EFFECTS OF NARCOTIC MEDICINES. 
2*27 
tuting, in lieu thereof, gruel, or linseed tea, and a more solid 
aliment. Were we in possession of some mild, readily and easily- 
acting aperient, we probably should not think of having recourse 
to (what surgeons would call a drastic and an irritating one like) 
aloes ; but, since we have it not in our power to nauseate by anti- 
mony or ipecacuanha, nor to purge with neutral salts, castor oil, 
or senna, we must by other means do our best to bring about the 
same ends ; and, for my own part, I do not know any thing that 
will so well answer that purpose as our ordinary cathartic mass. 
I am not an advocate myself for exhibiting aloes in very small 
doses at stated intervals — three or four times within the twenty- 
four hours — in bronchitic, pleuritic, or pulmonic affections, with 
the intention of creating and continuing a state of nausea, and of 
moderately opening the bowels and promoting the urinary dis- 
charges. Aloes is a cumulative medicine, and one that will — 
as most medicines are found to do — take a much greater effect, in 
proportion to the actual qualities taken, in small or divided doses 
than in one single administration ; and thus it too often happens, 
when exhibited in this divided form, that purgation sets in unex- 
pectedly, and that we find ourselves unable to suppress it; or that 
we do so at considerable risk, in consequence of the repetition of 
excitement the mucous membrane has been, and still continues to 
be, subjected to. 
ON THE PRIMARY AND SECONDARY EFFECTS OF 
NARCOTIC MEDICINES. 
By Mr. R. U. West. 
The most commonly-received opinion regarding the operation 
of narcotics is, that they act primarily as stimulants ; their sedative 
effect being considered as the exhaustion consequent on increased 
action. It certainly is the fact, that the first perceivable effect of 
a small dose of opium is a stimulant one ; but here, where we have 
great excitement, we have little or no consequent depression. On 
a cursory view of this theory, we should, judging from analogy, be 
led to imagine that the consequent depression would be in a direct 
ratio with the previous excitement; but with a small dose, as has 
been said, we have great excitement, and no depression; and with 
a full dose we have no primary excitement perceivable, and a great 
degree of depression : thus the theory may be said to contradict 
itself. Now, by supposing the primary operation of narcotics to 
be sedative , we shall be enabled to do away with every difficulty 
of this kind. 
