Pharmacology

“ The proper study of pharmacology is all-embracing. It includes not only the study of the mode of action of remedial agents in healthy individuals and the influence on such action of various abnormal or pathological conditions, but, also, the effect of a great variety of substances, as bacterial toxins, the secretions of venomous serpents and the products of metabolism, in short, all animal, vegetable or mineral substances in any way capable of altering normal physiology. ”

“ The inventions which I have here briefly enumerated represent the more important discoveries that were made in physical science during the sixteenth and seventeenth centuries.
The Beginnings of a Modern Pharmacopoeia, and One of the Last Attempts of the Disciples of Galen to Maintain Their Ascendancy in Therapeutics.—In the domain of pharmacology the first attempt in modern times to organize this department of practical medicine was made by an apothecary in Barcelona in 1497, and was published by him in printed form in 1521. (Von Gurlt.) ”

“ Canada, duty paid, Cloth, $2.75, net; Sheep, $3.60, net. Great Britain, Cloth, 14s. ; Sheep, 18s. France, Cloth, 16 fr. HO ; Sheep, 20 fr. 20. The volumes are sold separately. SHOEMAKER'S TREATISE ON MATERIA MEDICA, PHARMACOLOGY, AND THERA- PEUTICS STANDS ALONE. (1) Among Materia Medica text-books, in that it includes every officinal drug and every preparation contained in the United States Pharmacopoeia. (2) In that it is the only work on therapeutics giving the strength, composition, and dosage of every officinal preparation. ”

“ Everybody knows of the progress made in other branches—in bacteriology, in pathology, in biologic chemistry, in surgery, in etiology and in application of technical methods to diagnosis. Recently, however, pharmacologic research and the application of scientific methods in the study of the physiologic action of drugs are resulting in definite, positive progress. An important lesson, incidentally learned through this scientific investigation, is the fallibility of the drug therapy described in textbooks. ”

“ The enactment of the 1938 Federal Food, Drug, and Cosmetic Act illustrates the expansion of the definition of drug. One of the changes contemplated in S. 2800, an early version of the Act, [7] defined 'drug' to include
' (1) all substances and preparations recognized in the United States Pharmacopoeia, Homoeopathic Pharmacopoeia of the United States, or National Formulary or supplements thereto; and (2) all substances, preparations, and devices intended for use in the cure, mitigation, treatment, or prevention of disease in man or other animals ”

“ All drugs are more or less adulterated; and as not more than one physician in a hundred has sufficient knowledge in chemistry to detect impurities, the physician seldom knows just how much of a remedy he is prescribing. ”

“ Through laboratory research work, modern medical science has progressed to such an extent that in some diseases the form of medication has changed entirely, while in others medication is reduced to a minimum. Chemical combinations, synthetics, biological products, vaccines, etc., have all in a natural sequence deprived the pharmacist of many prescriptions. ”

“ The curious signs on the coloured carboys in chemists' windows, which were commonly to be seen until the middle of the 19th century, were signs used by the alchemists to indicate various chemical substances. In 1694 the apothecaries had increased from 114 to nearly 1000, and many of them, having acquired a knowledge of the uses of medicine, began to prescribe medicines for their customers and to assume the functions of the physician, who retorted in 1697 by establishing dispensaries, where medicines could be procured at their intrinsic value, or at cost price. ”

“ In a classification we do not so much consider the peculiarities of single remedies, as the points in which large numbers agree together. These points of resemblance we gene [Pg 20] rally find to be of the most importance. I have to consider three sets of authors in the second chapter. The first set treat of the general or ultimate effect of a medicine on the system; and classify medicines accordingly. A second set of writers have arranged therapeutical agents according to the organ or part of the body to which their action is especially directed. ”

“ His difficulties are only increased when diagnosis is complete and he turns to the labors of treatment. For with the advance of modern medical science there are left now but few physicians who believe that disease can often be cured by a drug. It is recognized by the better element of the medical profession all over the world that only in seven or eight out of about one hundred and fifty diseases clearly distinguished in our textbooks of medicine, have we a drug with any genuine pretensions to cure. What is to take the place of drugs in dispensary treatment? ”

“ Know your drug, know your dose, and know its effect, and you can, with the aid of your hypodermic, play with men and women just as you please. The world itself is but a plaything in the hands of the clever practitioner who specializes in toxicology. ”

“ Concluding, then, that it is impossible to account clearly for the actions of most medicines on Mechanical or on Chemical principles, we are led to infer that their influence must for the most part be vital in its nature—that it must be such as could only be exerted in the living body. Even then we are unable to fix upon any single rule or formula which shall be capable of accounting for the actions of all at once. So it seems that the only general explanation which we can offer of the modus operandi of medicines in the cure of diseases, is to say that they operate by various counteractions. ”

“ I have already observed that all extravagant systems tend, in the course of time, to introduce practices of an opposite kind; this truth finds another powerful illustration in the history of medicinal combination, and it becomes a serious question, which it will be my duty to discuss, whether the disgust so justly excited by the poly-pharmacy of our predecessors, may not have induced the physician of the present day to carry his ideas of simplicity too far, so as to neglect and lose the advantages which in many cases beyond all doubt may be obtained by scientific combinations. ”

“ Medicinal Treatment.—The average stockman or veterinarian is more familiar with the treatment of disease with drugs than he is with the preventive measures just described. This statement does not imply that a knowledge of medicinal therapeutics is not of the greatest importance in the treatment of disease. The ultimate object of all drugs is both to prevent and cure disease, but the injudicious use of a drug does neither. ”

