Therapeutae

“ As a student of the art of Therapeutics in large hospitals, clinics, and dispensaries, he had convinced himself that it is not by experiments on lower animals, nor yet on the human body in health, that the physician can attain the glorious power of alleviating pain and curing disease; it is only through the daily combat with sickness, by the bedside and in the consulting room. ”

“ We know that the real difficulty is to ascertain the nature and origin of our patient’s disorder; when that is done, the treatment in most cases is obvious, and in many effectual; when it is not done, our treatment is vacillating, and either futile or mischievous. We have already ample means at our disposal for influencing almost every organ of the body. A new tool is occasionally offered us which deserves proving, but what we want far more is knowledge how to use the tools that we have. ”

“ If, on the contrary, he faces it bravely, and without after-thought except that of responding to medical treatment, he will probably get well.
Pneumonia is only one example of the part the individual plays in therapeutics. In the popular mind it is supposed that for each disease there is a definite remedy, and that when the physician gives that remedy the patient gets well. This idea of specific remedies has come to the people from the physician, but only the quack now pretends to cure disease, the physician helps the patient to overcome the affection from which he is suffering. ”

“ All our processes of repair, all the reactions of the body against the attack of accident or of disease, are hereditary endowments, worked out with infinite pains and labor through tens of thousands of generations. The utmost that we can do with our drugs and remedies is to appeal to and rouse into action the great healing power of nature, the classic "Vis medicatrix Naturæ," an incarnation of our past experiences handed down by heredity. ”

“ Interrogated by the physician on the nature of the disease, and the proper remedies to be applied for eradicating it, they give answers, or rather they become channels through which the spirit, satisfied with the offerings made in his honour, condescends to declare that he has now left the patient, and that by placing him under a certain treatment, which he fails not to indicate, he will soon recover his health. ”

“ On such animals therapeutic remedies could also be tested, the whole process of healing and the final result experimentally observed, while the conditions of secretory activity during every phase of the healing process could be investigated. It can hardly [Pg 249] be doubted that scientific, that is to say ideal, medicine, can only take its proper position as a science when, in addition to an Experimental Physiology and Pathology, there has also been built up an Experimental Therapeutics. ”

“ When disease was ascribed to the operation of demons in residence in the patient’s body, a belief at one time world-wide in its distribution, the treatment mostly relied upon to cure the disease, and, granting the premises, a perfectly rational therapeutic method, was by various devices to render the patient’s body too uncomfortable for the demon. ”

“ I will admit that I came across some instances of real cure. Many cases of nervous disorders have undoubtedly been cured, and there have also been other cures which may, perhaps be attributed to errors of diagnosis on the part of doctors who attended the patients so cured. Often a patient is described by his doctor as suffering from consumption. He goes to Lourdes, and is cured. However, the probability is that the doctor made a mistake. In my own case I was at one time suffering from a violent pain in my chest, which presented all the symptoms of /angina pectoris/, a mortal malady. ”

“ There is, perhaps, no well proven remedy in the Materia Medica, of equal value to that of which I present a brief study, that has been so wholly overlooked by the homœopathic profession. There certainly is none which possesses a more marked individuality, and which more fully fills a place by itself. It is safe to say that not one in ten of those who practice the healing art has ever used it or is familiar with its pathogenesis. ”

“ Even in organic disease, such as tuberculosis or arteriosclerosis, it may still be true that we can help the patient chiefly through psychotherapy. There may be little that we can do for his arteries or his lungs, and indeed the incurable destruction which has gone on in these organs may not at the time that we are treating the patient be producing any symptoms. ”

“ Whether disease or treatment held the greater terror, it would be hard to say. Modern medical science has devised many alleviations, and often restores a patient without spot or blemish. But to have lived at all in that day evidenced extraordinary vitality. ”

“ The Methodists, it should be added, deserve special credit for having been the first to introduce and carry into effect the systematic treatment of chronic diseases; and, as a general proposition, it may be said that their treatment of all forms of disease was thoroughly practical, free from all tendency to resort to magical methods, and based largely on the employment of such hygienic measures as the use of baths of different kinds (hydrotherapy) , massage, moderate outdoor exercise, passive movements, sea voyages, fasting, regulation of the diet, etc. ”

“ The forms of medical treatment examined in a former chapter exhibited the connection which remained unsevered when portions of the body, or of its issues, or clothing, had been detached; so that it was sufficient to subject these objects to healing or sacred influences in order to effect the cure of the man himself. But if the kin together form one body in any substantial sense, the treatment of other members than the one actually suffering, if not sufficient to restore him to health, will at all events help his recovery. ”

“ One who, like a layman, is accustomed to ascribe to the treatment everything occurring during the disease, will probably judge differently. It is really not so long since our hydrotherapeutic asylums met with similar opposition. ”

“ Exclusive attention to Therapeutics is apt to bring a man dangerously near to Homoeopathy and other pretended Systems of treatment, but sound pathology, and diagnosis controlled by post-mortem inspection, give positive knowledge and that union of modest self-confidence and prudent enterprise which become the physician. ”

“ Among the medical procedures of this class are hydro-therapeutics or hydropathy, electro-therapeutics, and massage, or systematized rubbing, kneading, and manipulation; none of these remedial operations can be used without the patient's knowledge; none of them can be used in a different way from what the patient supposes they are being used; they are open, in clear sight, and affect the various senses so strikingly that satisfactory deception is impossible; patients know when they are being galvanized or faradized; they know when they are washed or showered ”

