462 MATER i A MEDIC A AND THERAPEUTICS. 



we have to direct a considerable part of our treatment to the 

 maintenance of the general nutrition, by preserving digestion, 

 and giving highly-nutritious foods, such as Cod-liver Oil until 

 the process has temporarily spent itself, and ended possibly with 

 the evacuation of the diseased parts. 



The question of the treatment of syphilis, chronic gout, 

 rheumatism, and a number of local diseases probably related to 

 these, for example, of the skin, joints, and nervous system, in- 

 troduces us to the use of alteratives. "We saw that alterative 

 drugs act by exercising the tissues, and we have now to point 

 out how exercise benefits an organ actually the seat of disease. 

 For instance, syphilis is characterised locally by masses or 

 patches of small-celled growths, with peculiar anatomical 

 relations, proceeding probably to ulceration, that is, to death of 

 the part. How do Mercury and Iodine remove these growths 

 and thus cure the syphilis ? In answer to this question it may 

 be said that there are two ways in which it may be desirable to 

 exercise tissues. First, there may be need of increased meta- 

 bolic change in order to remove excessive growth. Mercury 

 and Iodine act, partly at least, in this way upon syphilitic 

 growths. They hasten the life-processes of the young cells 

 so much, that the cells disappear in the form of products, or, as 

 it is commonly expressed, " are absorbed." It is essential to 

 the success of this plan of treatment that the alterative sub- 

 stances should be thoroughly under control, and, as we have 

 seen, that abundant food and air be ingested to prevent 

 failure of nutrition. 



Secondly, there is an effect of exercise beyond an increase of 

 work accomplished : work that is increased in amount can be 

 changed in kind ; exercise is beneficial, not only to the indolent 

 individual, but to the vicious. So with the tissues. Exercise 

 may bring them into a new, a normal, state of function, when 

 they have been deranged or even diseased. In order to get the 

 tissues to work normally, we must get them to work somehow, 

 knowing that such work means chemical change, or even active 

 nutritive renovation of the elements. The natural disposition 

 which all tissues inherently possess to return to the normal, is 

 thus afforded an opportunity of coming into play ; and the result 

 is, not a mere increase of activity, but also an alteration in kind 

 of the activity. Henceforth the protoplasm, if supplied with 

 an abundance of food and oxygen, itself returns to the normal 

 state. This powerful effect of alterative drugs is seen in such 

 diseases as chronic gout, skin diseases, rheumatism, and 

 disorders of the nervous system. Besides Iodide of Potassium, 

 the alteratives used for this second purpose are chiefly Arsenic, 

 Silver, Antimony, Phosphorus, and occasionally Copper and 



