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Acetate of Lead.
Cathartic Acid, hypodermi
Intestinal Astringents, contract the walls of the intestinal vessels, diminishing the exudation there from, and lessening the fluidity of the fæcal discharges. The more powerful members of this group have also a constringing action on the intestinal mucous membrane. The principal agents of this class are the following:
Nitric Acid (dilute).
Hepatic Stimulants and Cholagogues (kohlay, bile, ago, I bring away), are two groups of agents acting upon the biliary secretion, the first-named increasing the functional activity of the liver and the amount of bile formed, the second removing the bile from the duodenum and preventing its reabsorption into the portal circulation. Some hepatic stimulants are also cholagogues, others are not, while cholagogues proper generally act as hepatic stimulants by carrying off the bile and so indirectly urging the liver to secrete more. The discovery of the entero-hepatic circulation of bile has cleared up many of the discrepancies formerly existing with regard to the action of drugs upon this gland and its secreThe following list includes the principal drugs belonging to both groups :
Salines in large doses.
Oxide of Zinc.
Sulphate of Copper.
Those in the first column are the most powerful of the stimulant group, the second column including the less efficient agents. To secure the best cholagogue effect it is advisable to combine an hepatic stimulant with an intestinal stimulant which shall produce increased secretion from the intestinal mucous membrane and excite peristalsis.
The Glycogenic Function of the liver, and the production of urea are stimulated by the following-named drugs:
Hepatic Depressants are agents which lower the functional activity. of the liver, reducing the quantity of bile secreted, and lessening the production of glycogen and urea. They are as follows, viz. :
Thread Worms (Oxyuris Vermicularis.)
Sulphate of Iron.
Many purgatives act as hepatic depressants and diminish the secretion of bile by lowering the blood pressure in the liver, and by carrying off the materials from which bile might be formed.
Pancreatic Stimulation may be obtained by the administration of Ether, or by Galvanism of the gland itself. The secretion is depressed by Atropine and by inducing nausea and vomiting.
Anthelmintics (anti, against, helmins, a worm),-are agents which destroy (vermicides) or cause the expulsion of intestinal worms (vermifuges). The chief vermifuges are Castor Oil, Jalap and Scammony, while the vermicides may be enumerated as follows, viz:
The substances enumerated in the first column are all used locally by enema. Adjuncts to these remedies are such agents as prevent the excessive secretion of intestinal mucus, which affords a nidus for the worms. Such are Bitter Tonics and preparations of Iron, also Ammonium Chloride and Sodium Chloride.
AGENTS ACTING ON METABOLISM.
Restoratives,-are agents which promote constructive metamorphosis, including the Foods, Hæmatics, and Tonics, as well as many agents called Stimulants in other classifications.
Foods, are substances which, when introduced into the body, supply material to renew some structure or to maintain some vital process; being distinguished from medicines in that the latter modify some vital action but supply no material to sustain such.
The food of man is derived from all three of the kingdoms of nature, viz., the mineral, vegetable and animal, and includes many substances treated of in the Materia Medica, as Oils and Fats, Sugar, Starch, Gum, Alcohol, Beverages like Coffee and Tea, Water, Phosphate of Lime, Chloride of Sodium, etc.
Hæmatics (haima, the blood),—are medicines which augment the quantity of hæmatin in the blood, and thus restore the quality of that tissue by enriching its red corpuscles. They consist chiefly of Iron and Manganese and their compounds.
Tonics (tonnos, tension),—are agents which improve the tone of the tissues on which they have specific action, restoring energy and strength to debilitated subjects, by a scarcely perceptible stimulation of all the vital functions, their effects being apparent in an increased vigor of the entire system. The chief tonics are enumerated in the foregoing lists under the heads of the organs, or tissues particularly affected by them. (Compare the titles STIMULANTS, RESPIRATORY STIMULANTS, CARDIAC TONICS, VASCULAR TONICS, GASTRIC TONICS, etc.)
