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pharyngeal or csophageal nerves, and (2) General or Systemic
Squill. Tartar Emetic, Ipecacuanha and probably Apomorphine, act locally as well as systemically, for if injected subcutaneously they are excreted by the stomach in part, thus irritating the gastric nerves as well as the vomiting centre. Pilocarpus is a local emetic, and Digitalis and its congeners, also Muscarine, are systemic emetics, but none of these agents are used medicinally for that purpose. Opium, Morphine and Codeine usually produce emesis as one of their aster-effects.
Anti-emetics, --are agents which diminish nausea and vomiting, either through a local sedative action upon the end-organs of the gastric nerves, or by reducing the irritability of the vomiting centre in the medulla. The most efficient of the local sedatives is Ice, swallowed in small pieces. Astringents are very useful when there is congestion of the gastric mucous membrane, as in the vomiting of alcoholism and phthisis, where Silver Nitrate and Alum are respectively effective. The most important antiemetics are the following, viz. :Local Gastric Sedatives.
Ipecac s doses. Alcohol.
Amyl Nitrite. Vomiting being set up by irritation of many afferent nerves from various regions of the body, or by impulses from the brain excited through impressions on the nerves of special sense, the measures for combating it are very diversified. (Compare the title VOMITING in Part III.)
Gastric Pain is best treated by such local sedatives as Bismuth, Hydrocyanic Acid, or small doses of Morphine, Arsenic and Belladonna.
Carminatives (carmino, to soothe),-aid the expulsion of gas from the stomach and intestines, by increasing peristalsis, stimulating the circulation, and relaxing the cardiac and pyloric orifices of the stomach. They also act as diffusible stimulants, both of the bodily and mental faculties. The principal carminatives belong to the aromatic oils, alcohols or ethers, and are embraced in the following list :Asafetida. Mustard.
Oil of Eucalyptus.
· Oil of Fennel.
· Oil of Peppermint.
Oil of Anise. · Oil of Spearmint.
Oil of Cajuput. • Oil of Nutmeg.
· Oil of Caraway. Oil of Pimento.
Oil of Cinnamon. Oil of Valerian.
Oil of Coriander. Serpentaria.
Cathartics or Purgatives (rahaipw, purgo, to cleanse),— are agents which increase or hasten the intestinal evacuations. According to their respective degrees and direction of action they are subdivided into several groups, as follows:
Laxatives (laxo, to loose), or Aperients (aperio, to open),– include those which excite moderate peristalsis, and produce softened motions without irritation. Sulphur is the typical laxative.
Simple Purgatives,-increase peristalsis actively, and stimulate the secretions of the intestinal glands, producing one or more copious and semifluid motions with some irritation and griping. Senna is the type of this group.
Drastic Purgatives (òpaw, to act),—act still more intensely, producing violent peristalsis and watery stools, with much griping pain, tenesmus and borborygmi. They irritate the intestinal mucous membrane, cause exosmosis of serum from its vessels, and in large dose set up inflammation and symptoms of irritant poisoning. Jalap is a typical drastic.
Saline Purgatires,-consist of the neutral salts of metals of the alkalies or alkaline earths. They stimulate the glands, increase peristalsis, promote osmosis and cause free watery evacuations. Magnesium Sulphate is a typical saline.
Hydragogue Purgatives (còwp, water, ayw, to bring away), — include the most active of the drastic and saline groups, those which remove a large quantity of water from the vessels. Elaterium is a typical hydragogue.
Cholagogue Purgatives (zony, bile, öyw, to bring away), -are those agents which stimulate the flow of bile and produce free
purgation at the same time, the stools being green-colored, or
bilious," and liquid. Podophyllin is the type of this group.
Small doses of drastics, salines or cholagogues.
Magnesium Citrate. Gamboge.
Potassium Sulphate. Potas. Bitartrate.
Potassium Bitartrate. Salines in large doses.
Sodium Chloride. Mercurials.
Pot, et Sodium Tartrate. Aloes.
