Apparent Actions of Drugs

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Explaining The

Apparent Actions of Drugs

Herbert M. Shelton Ph.d.,D.C.

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.

Herbert M. Shelton

-- Peace be with you,

Don "Quai" Eitner

"Spirit sleeps in the mineral, breathes in the vegetable, dreams in the animal and wakes in man."

Nearly all men die of their remedies, and not of their illnesses. ~Baptiste Molière, Le Malade Imaginaire

The obstacle is the path. ~Zen Proverb