Some other medicines rest very closely upon the confines of this order. Squill is the chief of these. It is not quite clear whether Squill should be regarded as a Special Sedative, or considered simply as an irritant Emetic and Eliminative. It is a valuable Expectorant. It is also a Diuretic; and from the analogy of its operation to that of Digitalis (vide supra,) and because it appears to be a specific Emetic, it is most probably a true Neurotic.
But we must not confound with Neurotics those medicines which exert a slow operation in the blood which results at length in a nervous affection. This may take place, to a greater or less degree, with all Catalytic Hæmatics. Lead, which is anti-convulsive and astringent, approaches nearest of all to the recognised nerve-medicines. After existing for some time in the blood, it produces local palsy, particularly of the muscles about the wrist; and it sometimes affects the sensory nerves, causing sharp shooting pains in the limbs. These nervous symptoms are caused by the accumulation in the system of the poison of lead, and the deterioration of the blood which is thereby produced. In the case of the palsy, we cannot certainly say whether these causes operate first upon the motor nerves, or upon the muscles themselves.
Lead certainly has some tendency to affect the brain. All kinds of brain disorders may occur in cases of chronic lead-poisoning. The metal has been found in the brain after death; but it also exists at the same time in other parts of the body. In cases of Lead-colic there is generally a paralysis of the muscular fibre of a certain portion of the intestine. The pain of the disorder is caused by an irritation of the nerves of the part.
Neurotics are medicines which tend, immediately they enter the blood, to be discharged from it upon the nervous system. They therefore immediately affect the latter. Hæmatics, in small doses, pass through the blood without exerting any direct effect upon the nerves. They are never discharged upon the nervous system except after they have for some time existed in the blood in such quantity as materially to vitiate its healthy character. Corrosive poisons affect the nerves by a violent revulsive action; and are not to be considered in the same category as medicines. Thus Lead is not a true Neurotic, but a blood-medicine. (Vide page 175.)
We have now concluded our brief review of the action of Neurotic medicines. Some few will be again treated of in the fourth chapter. The views of their operation which I have wished to substantiate are in many cases the same as those which are generally adopted, in some cases different from them. In either instance I have attempted to base them on observation, or on simple inductive reasoning.
It has already been observed that these nerve-medicines are more rapid and more evanescent in their action than those which preceded them. They are unable, as a general rule, to produce a permanent effect. When such a permanent impression is desired, an approach to it can be made by a continual repetition of the dose, by which a transitory action may be constantly renewed and kept up. In other cases a mere transitory action may produce a cure. This may be the case in a sudden and dangerous emergency, which will pass over if the system can be supported through it, but which threatens life while it lasts. Or in Neuralgia, if the irritability of the sensory nerve be continually blunted by the external application of Aconite, it may at last subside altogether, and a right condition of things be restored. The same may be said of convulsive disorders, and the stimulant antispasmodics which are used to control them.
Neurotics are mostly employed in temporary emergencies. In such cases their action is often decisive and gratifying. Vital action may be restored and kept up; or excess of action allayed. Pain may be suddenly and effectually removed; delirium or convulsions subdued. Sleep may be substituted for wakefulness, or activity for torpor. By these powerful remedies we are enabled to exert an immense control over the varied manifestations of nervous force; and may often, when we wish it, substitute one condition for another which is the reverse of it. When there is a deficiency of nervous force, we make use of a Stimulant, or of one of the Inebriant Narcotics; when there is an excess of the same, we employ a Sedative, or one of the latter two Narcotic orders.
But when we desire to quell a long-standing and firmly-rooted disorder, which is not displayed by violent outward manifestations, but is nevertheless working fatally within, we must then call to our aid some Hæmatic medicine, which alone can be of permanent efficacy in such a case.