The fifth minor proposition treats of the application of these agents in the treatment of disease. They are of use when it is requisite that the function of a gland should be restored or promoted. There is scarcely any disease in which some or other of them may not be of service. Their remedial applications are many and important.
Eliminatives are used to restore the function of a gland when impaired. With this view, Cathartics are employed in constipation, Diaphoretics for dryness of skin, Cholagogues in torpid states of the liver.
They may eliminate a poison or morbid material, and thus resolve a disease. This probably is the rational explanation of the use of Diaphoretics and Diuretics in Fevers, Gout, and Rheumatism, and of purgative medicines in a great number of disorders.
We may, by an action on one gland, be enabled to replace the function of another gland. The amount of each secretion bears more or less an inverse proportion to that of other secretions. Thus when one of them is unduly copious, we may diminish it by stimulating the formation of another. In other cases the reverse condition may occur; one of the secretions may be diminished or suppressed by a cause over which we have no control, and the matters which should be contained in it may be left in the blood, causing various mischief there. Here again, by increasing one of the other secretions, we may replace the function of the diseased gland, and cause the elimination of these products from the body by another channel.
Fourthly, Eliminative medicines may be of service by draining away from the blood fluid and solid matters. The first result of their action is to stimulate the proper secretion of a gland; but when it is pushed to a further extent, they may actually case the excretion of some of the natural constituents of the blood. Thus by an action on the skin or the kidneys, we may cause a copious evacuation of water, holding in solution saline matters. By increasing the secretion of the intestinal glands, we may cause the albuminous serum of the blood to be poured out into the cavity of the bowels. Thus it is that all Eliminatives are more or less antiphlogistic. Cathartics are especially so. Their influence, when carried to excess, is analogous to that of blood-letting. As evacuants, Cathartics are employed in diseases of the brain especially; and Diuretics are made use of in dropsies to diminish the amount of fluid in the blood, and in this way to promote absorption.
So much having been said of the general action of Eliminatives, we proceed to make a few remarks on the individual orders of medicines which are included in this division. Those substances can alone be properly included in these groups which really act on the principle of elimination, as above defined. There are in many instances other medicines which are found to increase secretion in an indirect way.
Ord I. Sialagogues.[45]
This name is applied to medicines which in various ways increase the quantity or promote the excretion of the saliva. They are seldom employed as remedial agents; for the excretion of saliva is constant and very rarely suppressed, and it is so small in quantity, and so great a source of inconvenience when increased to any amount, that Sialagogues can never be employed as general evacuants. There are two kinds of Sialagogues.
Any solid substance which excites the mucous surface of the mouth, as the natural food,—or even the act of mastication alone,—will suffice to bring on the secretion of saliva. An irritant substance, as Ginger, or Pyrethrum, tends especially to cause this secretion when masticated. Catechu and Betelleaf are chewed for this purpose by the natives of the East.