Selected writings of John M. Scudder.
Care not to over-use medicines is the lesson inculcated in this editorial. Even water in excessive quantities may approach the poisonous in effect. To be able to discover the proper balance in the use of drugs is one of the marks of the discriminating physician, and the expert in this line ranks among the most successful of prescribers.—Ed. Gleaner.
MEDICINES AND POISONS.—One of the first lessons that should be impressed upon the mind of the student is—that medicines are poisons. Not that one or two, or a group of a dozen are poisons— mercury, arsenic, antimony, etc., but every article of our as well as other people's Materia Medica. I think it is probable that many practitioners have also the same lesson to learn, and. the sooner they learn it the better it will be for their patients.
I assert, that to the healthy man all medicines, without an exception, are poisons. That every one, without an exception, will cause a departure from the healthy standard, either in function or in structure, if given in the ordinary medicinal dose, if continued in the usual way.
It is true that the human body is so constructed as to resist causes of disease, whether in the usual form, or in the form of medicine, but it yields more readily to the medicinal poison than it does to the others. Very many persons can not take the mildest and simplest drug without being unpleasantly affected—I number myself as one of this class; some will resist the unpleasant influence for a considerable time, but eventually yield.
Of course we recognize the fact that medicines vary very greatly in their unpleasant influence, some being very virulent and speedy, others mild and slow. It is a singular fact that, as a rule, the most active, speedy, and virulent of these poisons make the best remedies. Many will object to this, and yet if they think of Aconite, Veratrum, Gelsemium, Nux, Belladonna, Rhus, and others, they will see that it is true. Some of the mild remedies have a very decided action in disease, but we could not afford to dispense with the others.
It is so essential to realize the poisonous character of medicines that I would advise every reader to prove it on his own person. One may admit a fact, and yet not realize it in his senses and continually forget it in the treatment of others. Try a half-grain of Podophyllin, repeated two or three times, drop doses of Aconite, Veratrum, Rhus, Nux, or ten-drop doses of Lobelia, Sanguinaria, Stillingia, or even the simpler remedies, Macrotys, Asclepias, Hydrastis, or a medium dose of Quinine repeated. Try anything you have in the office, and I think you will prove the truth of the proposition—that to the healthy all medicines are poisons.
If it is the fact that all medicines are poisons to the healthy, how is it that they are not poisons to the sick? I answer the question decidedly, that they are poisons to the sick, unless there is something in the disease to antagonize the medicine. Will a given case of disease antagonize all medicines? No, it will not; usually not but a few. If there is no relationship between the medicine and the disease it will just as surely do harm as it would do harm to the healthy person. To put it in a plainer form, we say, unless the medicine be indicated as a remedy it will always make the patient worse. There is no middle ground with medicines, they either do good or harm. Good if they are selected with reference to their relationship to the present disease, harm if they are not so selected.
It seems to be a common opinion, if we may judge from the common practice, that medicines are wholly innocuous for harm. String them together in groups, and get them into the sick person, and some one or more will find its way to the sickness and remove it. It would seem that physicians have counted the chances of getting the right remedy, and have grouped a dozen or a score together in the hopes that some one would fit the disease, or that the compound would fit more diseases, and with greater certainty than a single agent.
As above stated, I do not believe any lesson can be more profitable than the lesson that is taught by proving one or more of our more common remedies. We not only learn that the medicine has a decided influence upon the body, that in the common form and dose it is quite unpleasant, but we also learn the quality of this action, and that medicines have an elective affinity for certain parts to the exclusion of others. If we prove this of only one medicine, we have good grounds to believe it of all; if we prove it of but half a dozen, we establish the facts in our minds beyond all peradventure.
But we do not want to lose sight of the test—all medicines are poisons; are poisons to the sick as well as the healthy, unless they are antagonized by and antagonize disease. This being the case we propose to handle drugs with care, assuring ourselves of the curative relation of the drug to the disease before we administer it. I always enjoin upon my students "not to give medicine unless they can see clearly that the, medicine is likely to aid in removing the disease."—SCUDDER, Eclectic Medical Journal, 1875.
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"As a rule, it is best to effect changes insensibly or without shock to any organ or to the entire body."—Specific Medication, p. 36.
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The Biographies of King, Howe, and Scudder, 1912, was written by Harvey Wickes Felter, M. D.