Abstract
PROF. RUTHERFORD'S paper described the concluding results of the long research undertaken by him on “The Biliary Secretion with Reference to the Actions of Cholagogucs.” He pointed out the difficulties which had rendered it impossible for physicians to arrive at precise knowledge as to the actions of substances on the liver from observations on the human subject, and the imperative necessity for having recourse to experiments on animals, whereby some of the factors that complicate the case in the uninjured system may be eliminated, and definite knowledge regarding the action of agents on one of the most important organs of the body instituted for the vague guesses of twenty centuries. Several previous investigators had striven by experiments on animals to settle this question, but all had failed owing to the faulty character of the methods employed. By a new and precise method of continuous collection of the bile, and measurement of the amount secreted every fifteen minutes—with a careful elimination of disturbing factors—the whole physiological pharmacology of the liver has been worked out by Prof. Rutherford—as far as it seems at present desirable to proceed. The actions of as many as forty-six substances on the bile-forming function of the liver have been investigated, and results of much importance for rational therapeutics obtained. Some of the substances employed, viz., sodium salicylate, the beuzoates, phytolaccin, physostigma, eüonymin, sanguinarin, ipecacuan, &c., have not hitherto been known to stimulate the liver; and definite information has now been obtained regarding the influence of a number of other substances whose effects have been hitherto altogether doubtful. He has also proved that if a purgative agent has no direct stimulating power on the liver it diminishes the secretion of bile, and the importance of this fact is indicated. The results of the experiments which were performed on dogs are in complete harmony with every fact that has been perfectly ascertained in the human subject. The experiments with every substance supply a precision of knowledge regarding the effect of that substance on the liver which has not previously existed. In indicating the place for such experiments in medical science, Prof. Rutherford said:—“We all know how excessively complicated the analysis of the effects of drugs becomes when they are administered to a bodily system distorted in its action by the effects of disease. Of necessity the influence of a drug upon a diseased state is the ultimatum of pharmacology; and every experiment upon a healthy bodily system, whether of man or animal, is merely ancillary to experiments with the drug in disease. If we discover that a drug stimulates the healthy liver of a dog, we do not conclude that it must also stimulate the human liver in health, and still less do we conclude that it must have this action in disease. The experiments on the healthy liver of the dog, on the normal and on the abnormal human liver, are three sets of experiments, closely related, but still distinct. The results of any one of the three series cannot be substituted for those of the other two. Each set of facts has its own proper place, and must be carefully kept there. When, therefore, we show by our physiological method of experiment that such a substance as sodium salicylate or sodium benzoate powerfully stimulates the liver of a dog, we do not for a moment say to the clinical observer You will find that these things act thus in man; but we merely say this: Experiment with these agents on man, and tell us whether or not you find that they stimulate his liver, and tell us also in what diseased states you find the employment of this or of that substance most advantageous. The clinical experimentalist has a far more difficult task to discharge than the physiological investigator, and he urgently requires all the assistance that physiological methods can render him; and the more so because it is now admitted by all competent thinkers that the actions of medicinal agents in diseased conditions cannot be rightly understood unless we also know their effects in a healthy condition of the bodily system.“He further showed that although therapeutics can never be brought within the sphere of exact science, it is nevertheless very urgently our present business not to fold our hands in a despairing nihilism, but to search for every fact that can throw light on the function of every bodily organ, the nature of its diseased conditions, and the manner in which it is influenced by medicinal agents in its normal and abnormal states; and all we desire is that those who don't comprehend our methods of procedure, although they are ever ready and eager to profit by its results, will, instead of throwing obstacles in our way, leave us to do what we can to alleviate not only the sufferings of human beings, but also those of animals. At the conclusion of the paper Sir Robert Christison characterised the professor's communication as of the greatest importance, and as one which would hand his name down to a very distant future. The professor deserved the commendation of the Society for his courage in going on, in spite of a sentimental opposition, with his researches. He thought that the time would come when the public would wake up from the delusion in this regard in which it now was. Sir Wyville Thomson, in intimating the thanks of the Society to Prof. Rutherford, said that, in his opinion, if a man in a public position felt that he had knowledge and nerve sufficient to perform these experiments for lessening the suffering and prolonging the lives of men, even though they should involve a certain amount of suffering to the lower animals, he was not only entitled but was bound to peforrn them.
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ACTION OF DRUGS ON THE LIVER 2 . Nature 18, 268–269 (1878). https://doi.org/10.1038/018268a0
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DOI: https://doi.org/10.1038/018268a0