Exposure (medicine)

“ We must always keep in mind that the effect of medicine is in the greatest degree relative to the particular disease for which it is administered, and to the force of such disease. The doses of active medicines are to be diminished as symptoms abate. ”

“ For, as the tendency of the present generation of physicians is, I think, to rely less and less upon the action of drugs and chemicals, and to pay more and more attention to the circumstances surrounding the patient, so the discovery of purely remedial agents is becoming day by day of less importance, and the accurate study of those substances which we all necessarily make use of—air, water, food in its various forms—is becoming the great problem in medicine. ”

“ Undoubtedly one of the most important steps which medicine has made in its development, is the recognition of the difference between disease itself and those symptoms which may be caused as the result of such disease. We shall find that in most, if not in all, of the older writers on medicine, the treatment of the physician was directed towards the alleviation of those prominent symptoms, which, then not so much looked upon as symptoms, were only recognized as the main cause of the attack. ”

“ This universal and acknowledged rule is Pathology, the science which unfolds and exhibits the nature and character of disease, and "dictates the maxims of rational practice." It is the foundation and only base of rational medicine, which proceeds on the assumption that the nature and character of disease is fully known and appreciated. This knowledge is not only rational, but indispensable, in order to understand and apply the principles which ought to govern in the medication and cure of disease. ”

“ This empirical method, though hard on the patients, resulted in the course of five thousand years in the discovery of a number of useful remedies. But the modern medicine man when he knows the cause of the disease is usually able to devise ways of counteracting it directly. ”

“ A determination of whether adequate information on the health effects of each substance is available or in the process of development to determine levels of exposure which present a significant risk to human health of acute, subacute, and chronic health effects. ”

“ By John V. Shoemaker, A.M., M.D., Professor of Materia Medica, Phar- macology, Therapeutics, and Clinical Medicine, and Clinical Professor of Diseases of the Skin in the Medico-Chirurgical College of Philadelphia; Physician to the Medico-Chirurgical Hospital, etc., etc. The health of the skin and hair, and how to promote them, are discussed; the treatment of the nails; the subjects of ventilation, food, clothing, warmth, bathing; the circulation or the blood, digestion, ventilation; in fact, all that in daily life conduces to the well-being of the body and refinement is duly enlarged upon. ”

“ There is an endless variety in the constitution of the human frame, both in mind and body, as well as in the features of the face. There are, perhaps, no two individuals in the world in whom the same effect precisely is produced by the same food, air, medicine, poison, or passions of the mind. The different effects of infection, therefore, upon different people, seem to depend, in many cases, on peculiarities of constitution too obscure to be explained ”

“ But the great objection is, that books, however well adapted to explain the theory of medicine, are of little practical use in making us acquainted with disease as it occurs in nature. The ordinary symptoms of any morbid state, as described in books, are rarely if ever met with in any individual. ”

“ There is no formula by which you may cure consumption, or pneumonia, or a specific fever, or any other disease under the sun. The student or young physician who has felt so sure of himself while he was expounding the mysteries of physiology, stands silent and abashed before the rationale of the simplest therapeutic act ”

“ I pass now to the consideration of the third class of causes which render medicine an uncertain science, viz., natural changes, arising from the tendency which exists in the system to throw off disease, appropriately called the vis medicatrix naturæ, or curative power of nature; and, in connection with this, the tendency to a definite limit, which is manifest in many diseases, as, for example, small pox, measles, hooping cough, scarlet fever, &c. ”

“ Thus, for the proper perfection of medicine as a rational science, two things are in the main needed: the first is a right understanding of the causes and symptoms of disease; the second, a correct knowledge of the action of medicines. [Pg 15] Should our acquaintance with these two subjects be complete, we should then be able to do all that man could by any possibility effect in the alleviation of human suffering. This sublime problem is already being unravelled at one end. Diagnosis and Nosology are making rapid strides; and perhaps we shall soon know what we have to cure. ”

“ It is generally believed, that where there are particular and specific diseases, there also may be found appropriate and specific remedies; the discoveries of chemistry, it is not improbable, may in some respects have retarded the progress of natural medicine. ”

“ A hearty emetic effected a cure; and the first child of Jerry and Mary Wilson was distinctly marked on the left shoulder with a bunch of grapes.
HOW TO CURE FITS. Not none of the least difficult problems, in the practice of medicine, is the distinguishing between cases of real disease, and those that are feigned. It is a great stumbling block in the path of young practitioners, and even the old members of the fraternity find a few chips of it in their way occasionally. ”

“ So in natural science and in art the mind must, first of all, distinctly apprehend the thing that is to be studied, and after that its relation to associated things. So in medicine the only safe clue to an accurate conception of disease is through a minute study of all its forms and relations and the modifications they undergo through internal and external influences, and, next to those the variations imposed upon them by hygienic and therapeutic measures, i. e., by treatment. ”

“ Another remark: although there is unquestionably a physiognomy of disease as well as of health; of all parts of the body, the face is perhaps the one which tells the least to the common observer or the casual visitor. Because, of all parts of the body, it is the one most exposed to other influences, besides health. And people never, or scarcely ever, observe enough to know how to distinguish between the effect of exposure, of robust health, of a tender skin, of a tendency to congestion, of suffusion, flushing, or many other things. Again, the face is often the last to shew emaciation. ”

“ When medicine must be given, it should be borne in mind that there are various classes of purgatives, which produce very diverse effects. Some, like salts, operate to thin the blood, and reduce the system; others are stimulating; and others have a peculiar operation on certain organs. Of course, great discrimination and knowledge are needed, in order to select the kind which is suitable to the particular disease, or to the particular constitution of the invalid. ”

