Whole Drug Preparations vs. Fragments.

Selected writings of John King:

WHOLE DRUG PREPARATIONS VS. FRAGMENTS.—That plant medicines should be prepared to hold so far as possible the natural bonds of union of the characteristic structures found in the native state has been an oft-enunciated principle of latter-day Eclecticism. The divorcement of parent drug from broken out principles has been consistently opposed by leading Eclectic practitioners from the very beginning of our pharmacy, though early efforts at concentration were made by some. Even the latter proved to yield inferior medicines, and such methods were long ago relegated to the past history of experimental pharmacy so far as Eclecticism is concerned. Eclectics have from start to finish persistently and consistently demanded as nearly as possible whole plant medicines. They have done so because clinical experience, that best of medical teachers, has taught them that with energetic drugs the best, fullest, and most uniform results come from such medicines without the dangerous drug shock that so often comes from the administration of extremely toxic fragments—be they alkaloids or glucosides—even in the ordinarily approved dosage. On the contrary, it has also been observed that some presumably important fragments are not only not toxic but practically inert when compared with the drug from which they have been disrupted.

Notwithstanding the claims of some that an active principle represents the parent drug except in power, Eclectics who once went mad over proximates, have claimed that proximate principles vary largely, so much so that products of different manufacturers are found to produce the most variable of results, and that many so-called active principles, even of presumed ultimates, fail to exert the same action and give the same therapeutic results. In this connection one has but to read the story of the so-called Aconitines.

When one has long known a therapeutic fact clinically learned, but has clinical observations only to corroborate his belief, it is at least gratifying to have a connected scientific truth uncovered that will substantiate his position. Eclectics have justly contended that aconitine no more represents aconite than atropine represents belladonna, or gelsemine gelsemium. Even old school authorities (now traveling over the old Eclectic road) admit that morphine, though the chief alkaloid, nor any of the many principles of opium, singly or re-combined, do not represent the action of opium physiologically and that the therapeutic uses of the parent drug and its alkaloids are widely variant.

While the Eclectic has taken this ground he must not be misunderstood. To alkaloidal medication as such, through indications founded upon the long study and use of fragments, he is not antagonistic, nor does he deny to others the right to such a practice. He believes, however, that a more desirable practice comes from the use of whole drugs because certain alkaloids are often too energetic and less readily under the control of the prescriber. In other words, he regards it a far less safe therapy as now practiced. But what he objects to most strenuously, and rightly we believe the reader will concede, is what was pointed out by the writer in an early edition of the GLEANER, alkaloidal therapy teachings by indications not established upon a study of the use of alkaloids themselves, but upon the whole drugs from out of which the principles have been broken. Reasoning by kinship that such indications will apply is neither truthful nor just: for it is well-known that there are balanced therapeutic possibilities and power in such drug structures which have never been dissociated that can not possibly belong to an isolated fragment. Such power may be one of added strength or one of restraining influence. We assume that it is not fair to the practitioner to mislead him in this matter, nor to jeopardize the life or health of the sick by over or under medication through ill-adapted drug substances and ill-advised indications.

On the other hand the physician who uses natural drug compounds, upon indications founded upon such entire drugs, gets the fullest and best action of his medicine with the least variability and least danger of either toxic results on the one side or non-effect on the other. He has, too, a controllable medicine; and besides, he has the lessons of history to fortify him in the long and uniform testimony from the experience of Eclectic physicians in nearly fifty years' use of whole plant products. Few will gainsay the fact that the Eclectic physician has half a century of experience in these directions, nor will any one deny that our Eclectic pharmacists have advantages in the direction of proximate principle manufacture second to none, either as to experience or apparatus. The Eclectic knows and has tested the indications, which takes years to establish, founded upon drug integrity. He has found them to work out so true that for ourselves we can see no reason why he should risk the substitution of a dangerously toxic alkaloid in preference to the more kindly methods known to him, particularly if the treatment be of women and children.

The Biographies of King, Howe, and Scudder, 1912, was written by Harvey Wickes Felter, M. D.