I  IO 
Sugar-coated  Pills. 
f  Am.  Jour.  Pharm. 
{      Mar  ,  1877. 
"  Like  bubbles  on  the  sea  of  matter  borne, 
They  rise,  they  break,  and  to  that  sea  return." 
When  a  remedy  or  form  of  remedy  is  placed  under  the  ban  of  sus- 
picion, as  sugar-coated  pills  have  been,  since  the  senseless  tirade 
against  them  was  started,  it  is  apt  to  be  blamed  unjustly,  and  failure  of 
therapeutic  activity  ascribed  to  it,  which  may  be  due  to  the  deranged 
condition  of  the  system.  The  usual  dose  of  the  officinal  compound 
cathartic  pill  may,  in  the  same  individual,  at  one  time  produce  exces- 
sive action,  while  at  another  time  it  may  be  wholly  inoperative.  So 
with  quinia  and  other  tonics  ;  they  may  at  one  time  act  with  great 
precision,  certainty  and  with  magic  power,  while  at  another  time,  may 
be  continued  for  weeks  without  any  appreciable  effect.  This  capri- 
ciousness  and  uncertainty  of  the  action  of  medicines  is  a  problem 
very  difficult  of  solution.  This  lack  of  activity,  or  uncertainty  in  the 
action  of  a  medicine  may  depend  on  some  abnormal  condition  of  the 
Huids  and  secretions  of  the  stomach  and  intestinal  canal ;  hyperemia 
or  vascular  fullness  of  the  mucous  coat  may  retard  or  effectually  pre- 
vent absorption,  although  the  medicinal  substance  may  be  dissolved  or 
digested,  and  in  the  most  favorable  condition  for  assimilation.  Both  the 
gastric  and  intestinal  secretions  are  very  much  influenced  also  by  the 
variable  condition  of  the  nervous  system,  even  absorption  or  endosmotic 
action  may,  in  a  measure,  be  suspended  or  entirely  suppressed  by  cer- 
tain nervous  conditions.  This  is  evidenced  by  the  almost  entire  sus- 
pension of  digestion  produced  in  sensitive  persons  by  the  sudden 
announcement  of  bad  news  or  any  powerfully  depressing  circumstance. 
Grief  or  great  trouble  of  any  kind  in  persons  of  a  nervous  and  sensitive 
organization,  may  often  produce  an  awful  sense  of  weight  and  oppression 
in  the  gastric  region  after  food,  accompanied  by  depression  of  spirits, 
etc.  Every  nervous  and  dyspeptic  person  has,  I  have  no  doubt,  ex- 
perienced the  truth  of  this. 
Idiosyncracies  of  individuals,  which  may  be  unknown  to  the  physician, 
may  also  dwarf  the  power  of  medicines  and  interfere  with  their  physio- 
logical action  and  pervert  their  therapeutic  effects.  Opium,  belladonna 
and  other  narcotic  and  anodyne  remedies,  when  given  to  relieve  neu- 
ralgic and  other  painful  affections  and  to  produce  sleep,  often  produce 
effects  diametrically  opposite  to  what  are  expected  of  them.  Calomel 
and  other  preparations  of  mercury,  iodide  of  potassium,  arsenic,  the  vari- 
ous preparations  of  iron,  etc.,  are  all  conspicuous  examples  of  a  large 
