Explaining The Apparent
                                             Actions of Drugs
                                                         By: 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

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 effects"
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 narcotic, 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

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 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 organ
systems 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 properties 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 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

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 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
digestive.  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 perceived 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

Kellogg may be correct when he says of the diuretic that it did not occasion
"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 activities 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.  

By: Herbert M. Shelton

Article: Explaining The Apparent Actions of Drugs