« PreviousContinue »
The light of inductive reasoning and the marvellous progress in scientific knowledge which characterize the nineteenth century are a living appeal from the idealism of a less enlightened age. The release from tradition-anticipated in the labors of Bichat and others—to which later investigation owes so many signal triumphs has doubtless been profoundly affected by the realistic tendency of modern thought. It is to the startling advancement attained in the natural sciences, however, resulting in a chemical skill and in mechanical appliances of incomparable value, that we must look for the originating impulse which has inspired the therapeutic knowledge of the present day. It needs but little reflection to perceive the immeasurable superiority of actual acquirements over the vague, hesitating-though ardent and laborious-methods to which the theory and practice of medicine were so long subservient.
We have said that, considered in the larger sense, the history of medicine has been a harmonious rather than an intermittent development. It is not to be supposed that, in the evolution of so momentous a scheme as the formulation of a remedial system applicable to the extensive catalogue of human ailments, there should not have occurred spasmodic and ill-adjusted theories, crystallizing in many a strange cultus, which, if ineffectual in retarding the onward sweep of rational progress, has, it may be safely averred, worked incalculable injury to the cause of medical truth. Mesmerism, astrology, spiritualism, even theosophy, however incongruously conjoined, and similar vagaries have not failed to enlist among their votaries many enraptured, even noted, believers ; nor is the mental strabismus with which they are afflicted amenable to any resource of rational treatment. We need, moreover, but contemplate the pitiable hallucinations which urge the pious pilgrimages to Marpingen, Lourdes, and Trèves, and the criminal negligence and incredible offence to reason which stultify the so-called "Christian Scientists" (as ironical a misnomer as language permits), to realize that miraculous cures still hold blighting yet potent sway over the minds of the ignorant and credulous. May not even the assumption of thaumaturgical powers be one day possible with those who arrogate to themselves a knowledge little short of omniscience, and to whose rudimentary intelligence the laws of nature convey no perceptible lesson? As from the sublime to the ridiculous, so from faith to fanaticism, it is but a step, after all.
It is appropriate here to emphasize the unfailing-nay, everincreasing-importance of therapeutics in its relation to the welfare of mankind. Especially imperative is this obligation in an epoch of unprecedented achievement in every department of science which contributes to the perfection of the healing art, in which general advancement medicine has borne no inconspicuous a rôle.
The rapid advance of experimental philosophy, however, applied to medical treatment, culminating in bacteriological discoveries of signal value to mankind, and the remarkable triumphs attending the development of operative surgery, have inevitably tended to disparage the equally noble and far more widely cultivated field of therapeutic science. This result is the more deplorable since it creates in the minds of the young and inexperienced an impression of contrast and divergence in departments of study naturally and indissolubly correlated. It is scarcely surprising that the marvels of the laboratory and the splendid achievements of the arena should possess for the tyro an entrancing interest. Yet it is to be borne in mind that the most brilliant triumphs of diagnostic and surgical skill might prove futile as the means of arresting disease were they not supplemented by the course of treatment which constitutes therapy.
It must be confessed that medical art has too often been discredited by professional incompetence, and consequent failure to effect the cure that with the laity is wont to form, however ignorantly, the only criterion of ability. In America especially—where from defective laws the widest latitude is given to incapacity and imposture—the lack of proper academical training is frequently the cause of serious consequences in practice, little calculated to enhance the popular confidence and esteem. It therefore behooves the student of medicine to master thoroughly the details of the remedial art, become practically conversant with physiological conditions and the manifold phenomena of morbid anatomy, and so familiarize himself with the varying indications of disease that in the presence of whatever malady, his diagnosis and treatment may command respect—not only from the laity, but, what is of far more consequence to him, from the profession.
It is almost superfluous to lay stress upon pharmaceutical knowledge as a powerful weapon in the armament of the medical practitioner. Yet no branch of therapeutic science has, perhaps, been more neglected than a practical acquaintance with the nature and uses of Materia Medica, their origin, potency, and characteristic value, as well as their physiological action, and the incompatible
and synergistic agents upon which their efficacy often largely depends.
Thanks to careful and competent training among pharmacists, the skilful preparation and dispensing of drugs relieve the physician of much responsibility; yet he should be keenly sensible of the fact that the larger share of public confidence is reposed in him, and by diligent study of the subject endeavor to command the minutiæ of pharmacology, holding himself morally accountable for errors quite possible in the druggist's dispensary. It may not be irrelevant to add that in all medical procedure a sympathetic yet perfectly controlled nature, ready tact, and sterling common sense are cardinal requisites to professional triumph, it being generally true, as was long since observed by Hufeland, that "successful treatment requires only one-third science and two-thirds savoir faire."
