Part I.

Modes in which Medicines are introduced into the Organism.

Part II.

The Actions and Uses of Remedial Agents. I. Systemic Remedies:

1.  Those used to promote the constructive tissue metamorphosis (Tonics).

2.  Those used to increase the retrograde tissue metamorphosis (Alteratives).

3.  Those used to destroy micro-organisms or morbific germs, and to prevent or arrest septic processes (Antiseptics).

4.  Those used to modify the functions of organs:

A.  Of the Nervous System:

Increasing Action, Diminishing Action.

B.  Of the Gastro-Intestinal Canal:

Emetics,

Cathartics,

Anthelmintics. C.Of the Genito-Urinary Organs:

Diuretics,

Emmenagogues, etc. II. Topical Remedies: Rubefacients, Epispastics, Escharotics, etc.

In this scheme the medicament is followed from its introduction into the stomach to its elimination by the organs of excretion. One group of remedies is used for an action on the primary assimilation— to promote digestion and absorption—the first step in the great process of blood-making. Of this kind are pepsin, the bitters, but, above all, foods.

Some remedies are employed both to increase the activity of the primary assimilation and the utilization of materials in the construction of tissues; others, to hasten the retrograde metamorphosis, or the processes of waste and excretion. The action of iron furnishes a typical example of the one, and mercury of the other mode of influencing the function of assimilation.

An important group of remedial agents is constituted of those having the power to act on—to inhibit or destroy—pathogenic organisms, and to prevent or arrest septic processes. As these remedies are also antipyretic, there is supposed to be a relation between this attribute and the germ-destroying and antiseptic powers. As substances having the chemical reactions and toxic activity of alkaloids, and known as ptomaines, are produced by septic decomposition in the intestinal canal under certain conditions, and as similar agents are developed in the organism in the course of infectious diseases, remedies possessed of such powers must necessarily occupy an important place in therapeutics.

Besides the foregoing, there are several groups of remedial agents, that are used not to affect metamorphosis of tissue in any manner, but to modify the functions of organs. As the most influential and widely connected are the functions of the nervous system, the remedies affecting them are appropriately considered first. They may be conveniently grouped in two classes: those that exalt, those that depress function—as excito-motor, depresso-motor. Of these, strychnine is a type of the former, conium of the latter.

Other functions are affected by remedies in several modes: by coming in contact with the anatomical elements of organs engaged in their elimination, or being so irritant as to excite action for their expulsion. The diuretics, for the most part, illustrate the former mode of action, and some emetics and purgatives the latter. The actions cease with the expulsion or elimination of the offending matters.

Remedies that are truly topical should make a local impression only, but it is probable that no action can be confined to the part acted on. Absorption is not necessary to, and indeed hinders, the local effect; hence the systemic impression made by them is accomplished through the agency of the nervous system. Some of the most important of their therapeutical effects are due to the influence of the peripheral excitation on the nervous centers in anatomical connection with the part irritated. A superficial neuritis may excite extensive secondary lesions in the spinal cord. The vaso - motor and trophic systems are peculiarly impressionable to peripheric irritation, and hence, through the intermediation of this nervous apparatus, important changes may be wrought by slight counter-irritation.