Medical care

“ There will not be complete success until means are discovered for training and enlisting every medical practitioner as a medical officer of health in the circle of his private or public practice, and of securing his services not only in the early and prompt detection of disease, but also in the systematic supervision during health of the families under his care, and in advising them as to habits or methods of life which are inimical to health. ”

“ General practitioners shall mainly provide such services as diagnosis, treatment, referral, prevention, healthcare and rehabilitation of common diseases and frequently-occurring diseases, chronic diseases management, and health management. ”

“ The relatively large death-figure in the medical reports is explained by this statement.
Such cases of illness are the more serious that they are all, in fact, in the most urgent need of hospital care. To replace the latter as much and as efficiently as possible, is the task of our physicians. They visit the patients as often as necessary, and prescribe for them, at the expense of the Society, the requisite medicines. In the treatment of such patients our physicians encounter difficulties which it is possible to remove only partially. ”

“ At the head of each is a doctor-in-chief, assisted by an adjunct physician. The medical service comprises treatment of the patients for their mental affections and the incidental maladies attending them, correspondence with administrations or families, concerning their moral and physical condition, the direction and observation of the guards of section in all that concerns the medical service, surveillance of the nourriciers in points regarding the hygiene, food, and lodging of the patients intrusted to their care, and as to their own conduct and devotion to the welfare of their wards. ”

“ A new and in many respects a nobler conception of medicine has been developed. Formerly medical practice was almost exclusively a personal service to the sick individual, and measures looking toward the general relief of disease and its prevention received scanty consideration. The idea of a wider service to the city, to the state, to the nation, to humanity rather than the personal service to the individual, is becoming dominant in medicine. ”

“ It is a subject not unbecoming the highest attainments, to increase the stock of medical knowledge in that branch of our art. So important, indeed, to society, is the successful treatment of infantile diseases, that happy shall I be, if any effort of mine shall awaken attention to this hitherto neglected department of medicine. ”

“ ADVANTAGES OF SPECIALTIES.
By thorough organization and a perfect system of subdividing the practice of medicine and surgery in this institution, every invalid consulting us is treated by a specialist—one who devotes his undivided attention to the particular class of diseases to which his or her case belongs. The advantage of this arrangement must be obvious. Medical science offers a vast field for investigation, and no physician can, within the limit of a single life-time, achieve the highest degree of success in the treatment of every malady incident to humanity. ”

“ Yet we regard clinical medicine as illustrating art, and didactic medicine as representing science. What figure, think you, would the hospital professor make who should come before you with a patient, and be unable to determine with what disease the person was suffering, the organs affected by it, the nature of their functional disturbance, why some functions rather than others were disordered, how these various elements affect the issue of the attack, what that issue will probably be, and finally, what means should be taken to render it favorable? ”

“ Combe: “The little regard,” he says, “which has hitherto been paid to the laws of the human constitution, as the true basis on which our attempts to improve the condition of man ought to rest, will be obvious from the fact, that, notwithstanding the direct uses, to which a knowledge of the conditions, which regulate the healthy action of the bodily organs, may be applied in the prevention, detection, and treatment of disease, there is scarcely a medical school in this country (Great Britain) [4] in which any special provision is made for teaching it.... ”

“ We shall not advise treatment for these more grave disorders which should always, for the safety of the patient, be attended by the family physician, except to recommend some simple means which may be employed in the initial stage of the disease, or when a physician's services cannot be promptly secured. ”

“ The advances in general medical science and practice have also necessitated great elaboration of the resources for the study and treatment of the physical condition of the patients. Instruments of precision, laboratories, x-ray departments, dental and surgical operating rooms, massage and hydrotherapy departments, facilities for eye, throat, nose, and ear examinations and treatment, and all the other means of determining disease processes and applying proper treatment have been supplied and the methods and standards of modern clinical medicine and surgery are utilized. ”

“ In private and even dispensary [Pg 46] practice, where the subjects were of a better physical and moral nature, we often saw the disease subside, and health return, after less attention to administer medical aid, or to supply other wants, than was exhibited at the hospital. We are, notwithstanding, sanguine enough to anticipate useful results from our attentive study of the symptoms of the disease, in connexion with that of the post mortem examinations, and to consider ourselves as in possession of lights to guide us with more certainty than before. ”

“ In the more dangerous, obscure, or complicated forms of chronic diseases, the correct diagnosis and successful treatment of which tax all the skill possessed by the experienced specialist, the invalid will not be misled into the dangerous policy of relying upon his own judgment and treatment, but will be counseled not to postpone until too late, the employment of a skillful physician. ”

“ In a discussion of professional service, however brief, no thoughtful medical man could forbear some comment on the present general status of clinical medicine and its developments within the last few years. ”

“ While the practice of medicine is so vast and extensive a field, that it has been found necessary to subdivide it amongst physicians, surgeons, accoucheurs, apothecaries, oculists, aurists, dentists, men for the gout and men for the gravel, one for the belly and another for the brain, these reformers seem to regard medical knowledge and medical practice as in a nutshell,—as already perfect and complete. ”

“ But in sudden and painful attacks of acute disease, life may be suddenly and unexpectedly jeopardized, and immediate relief prove necessary. While under these circumstances the prompt application of such domestic treatment as good common-sense may dictate, guided by a knowledge of those first principles of medical learning which we shall hereafter endeavor to make plain, may result in speedy and happy relief, yet at the same time there should be no delay in summoning a competent physician to the bedside of the sufferer. ”

