The possession of decided hypnotic qualities has led to the use of hyoscyamine and hyoscine in the treatment of various mental disorders (Prideaux, Lawson, and others). Prideaux makes the important practical distinction, that it acts with different degrees of rapidity and potency under varying conditions of insanity. In acute mania with depression, one sixteenth of a grain will have a marked effect, while in the excitement of chronic mania large doses will be necessary. In chronic mania with exacerbations, he gives one quarter, one half, and even one grain by the stomach, or one tenth of a grain subcutaneously. The latter mode of administration he regards preferable in these cases. In cases of mania with great motor excitement, and of a destructive character, Prideaux regards hyoscyamine as "the most rapid and reliable narcotic we possess." In the epileptic mania of the epileptic status, he says, it diminishes the number and violence of the attacks. In delusional insanity he finds it brings about, under favorable circumstances, mental restoration. In chronic dementia, with destructive tendencies and sleeplessness, improvement is sometimes noted from the persistent use of small doses. Reinhard also has administered this agent in the dose of a milligramme (about one sixty-fifth of a grain) subcutaneously in cases of mania and epilepsy, with distinctly good results. In eight of fifteen cases of mania, calmative effects were produced and permanent good was accomplished; and in five of twelve epileptics with maniacal attacks, the number and severity of the seizures were lessened. Drs. Sapilli and Riva, eminent Italian alienists, have found hyoscyamine very useful in recurrent mania. Gill, Ringer, and Lawson have also had good effects from hyoscyamine, in suitable cases, as an hypnotic.

Stramonium and hyoscyamus may be used like belladonna for the relief of painful affections, the neuralgiae; but they possess no special advantages over their more powerful congener. Oulmont has used the hypodermatic injection of hyoscyamine with remarkable success in several cases of neuralgia, but he does not regard it as more conspicuous and rapid in this disease than are opium and belladonna. Stramonium is used with advantage in the treatment of dysmenorrhoea. Rx Ext. stramonii, ext. hyoscyami, ext. opii, āā gr. vj. M. Ft. pil. no. xij. Sig.: One pill every three, four, or six hours. This combination gives great relief in dysmenorrhoea, and may also be serviceable in neuralgia.

In affections characterized by spasm, as asthma, laryngeal cough, hepatic, intestinal, renal, and uterine colic, stramonium and hyoscyamus may be given with advantage, in place of or in combination with belladonna. The hypodermatic injection of hyoscyamine or daturine is an excellent expedient for procuring relief in these cases, but these alkaloids are not more effective than atropine. Hyoscyamus, especially in the form of tincture, is frequently prescribed in irritable states of the bladder due to the presence of stone, enlargement of the prostate, and in catarrh of the bladder arising by transference of irritation from the urethra. It should not be forgotten that liquor potassae, so much prescribed in a mixture with hyoscyamus, is incompatible.

M. Oulmont refers, in terms which may seem to be exaggerated, to the great efficiency of hyoscyamine in the treatment of mercurial tremor, senile tremor, paralysis agitans, locomotor ataxia, and tetanus. In mercurial and senile tremor cures were obtained, but, as might be expected, only amelioration in paralysis agitans, locomotor ataxia, and tetanus. The remarkable benefit obtained from this remedy in paralysis agitans is testified to by Empis, Joffroy, Charcot, and many other observers. The dose which Oulmont found effective was the one thirty-second of a grain of hyoscyamine, gradually increased to the one fifteenth of a grain.

The hypnotic quality is much more conspicuous in hyoscyamus than in belladonna or stramonium. In children it has long been known that, when opium is not well borne, hyoscyamus is an efficient substitute. Recent experience in asylum practice has shown that hyoscyamus in large doses is a very valuable hypnotic. According to Dr. Campbell, two and a half drachms of the tincture are equivalent in hypnotic power to thirty grains of chloral hydrate. In order to procure efficient hypnotic effects, from two drachms to an ounce of the tincture is necessary, and this large quantity appears to be free from danger.

Extract of hyoscyamus is used in combination with purgatives, with the object—which abundant clinical observation confirms—of rendering their operation more efficient, no doubt, because of its action on the muscular layer of the intestine.

The ointment of stramonium is a favorite application to irritable ulcers, superficial inflammations, etc.