Explaining The Apparent Actions of Drugs

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Posted: Fri Sep 12, 2003 9:13 pm

Post subject: Explaining The Apparent Actions of Drugs

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Dr Herbert M Shelton

Hygienic Review

 

Why is one substance poisonous and another not? Why do the actions

of the body in relation to different substances differ so greatly?

Why does not an apple occasion vomiting and bread occasion purging?

Why does not a baked potato occasion profuse sweating and brown rice

copious urination? Why are these substances, when taken into the

stomach, treated so differently from the way in which a drug is

treated? We know that normally they are digested and taken into the

bloodstream and utilized in the replenishment of the tissues of the

body.

 

We class them as foods, because they may be used for tissue

replenishment.

 

Why are not drugs digested and used? Why does one drug occasion

catharsis, another emesis, a third diuresis, etc? Why do some drugs,

when applied to the skin, cause vesication, others rubification and

others corrosion? Why is one drug, when swallowed, followed by

stimulation and another by narcosis? Why do foods not occasion

stimulation or narcosis? It is customary to say that vesication,

diarrhea, diuresis, emesis, narcosis, etc., are actions of the

drugs.

This, however, is no different from saying that digestion is the

action of foods. We know that emesis, diarrhea, diuresis, etc., are

actions of the living organism, not of the drugs, just as digestion

is a physiological process and is not done by foods.

 

 

But the swallowing of different drugs is followed by different

actions. Castor oil, for example, is commonly expelled by diarrhea,

tartar emetic is commonly expelled by vomiting. Aloes and rhubarb

occasion sweating. Why do different drugs occasion so many different

actions?

 

It is not to be thought that these drugs go through the organism

seeking out, from choice, the different organs and tissues for which

they have an affinity. They do not possess even this rudimentary

type of intelligence that enables them to seek for and act only on

certain structures.

 

Let us try to answer our first question first. Certain substances,

such as an apple or a nut, can be utilized by the body in the

replenishment of tissue. These substances are foods. Certain

substances cannot be utilized by the body in the production of

tissue. These substances are not foods. The answer to our question

seems to lie, then, in the usability and nonusability of a

substance. A substance is not a poison if it is usable, it is a

poison if it is not usable. We define food as any substance that can

be

 

transformed into living 'structure'. This is to say, food is any

material that the cells of the body can take into and incorporate

into their substances as integral parts of themselves. If it can be

transformed into cell substance, it is food. Anything that cannot be

transformed into cell substance is not food.

 

This last statement leaves us with a whole world of matter, both.

Organic and inorganic that is not food, at least, not for man. It

leaves us with far more nonusable than usable materials in the

universe. If a substance is not usable, it must be expelled. But

substances that are nonusable are not merely nonusable; they are

also chemical substances governed by all the laws of matter. They

tend to unite with other chemical substances. They tend to unite

with the elements of the cells. Such unions would be destructive of

the cells.

 

In plain English, the union of a drug with the substance of a cell

would result in the death of the cell. This creates the urgent

necessity to resist the union and to hurriedly expel the substance.

 

Substances that tend to form chemical unions with the substances of

the cells and thus destroy the life of the cell are incompatible

with life. Toxicity may be defined as the degree of incompatibility

between a drug and the cells of the body.

 

Some substances are highly toxic, others are only slightly so. Two

forms of incompatibility must be recognized: namely, chemical

incompatibility with the structures of the body and physiological

incompatibility with the functions of life.

 

The actions that occur following the swallowing of a substance that

is incompatible with life are very varied. They depend in part upon

the character of the substance, but for the most part they vary with

the tissues with which they come in contact. Each tissue acts in

keeping with its own powers.

 

A drug that is expelled before it reaches the kidneys will not

occasion any kidney action. A drug that the kidneys excrete with

great difficulty, may be expelled through the skin or through some

other channel. It was the view of Dr. Trail that drugs are expelled

through those channels and by those means that cause the least wear

and tear on the system. This gives the body a certain power of

selection in its work of expelling drugs.

 

But there are drugs that are resisted at every point and that are

expelled through a number of channels. It would seem that, as a

matter of necessity, every tissue in the body must resist and expel,

as far as it can, nonusable substances with which it comes in

contact. But not every tissue is so constituted that it can expel

drugs from the body. It can expel them only from itself. It can

offer local resistance. It would seem to be correct to say that the

tissue must offer resistance if the drug comes into contact with it.

 

This seems to be the explanation of the alleged " side efects " that

are so often mentioned today.

 

But why is one drug an emetic, another a purgative, another a

diuretic, another an expectorant, another a stimulant, another a nar

cotic, etc.? Do these different apparent actions of different drugs

represent actions of the drugs, as is taught and believed, or-are

they different actions of the living organism in relation to

different drugs? If so, why does the body behave differently in the

presence of one poison from what it does in the presence of another?

