Physiological medication embraces all those remedies, natural and artificial, prescribed purely on an empiric basis in an effort to restore the functions of organs or tissues to a normal condition. It is fortunate that present-day teachings tend toward milder dosage for often, when physiological means are indicated, new and milder methods are just as efficacious and not so harmful as the violent dosings of the past. To one who knows and appreciates the virtues of symptomatic prescribing, many of the agents, about to be mentioned, are unnecessary and interfere with homoeopathic medication. However, in some diseases and at times in almost any disease, aperients, diuretics, tonics and alternatives may be needed.
Aperients occupy a useful sphere in cutaneous diseases. If possible milder methods should be employed such as dietary changes including the eating of laxative fruits and the drinking of water between meals or the use of aromatic liquid albolene or other oils, because these simpler items have a food value as well as an eliminative virtue. Aperients often improve digestion. In this particular salines are useful except in anemic individuals, although they should not be used strong enough to cause active purging. Magnesium sulphate, sodium sulphate, sodium phosphate and the natural aperient waters may be used. If liver or other glandular torpidity is suspected, calomel in 1/10 grain doses (repeated at fifteen-minute intervals) may be administered to advantage. Antacid magnesia is a valuable laxative when gastro-intestinal complications are present. The extract or the fluid extract of cascara is the most useful of the vegetable laxatives but for infants and young children castor oil is frequently ideal. Low or high enemata with or without soapsuds or if necessary, containing a solvent, are to be recommended if flushing of the lower bowel is desired. Rectal atony can often be relieved by dilation of the sphincter, stimulation by the high- frequency currents or with soap or gluten suppositories.
Gastrointestinal antiseptics such as charcoal, salol, sodium salicylate, antacid magnesia or minute doses of calomel are valuable in urticaria, erythema multiforme and other diseases due to autointoxication. I can speak enthusiastically about the results accomplished in these conditions with a culture of the bacillus Bulgaricus. This microorganism produces a large percentage of lactic acid, displaces the microorganisms causing intestinal putrefaction and relieves or cures diseases created by intestinal autointoxication.
The best diuretic is water which may be drunk copiously on an empty stomach to promote the free flow of urine. Among the medicinal diuretics, the salines such as potassium acetate and potassium bicarbonate are the best. Most of these remedies are antirheumatic or antilithemic in character, and may be employed to advantage in such diseases as eczema, psoriasis, acne, rosacea, dermatitis exfoliativa and other inflammatory disorders. Sodium salicylate, ammonium salicylate, salophen, small doses of belladonna and other vegetable diuretics may occasionally exert a favorable influence but upon the whole it may be said that diuretics are less valuable in skin conditions than in other diseases.
Tonics have a nutritious as well as a stimulating effect and may be indicative in many skin diseases. The most valuable nutritional tonic is cod-liver oil but other oils and emulsions may prove equally efficient. Anemic conditions may call for iron, manganese, the hypophosphites, quinine, strychnine and small doses of arsenic. The ordinary digestive and bitter tonics may serve the same purpose as the above by improving the appetite. Laxatives may be required in connection with some of these times.