“ One of the most important of these, if not, as we have suggested, absolutely the most important, the one that in all the many variations of therapeusis has maintained itself, is the personal influence of the physician by which he is able to soothe the patient's fears, allay his anxieties, make him face the situation calmly so that he may not use up any of his vital force in useless worry, but on the contrary employ all his available psychic energy in helping nature to overcome whatever disturbance there is within the organism. ”

“ In such natural remedies as heat, light, electricity, hydrotherapy, climate, dietetics, hypnotism and psychotherapy, out-door exercise and simple living, the physician has many strings to his bow, apart from the more special arms of treatment like operative surgery, ophthalmology, orthopædics, etc. ”

“ They do, however, contain references to the use of the knife in surgery, the healing of fractures and the internal administration of herbs, but all essential therapy is obscured by mysticism, ritual observances and magical formula. From the point of view of diagnosis, it is of interest that these records refer to the inspection of the urine and blood and to the collection of a series of observations upon disease, what we would now call the "clinical history" or record of a patient. ”

“ Recommending a cure, and not a curtain to cover the wound which festers all the more rapidly by the fact that it is heated by the covering, should be the line of treatment adopted by the good physician of the public body, as of the individual body. ”

“ This general law, applicable to all organic beings, resembles in some respects that principle found in the human system called vis medicatrix. It was early discovered by physicians that in case any part or organ in the body became injured or diseased there was a surprising recuperative power in nature of healing or curing. All the sound parts of the body seem to conspire together to help the part or organ affected. ”

“ Psychotherapy represents one of the important elements in therapeutics, and we must learn to use it in a way suitable to our patients. We have to learn to use our drugs in accordance with the nature and physical make-up of the patient. We have to find out by experience just how to use hydrotherapy for each individual. Varying currents of electricity and varying forms of electrical action are needed for different individuals. ”

“ The cruder the art, the more powerful was the mental influence. The ways of primitive therapeutics are completely hidden from us except what we can gather from the races which retained their primitive practices in historic times. We can well understand, though, that the concoctions of medicine-men and witch-doctors could have little effect except in a suggestive way. Snakes' heads, toads' toes, lizards' tails, and beetles' wings have a small place in the pharmacopœia of to-day, except as placebos, and it is extremely doubtful if they were ever valuable for any other purpose. ”

“ The more perfect they are in these branches, the more accurately can they describe the seat of the disease. Their remedies are mostly botanical, and are generally safe in their operation. The regular "clairvoyant physician," so to speak, does not pretend to be in league with "spirits;" but there are those who profess that their prescriptions come from the other world—from those who, though dead, rest not from their labors. ”

“ The first time that the sick one insists upon having the treatment the doctor is called to perform the operation. But soon, as it becomes necessary to repeat the process oftener, making it expensive, it is entrusted to the nurse or to the family, and from that day the patient is lost; for how can the supplications of a suffering person whom one loves be resisted? Then on a day the sick one practices on himself—and from that on, without any control, with the avidity of passion, he uses the drug in the quantities of which I have told you. ”

“ It is in cases like these that metaphysical healing and hygienic living find their limitations. Such organic defects require systematic treatment by all the methods, active and passive, which the best Nature Cure sanitariums can furnish. It may be slow and laborious work to obtain satisfactory results, and if the vitality is too low or the destruction of vital parts and organs has too far advanced, even the best and most complete combination of natural methods of treatment may fail to produce a cure. ”

“ Owing to the imperfect state of our knowledge, the treatment of disease ordinarily pursued by judicious practitioners, partakes of both kinds; it is rational so far as the curative effect is sought through a primary influence on some or other of the natural functions followed by consecutive changes thence resulting; empirical, when from obscurity in the modus operandi, and failure in discerning the series of vital actions through which the cure takes place, this the ultimate effect can be alone perceived. ”

“ The patients' occupations must be regulated by proper advice and detailed directions, and distractions of various kinds must be provided to keep their minds from becoming concentrated on certain portions of their body, emphasizing whatever discomfort is present and preventing nature's curative processes. Finally, local treatment of various kinds must be employed suitable to each individual case, that will remove all mechanical difficulties, disperse congestions, relieve fatigue and over-tiredness, and make conditions favorable for the healthy, normal use of joints and muscles. ”

“ How frequently will simple rest and recreation succeed when medicinal and other forms of therapy have wholly failed! And how largely, may we remark, does the Vis Medicatrix Naturæ work through the medium of things psychic, not physical, to achieve its beneficent ends! ”

“ PSEUDO-SCIENCE AND MENTAL HEALING
An interesting phase of psychotherapy is found in the history of the applications of new scientific discoveries to medicine. The development of every physical science has been followed by an attempt to apply its new principles and discoveries to the treatment of disease. Such applications have nearly always been followed by excellent results at the beginning. But almost without exception, the medical significance of these discoveries has, after a time, been found to be nil. ”

“ Therapeutic doses—those given for medical treatment—by contrast, are given to patients with a disease that is in need of control, that is, the physician desires to destroy selectively cells or tissues that are abnormal. In these cases, therefore, the skill and experience of the attending physician must be applied to limit the effects to the desired benefits, without damage to healthy organs. ”