 

If we attempt to answer our last question first, it seems that there

is no basic difference between the actions of the body in relation

to one drug and its actions in relation to another. The differences

are more apparent than real and are the results of the structural

and functional differences of the organs and tissues involved in the

actions. Basically, the action is one of resistance and expulsion

and this is not radically different in any tissue.

 

In a work published in 1874 by the office of the Health Reformer,

apparently from the of M. G. Kellogg, M.D., who says that he derived

his views from Graham, Trall, Alcott, Shew and Tanner, the idea is

presented that different organs excrete different drugs because the

presence of the different substances is perceived by different

nerves.

 

He draws a parallel between the nerves of the organ-systems and the

nerves of special sense. Just as the nerves of the eyes perceive

objects and light and the nerves of the ears perceive sounds, those

of the nose perceive odors, those Of the tongue perceive flavors,

etc., so the different nerves of the organsystems perceive one drug

and not another.

 

The different ganglia perceiving a certain substance to be such

that " it cannot be used to replenish any of the tissues of the

body, " causes activities to be instituted to secure the expulsion of

the drug. He suggests that the different ganglia differ in their

perceptions, just as do different parts of the brain, hence the

action following the taking of a drug will be determined by the

particular ganglion that perceives its presence.

 

Assuming that there is a grain of truth in this idea, it does not

seem to cover the whole of the phenomena that follow the taking of

drugs. Although, he is probably right in saying that " all matter

does not possess the same sensible properties; if it did, we would

know of but one kind of matter, " and he is probably correct in

saying that it is through the " various senses " that we can recognize

various nronerties of matter, 'there seems to be a necessity that

the useless and harmful be recognized by all of the tissues and by

all of the 'nerves. There would seem to be, as a matter of fact, a

cellular recognition of the unsuitableness of drug substances.

 

He but echoes the words of Trall when he says that " instead of

medicines (drugs) having special affinities for certain organs and

tissues of the body, the vital organism has a special dislike for

drugs, and makes a special effort to eliminate them as rapidly as

possible.

 

" It is not amity, but antagonism that gives rise to those vital

actions of defense, resistance, expulsion and repair that are

mistaken for the actions of drugs. But he may have hit upon a vital

element in the explanation of the different actions that follow the

taking of drugs in his suggestion that, due to the fact that we

recognize different substances through the media of different

nerves, we act according to that recognition.

 

For example, it would seem to be the part of organic wisdom to

expel all drugs, when swallowed, either by vomiting or by diarrhea.

Why should any of them be permitted to be absorbed into the

bloodstream? Why send some of them to the. Kidneys, for instance,

for excretion? Why excrete others by diaphoresis and others by

expectoration; why excrete some through the liver?

 

Can this be because the nerves of the intestinal tract do not

adequately recognize the useless or injurious character of some

substances? Do drugs slip past the sentinels of the prima via

because they do not " appear " to the nerve end endings in the

gastrointestinal canal to be of a specially hurtful nature?

 

Must their injuriousness be perceived by other nerves and must they

then be appropriately dealt with by other organs and sent out

through other channels? Why, when a certain drug is taken, is it

later expelled by the kidneys (diuretic)? Was its useless and

hurtful character not perceived in the stomach and why was it not

expelled by emesis or diarrhea? Perhaps the explanation lies in the

suggestion of Kellogg.

 

He is certainly wrong, however, when he says, after giving the

actions that follow certain drugs, " if each of the medicines named

above is given in proper doses, it will occasion the effects named,

and no other. "

 

There is no known drug that occasions but one action on the part of

the body in resisting and expelling it. Perhaps but one effect will

be produced if it is all expelled by the primary effort at

expulsion, as when vomiting may expel all of a drug that is

swallowed. But if it is not all thus expelled, it may occasion a

diarrhea or small amounts of it may be absorbed into the bloodstream

and it may then be expelled by diuresis or by diaphoresis or by

expectoration or by all three of these processes.

 

The secretion of digestive juices upon the food eaten is controlled

by the nervous system. We get one kind of juice or another kind of

of juice depending on the character of the food eaten and this is

appreciated and appropriate nerve and glandular action instituted,

when the food comes into contact with the nerve endings (taste buds)

in the tongue. The character of the saliva, as well as of the

gastric juice, is thus determined.

 

If we eat a potato we have the outpouring of one type of gastric

juice; if we eat a beefsteak we have the outpouring of another type

of digestive juice. If we swallow a marble there is no outpouring of

digestive juice. If we take sugar there will be a copious outpouring

of saliva, but it will contain no ptyalin. Control of action here

lies in the nervous stem and its perceptions of the character of the

food eaten.

 

Suppose, instead of food, we swallow a teaspoon full of castor oil.

This is a poisonous oil that must be expelled. Its presence and its

character are recognized by the same nervous system that appreciates

the differences between foods.

