Excerpt from The Medical Brief, Vol. 39: A Monthly Journal of Practical Medicine and Surgery; January, 1911
And, finally, in respect of the chemico-physiologic disposition Of the drugs which we inject, our knowledge, although equally limited, is equally clean-cut so far as it goes, and enables us to pick our way with reasonable assurance. All of the substances which we are of late proposing to introduce by the intravenous route have been given by mouth from time immemorial. So that the only new question in physiological chemistry that the intravenous method raises is whether, by skipping the digestive tract and the portal system, these substances lose any good qualities or acquire any evil ones. Our knowledge of this gastro-hepatic circuit assures us that, with the possible exception of certain mild acido-alkaline reactions, there is nothing in its chemistry or physiology to inﬂuence drug action one way or the other: and of course no one is going to put hurtful acids directly into the blood. Indeed, so far as this particular consideration is concerned, anything that can legitimately be introduced by the hypodermic method, or by rectal enema, can with equal impunity be given intravenously.
It seems clear, then, that the Old Objections to intravenous medication no longer hold any water. Neither practitioner nor patient need hesitate to employ, or to submit to, the method on these scores. The only real question to consider is whether the intravenous route has any positive advantages over the prima via; and if so, in what instances. We do not advocate - no one, we think, advocates the adoption of the intravenous method for all, or even for the great proportion of, medication. As stated, the revival of the mode is subject to the modification and discrimination of modern science. But, as a general proposition, it may be said that there is always a marked advantage in introducing medication as directly, as promptly, and as economically as possible to the tissue or organ which it is destined to inﬂuence. Hence the medicines to which this mode of administration is most adapted are those which are intended to act directly upon the blood itself.
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