The most typical medicinal agents which impart a general sense of tone and strength are Strychnine, Quinine, Iron and Vegetable Bitters. Those especially acting upon the stomach, are Arsenic, Bismuth, Cinchona, Hydrastis and Nux Vomica,-on the spinal cord and general circulation, Strychnine,-on the heart, Digitalis, Squill, Convallaria and Cimicifuga, on the nervous system, Phosphorus, Quinine and the Valerianates,-on muscular tissue, Tannin,-on the blood, Iron, Manganese, Cod-liver Oil, and other fats.
Alteratives,—are certain remedies which alter the course of morbid conditions in some way not yet understood, perhaps by promoting metabolism. They certainly modify the nutritive processes and thereby cure many diseases of chronic type. Mercury and Iodine are the most prominent agents of this class, the former being endowed with the power of breaking up newly deposited fibrin, and disorganizing syphilitic deposits, while the latter acts energetically upon the lymphatic system and promotes absorption. Arsenic also is almost specific in many chronic skin affections, and has remarkable power over chronic pulmonary consolidations, probably producing fatty degeneration and softening of the effusion, so that it may be absorbed or expectorated. The principal alteratives are:
Certain therapeutists of laboratory type have, of late years, seen fit to denounce the term Alterative as “a cloak for ignorance," but have never been able to present a better designation for a class of agents whose effects are among the most thoroughly established of clinical facts.
A subdivision may be made of the Resolvents or Discutients (Resolvo, I unbind, Discutio, I dissipate),-agents which promote the absorption of inflammatory products or other materials of morbid origin, apparently by stimulation of the lymphatic system. They include Mercury, Arsenic, Iodine, and Cadmium, as well as such local measures as Poulticing and Counter-irritation.
Metals and their salts.
The Destructive Metamorphosis of the tissues is promoted by a number of agents, most of which are classed as Alteratives or as Astringents, the most important of which are the following-named :-
Oils and Fats.
Sulphides and Iodides.
Tannic and Gallic Acids, and substances containing them.
On the other hand, Metabolism may be diminished by many substances, the following-named being the chief ones:
Antipyretics (anti, against, peuretos, fever), are agents or measures which reduce the body-temperature when abnormally high. This may be done by two principal methods, and the agents doing either accomplish the result by different actions, as follows, viz. :
By Lessening the Production of Heat, by 2. Reducing the circulation.
4. Producing perspiration, and its evaporation.
The following list contains nearly all the antipyretics, the number following each referring to its proper method of action, as enumerated above:
Other Essential Oils.1
Purgation and Venesection produce antipyretic results, but their mode of action is doubtful (Brunton).
Antiphlogistics (anti, against, pfleggo, I burn), -are measures and medicines which are supposed to have some specific power in reducing inflammation. The term is becoming obsolete, but frequent references are seen yet to the influence of Mercury and Opium in inflammations of serous membranes, Antimony and Aconite in inflammations of the respiratory tract and organs, and to the power of Veratrum Viride over puerperal metritis. The chief antiphlogistics are the following:
Nitrous Ether. 3,4
Rest, recumbent position.
Cinchona Bark and its Alkaloids.
Antiperiodics are remedies which affect certain periodical febrile diseases, lessening the severity of their paroxysms or preventing their return. They act probably by arresting the development in the blood of successive crops of pathogenic organisms, upon which the disorders are supposed to depend. The principal antiperiodics are :
AGENTS ACTING UPON EXCRETION.
Diuretics (decouraysis, urination), -are remedies which increase the renal secretion. They may act in several ways, namely:
3. By stimulating the secreting nerves or cells of the kidney.
4. By simply washing out the kidneys, as by Water in quantity.
I. By raising the general blood-pressure by contraction of efferent vessels or vessels in other regions of the body.
2. By dilating the renal arteries and increasing the renal blood-supply, raising the pres. sure in the glomeruli.
The following list contains the most important agents of this class, which are usually subdivided into the two groups indicated by the subtitles. The numbers refer to the modes of action of the drug in the above synopsis: