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SECOND DIVISION. OF LOCAL STIMULANTS IJ sngst this division are comprehendod those ae medies,
the stimulant operation of whicli is directed to particular gans. This comprises Emetios, Calliartios, Diuretics, Fia-IOgogues, and those various other classes that have usuallybeen areanged under the titie of Evacuanis, their locat operation giving rise to encreased secretion, Or encrea Sed eV
OF EMETICS. ΕΜΕTics are defined, Medicines Whicli excite vomit innindependent of any effect arising DOm the more quantity of matter introduced into the stomach. I his definition, however, requires to be stili more limited ; for there are many substances whicli occasionalty induce vomitinia that are notusualty ranked as emetic s. Ali bitter and nauseous drugs havo this effeci, When given in large dosos, or in an irritablestate of the stomach and it occurs frequently 9S the consequence of the action os many stimulanis and narcotics. The emetic operution, however, in these CaSes, is iacillior uniformuox certain: there axe, On the contrary, a number of Sub-
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whicli can havo that iuste concealed, but whicli stili excito vomiting wlion Hven tu a susscient d e, in oveo indivi dual, and in euco state of the stomach. TO i laeso substances the appollation of Emeties is exclusively applied. Theymay thoro re bo desined, Substances whicli excite vomitiura indepcndont of any effect sarising froin the quantity os matter
ich continues oncreasing untii vomiting be n. While illo nauSea onb iS present, the countenance is pale, the pulse is Reble, qui cla and irregulari and there is a laesing of coid ;but during the action os vomitiug the face becomes Bushed, the pulse is quickened, though stili laetae, and it remalasso in the intervat os vomiting. The vomiting generalb re- eurs t vice O timce, and then Ceases ; a degree of nausearomatus, Which goes off only gradually ; there is a degree os languor, and osten a disposition to fleep; the pulse is wealaand flow, but hecomes gradu atly fuller; the stan is usually
The generaΙ the y of tho operation of vomiting is sum- ciently evident. The vermicular or peristestic motion ofilio stomach, by Whicli the laod is propelled thro O the py- Iorius, is iuvericii; tiae diaptiua in and abdominat musclesare called into action by association; ille pylorus is contracted, and the colitents of the stomach axe sorcibly dis-charged upra artis. In many cases os vomit ing, especiallyWlien violent, illo preistallic motion even of the upper partos the intestinui canat is also inverted, and bile is brought into the stomach f in the duodenum.
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At the fame time, it is dissiculi to cxplain bo in the possis- aestic motion is inverted by omelics. It is a singular fac
such locat stimulant action. Nor is it easy to assign .a cause sor this specific operation. Dr Darwin gave a different explanation of the nature or 'vomiting. He consideria it as the effeci, not of encreased, hut os decreasta action of the fibres of the stomach. Whon In emetio is administeria, it produces, he observes, the pa in f Sicliness, ns a disagreeable t te in the mouili produces thepain os nausea: these measy sensations not bemg acutebPamsul, do not excite the organ into greater action, hut T ther repress the motions stroady existing. The peristallicanotion of the fibres of the stomach bocomes languid Dona theri ant of the usitat stimulus of pleasurabie sensation, and in ConSequeiace stops for a time, and then hecomes inverted,
which gives vise to the phenomena of vomiting. In this hypothesis, there is however equalty a deficiency in explaining 3iow the inversion of the motion is effected. There is a considerable differetice among individuulf Mithregata to the facility with whicli vomit ing is excitod. This Susceptibility is also Eable to bo altered by dis se. In thegreater number of 1 rite affections, vomiting is eaSij eX-cited ; while in severat of thti dissenses of the class N euroseri,M mania, melancholia, and hypochondriasis, it is excited villi much more dissicut ty. In the case of poisons, Whichin luce inflammation of the stomach, vomiting is almost a Constant sympto in ; while in those whicli act hy a narcoticy0 ver, and in hich ille irritabili sy of the stomacli is in
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somelimes requiring to be attended to in the administrationos individuals of this claSS. The feoble and low state of the pulse, whicli attendS vomiting, has been ascribed either to direct association het weenthe motions of the stomach and those of the heari ; or to thenai ea excited, which, like other disagree te sensations nota cutely painsul, have a depressing effeci, being equivalent toan abstraction of Stimulus. Emetices, at least those whicli are mild in their operation, do not appostr to waste the irritability of the stomach : theyhave rather an opposite effeci: heiace digestion is osten vi- rous after vomiting, and lience too gentie emetics are ostenseruic able in dyspepsia, and in the temporaary di minishedione of the stomach occasioned by intoxication. The state of the stomach produced by vomiting Scenas tobe osten extended to the vessias of the skin ; it is there resollowed frequently by diaphoresis, and is one of the mostpowerfui means of removing spasmodic stricture froin thesursace of the body. Emetics have a roma able potver of incre ing absorption : herice the bonosit they afford in anasarca, and the Sud-den dis pearance of tumors Whicli soluetimus halapens aster violent vomiting. Emetios frequently occasion increased evacuation Domitio intestinat caual ; and they fuit to excito vomit ing, Very nCralty operate as catharties. Some aro more Illi to ha e
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Uis effect than others, as the preparationS Os antimony Coi pared with ipecacuum. Froin the difforent Indications whicli emetics are capilleos sulfilling, they are adapted to the triniment of many m hid assectionS. Where disisse depentis on a disordered state of the' si machi, ariSing Dom ovo dinention, the presence of acrid orindigestibist mattea's, or any other cause, vomiting is thoe test and most effectual modeios affording at least pi sentaeelies. Heuce iis utility in ali cases of indigestion, impiared oppetite, acidi in the stomach, pyrosis, or an orexia ; in the symptotus arising Dona intoxication, and where piasons of y tand have been swallowed. Froni the strong action of the diaphragin and abdomines muscies in vomiting, the gall-bladder and hepatio ducis a re . emptied of theiae contents ; and lience jaundice, ou ing to obstruction in bili y calculi, is Sometimos suddenly vel ex ed by vomithag. A similar pressure is suppoSed to he CXertia ed during vomiting on the thoracla viscera, and from illis has been expla od the expectorant essects of emetios, and ille relies they afford in Somo varioties of asthma aud cui rh. In the different varieties of febrile disesses, much ad antago is derived spolia the administration os an emetic, especialty in the commenoement of the disease. In synoch Where there a re sympionis of highly enorea sed action, and particularly where there is determination of blood to the
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distressing to the patient, and does not appear to he cquallyessectual in stopping the progress of the discasu. This modo,however, of giving nauseating doses of emetios, is osten use- fui in haemorrhage, where fuit vomiting Would be dano erous, the nausea excited diminishing the force of the circulation ;it is there re sumetimes cmployed in haemoptySis and me-norrhagia.