“ It is to the science of Chemistry that Pharmacy must look for future advancement, and even the most obscure and most unintelligible of the many chemical investigations which are being carried on at present may eventually prove to be important steps in some line of reasoning which will have the enriching of pharmacy as its result. Nothing in science is too insignificant for notice. ”

“ A small dose of a drug may serve as a stimulant for the lagging forces, while a larger dose would directly repress them or produce injurious secondary effects. As soon as we recognise that the aim of medicine is not to destroy the disease but rather to stimulate the resisting forces of the body, the whole logic of therapeutics assumes a new aspect. ”

“ When medical science has so far progressed that the physician will be able to put his tag on the molecule of drug substance and follow it through the various metabolic processes to its final elimination we will not need any Council on Pharmacy and Chemistry to decry what it cannot understand. ”

“ But the main work of the pill will be done by the man's belief in its efficacy. I'm thinking out a medicine now which I expect will cure almost everything. It will cure, in any case, all the ailments that lead to organic disease. ”

“ It will bean almost indispensable companion to the practicing Pharmacist and a very useful reference-book to the [17] Physician. It contains a brief but thorough explanation of all terms and processes used in practical pharmacy, an abstract of all that is essential to be known of each officinal drug, its preparations and therapeutic action, with doses: in Chemistry and Botany, much that is useful to the Physician and Pharmacist ”

“ Under the general terms drugs and medicines, are embraced all articles intended for the treatment of the diseases of the human system, and though they admit of many subdivisions, these terms, included under the two heads of chemicals and compounds, and crude drugs, are all that is necessary for my {265} purpose in speaking of the effects and applications of the law. ”

“ An extended examination of the subject would show us that pharmacy played a very important part in the founding, particularly of that field of chemistry which is usually designated by the name "organic chemistry"—a field in which many of the brilliant modern victories of chemists have been achieved. Without the fundamental work of pharmacists in extracting from plants their valuable constituents, organic chemistry would to-day be in its infancy, instead of being what it is—a giant of mighty strength, exerting a controlling influence upon a number of important occupations, including pharmacy. ”

“ It is a remarkable fact, and one which is attested by every medical man, that the action of a drug may be made effective or ineffective according to the manner in which it is prescribed. There are certain subordinate drugs which prepare the way, as it were, for the action of a principal drug, and the proportion between the ingredients of a prescription is of vital importance in relation to the effect produced. ”

“ For ordinary purposes a limited amount of such knowledge is all that is needful; but for the pursuit of the higher branches of physiology no knowledge of these branches of science can be too extensive, or too profound. Again, what we call therapeutics, which has to do with the action of drugs and medicines on the living organism, is, strictly speaking, a branch of experimental physiology, and is daily receiving a greater and greater experimental development. ”

“ Pharmacy cures sickness by drugs, surgery heals by the use of knife and cautery, the species concerned with diet prescribes a regimen for the removal of disease, that concerned with diagnosis proceeds by determining the nature of the ailment, that concerned with remedies by prescribing for the immediate removal of the pain. The species of medicine, then, are pharmacy, surgery, diet and regimen, diagnosis, prescription of remedies. ”

“ The great variety of forms into which almost every article of medicine has been manufactured, affords another proof of the imperfection of the medical art. A drug which is perhaps most efficacious in the simplest form in which it can be administered, has been nevertheless served up in so many different shapes, that one would be induced to think the whole art of physic lay in exhibiting medicine under as many different modes as possible. ”

“ I am well satisfied that the regulation of the dose of a medicine is even more important than it is usually supposed to be. Substances perfectly inert and useless in one dose may prove in another active and valuable. Hence may be explained the great efficacy of many mineral waters, whilst the ingredients which impart activity to them are found comparatively inert, when they become the elements of an artificial combination; and hence probably the failure of many alterative medicines, when no other rational cause can be assigned for it. ”

“ They treated the various complaints that fell under these headings by suitable doses of one or more ingredients taken from the five classes of drugs, derived from herbs, trees, living creatures, minerals, and grains, each of which class contained medicines of five flavours, with special properties: sour for nourishing the bones, acid for nourishing the muscles, salt for nourishing the blood-vessels, bitter for nourishing general vitality, and sweet for nourishing the flesh. The pulse has always been very much to the front in the treatment of disease ”

“ There are four great groups of medicines, the action of each of which is well marked and distinct. The first class acts in the blood; and as a large number of diseases depends on a fault in that fluid, we may by their means be enabled to remedy that fault. They are the most important of all medicines. They are called Hæmatics, or blood-medicines. They are used chiefly in chronic and constitutional disorders. But a second class of remedies are temporary in their action. They influence the nervous system, exciting it, depressing it, or otherwise altering its tone. ”

“ The chemist knows that a certain drug possesses qualities adapted to cure a particular malady, but if he comes to experience its efficacy in the cure of the disease in his own body, he has a knowledge which far surpasses the merely theoretical. ”

“ If we consider the knowledge positively acquired, in this short time, of the modus operandi of urari, of atropia, of physostigmin, of veratria, of casca, of strychnia, of bromide of potassium, of phosphorus, there can surely be no ground for doubting that, sooner or later, the pharmacologist will supply the physician with the means of affecting, in any desired sense, the functions of any physiological element of the body. ”

“ When medicine must be given, it should be borne in mind that there are various classes of purgatives, which produce very diverse effects. Some, like salts, operate to thin the blood, and reduce the system; others are stimulating; and others have a peculiar operation on certain organs. Of course, great discrimination and knowledge are needed, in order to select the kind which is suitable to the particular disease, or to the particular constitution of the invalid. ”