July 29, 1871.] 
TIIE PHARMACEUTICAL JOURNAL AND TRANSACTIONS. 
87 
of the encephalon, on the spinal cord, on the sensitive 
nerves, and purely on the motor nerves. By suitable 
means we can increase or diminish the exhalation from 
the skin and mucous membranes, and can alter in quality 
and quantity the secretions of many important glandular 
organs. At pleasure we can contract or dilate the pupil 
of the eye, can stimulate striped and unstriped muscles, 
can poison some internal parasites with certainty, and 
can aid in the elimination of metallic poisons from the 
body. And, let it be observed, that not only have we 
Hiese and other powerful means at our disposal, but that, 
in many, very many cases, we have the knowledge how 
to apply them to the treatment of disease with benefits 
•which cannot be gainsaid, and in a few cases we know 
why we so apply them. 
Our theories as to the nature of disease are under¬ 
going a profound change, necessarily followed by cor¬ 
responding modifications in the way in which we en¬ 
deavour to meet or anticipate it. The notions of elimi- 
•nation and allopathy, of antidotes and of counter-irri- 
’tation, have all their measure of truth, and arc all 
visefully applied in practice, but it is to be hoped that 
none of them will ever again be raised to the rank of a 
system to cramp and fetter our ideas. As a positive 
and well-founded advance in the doctrines of thera¬ 
peutics, it could easily be shown that certain injudicious 
or noxious lines of treatment have been abandoned, and 
•-that, in general, the habit of over-drugging has been 
•given up. This beneficial change is due partly to a 
more accurate acquaintance with the local causes of 
disease, c.g. the parasitic skin diseases, partly to a more 
•intimate knowledge of the pathology of disease, e.g. 
chronic pulmonary phthisis, and partly to a recognition 
-of the principle that we are not to treat our patients as 
so many sponges doomed to soak up the maximum quan¬ 
tity of medicine possible, but, as living beings, whose 
functions are disordered by disease, and whom we seek 
to restore to health by aiding the natural tendency to 
recover, and by striving to modify the direction of action 
of the natural forces of the body. We know now that a 
large number of acute diseases occurring in previously 
healthy persons naturally run a definite course and ton'd 
to spontaneous recovery, in the absence of or even in 
spite of misdirected drugging, and we have recognized 
that certain acute diseases supposed to be of indefinite 
duration lie within appointed limits. We, therefore, by 
this advance in knowledge, avoid drawing false conclu¬ 
sions as to the efficacy of drugs in particular maladies, 
and although Ave do not pretend to be able to strangle 
acute disease by specifics, or suddenly arrest the cycle 
of morbid action, much still remains for our art in meet¬ 
ing special symptoms and controlling intercurrent com¬ 
plications. Sometimes advances in knowledge teach us 
a more correct appreciation of the composition and mode 
of action of drugs, or at least displace a faulty explana¬ 
tion. This certainly is a gain, and wo know too little 
yet to sec how far the application of the physical pro¬ 
cesses, dialysis, diffusion, and osmosis may before long 
enlighten some of the dark recesses of therapeutics. 
Among the tributes levied from chemistry and natural 
history, we can reckon carbolic acid and its compounds, 
dhe alkaloids, the bromides, permanganate of potassium, 
sulphurous acid, and the sulphites, the whole group of 
.amesthetics, chlorofoim, ether, bichloride of methylene, 
nitrous oxide, and njtrito of amyl, Calabar bean, glycerin, 
pepsin, santonin, podophyllum, and lastly chloral, and 
-its allies broinal and iodal. The mention of the class of 
alkaloids suggests the thought that very great benefit 
would, doubtless, accrue from the more extended use of 
ihe alkaloids in the room of the crude vegetable products 
from which they are derived. Our therapeutical experi¬ 
ence would be rendered infinitely more accurate by the 
•employment of these definite active principles which arc 
chemically stable, and whose dosage can be exactly pro¬ 
portioned, and the differences which are often asserted 
to exist between the active principle and the crude drug 
itself would doubtless be found to bo much less consider¬ 
able than is generally thought. In the case of bella¬ 
donna and conium, for example, the efficacy of these 
dings is fairly and fully represented by their respective 
alkaloids, and even in the case of a corn]ilex substance like 
opium which contains several organic bases of different pro¬ 
perties, it would be quite possible, after proper investiga¬ 
tions to combine these bases in a compound solution 0 so 
as to represent perfectly the action of the crude opium. 
As illustrations of the confirmation and extension of tho 
curative powers of single drugs wo can adduce the mass 
of evidence that now exists as to the respective value of 
mercury and iodide of potassium in different stages of 
syphilis, and of mercury especially in infantile syphilis, 
of the utility of arsenic in the relapsing skin diseases, 
of bromide of potassium in epilepsy, and certain other 
abnormal conditions of the brain and sexual organs, of 
quinine in periodic diseases other than ague, and of 
ipecacuanha in dysentery. Wo are better acquainted 
with the action of digitalis, opium, belladonna, hyoscya- 
mus, and conium, and there is a clearer understanding 
gaining ground as to the worth and indications for the 
employment of alcohol in the treatment of disease. 
Tho uses of iodide of potassium have been brought 
into greater prominence, and have been more sharply 
defined, and amongst the results “we may boast the dis¬ 
appearance of radesyge in Norway, of yaws in our West 
Indian colonies, and of most of the severe forms of ter¬ 
tiary syphilis at home.” Since the more important of 
these drugs are of quite recent introduction, they are to 
be looked on as but an earnest of the harvest we are yet 
to reap from the domain of tho natural sciences. Im¬ 
proved modes of administration are only second in im¬ 
portance, and hypodermic injection is an aid for which, 
we cannot be too grateful, triumphing especially in the 
relief of painful and spasmodic affections. Lastly, a dis¬ 
crimination between the properties and uses of the direct 
and induced currents, i.e. of galvanization and faradiza¬ 
tion, has led to most important and gratifying results in 
the treatment of such formidable diseases as epileptiform 
neuralgia, infantile paralysis, and progressive muscular 
atrophy. It is proved that it is possible and feasible to 
galvanize directly the brain and spinal cord, and the 
galvanic irritation of tho sympathetic nerve may yet 
furnish us with a powerful lever for controlling the 
nutrition of even remote parts. 
Many circumstances have contributed to clog the pro¬ 
gress of therapeutics, some of which belong to the in¬ 
herent difficulties of its investigations, while others, and 
that a large portion, are due to the ignorance and incom¬ 
petence of those to whom we should look for aid. The 
fallacies connected with the application of the inductive 
method of reasoning to the science of medicine, and the 
sources of error in practical and theoretical medicine, 
have been well exposed by Sir Cl. Blanc and by Dr. 
Barclay, and I would merely remark that tho principles 
enunciated by these authors, while they arc the philo¬ 
sophical basis of the practice of physic, constitute the 
best answer to morbid scepticism on tho one hand, and 
vulgar credulity on the other. 
Faulty modes of preparation, and tho use of entirely 
worthless compounds, are fruitful sources of error, and 
we can point in illustration to tho investigations of Dr. 
Harley on the Galenical preparations of oonium, in which 
he proves the absolute valuelessness of tho extractum 
conii. Again, the assemblage of a number of active 
drugs in a prescription, often introduced at random, is 
destructive to a right appreciation of the effects of medi¬ 
cines ; and, as a rule, the principle of combination should 
not be extensively tried till we are in a better position 
to estimate justly the influence of certain drugs on special 
diseases, 
(7b he continued.) 