Froni the powerfui effecis of emetios, their improper administration may be injurious, and there a re Various states of the system which either prohibit their use, or allow themto bo employed only with caution. During the operation Orvomiting, the blood returus Metili more dissiculty hom theheud, o ving partly to the preSSure on the deScending aorta, and partiv to the interrupted respiration, by whicli the trans
reditess of the colantenance and the vertigo whicli sume- times accompany it. Frum this cause it must be attendedivitii dangor in ali cases where there are symptoms Os dete
mination to the head, and more espectat ly vi plethoric habiis Froin the Strong action of the abdominat muscies exerted in vomiting, it has been considered as not without rish in viscerat inflammation, in the adu ced Stage of pregnancy, andiu hernia and prolapsus uteri. In extreme debility, there is tanger of the patient sinking iuider the violetice of the operation. The frequent repetition os emeties in chronio dise esis in generat pre judiciat, by weakening the tone of the si macta, and vendering iis motions more si te to be inverted by slight cauSES. The mode of administering emctios docs not admit os many generat observations. They should be given in tho laxin os
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ilmugiit; as is in a solid sorni, the emetic micti pass stomthe stomach lato tho intestines, without exciting Vomiting. A common practice is to promote the action of cmefices l, vtaking lmpe draughts of tepid water, or os an infusion orchamonide. Is an emetic is seven in a large dose, this is not inecessa , as it ivili excite vomiting repeatedly at intervalla; but is given in a moderate dose, it may excite vomiting onlyonce; naeusea and estoris to vomit Will recur, however, at intervias, and then vomiting may be renewed by a diau tof tepid water, or os a bitter infusion. We thus obtain theaduantages of repented vomiting, without the risti attendingi a large dose of a potve ut emetic. Too large a drauctiought not to be tineia, as it 1 endeus the operation more di siculi or patulat. Some acrid emeties, how er, aS mu Stard, require always to be largely diluted. The most natural subdivision of this class is hilo Emeticssrom the Vegetabie, and Doni the Miuerat Κingdom. '
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class that iis generat history may be introduced. timony, in the modern chemicat nomenclature, is ille name applied to the pure metal. It is found in nature most abundantly combined with sulphur, and to this ore the nameos Antimony was Once generalty giveu by chemical aud me dicat writers; the epithei Crude being frequently added todistinguish ii, when it is meited out froni the impurities min-Hed with it. The ore in this state is no v named Sulphuret os Antimony, and the Simple name Antimony is appropriated tothe metal itself. The native sulphuret os antimony is os a grey or blue colour, with metallic lustre ; it is opaque, aud has ustolly Astriated texture. To Dee it froni the earthy matter Witti vhicli it is mixed, as it is dug froni the voin, it is fused: tho fused sulphuret subsides and is ruit oss. Iis lustre is greator the more completely it is purifled. The proportions, of iis principies are Various ; Sometimes they a re noualy equul; in other specimens the quantity of metat is largor ; and there aresume varieties uniit sor modicines use, as containing other metuis, particularly lead, and SometimeS copper. Theseliave in serior lustre, and a less distinctly Striated textrue.
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. The pure metat is usualty obtained Doni the ore by meIt ing the latior with iron-silings, the iron combining with the sulphur, whilo the antimony, being Very susible, is run out . The metat is os a bluish-white colour, and a plated texture, has a specific gravio of '6. 7, is moderately hard, and very britile ; it melis at a heat not much higher thon that os ignition, and is volatili aed by a heat not very intenso ; it isoridated by expos e to the air at the temperature at whichit is volatiliged ; and in the state of Oxide, it is cap te of combining with the greater number of the acids. The sulphuret os antimony has littio activity, and indoed
produces Scarceb any Sensibie effect on the system. The preparations of the metat are much more active, and thoughof very disserent degrees of Strength, retain the Same modeos action, and possess there re the fame medicinal virtues. They do not exert any generat Stimulant operation on the system, but are ulways directed in their action to particular
The principes generat medicinal application Os aut ony, under iis disserent fornas of preparation, has been for thecure of febrile assections: and in the treatinent of laver ithas long been more or less extensively used. It is iveneither so as to induce vomitiug Or purging, or Sometimes in smallier doses, so as to produce only gentie diaphore- sis ; and exhibited in either mode in the commen ement of the disease, it has been considered as cap te of cuttinginori iis progress . The use of James's powder, Whicli is an antii noniat, has been extensive With this victi , and bothit, and the tartrate of antimony and potasti, or the emetictartar, continue tu he used . Their ossicacy has usually becna scribed to the evacuation they occasion, whilo Othera have considered uni imony, apparently With litile reason, exert
ing an actim specific or peculiar in iiseis in tho removul of