Efficacy

“ Many of the absurd practices which have been deemed to possess medicinal efficacy, have been indebted for their reputation to non-observance of some accompanying circumstance which was the real agent in the cures ascribed to them. ”

“ Let us then, before we decree the honours of a cure to a favourite medicine, carefully and candidly ascertain the exact circumstances under which it was exhibited, or we shall rapidly accumulate examples of the fallacies to which our art is exposed; what has been more common than to attribute to the efficacy of a mineral water, those fortunate changes of constitution that have entirely or in great measure, arisen from salubrity of situation, hilarity of mind, exercise of body, and regularity of habits, which have incidentally accompanied its potation. ”

“ Undoubtedly, the good effect produced by a well-chosen remedy is heightened and strengthened by the mental and magnetic influence of the prescriber. The positive faith of the physician in the efficacy of the remedy, his sympathy and his indomitable will to assist the sufferer affect both the physical substance of the remedy and the mind of the patient. ”

“ Competency is equal to the occasion, readiness prompt for the occasion. Faculty is an inherent quality of mind or body; talent, some special mental ability. Dexterity and skill are readiness and facility in action, having a special end; talent is innate, dexterity and skill are largely acquired. Our abilities include our natural capacity, faculties, and talents, with all the dexterity, skill, and readiness that can be acquired. Efficacy is the power to produce an intended effect as shown in the production of it; as, the efficacy of a drug. Efficiency is effectual agency, competent power ”

“ But the main work of the pill will be done by the man's belief in its efficacy. I'm thinking out a medicine now which I expect will cure almost everything. It will cure, in any case, all the ailments that lead to organic disease. ”

“ There is surely no question connected with our subject which can be more interesting and important, no one which requires a more cool and dispassionate inquiry, and certainly not any which can be more appropriate for a lecture, introductory to the history of Materia Medica. I shall therefore proceed to examine with some attention the revolutions which have thus taken place in the opinions and belief of mankind, with regard to the efficacy and powers of different medicinal agents ”

“ The unprofessional experimenter or observer has no large experience to correct his hasty generalization. He wants to believe that the means he employed effected his cure. He feels grateful to the person who advised it, he loves to praise the pill or potion which helped him, and he has a kind of monumental pride in himself as a living testimony to its efficacy. ”

“ Progress has come by taking what is really an activity as if it were only an object. It is the capacity to effect this transformation of life-activity which measures both the scientific character of the physician's procedure and his practical control, the certainty [pg 20] and efficacy of what he, as a living man, does in relation to some other living man. ”

“ Each standing firm (or falling where he stands) preserves the unity, and therefore the efficacy, of the whole. A few yielding at the critical point (and the critical point is usually also the point where men most desire to yield) destroy the efficacy of nine times their number. ”

“ Other preparations do more or less good; but this cures such dangerous complaints, so quickly and so surely, as to prove an efficacy and a power to uproot disease beyond anything which men have known before. ”

“ What had the imagination to do with the fall of the axe, hung up in his lordship’s closet? But it is doubtless true that expectation is a potent element of cure, and it is one every good physician, as well as every mercenary quack, makes full and constant use of. In many cases of illness, it makes no difference what medicine is given, so that it is not absolutely hurtful, or whether we only pretend to give a remedy. Bread pills, properly administered, produce a great variety of decided operations. Chalk powders, or a few drops of coloured water, act with great efficacy. ”

“ For one who knows little may explain that little with more ease and efficacy than one who has his head stuffed full of the prescribed bunch of official wisdom. ”

“ There will be more precision to all our investigations in regard to the action of remedies, and especially of new remedies. At the present time we know not whether to believe or reject any report of the virtues of any new medicine or mode of treatment, however high the authority for the reports, for we feel instinctively the elements of error which those who introduce new remedies and modes of treatment ought to know, and in time will know and rationally provide for. ”

“ And our plan of treatment will become rational, when on the one hand, from an accurate knowledge of the symptoms of diseases, we are better enabled to meet each by its appropriate remedy, and on the other hand, from some acquaintance with the general action of a medicine, we are fitted to wield it with more skill and effect, and to apply it even in cases where it has not yet been proved beneficial. ”

“ The practical value of these methods of treatment—and they are all of undoubted value—could only be ascertained, as it has been ascertained, by the immense variety of the experiments that have been made with them, wherein through the process of time the six sources of error have been little by little eliminated.
In all new remedies and systems of treatment the aim of the scientific physician should be to make the deception so thorough that whatever effects are obtained must be known positively to be the objective action of the treatment or of nature. ”

“ Where so much depends on personal observation, and the adaptation of our knowledge to special circumstances, the acquirements which are most essential to success are a practical familiarity with the different phases of disease, and a well-grounded confidence in the administration of remedies—acquirements which the greatest talent will not command without steady, persevering industry, and which any man of moderate ability may possess, if, with a determined will, he devote himself to their attainment. ”

“ Our efficiency? We are in the condition of the two physicians called in to the same patient—one of whom should be intent on applying the proper remedies for expelling the disease from the body and thus restoring and purifying its functions ”

“ It is order, pursuit, sequence, and interchange of application, which is mighty in nature; which although it require more exact knowledge in prescribing, and more precise obedience in observing, yet is recompensed with the magnitude of effects. And although a man would think, by the daily visitations of the physicians, that there were a pursuance in the cure, yet let a man look into their prescripts and ministrations, and he shall find them but inconstancies and every day’s devices, without any settled providence or project. ”

