At the present day a more enlarged view is adopted. It is admitted that we may often assist these attempts of nature at a cure, and do good by the use, when thus needed, of evacuant medicines; but at the same time we must allow that there are many other advantageous modes of treatment,—that we may sometimes cut short a disease in the blood, or relieve a disorder by controlling vascular or nervous excitement, without resorting to elimination at all.
f. M. Broussais was one of the first who rightly maintained that many medicines were of use by means of an alterative or revulsive action, by producing a distinct effect which diverted the attention of the system from the disease. His followers have classed remedies under three heads,—as Stimulants, Debilitants, and Revulsives. He maintained also some other peculiar ideas.
Blood-medicines are commonly termed Alteratives, from the notion that they divert or alter the original disease by setting up in the system a peculiar process of their own. The term Revulsive is especially applied to medicines which produce a powerful local effect, and are supposed so to occupy the attention of the system as to tend to cure the disease which formerly engaged it. Counter-irritants externally, and emetics among internal medicines, are generally admitted as revulsives.
The idea of revulsion is a prominent feature in the arrangement of medicines adopted by Dr. Schultz, of Berlin, who adds to the above, Expectorants, Purgatives, Diuretics, and Sudorifics. He divides medicines into Biolytics, tending to dissolve life and structure; Anabiotics, which tend to stimulate the same; and Agonistics, tending to produce a "defensive" process, and acting by revulsion. Each class is again divided into those which affect the organs and nutrition in general; those which act on the blood; and those which particularly influence the nerves. I will give examples of each.
| Schultz's Classification. | ||
| A. Biolytica. (Depressents.) | ||
| 1. Plastilytica. (Mercury, Alteratives.) | ||
| 2. Hæmatolytica. (Acids, Alkalies.) | ||
| 3. Neurolytica. (Sedatives.) | ||
| B. Anabiotica. (Excitants.) | ||
| 1. Plastibiotica. (Astringents.) | ||
| 2. Hæmatobiotica. (Diffusible stimulants.) | ||
| 3. Neurobiotica. (Opium, Strychnia.) | ||
| C. Agonistica. (Revulsives.) | ||
| 1. Plastagonistica. (Purgatives, etc.) | ||
| 2. Hæmatagonistica. (Irritants.) | ||
| 3. Neuragonistica. (Emetics, Expectorants.) | ||
These divisions are again subdivided with great minuteness, according to their supposed operation. And yet it will be seen that, in spite of the hard names, there is an admirable simplicity in this arrangement. So many and so various are the statements made, and so plausible the theories involved, that I cannot accord to it here a fair consideration. I must object to it, however, that there is too much generalization, and, what is more important, that many medicines may cure diseases without necessarily causing either excitation or depression or acting distinctly by revulsion. The only principles of action admitted here are these three, the same which are adopted by the disciples of Broussais. To suppose that medicines acting on the glands are only of use as revulsives, that they have no influence on the blood, and are never engaged in purging the system of peccant or morbid matter, is surely incorrect in theory. Medicines of the first class, when given in proper dose and in fit cases, are not engaged in destroying organization, nor is it invariably the case that such remedies as Mercury, Acids, and Alkalies act even as depressents, when given in moderation.
Further, the lines of distinction are too arbitrary, and drawn with too much precision. The variations in the actions of different medicines are too many and too great to be thus easily accounted for, and we do not know enough about many of them to be able to define their operation so exactly. And there is no explanation at all given here of the special tendencies of some remedies, by which we are enabled to cure a great number of disorders.
g. The Hippocratic maxim was a step towards a correct solution of the therapeutical operations of remedial agents. The humoral theory of Sydenham, and the threefold action supposed by Broussais, were further advances in the right direction. But these views were all too confined. Correct as far as they extended, they did not embrace the whole range of the subject; for it is impossible to explain by any one of them the operations of all medicines.