The Action of Medicines in the System / Or, on the mode in which therapeutic agents introduced into the stomach produce their peculiar effects on the animal economy

by Frederick William Headland

[CHAPTER IV.]

ON THE ACTION OF SOME OF THE MORE IMPORTANT MEDICINES IN PARTICULAR.

The chief objects for which I have designed this Fourth Chapter are that I may be enabled to illustrate some general principles of the action of medicines which have been laid down in the Propositions, and show in what manner they are applicable to special cases,—and to enter into certain details respecting the more important remedies, which have not been attempted as yet. Of many of these medicines a tolerably full account has already been given; but they may again be mentioned here for the purpose of shortly summing up their several actions, and comparing them one with another.

It often happens that there is more than one point of view from which the action of a medicine may be regarded. For many medicines are numbered under several distinct heads, being included in different groups on account of the several phases of their operation. There are three stages in the progress of the remedy through the system, at each of which it may exert a special action. There is a contact with the surface; a continuance in the system; and a passage out of the system. In the first place a medicine touches the mucous surface of the alimentary canal; here some few evidence their action. From this, if in any way soluble, it passes into the blood. Here it may act on the blood, being Hæmatic. Or it may employ the blood merely as a means of transit, and direct itself towards nerve or muscular fibre, being Neurotic or Astringent. But we have seen that none of these medicines, with the only exception of Restorative Hæmatics, can remain long in the system. They must pass out, and the mode of passage is through the glands. Here is a third opportunity of operation. The medicine may act now as an Eliminative, increasing the secretion of the gland; or, more rarely, as a glandular Astringent, because tending to diminish it.

As a general rule, though not in all cases, the most important action of a medicine is that which it first evidences, the subsequent operations being secondary, and of less moment. Thus Mercury is, in the first place, a Catalytic Hæmatic; in the second place, an Eliminative. Creosote is firstly a general Sedative, secondly an Astringent. Antimony probably belongs to three out of the four classes, and its second operation is perhaps the most important. It is a Catalytic, a special Sedative, and also an Eliminative.

COD-LIVER OIL.

Class I. Div. I. Ord. I. Alimenta.

This oil has been proved by the experience of many physicians to be a medicine of great utility in most cases in which there is a general deficiency of fat in the system. It is thought also to exert a specific action in the cure of pulmonary Phthisis, and it certainly appears to be the only medicine that possesses any marked or peculiar power over the progress of this disorder. When administered in favourable cases it seems not only to have the power of fattening the patient, but to be able also to combat and cure the disease itself, arresting or retarding the tubercular deposit. Sometimes it is unable to do this; but in all cases of consumption a trial should at least be given to it. It is of most service when the disease is only incipient, and, if given in the first stage, may often prevent its further progress; but it may even cure patients in whom the deposit has passed the stage of softening, as appears from the reports of the Brompton Hospital.

It is also of use in Scrofula, in chronic Rheumatism, and in cases of emaciation generally. It may prove nutritive in Diabetes mellitus, because it is not likely to be converted into sugar in the system, whereas in that disorder all kinds of food, excepting fats and oils, are liable to this change. Cod-liver oil is assimilated to the tissues, and there seems to be something in it which not only renders it more easy to assimilate than other oils, but which further endows it with a special influence over tuberculous diseases. It does not appear that any other oils are equally effective. Though Dr. Duncan and Mr. Nunn have recommended Almond-oil instead of Cod-liver oil, yet the general experience of others is decidedly against such a substitution.