis, 1914,- and Carnot and Cairis, 1914, have studied these on guinea pigs. With oral administration, the toxicity of camphor is greatly decreased by oil. Hypodermically, oily solutions are also less toxic than alcoholic, ethereal or even watery solutions. Intraperitoneal are more toxic than hypodermic injections. Oral administration is more effective than intra- muscular (Hatcher and Eggleston, 1914). CAMPHOR ISOMERS The synthesis of artificial camphor is described by Kebler, 1907; Houseman, 1915. Langgaard, and Maass, 1907, showed that the actions of the three isomers ar,e qualita- tively identical. Grawitz, 1907, claimed that the therapeutic effects, internal and external, are indistinguishable. Haemaelaeinen, 1908, states that the levorotary is less effective on the heart; but its central actions are more powerful (Grove, 1910). Heffter, 1914, concluded that artificial camphor is probably more toxic and often contains im- purities; that it could be substituted externally, but more experience would be needed to justify its internal use. The war has furnished the occasion for this experience; and Luetz, 1915, concludes that its hypodermic use, clinically, has given no bad effects. Borneol (Borneo-Camphor, CioHisO), is used in the orient. It acts similarly to camphor. CAMPHORIC ACID This was introduced by Fuerbinger, 1888, as anhydrotic against the night-sweats of phthisis. It aroused some enthusiasm at first (literature, Fujitani, 1906); but experimental investigations have given entirely nega- tive results (Dreesmann, 1889; Fujitani; Tyrode, 1908; Roth, 1911); and the clinical effects were also disappointing (Tyrode). The drug is there-
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