Page:EB1911 - Volume 04.djvu/990

 spinal cord is very marked and characteristic. The reflex functions of the cord are entirely abolished, and it has been experimentally shown that this is due to a direct influence upon the cells in the anterior cornua. It is precisely the reverse of the typical action of strychnine. Near the termination of a fatal case there is a paralysis of the sensory columns of the cord, so that general sensibility is lowered. The alkaloid calabarine is, on the other hand, a stimulant of the motor and reflex functions of the cord, so that only the pure alkaloid physostigmine and not any preparation of Calabar bean itself should be used when it is desired to obtain this action.

Besides the secretions already mentioned as being stimulated, the bile, the tears and the perspiration are increased by the exhibition of this drug.

There remains only to consider its highly important action upon the eye. Whether administered in the form of the official lamella or by subcutaneous injection, physostigmine causes a contraction of the pupil more marked than in the case of any other known drug. That this action is a direct and not a nervous one is shown by the fact that if the eye be suddenly shaded the pupil will dilate a little, showing that the nerves which cause dilatation are still competent after the administration of physostigmine. Besides the sphincter pupillae, the fibres of the ciliary muscle are stimulated. There is consequently spasm of accommodation, so that clear vision of distant objects becomes impossible. The intra-ocular tension is markedly lowered. This action, at first sight somewhat obscure, is due to the extreme pupillary contraction which removes the mass of the iris from pressing upon the spaces of Fontana, through which the intraocular fluids normally make a very slow escape from the eye into its efferent lymphatics.

There is a marked antagonism in nearly all important particulars between the actions of physostigmine and of atropine. The details of this antagonism, as well as nearly all our knowledge of this valuable drug, we owe to Sir Thomas Fraser, who introduced it into therapeutics.

The clinical uses of physostigmine are based upon the facts of its pharmacology, as above detailed. It has been recommended in cases of chronic constipation, and of want of tone in the muscular wall of the urinary bladder. It has undoubtedly been of value in many cases of tetanus, in which it must be given in maximal doses. (The tetanus antitoxin should invariably be employed as well.) Sir Thomas Fraser differs from nearly all other authorities in regarding the drug as useless in cases of strychnine poisoning, and the question must be left open. There is some doubtful evidence of the value of the alkaloid in chorea. The oculist uses it for at least six purposes. Its stimulant action on the iris and ciliary muscle is employed when they are weak or paralysed. It is used in all cases where one needs to reduce the intra-ocular tension, and for this and other reasons in glaucoma. It is naturally the most efficient agent in relieving the discomfort or intolerable pain of photophobia; and it is the best means of breaking down adhesions of the iris, and of preventing prolapse of the iris after injuries to the cornea. In fact it is hardly possible to over-estimate its value in ophthalmology. The drug has been highly and widely recommended in general paralysis, but there remains grave doubt as to its utility in this disease.

Toxicology.—The symptoms of Calabar bean poisoning have all been stated above. The obvious antidote is atropine, which may often succeed; and the other measures are those usually employed to stimulate the circulation and respiration. Unfortunately the antagonism between physostigmine and atropine is not perfect, and Sir Thomas Fraser has shown that in such cases there comes a time when, if the action of the two drugs be summated, death results sooner than from either alone. Thus atropine will save life after three and a half times the fatal dose of physostigmine has been taken, but will hasten the end if four or more times the fatal dose has been ingested. Thus it would be advisable to use the physiological antidote only when the dose of the poison—assuming estimation to be possible—was known to be comparatively small.

CALABASH (from the Span. calabaza, a gourd or pumpkin, possibly derived from the Pers. kharlunza, a melon), the shell of a gourd or pumpkin made into a vessel for holding liquids; also a vessel of similar shape made of other materials. It is the name of a tree (Crescentia Cujete) of tropical America, whose gourd-like fruit is so hard that vessels made of it can be used over a fire many times before being burned.

CALABASH TREE, a native of the West Indies and South America, known botanically as Crescentia Cujete (natural order, Bignoniaceae). The fruit resembles a gourd, and has a woody rind, which after removal of the pulp forms a calabash.

CALABOZO, or, an inland town of Venezuela, once capital of the province of Caracas in the colonial period, and now capital of the state of Guárico. Pop. (1891) 5618. Calabozo is situated in the midst of an extensive llano on the left bank of the Guárico river, 325 ft. above sea-level and 123 m. S.S.W. of Caracas. The plain lies slightly above the level of intersecting rivers and is frequently flooded in the rainy season; in summer the heat is most oppressive, the average temperature being 88° F. The town is regularly laid out with streets crossing at right angles, and possesses several fine old churches, a college and public school. It is also a bishop’s see, and a place of considerable commercial importance because of its situation in the midst of a rich cattle-raising country. It is said to have been an Indian town originally, and was made one of the trading stations of the Compañia Guipuzcoana in 1730. However, like most Venezuelan towns, Calabozo made little growth during the 19th century. In 1820 the Spanish forces under Morales were defeated here by the revolutionists under Bolívar and Paez.

CALABRESELLA (sometimes spelt Calabrasella), an Italian card-game (“the little Calabrian game”) for three players. All the tens, nines and eights are removed from an ordinary pack; the order of the cards is three, two, ace, king, queen, &c. In scoring the ace counts 3; the three 2; king, queen and knave 1 each. The last trick counts 3. Each separate hand is a whole game. One player plays against the other two, paying to each or receiving from each the difference between the number of points that he and they hold. Each player receives twelve cards, dealt two at a time. The remainder form the stock, which is left face downwards. There are no trumps. The player on the dealer’s left declares first: he can either play or pass. The dealer has the last option. If one person announces that he plays, the others combine against him. If all decline to play, the deal passes, the hands being abandoned. The single player may demand any “three” he chooses, giving a card in exchange. If the three demanded is in the stock, no other card may be asked for. If a player hold all the threes, he may demand a two. The single player must take one card from the stock, in exchange for one of his own (which is never exposed) and may take more. He puts out the cards he wishes to exchange face downwards, and selects what he wishes from the stock, which is now exposed; the rejected cards and cards left in the stock form the “discard.” The player on the dealer’s left then leads. The highest card wins the trick, there being no trumps. Players must follow suit, if they can. The single player and the allies collect all the tricks they win respectively. The winner of the last trick, besides scoring three, adds the discard to his heap. The heaps are then searched for the scoring cards, the scores are compared and the stakes paid. It is important to remember that the value and the order of the cards are not the same, thus the ace, whose value is 3, is only third as a trick-winner; also that it is highly important to win the last trick. Thirty-five is the full score.

CALABRIA, a territorial district of both ancient and modern Italy.

(1) The ancient district consisted of the peninsula at its south-east extremity, between the Adriatic Sea and the Gulf of Tarentum, ending in the Iapygian promontory (Lat. Promunturium Sallentinum; the village upon it was called Leuca—Gr. , white, from its colour—and is still named S. Maria di Leuca) and corresponding in the main with the modern province of Lecce, Brundisium and Tarentum being its most north-westerly cities, though the boundary of the latter extends somewhat farther