“ We do not profess to perform impossibilities, but do confidently assert that in the course of a short time the method which we adopt, if fairly carried out, will do more for the promotion of health, elegance of figure, and prevention of disease, than all the medicine which may be administered for the purpose. ”

“ Different constitutions, different symptoms, and stages of disease, all require more or less a separate consideration. What is more natural than to place confidence in a remedy, which has been known to afford relief to others in the same kind of disposition? The patient anxiously enquires after a person who has been afflicted with the same malady; he is eager to know the remedy that has been used with success; his friend or neighbour imparts to him the wished for intelligence; he is determined to give the medicine a fair trial, and takes it with confidence. ”

“ Proceeding thus,—patiently,—diligently,—candidly,—we may hope to form a system as far inferior in pretension to that which we have been examining and as far superior to it in real utility as the prescriptions of a great physician, varying with every stage of every malady and with the constitution of every patient, to the pill of the advertising quack which is to cure all human beings, in all climates, of all diseases. ”

“ The action of the remedies in this division, which are the surest and most potent of all those that are employed in the treatment of disease, is involved in a greater degree of doubt and obscurity than that of any other class. ”

“ Never permit the patient, or those around him, to expect more from medicines than medicines can perform.
'3. Never prescribe medicines, except avowedly as mere palliatives, when the period is gone by for them to be of ultimate service.
'4. Never conceal the general intention of the treatment; that is, whether it be adopted with a view to cure, or only to mitigate the disease, or merely to alleviate a symptom or symptoms.
'5. Never prescribe medicines more powerful than are necessary; or continue a powerful medicine longer, or repeat it oftener, than the disease actually requires. ”

“ And it is to the accuracy with which this system has endowed us that we owe our almost world-wide reputation for the skillful treatment of all lingering, or chronic, affections. This system of practice, with the marvelous success which has been attained through it, demonstrates the fact that diseases display certain phenomena, which, being subjected to scientific analysis, furnish abundant and unmistakable data to guide the judgment of the skillful practitioner aright in determining the nature of diseased conditions. ”

“ This artifice for restoring health to a bedridden patient, is not mentioned in a way of approbation, but of regret, or at least of confession. Yet, while it declares my weakness, it develops or at least confirms a well-known principle, which it concerns mankind, patients as well as physicians, most fully and clearly to understand. The medical efficiency of an agent is greatly enhanced when the mind can be made to go along with it. ”

“ If true, it is the kind of medication which every one would choose. The patient has neither the time nor the means of examining the principles of the proposed method; but believing it to be something new, he concludes, of course, that it must be an improvement upon all former methods. ”

“ Even from this passing glance at the conditions that must modify every plan of treatment, it is evident that to assert of a particular medicine or method that it is the most efficient in a given disease is to convey very little information. ”

“ Those doubts and difficulties, which are now slowly clearing away before the efforts of a few, will then be finally dispelled by the united energies of all; and instead of our present indecision and uncertainty on many points, we shall find ourselves eminently qualified to wage the conflict with disease, being skilled in that science whose name bespeaks its peculiar importance, the science of Therapeutics. ”

“ In securing such a result there will be needed medical practitioners who are imbued with the ideals of preventive medicine in its widest sense. Let me, in this connection quote the following extract from a recent official report of my own:
There is needed a reconstruction of the training of each medical student, which will make preventive medicine in its widest sense an integral part of his training, and will insure that before he begins practice he has definite instruction in the application of the whole of his knowledge to preventive purposes. ”

“ Tens of thousands of grateful people testify to its efficiency, not only as a remedial process, but better still, as a preventive of disease. Truth must ever prevail, and this treatment being based on natural law (which is unerring) , must achieve the desired result, which is the restoration and preservation of health. ”

“ In a classification we do not so much consider the peculiarities of single remedies, as the points in which large numbers agree together. These points of resemblance we gene [Pg 20] rally find to be of the most importance. I have to consider three sets of authors in the second chapter. The first set treat of the general or ultimate effect of a medicine on the system; and classify medicines accordingly. A second set of writers have arranged therapeutical agents according to the organ or part of the body to which their action is especially directed. ”

“ To which perfectly natural query, I gladly reply, I have a system of treatment to propound, a system that has triumphantly stood the test of years, a system that must commend itself to every intelligent reader, because it is strictly in accordance with natural law. ”

“ Now as a sharp tool is not to be handled but by a good workman, so likewise a powerful medicine ought to be managed by an understanding and conscientious physitian, who according to the condition of the person, and the disease, knows to increase or abate the strength of the medicine, and not by such a one, as doth minister it ignorantly without making any difference at all. ”

“ To physicians who are students not alone of the manifestations of disease but also of the workings of human nature, there are few chapters in the history of medicine more interesting than those which record the welcome by each generation of the supposed advances in the treatment of disease. Each generation announced its cures for diseases, provided its remedies to relieve symptoms, and invented methods of treatment that seemed to put off the inevitable tendency toward dissolution. ”

“ That this confident expectation of a cure is the most potent means of bringing it about, doing that which no medical treatment can accomplish, may be affirmed as the generalized result of experiences of the most varied kind, extending through a long series of ages. ”