THE EFFECT OF ATROPINE, PILOCARPINE, PROSTIGMINE, ESERINE, MECHOLYL AND EPHEDRINE ON THE TONUS AND CONTRACTION MECHANISMS OF THE URINARY BLADDER, WITH OBSERVATIONS ON THE CLINICAL APPLICATION OF THESE DRUGS

¹ From the Sub-department of Neurology, the Johns Hopkins University, Baltimore, and the Neurological Service (Cornell Division) of Bellevue Hospital, New York

1. Pilocarpine, prostigmine, eserine and mecholyl have a strong stimulating effect on both the tonus and contractility of the bladder.

2. Atropine has a selective inhibitory effect on the bladder. It can lower a high state of tone and abolish rhythmic activity, whether these states are present normally or are due to stimulating drug activity. Atropine can strongly inhibit bladder contractions due to drug action but only slightly inhibit bladder contractions that are normally present.

3. Ephedrine in large doses was not observed to have any effect on the bladder.

4. The value of atropine in relieving the symptoms of increased bladder tone without the danger of causing urinary retention is pointed out.

5. The stimulating parasympathomimetic drugs have a very beneficial effect on hypotonic bladders due to disease of the nervous system. Pilocarpine, it is shown, is able to stimulate the formation of an automatic bladder in cases with vesical distension and overflow incontinence due to transverse lesions of the spinal cord.