Alternatives are remedies that restore, often in an unknown way, the functions of an organ or of the system. These remedies are sometimes divided into general alternatives and special alternatives depending upon whether they do or do not possess the quality of improving nutrition independently of any other power. No doubt the alleged action of many of these drugs may be referred to their germicidal influence. Mercury is well known for its efficient work in the early and late stages of syphilis. The choice of a mercurial and the method of its administration will be considered in the treatment of syphilis. The iodine preparations, especially potassium and sodium iodid, are useful in late syphilitic conditions, strumous affections, actinomycosis, blastomycosis, psoriasis and other diseases. Tar, phenol and phosphorus have been prescribed internally for psoriasis, eczema, lupus erythematosus and lupus vulgaris. Antimony, turpentine and copaiba have been suggested for eczema and psoriasis. Quinine is apparently useful in diseases where there is an underlying malarial taint such as some cases of erythema multiforme, erythema nodosum, elephantiasis, eczema and herpes zoster. There are few remedies given empirically like the above which probably have any direct effect on the skin. If any one might be said to have special cutaneous affinities, it is arsenic. It is possible that this drug acts both directly and indirectly through the nervous system and its chief value is for indolent dermatoses such as psoriasis, lichen planus and some dry eczemas, as well as neurotic disturbances such as pemphigus and dermatitis herpetiformis. Arsenic has been administered in various forms for many years and its chief preparations are arsenious acid in the form of tablet triturates, Fowler’s solution, Donovan’s solution, de Valangin’s solution and the Asiatic pill. Many combinations of arsenic with other medicinal substances have been in vogue recently. Sodium cacodylate is an organic compound of arsenic often administered hypodermically. Atoxyl has given good results in the treatment of syphilis and other affections, and salvarsan and neosalvarsan do not need description here because their methods of administration are described under syphilis. Jaborandi or its active principle pilocarpin may be useful in cases where stimulation of the sweat function is desired, such as ichthyosis and generalized psoriasis.
It is not probable that any remedy administered internally is germicidal but many of those mentioned and some others contribute to make the tissues an unfavorable home for microorganisms, or at least are antidotal in their effects. The efficiency of quinine in malaria, mercury in syphilis and potassium iodid in actinomycosis is partially based upon the germicidal theory. Sulphur probably exerts a similar influence in respect to many diseases of germ origin and the action of calcium sulphid in furunculus, acne and seborrhea is well known.
Animal extracts, especially the preparations of the thymus, thyroid and suprarenal glands of the larger animals, have been employed with indifferent success in the treatment of skin conditions. Thyroid extract has proved its worth in myxedema and has benefited occasional cases of ichthyosis, psoriasis and lupus vulgaris. Suprarenal gland extract has been urged for vitiligo. Thymus gland extract has some virtue as a remedy for dermatoses with a rheumatic or lithemic causation. It may be said that some of these animal extracts have a general alterative effect as well as a special alterative action.
Vasomotor constringents have been employed forrosacea, purpura, pruritus and a few other diseases. Ergot, ichthyol, thiol and adrenalin chloride have been variously suggested for their action upon the cutaneous vessels leading to a contraction of the vessels themselves and the consequent reduction of hyperemia.
Analgesics and antipruritics play a comparatively unimportant part in internal cutaneous medication. They should be avoided if possible because they not only often aggravate existing conditions but also may cause pronounced damage. While opium or morphine may be indicated for the pains of malignant disease or for the neuralgia of herpes zoster, they should never be employed for pruritic diseases, lest they aggravate the itching. The bromids, chloral, phenacetin, antipyrin, lupulin, belladonna and gelsemium may be employed as sedatives and antipruritics but relief from itching is more sensibly obtained by local applications.
Natural mineral waters have unquestioned value in the treatment of dermal conditions but they are best taken at the various Continental and American springs from which they come because the strict dietary regimen, compulsory exercise, relief from the care and toil of business, change of climate and scene all contribute to the success of the cure. It is questionable if the medicinal ingredients of the waters are of great relative value. In this connection it may be said that chemical laboratories are now placing before the public the constituents of most of the popular mineral waters either naturally or artificially produced. Thus the proper solution of the salts may be made in any pure water and the actual medical result would be the same. No doubt the stronger mineral waters owe their virtue to their laxative action while the milder ones, usually taken at the springs and in larger quantities, serve as diuretics as well as laxatives. When our domestic springs are made attractive, well advertised and controlled by national, state or local authorities, they no doubt will complete in all respects with the foreign establishments which now enjoy a greater reputation, not because of any different inherent value of their waters but solely because of the items of management which our springs lack.
American homeopath, he directed several hospitals in New York.
Professor of dermatology.
Served as Lieut. Colonel during the 1st World War.
See his book online: American homeopathy in the world war