For generations it has been asserted that drugs, food, drink, etc., act upon the living organism and that disease is a something which seizes upon the organism and seeks its destruction; in a word, it is an almost universal belief that the living organism is an object to be acted upon by extraneous matter, and not the actor which seizes and appropriates or rejects food, drink, drugs, etc., and that the process of rejection is the essential disease. Due to the folly of supposing that the nature of life on the one hand and of drugs, food or drink on the other is changed because the individual has become weakened, it has proved difficult to immediately abandon the belief in the action of lifeless things.

While in health it may be admitted that the organism acts, in disease it is said the drug acts or the food and drink act upon the organism. The folly of thinking that the relations of lifeless substances to the living organism are changed merely because the organism is sick or weak should be patent to every intelligent individual. The Hygienic theory that, in the relations between living structures and lifeless matter, the living is active and the lifeless passive, always, was first advanced by Dr. Trall in 1850. This principle is a vitally important one and must sooner or later be accepted by the men of science.

Writing in 1865, the famous French physiologist, Claude Benard, said: ". . . when we reach the limit of vivisection, we have other means of going deeper and dealing with the elementary parts of organisms where the elementary properties of vital phenomenon have their seat. We can introduce poisons into the circulation, which carry their specific action to one or another histological unit . . . poisons are veritable reagents of life, extremely delicate instruments which dissect vital units. I believe myself the first to consider the study of poisons from this point of view, for I am of the opinion that studious attention to agents which alter histological units should form the common foundation of general physiology, pathology and therapeutics."

Benard's idea that poisons act upon histological units and that a study of such actions would supply a foundation for therapeutics, while expressing a popular view of life, is the exact opposite of the Hygienic view. Trall had previously employed the phenomena of drug administration as a means of studying pathology, but it certainly has no relation to physiology nor can it be said to have any possible connection with any system of therapeutics that could be based upon physiological principles. Today one sees such unscientific statements as "a potential therapeutic agent (a drug) is first screened for biological activity in laboratory mammals." How any sane man can seriously speak of the biological activity of a drug (a poison) is beyond the writer's comprehension. The only possible actions of which drugs are capable are mechanical and chemical and, as these relate to the living organism, such actions are destructive.

It was generally admitted that "the operations of medicines (drugs) are not susceptible to that precise demonstration peculiar to the sciences of chemistry and mathematics . . ." It was also admitted that, though a drug "may fulfill an indication so far as its sensible action is concerned, it may still be doubtful whether it has accomplished a single point in the curative process of the case; in fact, we know that it has not unfrequently happened that medicine has essentially aggravated the disease, without any suspicion, at the time, that it had any relation to the change which followed its operation." This simple confession of ignorance of how drugs act was repeated over and over in many forms.

The celebrated Dr. Meigs of Philadelphia wrote in his letter on Woman and Her Diseases: "I conceive that we have not and cannot ever reasonably expect to have any very clear notions as to the methodus operandi of any medicine. Who can explain the cathartic power of jalap as contradistinguished from the emetic force attendant upon the general constitution of calicea ipecauna, or the tartrate of antimony and potash?

"We are well acquainted with the facts, the phenomena; yet to say why tartar emetic shall produce vomiting, while sulphate of magnesia shall have the effect of a purgation, is beyond the power of the human mind . . . I do not consider myself as credulous in believing that iron has a special affinity to invigorate the tissues composing the paermatosic membrane; certainly not more so than ten thousand American physicians, who confidently administer five or twenty grains of calomel, with the utmost certainty of exciting the liver into greater or more healthy activity; squills to excite the mucous follicles of the bronchi; nitre to arouse the kidneys, or belladonna to arouse the skin; and strychnia to wake up again the torpid muscles of a paralytic leg or arm. In the methodus operandi of drugs and medicines, all our cogitations are purely empirical."

In its issue of March, 1853 (page 672), the New Orleans Medical and Surgical Journal says: "We are free to confess that the profession knows, in reality, little or nothing of the modus operandi of therapeutic agents; from the most obvious effects of medicines, we are too ready to conclude that we appreciate their full influence upon the economy; forgetting in the meantime, all those molecular changes which are undoubtedly brought about by every perturbating agent which may be applied to, or introduced into the living system. To know that one medicine acts as a cathartic, another as a narcotic, and so on, is indeed to restrict our information to a few simple self-evident facts; but to go beyond this limit--to fathom the mysteries of therapeutics, hic opus, hic labor est--this is the Gordian knot, which as yet we are not prepared to untie. Perhaps the day is not far distant, when, by the aid of organic chemistry, we may be made acquainted with the influence of medicinal substances upon the organism; at present, however, we must be content with the knowledge of a few isolated facts and look forward to the future for more reliable information on the subject of therapeutics. The great discrepancy of opinion which everywhere exists on the peculiar action of most medicinal substances, proves conclusively how little we actually know of therapeutics."

It must have been a pleasant feeling to have been able to look forward, hopefully, to the future to demonstrate that they were right and to have no doubts about the outcome. To be able to rely upon the "self-evident facts" that "one medicine acts as a cathartic, another as a narcotic, and so on," and to be secure in the blind belief that in the near future, organic chemistry would give them a basis for their therapeutics, must have steadied the hand that poured the poisonous drugs; but it provided no safety for the patient.