 

There is again a copious outpouring of juice into the stomach, but

it is not a digestivee. It is a watery mucus. The muscles of the

stomach also act, but their action is somewhat different to what

goes on in digestion. They hasten the mucus and oil to the pyloric

orifice of the stomach and the valve opens and the mixture (oil and

mucus) is expelled into the intestine, where, instead of being met

with digestive juices, it is met with more mucus.

 

Here, also, instead of the regular movements of peristalsis and

antiperistalsis, there is only a hurried peristalsis, thus hurrying

the mixture along towards the colon. When it reaches the ileocecal

valve, this opens and the mixture is expelled into the colon, which,

in turn, hastens it to the rectum, where it is expelled from the

vital domain.

 

What part did the oil play in all this activity? It did not perceive

its own toxic character. It did not pour out mucus to dilute it and

flush it along. It did not perform the muscular work of the stomach,

small intestine and colon. It did not expel itself. Indeed, being

lifeless, inert and as incapable of any action as a dry stick or

clod of earth, it was passive in the hands of the forces of life. It

no more acted in the stomach than it acted in being poured into a

spoon and taken to the mouth for ingestion. It was as passive and

actionless during the whole of its journey through the alvine canal

as while resting in the bottle on the shelf.

 

Living hands poured it from the bottle; living hands took it to the

mouth; living organs of deglutition swallowed' it living nerves

percieved its presence and its character; living glands poured out

mucus upon it; living muscles propelled it through the digestive

tract; living muscles expelled it from the rectum. The living

organism was the actor from start to finish. The living organism

alone possesses the instruments of action and the energy of action.

It is specialized in myriads of ways for the performance of myriads

of actions.

 

Kellogg suggests that certain drugs are diuretics, this is to say,

they are expelled through the kidneys, because " the properties of

this class of poisons are not recognized by the nerve centers which

preside over the stomach, hence vomiting does not occur. "

 

They are thus permitted to enter the bloodstream and circulate in

the blood to all parts of the body. But their useless character is

immediately recognized by other nerves and they are excreted through

the kidneys. There is increased action, diuresis, to expel the

poison

 

Here, again, it is the living organism that does all the acting.

Diuresis is as much an action of the living organism as is diarrhea.

In diuresis the kidneys and bladder and the other parts of the

urinary apparatus are the actors rather than the intestinal tract.

 

Kellogg may be correct when he says of the diuretic that it did not

occasion vomiting " simply because they (the diuretic drugs) were not

recognizable by the nerve centers which preside over the stomach. "

But there is reason to think that this may not be the whole

explanation. Ipecac is classed as an emetic.

 

In a dose of a certain size it occasions vomiting. In a much

smaller dose it occasions diaphoresis and expectoration. It may be

that in small doses the nerves of the stomach fail to recognize the

poison; it may be that when sufficiently camouflaged with food or

other substances, they fail to appreciate its character.

 

This drug can be classed according to the faulty classifications

that have been adopted by pharmacologists and physicians, as an

emetic, an expectorant and a diaphoretic. Applied locally, it can be

given other classifications.

 

It is entitled to but one classification-it is poison. Its presence

in the body is resented; it is expelled, not through one channel,

but through several.

 

Trall indicated that just as the special senses take cognizance of

external elements in our environment, so the nerves of organic life

take cognizance of things that find their way into the body. Kellogg

followed this thought in his suggestion that different drugs

occasion different actions due to the fact that their presence and

character is detected by different nerves. Graham had previously

indicated such explanation, calling the perceptive faculties of the

nerves of organic life, organic instincts.

 

Graham and Trall and later Kellogg took the position that, just as

the brain sets in action the organs of voluntary motion and causes

these to act, according to its recognition (through the special

senses) of external objects, so the nerves of organic life (the

organic instincts, to use Graham's term) set in motion the

appropriate glandular and muscular activity in accordance with the

character of the substances that are within-actions designed to use

one type of substances and actions designed to expel another type.

 

 

As every organ and tissue is under the control of the nervous

system, there is nothing illogical in thinking that the nervous

system is the controlling mechanism in determining the actions of

the body in relation to not only foods but poisons. Thus it is that

the presence of poisons in the body occasions unusual vital

activities in the various organs of the body. We commonly, refer to

such unusual betivities as disease; at other times we simply

recognize them as symptoms of poisoning.

 

Each organ is capable of a certain kind or kinds of activity,

depending on its structure or structures.

 

Each organ acts in relation to toxins in accordance with its

functional capabilities, as determined by its structural adaptations.

 

The number and varied assortments of actions of the human body are

possible only because of its almost infinite structural complexity

and the resulting functional capacities.

 

Drugs are simple substances, lacking both structural specializations

and functional abilities.

 

They not only lack the instruments of action, but they are also

lacking in the energy of action. We are correct, then, in saying

that the body acts; the drugs are acted upon.