Use of diaphoresis and diaphoretic agents in ophthalmic therapeutics / Hiram Woods. Diaphoretics and diaphoresis and ophthalmic therapeutics / T.A. Woodruff.

  • Woods, Hiram.
Date:
[1902?]
Catalogue details

Licence: In copyright

Credit: Use of diaphoresis and diaphoretic agents in ophthalmic therapeutics / Hiram Woods. Diaphoretics and diaphoresis and ophthalmic therapeutics / T.A. Woodruff. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the deficiency, thus eliminating morbid products to- gether with physiologic excretions.” If the therapeutic efficacy of diaphoresis is due solely to this vascular effect, equally good results should fol- low similar action on other vascular areas, which, for our purposes, are essentially peripheral. Those of the intestines and the use of salines and hydragogue ca- thartics illustrate. The copious watery evacuations from these agents are not, however, at least in my experience, followed by anything like the results observed after the use of diaphoretics. Nor does emptying the cutaneous vessels, with compensative filling from internal struct- ures, explain the good results of small doses of diaphor- etic agents, which do not produce copious sweats. There must be something besides this transudation from peripheral vessels, and, I think, we may well con- sider in this connection the nervous influence which lies behind the diaphoresis. Pilocarpin is the drug in most common use. It acts on the skin by its stimulating ef- fect on the cerebrospinal nerves supplying the sweat glands. Another of its physiologic effects is its inhib- itory and paralyzing effect on the vasomotor system. One is surprised—at least I was—to note the similarity between the physiologic effect on the eye of pilocarpin and the results of section of the cervical sympathetic nerve or ganglion, when reading the scholarly paper pre- sented to this Section a year ago by de Schweinitz. If one has occasion to observe cases of bad effects from diaphoretic agents—the nausea, vesical disturbance, car- diac weakness, etc. —he will find abundant evidence, that in both its stimulating and depressing effect, a diaphoretic has marked nervous influence. By its ac- tion on the vasomotor system dilatation of the small ar- teries, with lessened resistance to blood flow and height- ened local temperature, are produced. It seems to me, then, that in estimating the cause of the efficacy of di- aphoretic agents, we should count first, as Hansell has said, depletion of cutaneous vessels; and secondly, the action of diaphoretic agents, pilocarpin particularly, on the small arteries. From this we can draw two theoretical conclusions which clinical experience confirms: 1. Diaphoretic agents should have their greatest efficacy in structures richly supplied by blood vessels. 2. This efficacy should