Finally, the author would counsel the utmost seriousness in the pursuit of a calling which might aptly be termed “Christian Science"—the power to alleviate human suffering by means of curative agents with which the laboratory of nature has been mercifully stored. There can be no loftier, more practical manifestation of love to men than is exemplified in the benignant effort to assuage the ills to which mortality is heir ; nor can any devotion be more privileged and inspiring than that which softens the shock of disease, illumines the darkness of mental and physical distress, and from the débris of misfortune, vice, and heredity creates anew the image of divine perfection. It is this uplifting, consecrated zeal, akin to veneration for medical science, which has endeared to the world the masters of the profession-of which the same wise Hufeland said: "To him who fails to make a religion of the healing art it is the most cheerless, wearisome, and thankless labor upon earth; indeed, in him it must become the greatest frivolity and a sin.” And for those—and they are many—to whom the material, possibly mercenary, aspect of their task appeals unduly it is enough to cite in rebuke the elevated maxim of Stigelius :
Non omnia quae suscipimus lucrum spectant.
PHARMACOLOGY AND GENERAL THERAPEUTICS.
Remedies.—In a comprehensive sense every means of counteracting, curing, or mitigating disease or bodily disorder may be termed a remedy or remedial agent. The mode of treatment may be preventive, reparative, or restorative; but the agents employed by the physician are properly called remedies. Although their number is wellnigh as great as the multifarious causes of disease, the chief classes of remedies are comparatively few, and may be grouped mainly under the following heads :
Prophylactic, whereby attention is directed to the immediate environment of the patient, with a view to secure proper sanitation and outward conditions more favorable to recovery suggested by hygienic laws.
Sanitary, when hygienic treatment is combined, as it now usually is, with medical remedies, constituting what is known as regimen, including proper ventilation, temperature, diet, bathing, and exercise.
Imponderable, as when the forces of light, heat, cold, and electricity or magnetism are brought into requisition by the aid of science.
Mechanical, pertaining to certain surgical methods and remedial applications, or a course of physical training, including the peculiar yet often efficacious treatment known as massage.
Pharmaceutical, including a very large and varied class of remedies which, from their established curative properties and their signal importance to the physician (mědicus), are technically termed medicines. They are designed to preserve or restore the health of the animal organism, promote recovery in cases of injury or disease, and, in short, perform every office proper to a palliative or remedial agent.
Physiology is the study of the functions of the different organs of the animal body under normal conditions. Pharmacology is, strictly speaking, the study of the functions of the different organs of the animal body rendered abnormal by drugs.
Materia Medica deals especially with the sources from which drugs are derived, their chemical and physical properties, their constituent elements, and their general function as substances or agencies in the practice of medicine.
Pharmacy is restricted to the analysis and determination of drugs, and the science of preparing and dispensing medicines in the forms in which they are best administered.
Pathology is the study of the animal body rendered abnormal by disease.
Therapeutics (from the Greek word meaning to attend, to serve) is the study of the diseased body under the influence of remedial agents and the science and practice of selecting and applying remedies for sickness and disease, and necessarily includes the proper care and treatment of invalids. “The ultimate aim of all medical research,” it has been truly said, “is the treatment and prevention of disease.” This constitutes the primary object of the therapeutist.
In its amplest signification therapeutics embraces all that relates to the science and art of healing, and the application not only of medicines, but of every remedial agent likely to accomplish this paramount motive of the physician's labor. Under the general term of therapeutics, therefore, are included the action of natural forces, the varied resources of Materia Medica, and the contingent considerations of climate, food, clothing, etc., grouped under two principal divisions :
Natural Therapeutics, being, as the term implies, a curative method dependent upon the laws of nature rather than the subsidiary arts of man.
Applied Therapeutics, including the scientific application of palliative or remedial agents having no counterpart in the living organism, designed, through the art of medicinal administration, to assist nature in the process of restoring health. This division constitutes more properly the study of therapeutics and the domain of professional practice.
Empirical Therapcutics implies the application of remedies to which experience has ascribed certain specific properties irrespective of systematic value. It is not based upon scientific research, but rather upon formulæ established by the accumulation of isolated facts-empiricism-and practical observation, apart