INTRODUCTION
ALOE.- Allg. Hom. Zeit., XX.- Duration of Action?.
ANTIDOTES.
Vinegar, vegetable acids.
RATIONALE OF ITS ACTION.
ON THE NERVOUS SYSTEM.
Aloes does not act specifically, either upon the nerves of sensation or motion; it may possibly exert a secondary action upon the great sympathetic nerve.
VASCULAR SYSTEM.- It acts far more specially upon the vascular system than upon the nervous; it may, however, act specifically upon those parts of the great sympathetic nerve which accompany the blood-vessels into every part of the system.
BLOOD.
It was once a common opinion that Aloes dissolved the blood, or increased its fluidity. Lewis alleges that this is the condition of the blood drawn from persons who are in the constant habit of using Aloetics, although, according to Schwencke, it seems rather to coagulate than dissolve the blood, when added to some which has been drawn from a vein. It was also an old opinion that it proved emanagogue, from its power of dissolving the blood, and hence would be hurtful in scurvy, and in all haemorrhages proceeding from a lax state of the blood and system. It is probable that Aloes acts in the same way upon the venous system that Iron does upon the arterial; they both diminish the quantity of fibrin in the blood, and increase the quantity of blood- globules.- J.C.P.
FEVER.
Dierbach says it is a heating remedy, which readily excites febrile symptoms of in young persons, such as a quick pulse and a troublesome sensation of warmth in the abdomen. The excited state of the portal system, which it so readily causes, may, in some cases, extend to the whole venous side of the circulation, and congestion, to the head and chest, but especially to the abdomen may arise, attended with unpleasant heat, anxious feelings and throbbings, with increased sensitiveness and distention of the abdomen, frequent stools, mixed with blood, or bloody stools with violent abdominal pains, piles, severe distress in the kidneys, hot, scanty urine with burning while urinating, and pain in the back. Harnisch says, in very sensitive and plethoric persons it may cause an excited state of the whole vascular system, so that the pulse becomes fuller and harder, the mouth dry with thirst, scanty discharge of red urine, increased warmth in the abdomen, throbbing and aching in the region of the liver, congestion to the head and chest, with oppression and anxiety, bleeding from the lungs, and apoplexy.- J.C.P.
HAEMORRHAGES.
Aloes is particularly apt to excite haemorrhages, especially and more frequently from the haemorrhoidal vessels and with womb; occasionally from the kidneys and bowels, and rarely from the stomach, lungs, and head.
LIVER.
Aloes has been supposed to act upon the liver from time immemorial. Aloe bilem rubrum expellit (Rhazes). Aloe adinfernis intestinum bilem ducit (Aretaeus). According to Sigmond, its influence upon the liver is marked by the particular composition of the evacuation, the color and odor of which, and their peculiar pungent effect on the rectum, prove that an increased quantity of bile has been poured out. Wedekind assumes that the operation of Aloes upon the bowels depends upon an increased secretion of bile, excited by its specific action on the liver, and asserts that, as long as the stools are white or grey in jaundice, Aloes will not purge, even in large doses, while the purgative effect supervenes as soon as the faecal matter contain bile. When there is an excess of bile, it is apt to cause bilious dysentery and hepatitis. Vogt says that it exerts a special action on the liver, and tends more to the restoration of a checked secretion of bile than any drastic purgative. Antyllus counts it among the remedies which evacuated yellow bile. It causes aching and tension, and uneasiness in the region of the liver, bilious papescent stools, with heat of the whole body, while body, while the evacuations are not watery and copious, but faecal and bilious, and emit a peculiar putrid smell.-J.C.P.
VENA-PORTA.
Another class of physicians think that Aloes acts primarily and specifically upon the portal system, and assume that its influence upon the liver and bowels is secondary to this. That it acts upon the vena-portarum is fairly to be deduced, from the very peculiar state into which the haemorrhoidal vessels are thrown by the congestions which so rapidly occur after a dose of this drug has been taken. Wedekind says it exerts says it exerts a specific stimulant action on the venous system of the abdomen and pelvis, and hence causes an increased secretion of bile, irritation about the rectum, and vascular excitement of the sexual organs. It readily causes stagnation and accumulation of blood in the abdominal vessels, and the various affections and consequences of plethora-abdominalis.- J.C.P.