Manganese Sulphate. Rhubarb.
Iridin. Intestinal Astringents, contract the walls of the intestinal vessels, diminishing the exudation therefrom, and lessening the fluidity of the fæcal discharges. The more powerful members of this group have also a constringing action on the intestinal mucous membrane. The principal agents of this class are the following: Astringents.
Oxide of Zinc.
Sulphate of Copper.
Persalts of Iron, Hepatic Stimulants and Cholagogues (zóln, bile, äyw, to bring away),-are two groups of agents acting upon the biliary secretion, the first-named increasing the functional activity of the liver and the amount of bile formed, the second removing the bile from the duodenum and preventing its reabsorption into the portal circulation. Some hepatic stimulants are also cholagogues, others are not, while cholagogues proper generally act as hepatic stimulants by carrying off the bile and so indirectly urging the liver to secrete more. The discovery of the enterohepatic circulation of bile has cleared up many of the discrepancies formerly existing with regard to the action of drugs upon this gland and its secretion. The following list includes the principal drugs belonging to both groups:Hepatic Stimulants.
Potassium Sulphate. Aloes. Podophyllin.
Sodium Sulphate. Podophyllin. Mercuric Chloride.
Bicarbonate. Mercurous Chloride. Sodium Benzoate.
Ammonium Benzoate. Pil. Hydrargyri.
Chloride. Mercury with Chalk. Salicylate. Nitric Acid (dilute). Sodium Phosphate. Nitro-hydrochloric Acid. Benzoic Acid.
Potassium Sulphate. Iridin.
Iridin. Those in the first column are the most powerful of the stimulant group, the second column including the less efficient agents. To secure the best cholagogue effect it is advisable to combine an hepatic stimulant with an intestinal stimulant which shall produce increased secretion from the intestinal mucous membrane and excite peristalsis.
The Glycogenic Function of the liver, and the production of urea are stimulated by the following-named drugs:Increasing Glycogen.
Antimony. Phosphorus, · Nitro-hydrochloric Acid.
Hepatic Depressants are agents which lower the functional activity of the liver, reducing the quantity of bile secreted, and lessening the production of glycogen and urea. They are as follows, viz.:
Lessening Bile. Diminishing Glycogen. Lessening Urea.
Many purgatives act as hepatic depressants and diminish the secretion of bile by lowering the blood-pressure in the liver, and by carrying off the materials from which bile might be formed.
Pancreatic Stimulation may be obtained by the administration of Ether, or by Galvanism of the gland itself. It is depressed by Atropine and by inducing nausea and vomiting.
Anthelmintics (duti, against, Theers, a worm),—are agents which destroy (vermicides) or cause the expulsion (vermifuges) of intestinal worms. The chief vermifuges are Castor Oil, Jalap and Scammony, while the vermicides may be enumerated as follows, viz. :Thread Worms. Round Worms.
Calomel. ) above. Turpentine.
Chloroform. The substances enumerated in the first column are all used locally by enema. Adjuncts to these remedies are such agents as prevent the excessive secretion of intestinal mucus, which affords a nidus for the worms. Such are Bitter Tonics and preparations of Iron, also Ammonium Chloride and Sodium Chloride.
AGENTS ACTING ON METABOLISM.
Restoratives,—are agents which promote constructive metamorphosis, including the Foods, Hæmatics, and Tonics, as well as many agents called Stimulants in other classifications.
Foods, -are substances which, when introduced into the body, supply material to renew some structure or to maintain some vital process; being distinguished from medicines in that the latter modify some vital action but supply no material to sustain such.
The food of man is derived from all three of the kingdoms of nature, viz., the mineral, vegetable and animal, and includes many substances treated of in the Materia Medica, as Oils and Fats, Sugar, Starch, Gum, Alcohol, Beverages like Coffee and Tea, Water, Phosphate of Lime, Chloride of Sodium, etc.
Hematics (aina, the blood),-are medicines which augment the quantity of hæmatin in the blood, and thus restore the quality