The Untoward Effects of Drugs - A Pharmacological and Clinical Manual E-Book

Louis Lewin

• Herausgeber: Youcanprint
• Kategorie: Ratgeber
• Sprache: Englisch
• Veröffentlichungsjahr: 2017

Beschreibung

Occupying, as it does, a middle ground between pure experimentation and empiricism, the science of materia medica, is enriched alike from the laboratory and observations at the sick bed. It is through a combination of the results furnished through these two channels, that the typical modus operandi of any individual drug can alone be determined. There occur, however, now and then, in the therapeutics! application of certain drugs, certain deviations from this typical, and, to a degree, normal action, the correct perception and significance of which are not always understood. But a knowledge of these is of the utmost importance to the physician, as affording him an explanation of the causes of certain symptoms, and also furnishing him with a guide to his practical management of them. The records of the individual facts here indicated—the appearance of abnormal effects of drugs—are scattered throughout the most diverse parts of medical literature, and are either not at all or but superficially considered in the manuals or text-books of materia medica. For this reason I have for a long time been making a collection of these facts, examining them critically, and making additions to this collection from my own personal experience. I have presented the results of this labor in this book in the hope that they will meet a practical want, and at the same time stimulate others to further observations in the same direction.

Leseprobe

Contents

PREFACE

TRANSLATOR'S PREFACE

INTRODUCTION

TONICS

ASTRINGENTS

ALTERATIVES

EXCITANTS

NARCOTICS

EVACUANTS

EMOLLIENTS

RUBEFACIENTS AND VESICANTS

The Untoward Effects of Drugs

A Pharmacological and Clinical Manual

Louis Lewin

First digital edition 2017 by David De Angelis

PREFACE

Occupying, as it does, a middle ground between pure experimentation and empiricism, the science of materia medica, is enriched alike from the laboratory and observations at the sick bed. It is through a combination of the results furnished through these two channels, that the typical modus operandi of any individual drug can alone be determined.

There occur, however, now and then, in the therapeutics! application of certain drugs, certain deviations from this typical, and, to a degree, normal action, the correct perception and significance of which are not always understood. But a knowledge of these is of the utmost importance to the physician, as affording him an explanation of the causes of certain symptoms, and also furnishing him with a guide to his practical management of them.

The records of the individual facts here indicated—the appearance of abnormal effects of drugs—are scattered throughout the most diverse parts of medical literature, and are either not at all or but superficially considered in the manuals or text-books of materia medica. For this reason I have for a long time been making a collection of these facts, examining them critically, and making additions to this collection from my own personal experience. I have presented the results of this labor in this book in the hope that they will meet a practical want, and at the same time stimulate others to further observations in the same direction.

BERLIN, January, 1881.L. LEWIN,

TRANSLATOR'S PREFACE

When I saw the announcement of Dr. Lewin's book on "Die Nebenwirkungen der Arzneimittel," I was constrained from experience, both in private practice and in the capacity of teacher of materia medica and therapeutics, to send for a copy. The necessity ofa treatise on the subject indicated by this title must have been felt by all practitioners, for previous to the appearance of this book by Dr. Lewin there was no systematic work of this nature, such information as was extant existing merely as it was scattered in occasional references in text books and periodical literature. An examination of the work so convinced me of its great value as to induce me to undertake the translation herewith presented, the author's consent having been previously obtained. I am under obligations to Dr. Lewin for his review of the proof sheets and his endorsement of the translation. He hat also made copious additions to the original, so that the book as it now appears in English is virtually a second and revised edition.

J. J. MULHERON.

INTRODUCTION

- § 1

Medicines exert a localized influence in the animal economy, i.e., they influence, according to their chemical or physical properties, certain classes of cells or cellular tissue, chiefly or exclusively. "Certain substances are possessed of an affinity for specific parts of the system." From this fundamental view, first enunciated by Virchow,it follows that a whole series of remedies may, in addition to their curative effects, give rise to symptoms, either. by direct or through reflex action upon similar. or dissimilar groups of cells, which should not have been occasioned in securing the therapeutic effects of the remedy. In this way, in the exhibition of opiates, for instance, are not only the nerve centres and nerves affected, but also the peripheral nervous structure, and there follows in consequence, in addition to the more or less pronounced hypnotic effects of the drug, a transitory impairment of the motor nerve supply of the intestines, and through this, constipation. In the case of tartar emetic, given internally, vomiting occurs in consequence of irritation of the mucous lining of the stomach, but the drug, through its direct effect on the cardiac tissue, causes also a simultaneous reduction in the force of the hearts action. When chloroform is given by inhalation we have a direct action on the cerebro-spinal nerve centres, but particularly on the cerebrum; at the same time we have a checking of the heart's action through reflex action aroused by local contact of the drug on the mucous lining of the air passages. While, therefore, under the influence of opium and chloroform, similar nerve substance in different parts of the body suffers change, the antimony in tartaremetic affects tissue of a heterogeneous nature, as mucous membrane and muscular tissue. In an analogous manner may substances possessed of an inherent property of influencing a still greater variety of cellular formations, induce a corresponding complexity of pathological conditions. But in spite of this these operations are regarded as physiological, inasmuch ,as they are inseparable from each other and are inherent as a whole to the medicine employed. The individual symptoms are differentiated, in respect to the claim of, therapeutic action, only in so far as a distinction is made between the characteristic action and untoward effects induced.

-§ 2

While nearly all the various medicinal agents, and in the manner indicated, exert their typical inherent action on certain groups of cells, each group, respectively, being a focus of disease, and thus act therapeutically, it is not 'infrequently evident that in individual cases the desired localized action does not obtain, the drug being in this regard inert. Thus chloroform may fail to exert its hypnotic action, quinine to reduce as enlarged spleen, and purgatives, even such as are classed as drastics, to induce catharsis.