“ Now let us speak of material healing. The science of medicine is still in a condition of infancy; it has not reached maturity. But when it has reached this point, cures will be performed by things which are not repulsive to the smell and taste of man—that is to say, by aliments, fruits and vegetables which are agreeable to the taste and have an agreeable smell. For the provoking cause of disease—that is to say, the cause of the entrance of disease into the human body—is either a physical one or is the effect of excitement of the nerves. ”

“ Know your drug, know your dose, and know its effect, and you can, with the aid of your hypodermic, play with men and women just as you please. The world itself is but a plaything in the hands of the clever practitioner who specializes in toxicology. ”

“ The modern reader will probably be surprised at the comprehensiveness of the work, which, besides general diseases, includes considerable portions of physiology, physiognomy, ophthalmology, laryngology, otology, gynecology, neurology, dermatology, embryology, obstetrics, dietetics, urinary and venereal diseases, therapeutics, toxicology, operative surgery, cosmetics and even the hygiene of travel and the prevention of sea-sickness. ”

“ That minute doses of medicine can exert an active influence over the body is not to be denied, but these must consist of powerful drugs, as arnica, aconite, and nux vomica, with others, and it is more than probable, that of such medicines, an inconceivably small amount may produce a specific effect upon some portion of the organic nervous system. ”

“ The medicine (he says) sets up in the suffering part of the organism an artificial, but somewhat stronger disease, which on account of its great similarity and preponderating influence, takes the place of the original disease, and the organism from that time forth is influenced only by the artificial complaint; and as soon as the temporary effect of the medicine passes off, the patient is cured. ”

“ Although medicine is useful in some instances, yet, in a great proportion of the cases of disease, including fevers and inflammations of all kinds, attention to the laws of health will tend to relieve the system from disease; more certainly and speedily, and with less danger, than when medicines are administered. ”

“ Encouraging Examples.—On the other hand, many men have been able in spite even of a severe stroke to go on after a time with the work they had been at before and, though feeling its effects, accomplish the best achievements of their lives. A typical example is the case of Pasteur, the great French bacteriologist, to whom we owe most of our modern preventive medicine and to whom Lord Lister frankly attributes the germ idea of the antiseptic theory. ”

“ If you find that one of your bodily organs betrays a tendency to disease, you are careful to avoid the exposure, or the strain, or the derangement, which would unfavourably affect it. If your lungs are delicate you shun fogs and chills ”

“ Such physicians are more careful to supply the vital organism with whatever of air, light, temperature, food, water, exercise or rest, etc., it needs in its struggle for health, and to remove all vitiating influences all poisons, impurities, or disturbing influences of any kind. This is hygienic medication, the natural and rational method of cure, and the more closely it is examined, the more strongly it will commend itself to reason. ”

“ From Neuburger.—Equally crude are their ideas respecting the causes of disease, as shown by the following items selected from quite a long list of etiological factors: errors in diet and in the habits of life, climatic influences, psychic factors, heredity, poison, supernatural influences like the anger of the gods, the evil powers of demons, etc. For purposes of diagnosis the earlier Indian physicians utilized not only inspection, palpation and auscultation, but also the senses of taste and smell. ”

“ The practice of medicine in the past has been directed towards the curing of disease and physical ailments already developed. The practice of medicine in the future is to be along preventive lines. Science is showing us how to prevent infection. Science is fighting the deadly microbe which comes to us in the air we breathe, the water we drink, and the food we eat, and the infected things we touch. ”

“ It is evident that scientific medicine must turn its attention toward the strengthening and stimulating of the resisting and curative forces of the body. It must be the physician's aim to enable the body to resist the poisons as well as possible and to stimulate it to re-enforce its resistant forces. ”

“ Qualitatively, risk may be thought of as some function of the combination of exposure and the intrinsic properties of the substance or process under consideration by linking an exposure to the likelihood of an outcome. ”

“ COUNTER-IR′RITANTS. In medicine and pharmacy, substances applied to the surface of the body to establish a secondary morbid action, with the view of relieving one already existing. In painful and spasmodic affections, as neuralgia, spasms, and cramp; in rheumatism, lumbago, swelled and painful joints; in headache, sore throat, sprains, languid glandular tumours, and many other cases, this class of medicine often proves extremely valuable. The counter-irritants which are best known are blisters, mustard poultices, hartshorn-and-oil, and liniment of ammonia. ”

“ Who has not often felt embarrassed to select the right remedy among three or four that seemed indicated by the symptoms, and where it was nevertheless important, in view of the threatening danger, to select at once the right remedy? Who has not been struck by the strange irregularity that in a disease which generally sets in as an epidemic, different remedies are often indicated by different groups of symptoms? ”

“ Such work as does the scientist who studies the depredations of malignant germs, who straightens the body of the crippled child, who precipitates a toxin which cleanses the blood of a frightful and loathsome disease! ”

“ The experiments of the pharmacologist in the investigation of the action of drugs can be and are carried out under anæsthesia in the same way as those of the physiologist. But the experiments of the pathologist, which consist in conveying germs and other disease products to animals, come under a different heading. One does not deny that if the animal takes the disease, suffering is produced. ”

“ In the fourth place it is affirmed that being thus fitted for the blood, and allowed to remain in it, they tend to cure a disease which depends on the want of a substance similar in nature to themselves. ”

“ The study of the interaction of these internal secretions, their influence upon development, upon mental process and upon disorders of metabolism is likely to prove in the future of a benefit scarcely less remarkable than that which we have traced in the infectious diseases. ”