The chemical combination of drugs with plasma constituents and with cell constituents cannot explain the alleged actions of drugs, for the reason that these combinations render action impossible. It was pointed out by Trall that when arsenic combines with the tissues, it converts these into dead, but fixed, chemical compounds. Certainly, there is no action, physiological or therapeutic, in arsenate of flesh.
Another explanation of the alleged action of most drugs used medicinally is that they change the intensity of body function by acting on physiological control systems, especially those that mediate the adaptive response of the living organism. In keeping with the medical notion that drugs have power to act, such drugs are designated pharmacodynamic agents. It is said of such drugs that they mimic or release hormones or neuro-hormones or that they serve to block the action, synthesis, release, storage, or metabolism of these hormones. In further explaining the alleged action of such substances, it is said that untoward effects are due to an exaggeration of the desired action, or to an unwanted effect on a second physiological control system.
When it is said that drugs act by acting on physiological control systems, the very thing that needs to be proved is assumed to be true. How explain the action of the drug on the physiological control system? To assume that they act by acting is not a solution to the problem before us. To call them pharmacodynamic agents is merely to embalm in technical jargon an ancient fallacy. From the Hygienic viewpoint, we observe biodynamics and not pharmacodynamics.
Medical students, studying in their materia medica what are designated the properties of all the poisons of the three kingdoms of nature, firmly believe everything they read of the medicinal properties of herbs and minerals, and become lost in wonder and admiration at their astonishing qualities and powers, and at the great array of cures with which the physician is equipped.
All manners of ingenious "incentives" to action are possessed by the medical profession--drugs to cause the stomach to empty itself, drugs to occasion violent bowel action, drugs to occasion diuresis, from the gentle tonic persuasives to the powerful revulsives and when, after such abuses, the offended organs cry out in pain or fail in their functions, they have other drugs with which to silence the outcries and further goad the organs to action. The basis of our objection to the employment of these substances in treating the sick is the well established relation existing between the living organism and all extraneous substances, properties and forces.
Drugs can have but one primary effect, when introduced into or applied to the body, and this is the effect of bringing the forces of the body into activity in defense of the integrity of the body. The nervous system is a protective system of the general organism and, while it is unimpaired and filled with energy, no noxious substance can long be tolerated in the organism. In any action of the complex organism, there must first be the decision, what is to be done; then the nerves that control action must carry the message to the appropriate structures. These organs then act as instructed. Suppose, when an emetic is swallowed, the nerve wires get crossed and convey the message to the muscles of the lower limbs, then we would walk or run or kick or jump, but not vomit.
It may be no easy task to determine the precise methodus mendendi of the living organism in producing the many and varied phenomena which have been mistakenly considered properties of drugs--such as tonic, astringent, emetic, cathartic, diaphoretic, diuretic, expectorant, narcotic, depressant, stimulant, etc.--but if we can establish the principle of vital agency and can demonstrate it as a general cause, it will require no stretch of the imagination to accept it as the probable truth rather than endow inert drugs with mystical virtues.
The resident forces in the various tissues, acting in their preservative capacities against that which is unusable, hence hurtful in its relations with the living organism, give rise to all the actions that follow the administration of drugs. Vital resistance in order to self-preservation is the law. Hence, what we view is not the modus operandi of drugs, but the modus operandi of the vital organism. There is no such thing as the modus operandi of a drug. This term, when applied to drugs, is a misnomer; its use tends most certainly to lead the mind astray, since it expresses a fallacy.
On this basis, we do not say that cantharide has a "special affinity" for the kidneys, but that the poison is excreted through the kidneys; it has no diuretic property, but as a poison, is expelled by diuresis. So-called cathartics do not have a "special affinity" for the membranes of the alimentary canal, but are recognized by these membranes as unsuitable for entrance into the body and are expelled by catharsis. To express this as a law, we would say that, resident forces in the various tissues, acting preservatively, expel the non-usable substances, and this determines the modus operandi of all drugs.
The doctrine of the older pharmacologists that drugs elect or select particular organs or structures on which to act, either therapeutically or toxicologically, constitutes the basis of the whole system of drugging the sick. The Hygienic doctrine, as developed by Trall, is the exact opposite of this. We say that the living system, the organism itself, elects or selects the particular structure or organ through which it can best expel the drug.
It is a law of organic existence that living structures reject, resist and expel all injurious substances, that they shall act on the defensive, that they shall protect themselves from injury, and maintain so far as possible an equilibrium of organic and nervous forces--hence, the resistance and expulsive actions when any incompatible thing comes in contact with the living structures, the resistance being in direct proportion to the degree of incompatibility, and in keeping with the power of action of the organism. In extreme cases of paraplegia, when the bowels and lower extremities are paralyzed, cathartics lose their "special affinity" for the bowels.
The actions of the living structures in relation to drugs determine the properties of the drugs--they are one thing or another, depending on the manner in which the body finds it expedient to cast them out. Some are ejected by vomiting, some by diarrhea, some by diuresis, some by diaphoresis, some by expectoration,etc. No greater blunder was ever made than that of having drugs act on the body.
Drugs will be expelled in the most convenient manner, through the most efficient channel. In all ages, medical men have mistaken these defensive and expulsive actions for the actions of their drugs. Their drugs have acted on the stomach, on the bowels, on the kidneys, on the circulation, depending on the resistive and expulsive processes instituted by the body.