Pharmacologia / Fourth American, from the Seventh London Edition

by John Ayrton Paris

But the therapeutical utility of Cathartics extends beyond the mere feculent evacuations which they may occasion. In consequence of the stimulating action which some of them exert upon the exhalent vessels, they abstract a considerable portion of fluid from the general current of the circulation, and are, on that account, beneficial as Anti-phlogistics. For the same reason they may act as powerful promoters of absorption, for there exists an established relation between the powers of exhalation and absorption, so that when the action of one is increased, that of the other is augmented.

Certain Purgatives, as I have just stated, exert their influence upon the neighbouring organs, and are calculated not only to remove alvine sordes, but to detach and eliminate foul congestions from the biliary ducts and pores.

With such facts before us, it is impossible to concede to the opinion of Dr. Hamilton,[^[155]] that the different species of purgative medicines do not possess distinct powers over the different species of matter to be evacuated; on the contrary, there is reason for reviving the ancient theory, too inconsiderately abandoned, and which acknowledged these different distinctions in the operations of cathartic medicines, under the appropriate names of Hydragogues, Cholagogues, &c.

The importance of cathartic medicines having been shewn, and the distinctions in their modes of operation established, it only remains to say a few words upon the subject of their abuse. All the remedies of this class, but more especially those of considerable power, require caution in their administration, even in those diseases where they are indicated by peculiar symptoms, especially if there be any tendency to inflammation, or to extreme debility, although this latter symptom is often rather apparent than real, and is at once removed by the brisk operation upon the bowels; during pregnancy and immediately after delivery, and during the flow of the menses, the prudent practitioner will use a discretionary caution in their exhibition. The too frequent use of these medicines will induce marasmus, and render the bowels so morbidly irritable, that purging is easily excited by the ordinary stimulus of our aliments; while in some habits the contrary obtains, and the resource to which the valetudinarian flies for relief only increases the torpor of the intestines, and confirms his costiveness.

The mode of adapting, combining, and administering Cathartics, will present subjects for our future consideration.

EMMENAGOGUES:

Medicines which are capable of producing the Menstrual discharge.

As Amenorrhœa, or retention of the menses, is generally the effect of a morbid state of the body, it follows that remedies capable of acting as Emmenagogues can only be relative agents, unless indeed we are disposed to accede to the opinion so generally maintained in the writings of the older physicians, but now generally discarded, that certain substances exert a specific[^[156]] action upon the uterus. It may certainly be asserted without fear of contradiction, that there are many substances which, when received into the stomach, have their stimulant operation more particularly determined to one part than to another; alkalics, for example, to the kidneys; cantharides to the bladder; mercury to the salivary glands, &c. Reasoning therefore by analogy, it was not unphilosophical to conclude, that similar medicines might exist with respect to the uterus; but experience has negatived the supposition, there being no proof of any of the substances styled Emmenagogues producing their effects by any specific influence upon the uterine system. If the term Emmenagogue be assumed conventionally, according to this view of the subject, it may be retained without any fear of error, otherwise it would be wiser to remove the name from our classification.

The suppression of the catamenia usually depends upon a debilitated state of the body, although it is sometimes the consequence of a plethoric diathesis; in the former cases tonics, in the latter, venesection may display the powers of an emmenagogue; upon which occasion, I have frequently derived the greatest benefit by cupping the patient upon the loins. Where the disease occurs in young women, about the age of puberty, it is very generally connected with extreme debility of the system; the preparations of iron, bark, and other invigorating medicines, are accordingly the most likely to succeed in its cure. Whereas in full florid habits, when the catamenia are suddenly suppressed, Laxatives, Diaphoretics, or blood-letting, afford the surest means of relief.

There are two other classes of medicine which may occasionally prove emmenagogue—Acrid Purgatives, which act upon the rectum, and hence by contiguous sympathy upon the uterus, as Aloes, &c. and Stimulating Diuretics, as Cantharides, the Turpentines, &c. which are supposed to excite the womb, sympathetically, by their stimulus upon the bladder. Nor is the advantageous influence of mercury to be overlooked, which, in cases of morbid action in the secreting functions, prove a Herculean remedy.