m. p. 1.—That Eliminatives are medicines which pass into the
blood.
m. p. 2.—That they cannot remain there, but must pass out
of the body.
m. p. 3.—That in so doing, they tend to pass out by some
glands more than by others.
m. p. 4.—That the result of their passage through a gland is
to increase its secretion.
m. p. 5.—That they are of use when the state of the system
requires that the function of a gland should be
restored or promoted.
What I wish to prove is, that a medicine increases secretion simply by being itself secreted; that while passing through a gland it stimulates the secreting cells, and rouses them to a proper performance of their natural function; that each eliminative medicine has a tendency towards particular glands, and increases the secretion of those glands; that thus, as far as our information on the subject extends, we find that Cathartics are excreted from the blood by the glands of the bowels, and pass out with the fæces; that Diuretics are to be discovered in the urine, Diaphoretics in the sweat, and those Expectorants which are volatile may be detected in the odour of the breath.
Any material which is naturally eliminated would act as an eliminative medicine. Thus if a drachm of Urea be dissolved in water, and injected into the veins of a dog, it causes copious urination, which continues until the whole is excreted. This well illustrates the argument.
Further, we find that when an eliminative medicine is diverted from the gland by which it usually passes out, it no longer augments the secretion of that gland. Dr. Ward gives an interesting case of a woman who was never purged by Castor-oil, but in whom the oil exuded from the skin, and acted as a Diaphoretic. And it is, as I have said, well known that the conditions of cold and exercise will cause a Diaphoretic, in most cases, to act on the kidneys, because it is then excreted by them. For the same reason, warmth, confinement, and rest, will induce a Diuretic medicine to act on the skin.
Thus if it be shown, on the one hand, that Eliminative medicines themselves pass through the glands whose secretions they augment; and, on the other hand, that when they do not pass through them, they do not, as a general rule, augment their secretion,—it may then fairly be presumed that they operate by so passing through.
I assert, then, that medicines which stimulate secretions are themselves secreted. But the converse of this—i.e. that all medicines which are secreted at the same time increase secretion,—though it holds good in the main, is not invariably true. There are two chief exceptions to it. These are Astringents and Hyperæmics.