“ The physician may do very much for the welfare of the sick, more than others can do, although he does not, even in the major part of cases, undertake to control and overcome the disease by art. It was with these views that I never reported any patient cured at our hospital. ”

“ Believing that the diffusion of knowledge for the prevention of disease is quite as noble a work as the alleviation of physical suffering by medical skill, we have devoted a large portion of this volume to the subjects of physiology and hygiene. ”

“ When the examination in these subjects has been satisfactorily negotiated, she passes on to medical work proper, the study of disease and the result of accident in the living person—in other words, she walks the wards of the hospital and undertakes duties as clerk to physicians and dresser to surgeons, from whom she receives instruction in medicine, surgery, and pathology. Special branches are also studied, such as midwifery, women's diseases, and affections of the throat, ear, eye, and skin. The treatment of minor accidents also receives special attention. ”

“ A Physician will reside in the house, and one or more Physicians, of established character and experience, will attend regularly, and afford medical aid in all cases where the general health, or the particular cause of the patient's insanity, may require it. ”

“ A high sense of the duties and dignity of the medical profession animates every precept he enforces on the attention of those who are to deal with disease. Like all the advanced thinkers of his profession, he relies, in the art of curing, more on Nature than on drugs ”

“ Among the various avocations of men, that of the physician deserves to be placed in the foremost rank. The profession is founded in the multiplicity of diseases to which humanity is liable, and in the medical qualities of certain substances, which have been found to supply a remedy. ”

“ The great majority of physicians allow acute maladies, diseases of children, and the practice of midwifery, to engross most of their time and attention. They manifest an absorbing interest in everything that [pg 958] relates to these subjects, and devote little or no time to acquiring an intimate knowledge of the great variety of chronic maladies which afflict mankind. ”

“ The practice of medicine is every year becoming [pg 293] more successful. New and improved methods of treating disease are being discovered and developed, and the conscientious physician will avail himself of all the means, by a knowledge of which he may benefit his fellow-men. ”

“ It is perhaps not too much to say that everybody nowadays knows as much about the treatment of disease as a large proportion of the members of the medical profession did in your time. As you may readily suppose, this is a situation which, even apart from the general improvement in health, would enable the people to get on with one physician where a score formerly found business. ”

“ So, likewise, are there numerous, acute diseases of a milder character which are easily and unmistakably recognized without the possession of great medical knowledge, and which readily yield to plain, simple, medical treatment which is within the ready reach of all who strive to acquaint themselves with the rudiments of medical science. ”

“ Another difficulty is often found to arise, from the almost exclusive occupation of the physician’s mind by the diseased condition of the sufferer, the relief of which is, of course, our primary and incumbent duty. In order to give to each symptom, as well as to the whole assemblage of symptoms, a close and discriminating attention, and to adapt, with equal care, a corresponding treatment in medicine, diet and general management ”

“ The second and most urgent element consists in the organization of hospital and consultative expert services for all, which, while greatly increasing each patient’s prospect of prompt recovery, will enable the general practitioner to escape from the soul-destroying inefficiency of unaided medical practice. ”

“ Again, not only is a firm and strict compliance with medical directions in the administration of remedies, of regimen, and general measures, necessary, but an unbiased, faithful, and full report of symptoms to the physician, when he visits his little patient, is of the first importance. An ignorant servant or nurse, unless great caution be exercised by the medical attendant, may, by an unintentional but erroneous report of symptoms, produce a very wrong impression upon his mind, as to the actual state of the disease. ”

“ The specialist, however, dealing with chronic diseases exclusively, will occasionally meet with a case which has been the rounds of the home physicians without benefit, that will tax his skill and require the exercise of all his perceptive faculties to determine the exact condition of the patient's system, upon which the obstinacy of the disease depends. When this is ascertained, the remedies will naturally suggest themselves, and the malady will generally yield to them. ”

“ None of the learned professions have advanced during the last thirty years so much as the medical. Medicine has become a new science since it has taken hold of the sanitary improvement of our towns and dwellings. ”

“ We shall devote the largest amount of space to a careful and thorough consideration of those chronic diseases, which, by a little study, may be readily recognized and understood by the masses, and for the cure of which we shall suggest such hygienic treatment and domestic remedies as may be safely employed by all who are in quest of relief. ”

“ A vast variety of the approaches known to medical science has been explored to find better methods of treatment and prevention of major diseases, particularly heart diseases, cancer, and mental illness. ”

“ For its sins of omission, as for its sins of commission, the medical profession shares responsibility with laymen. For years leading educators, business men, hospital directors, public officials, have known that communicable diseases could be stamped out. ”

“ Every family needs a COMMON SENSE MEDICAL ADVISER. The frequent inquiries from his numerous patients throughout the land, suggested to the Author the importance and popular demand for a reliable work of this kind. Consequently, he has been induced to prepare and publish an extensive dissertation on Physiology, Hygiene, Temperaments, Diseases and Domestic Remedies. It is for the interest and welfare of every person, not only to understand the means for the preservation of health, but also to know what remedies should be employed for the alleviation of the common ailments of life. ”