Vol. 27

O

LD MEDICAL LITERATURE deals with many drugs empirically, ascribing curative powers to many substances that modern science shows are possessed of little definite activity. Yet science may overlook an important point in drug activity, even as science ascribed no value to the tomato as a food while blissfully ignorant of the role played by vitamines and that the tomato is rich in these substances. It is wise for the scientist to be becomingly modest and to make an effort to explain why the clinician finds value in certain remedies concerning the activities of which science affords no light.

It is not to be wondered at that many undetermined remedies have fallen into disuse, and it is probably true that a large number of them never will be justified because actually possessed of no essential remedial value; but it is not that phase of the matter that we wish to discuss, but, rather, to direct attention to certain drugs of defined physiologic activity and that have, for various reasons, failed to obtain general favor in the eyes of the clinicians. Arnica

Arnica in moderate doses slows the pulse and slightly raises the blood-pressure, while in larger doses it stimulates the vagus nerves and toxic doses paralyze these nerves; it is also a gastroenteric irri

tant.

The vagus may be involved from neoplasms on the floor of the skull, from the toxins of syphilis or diphtheria, or by alcoholic excesses, for instance; but muscarine and pilocarpine also stimulate the vagus, as do other drugs, especially the anesthetics; but the action of arnica is so uncertain, and in adequate doses it is so irritating, that when vagus stimulation is necessary it is better accomplished by drugs with less irritating qualities than by arnica. Here is a drug which has been recommended in a host of conditions, and which really does possess definite activity, yet with the extensive drug re

No. 1

sources of modern times available arnica is going out for the simple reason that it is unnecessary. Pomegranate

This is an exceedingly unpalatable drug which is usually vomited if administered in adequate dose, and it is quite toxic; yet there is no doubt at all that it possesses a specific toxic action on tapeworms, a solution of one part of its proximates in ten thousand in ten minutes causing their death. The drug contains four alkaloids naturally combined with tannin, in which the drug is rich; and pelletierine tannate has displaced the crude drug almost entirely, for this modern substitute for the crude drug, is almost insoluble in the stomach. Here is an instance wherein a drug with valuable properties is too disagreeable to use in the crude form and had almost passed out until its active principles became available. Sparteine

This drug belongs to the uncertain coniine group; it paralyzes the respiratory and motor centers, as well as the pneumogastric, when given in large doses. The long use of sparteine as a heart remedy is not based on any proved action on the heart, and its use therein was probably based on the definite diuretic action of scoparius, from which sparteine is derived. We know now that it is the scoparin in scoparius that is diuretic, not the sparteine, and sparteine is rapidly going out of use. Here is an instance of the wrong proximate principle being used. Yet scoparin is uncertain in action and a decoction of scoparius is the better diuretic.