ABDOMEN.
Pressure, tension, and heat in the region of the liver. Fullness, heat, and distention of the abdomen. Beating, boring, and stinging in the umbilical region. Diarrhoea, preceded by colic. Most violent colics. Discharge of a large quantity of fetid flatulence. Violent cutting pain in the abdomen.
BOWELS.
It is a specific purgative; for, when applied externally to a blister, it will operate upon the bowels (Gerhard); tincture of Aloes, put into a carious bone, has excited purging (Munro); an Aloetic pill, applied to an issue, has had the same effect (Pereira); also an Aloetic salve, rubbed upon the abdomen (Dierbach). Dr. Heller injected a solution of half an ounce of socotrine Aloes in six ounces of warm water into the jugular vein of a cow, which had suffered, of six days, with obstinate constipation and constant vomiting, and had withstood all ordinary injections and purgative medicines; the cow shivered immediately, followed by quickness of the pulse and respiration for one hour; then succeeded frequent urgings to stool, by which, however, only a small quantity of hard faeces were evacuated. The same procedure was repeated the next day, when violent straining produced first the discharge of some dry dung, followed by profuse soft evacuations; the vomiting ceased, and appetite and health soon returned.- The part of the bowels upon which it operates by preference is a matter of dispute. Wood and Bache think that it has a peculiar affinity for the large bowel, and acts rather upon its muscular coat than upon the exhalent vessels. Cullen agrees to this, and asserts that it rarely or ever produces more than one stool, which seems to be merely an evacuation of what may be supposed to have been already present in the great intestine. Hardly any dose under twenty grains will produce a liquid stool, which effect is always attended with pain and griping; on the other hand, the ordinary bulky and rather hard Aloes-evacuation may, in innumerable instances, be constantly obtained from one to two grains. The slowness of its effects has also been advanced by Lewis in proof that it acts on the large rather than the small bowels; for Aloes hardly ever operates under ten or twelve hours, and often not till sixteen to eighteen, white even twenty-four hours may elapse. Finally, to be still more minute, Newman has conjectured that it acts more especially upon the circular than upon the longitudinal muscular fibres of the colon. Whether given in a large of small dose, it hardly ever causes copious evacuation, and an increased quantity does not produce a corresponding cathartic effect. But these authors forget its decided action upon the liver and bile. Its effects upon these are so distinct and characteristic that, when added to other purgatives, its peculiar operation do not take place until some hours after the evacuations caused by the other purgatives have occurred, and the Aloes-stools differ from them both in color and smell. It rarely or never causes watery stools, but the dejection are always yellowish, greenish, or blackish and slimy, and often emit a peculiar, offensive, and almost putrid smell; the color and odor of the evacuations, together with their pungent effect and on the rectum, prove than an increased quantity of bile has been poured out.- J.C.P.
It may cause emaciation, stricture of the rectum, and enteritis. If its use be long continued, it causes dryness of the intestines rigidity of the muscular coat of the bowels, especially of the colon and rectum, in consequence of which obstinate constipation may ensue. Very large doses may causes violent cutting abdominal pains, watery and long-continued diarrhoea, tenesmus, and inflammation of the lower portion of the alimentary canal. The faeces may be enveloped in a thin pellicle of altered intestinal slime, or there may be enveloped in a thin pellicle of altered intestinal slime, or there may be discharges of membranous-like pieces from the rectum, or very large rolled- up pieces of intestinal mucus.
One of the most common effects of Aloes is irritation of the rectum, giving rise, in some instances, to haemorrhoids. Cullen has seen piles produced by large and frequent doses, with heat and irritation about the rectum, and tenesmus. Fallopius says, of one hundred persons, who had used Aloes freely as a purgative, at least ninety became affected with a haemorrhoidal flux, which ceased when their use was omitted.
