Volume 1

Modern treatment : the management of disease with medicinal and non-medicinal remedies / in contributions by American and foreign authorities ; edited by Hobart Amory Hare ; assisted by H.R.M. Landis.

Date:
1911
Catalogue details

Licence: In copyright

Credit: Modern treatment : the management of disease with medicinal and non-medicinal remedies / in contributions by American and foreign authorities ; edited by Hobart Amory Hare ; assisted by H.R.M. Landis. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    V which we desire. The variation from the normal in tlie body affected by disease may completely reverse the known effect of a drug upon a healthy organism. A host of illustrations might be cited, but a few suffice. Nearly all of our knowledge of the so-called physiological eflects of alcohol is that obtained by investigations of its effects on healthy animals or men. In the healthy oiganism the alcohol must be burnt up in addition to the ordinary processes of oxidation; whereas, in the febrile patient it is not only more readily burnt up, but by its oxidation it pro- tects the tissues of the patient. Another instance is the extraordinary impairment of the value of digitalis by the presence of fever. Still anothei is the immunity to chloroform possessed by parturient women. Other instances are the tolerance of iodides by syphilitics and of opium by those in pain. There can be no doubt that oftentimes remedies gain a reputation that they do not deserve chiefly because of coincidence of improvement with theii administration, when in reality there is no relationship of cause and effect, or because the imagination of the physician, or of the patient, plays a role which in the case of the former should be con- trolled, but which in the patient is certainly advantageous. In either event a remedy may seem beneficial when really inert. But these errors are rarely harmful, and a great number of remedies have stood the test and have proved themselves of positive value, even if their effects are inexplicable. In many instances the advance of scientific knowl- edge has discovered how they do good many years after thousands of lives have been saved by their use, as with quinine, for example, or with digitalis, the so-called physiological action of which w'as at first thought to be quite the reverse of what we know it to be today. It is the duty of the physician, therefore, to resort to all measures proved use u y ong expeiience unless it can be proved that they possess power tor harm. At the same time that it is the duty of the pharmacologist to be a constructive agent, so is it also the duty of the bedside physician to be continually on the alert to improve his methods, to analyze his practice, to improve his mental processes, and to avoid giving a remedy by rule of thumb or because someone else has done so. lie should be constantly on the lookout to discover Avhy a remedy does good, and not le content with the result alone, since by this means he acts by reason and not by slavish example. To put it briefly, the attitude of the competent medical man of today must be that of clinical investigator, who welcomes m^ery gam m knowledge as an additional aid in his efforts to do good. He must hold fast to that which is good, being careful that what he holds must ever be controlled in his practice by the fact floor ^ le^'tmg a patient, not a disease, a patient whose powers of flir a malady are marvellous, with an organism that is to be so onrf 1^'^st of all, let him be dLegatd'L''^ ' '''''' '''' ^ ■ II. A. II. N. W. coHNER Spruce and Kiohteenth Streets, PillEADELPHiA, 1910.