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Holmes, Oliver Wendell, 1809-1894

"Medical Essays, 1842-1882"


Strictly speaking, every poison consisting of assimilable elements may be
considered as unwholesome food. It is rejected by the stomach, or it
produces diarrhoea, or it causes vertigo or disturbance of the heart's
action, or some other symptom for which the subject of it would consult
the physician, if it came on from any other cause than taking it under
the name of medicine. Yet portions of this unwholesome food which we
call medicine, we have reason to believe, are assimilated; thus,
castor-oil appears to be partially digested by infants, so that they
require large doses to affect them medicinally. Even that deadliest of
poisons, hydrocyanic acid, is probably assimilated, and helps to make
living tissue, if it do not kill the patient, for the assimilable
elements which it contains, given in the separate forms of amygdalin and
emulsin, produce no disturbance, unless, as in Bernard's experiments,
they are suffered to meet in the digestive organs. A medicine consisting
of assimilable substances being then simply unwholesome food, we
understand what is meant by those cumulative effects of such remedies
often observed, as in the case of digitalis and strychnia. They are
precisely similar to the cumulative effects of a salt diet in producing
scurvy, or of spurred rye in producing dry gangrene. As the effects of
such substances are a violence to the organs, we should exercise the same
caution with regard to their use that we would exercise about any other
kind of poisonous food,--partridges at certain seasons, for instance.


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