We are told that recent studies suggest that enzymes which metabolize drugs are not the usual enzymes of intermediary metabolism. Rather, it is speculated that they are the results of evolutionary developments that had to take place before animals could migrate from water onto the land in order that the organism could protect itself from a multitude of fat-soluble compounds which it would receive in its food. We are also informed that, in general, drugs are not metabolized by processes acting on substances normally present in the body and that usually they are not even metabolized in the organ where they are supposed to act. Instead, so we are told, their action is terminated by specialized microsynes which have a predilection for fat-soluble compounds. It is customary to go further in this discussion of drug metabolism and speak not only of the metabolism of drugs, but of their tissue distribution. For example, they talk of the tissue distribution of thalidomide. Distribution is the action of distributing, apportioning, arranging or disposing. To distribute is to divide among a number, a portion; share; make a distribution; to classify or arrange; to separate, as from a collection.

Within the broad meaning of this definition, drugs are not distributed. It is true that they are carried by the blood to various tissuesbut they are not apportioned; they are not allocated. They are not divided among the tissues; they are not shared by the tissues. As the tissues have no need for them, can make no use of them and must reject and expel them and, as they are poisonous to every tissue in the body, they have to be met with resistance. To speak of the mere carrying of toxic substances by the blood stream throughout the body as their distribution is to misuse the term and to mislead the unwary reader.

That drugs undergo chemical changes in the body, in the digestive tract, in the blood stream, in the liver and elsewhere, as the body seeks to protect itself from them, that is, as it seeks to lessen their toxicity and to render them more easily excreted, has long been known. But this is a far cry from the biochemical process by which food substances are metabolized. Drugs do not, as a consequence of these changes, become cell constituants and they are not used in performing the functions of life. They provide the body with no energy. There is nothing in the changes that drugs undergo in the body that contribute to tissue change or that help to build and maintain organized substance or that provides energy for the use of the organism. The drugs are simply "detoxified," altered and expelled. They never become part of the body's tissues; they are never used in performing any of the functions of the body; they form no part of any of the body's functional results. Drugs are not, in other words, metabolized in the body and all efforts to confuse the changes they undergo in the body, as the body seeks to protect itself from their chemical union with its tissues, with the metabolic processes by which foods are assimilated and disassimilated, can only lead to greater confusion.

It would be proper to speak of drug changes as metabolism if the cell could actually incorporate drugs into their substance as integral parts of their protoplasm and make use of them in the same way they do food substance. Inasmuch as this transformation of drug substance into living protoplasm is not possible, but as drug substance must be expelled as foreign material, it is not proper to talk of the chemical changes that may take place in the drugs while in the body as metabolism. If they could be metabolized, they would be classed as foods and not as medicines.

It is not enough to understand the normal relations of various substances to living organisms as a whole, for many organisms can metabolize substances that other organisms cannot make the slightest use of. Soil is food for plants, but is useless to animals. The tobacco leaf is food for certain forms of insect life; it is a virulent poison to man. Belladonna is poison to man, but is food for the rabbit. We need, most of all, to understand what has a normal relation to man. If certain types of organisms flourish in sunless caves, this is no clue to the needs of man.

It is so appropriate to judge of things in their relations to life by their effects, rather than by their names, that it is a matter of wonder to us that the principle has been so long overlooked. A substance is not beneficial or injurious because of its name, but because of its effects on the living structure. Without reference to its name, a substance is to be regarded as good or bad in its relation to the living organism in exact ratio to the beneficial or injurious effects it produces. All things must be measured by the same standard and accepted or condemned under the same rule.

It is stupid for physicians and pharmaceutical chemists to speak of the physiological effects of toxic substances. Their effects are always pathologic and experiments to determine their pathological effects are understandable.

It is not difficult to demonstrate that drugs that are poisonous to man are also poisonous to animals; that if a dose is large enough it will kill the animal if it will kill man. Chloral will hypnotize a rabbit or a pigeon; bromide or potassium will render the pigeon stupid; alcohol will do the same for birds; strychnia will induce spasms, coma, paralysis; chloroform will anesthetize a gold fish--but what has all this production of disease in animals to do with curing the sick? That poisons will sicken and kill both men and animals is well known. We want something that will restore health.

There is a large element of stupidity in the belief that when it is demonstrated that drugs will produce disease (coma, paralysis, narcosis, etc.) and death in animals, this demonstrates that they are valuable in the treatment of sick human beings. We must learn to respect that which saves life, not that which destroys it. Anything that finds its way into the organism or that evolves within the organism that is unusable and must, therefore, be expelled may necessitate greater than usual or modified vital actions for its removal-this is disease.

It was demonstrated by Hygienists more than a century and a quarter ago that the living organism seeks to repel or expel anything that is harmful to its constitution. This is to say, it rejects and expels anything that it cannot transform into living structure. Whatever is not a normal constituent of the fluids and tissues of the body is foreign to the organic constitution and must be resisted and expelled. As we will learn later, the actions of resistance and expulsion that follow the ingestion of a drug are mistaken for the actions of the drug; whereas, the drug is just as inert and passive in the body as in the bottle on the druggist's shelf. Perhaps now we can answer the question: what is a medicine? The body wants and can make use of only such substances as it can assimilate and use as food. There are no substances that can be so used in disease that cannot be used in health. This is to say, anything that is to be used remediably must bear a normal or physiological relation to the living organism and must be useful and needed in a state of health. When the public learns the truth, it will see the absurdity of talking about the physiological influence of drugs on the human body and will understand that no drug can have a physiological effect or influence, but that its influence is always and invariably pathological and that no man who understands the nature of disease or the so-called modus operandi of drugs will ever apply the term physiological to any disease-causing substance. Then the public will abandon the nonsensical and frankly contradictory facts of the medical profession and the practices built thereon.