The Action of Remedies.
Selected writings of John M. Scudder.
THE ACTION OF REMEDIES.—Can any one tell me how or why quinine cures ague, Morphia produces sleep, Atropia dilates the pupil. Lobelia vomits, or Podophyllum purges? Can you tell why or how Aconite and Veratrum slow the pulse and reduce the temperature, Asclepias or Jaborandi produces diaphoresis, or Macrotys relieves rheumatism of the uterus? Can you tell why or how a minute portion of rattlesnake or cobra poison, or the virus of hydrophobia, will produce death? or why small-pox virus or scarlatinal poison will produce those dread diseases? Why is it that nitro-glycerine (glonoin) is such an intense poison, whilst its elements, nitric acid and glycerine, may be used freely? In chemical elements, Quinine, Morphine, Atropia, and Aconitia, are very much the same; why the diversity of action? Why the intense action of Aconitia and Atropia in minute doses, when quinine may be taken by the teaspoonful ?
These are knotty problems, but they require an answer before one is ready to say that good can only come from certain drugs and large doses, and can not come from other drugs and small doses.
When a man is ready to tell us why the atoms of carbon are brought together to form that most wonderful and precious of all stones, the diamond, then he will be able to offer an objection when we say that the same atoms will confer on some sick that most precious of all gifts, health. Protein bodies of oxygen, nitrogen, hydrogen, and carbon are our daily food, and renew our tissues, yet the same elements give us the most deadly poisons.
There are many things in this world that we do not know, very many that we can not know. What we know, frequently, is the bare fact that certain causes produce certain results; how or why they are produced, we can not know. When we study the action of remedies we go thus far, no farther. I note a certain condition of disease, give a remedy, and get a result. I try it time and again with the same result, and I associate them as cause and effect. I give the minute dose of graphites, and find that the patient gets well. I repeat it in case after case with the same result, and I associate the getting well with the administration of the remedy. I am not obliged to tell why the minute quantity (a few atoms probably) of carbon influences a body that contains millions of times the quantity, or takes as food daily thousands of times the quantity, or expires the same material; I simply note the fact that it does. Neither am I obliged to tell why stone-coal, charcoal, diamonds, effervescent water, or carbonic acid gas should not be given in place of graphites. You might just as well ask me to tell why I use morphia in one case, atropia in another, and quinine in another, only as experience has shown the result of their administration.
Ten drops of Baptisia to four ounces of water, in teaspoonful doses, has arrested the progress of the most severe zymotic disease. Ten drops of Phytolacca in four ounces of water has been found the remedy in hundreds of cases of diphtheria; the same remedy will arrest inflammation of the mammary gland, or prevent it when threatened. The moderate dose of chlorate of potash will arrest puerperal sepsis, and save our patient from puerperal fever. The hundredth of a grain of mercury in Donovan's Solution controls the syphilitic poison more efficiently than ten-grain doses of calomel. Why and how all this?
I have arrested passive hemorrhage a hundred times by the administration of the second trituration of charcoal, and in some of these cases the entire routine of the ordinary remedies had been used without avail. In a recent case it cured a hemorrhage from the kidneys where a score of remedies had failed.
I do not think that I am over credulous, and I am pretty sure I have fair to ordinary senses, and when I see a thing in the practice of medicine repeat itself from time to time, I am pretty sure that I see it; and when I say that I know that a small dose will cure, the reader may be pretty sure that I know it.—SCUDDER, Eclectic Medical Journal, 1878.
The Biographies of King, Howe, and Scudder, 1912, was written by Harvey Wickes Felter, M. D.