Medicine case

“ The answer to this objection is that vivisection, and other experiments upon live animals, permit of experimentation to a considerable degree, and often effectually point out the proper course of treatment of the human subjects. In the case of drugs and medicines the practice is well known of physicians trying the effects thereof upon their own persons, in their zeal and anxiety to give to the world new discoveries. ”

“ Twenty men employed constantly in putting up this medicine would not have been sufficient to have complied with all the demands which were made of me for it. Hundreds who were in health called or sent for it as well as the sick, in order to have it in readiness in case they should be surprised by the disease in the night, or at a distance from a physician. ”

“ The treatment of every case of sickness must be determined ultimately for and by itself, tentatively by skilled men, and as their practical sagacity may determine, while they bear in mind that the virtues of a medicine depend less upon its intrinsic properties and powers than on the sagacity of the physician who administers it; just as the efficiency of firearms depends less upon the explosives and the missile they contain than on the judgment and accuracy of aim of the man who discharges them. ”

“ His difficulties are only increased when diagnosis is complete and he turns to the labors of treatment. For with the advance of modern medical science there are left now but few physicians who believe that disease can often be cured by a drug. It is recognized by the better element of the medical profession all over the world that only in seven or eight out of about one hundred and fifty diseases clearly distinguished in our textbooks of medicine, have we a drug with any genuine pretensions to cure. What is to take the place of drugs in dispensary treatment? ”

“ Few professions require more careful preparation by one who seeks to enter it than that of medicine. It has to deal with all those subtle and mysterious influences upon which health and life depend, and requires not only a knowledge of the properties of vegetable and mineral substances, but of the human body in all its complicated parts, and their relation to each other, as well as their influence upon the mind. The physician must be able to detect readily the presence of disease, and prescribe appropriate remedies for its removal. ”

“ Under the proper construction and ad­min­i­stra­tion of the law, all this will and is now mostly prevented. It must be evident that any article of medicine essentially damaged, is not fit to be given to the sick as a remedy. ”

“ Such medical testimony must be convincing of their efficacy as well as conveying the satisfactory assurance of their freedom from any medicine in the slightest degree injurious to the constitution, Medical Men being well aware of the deleterious effects of many preparations, which in Pulmonary Affections do but mask the symptoms for a time, and afford only temporary relief, while perhaps the constitutional disease is aggravated, or at least unsubdued. ”

“ This state of things has been occasioned by the circumstance that medical practitioners have often been more given to the formation of theories upon the nature of disease and the mode of its treatment, than to that careful observation and patient accumulation of facts, by which, in other sciences, the phenomena of nature have been unravelled. ”

“ He also called attention to the important bearing which the history of the disease has toward its products, and found his discoveries of advantage, even when they were unable to promote the cure of disease, because of the light which they threw upon physiology and normal anatomy, and because they prevented incurable patients from being continually tormented with drugs intended to cure them; also because pathological investigations alone could settle disputes in diagnosis and matters of honor among physicians. ”

“ In short, a physician or surgeon cannot contract with a patient that the patient shall waive any claim for damages growing out of his want of ordinary care and skill. Nevertheless, the physician or surgeon may frankly inform his patient of his want of knowledge and experience as to the particular kind of treatment required by any special and unusual disease or injury. ”

“ It is a very narrow and unjust view of the practice of medicine, to suppose it to consist altogether in the use of powerful drugs, or of drugs of any kind. Far from it. “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. ”

“ When in doubt run no risks; better let a patient perish from disease or injury, than while attempting uncertain experiments with the surgeon’s knife or the use of dangerous drugs. The safe rule is to take no chances, unless there is a consensus of judgment of several physicians. It may be objected that if no experiments are tried no new medicines or surgical devices could be discovered, or their effects observed. ”

“ Humourous from [21] one point of view but quite perturbing for a physician was the innocent disregard for the directions left with medicines; indeed the doctor could never tell whether the failure of a prescription was due to the ineffectiveness of the drugs or to the failure of the patient to take the medicine as prescribed, for he found that the patient was liable to take the whole potion at once or just as liable to have another member of the family take the remedy vicariously. ”

“ To battle with the occult forces which play so important a part in determining the course or consequences of disease, it is absolutely essential that the physician should know all that is possible to be known of the patient’s history, and of the history of the patient’s family. ”

“ In the nature of things few physicians are sufficiently expert in chemistry and allied sciences to be able unerringly to discriminate between the true and the false as regards many preparations that he is asked to prescribe.
2. The Reports of the Council on Pharmacy and Chemistry.—A medicament may be inadmissible to New and Non­official Remedies for various reasons; it may be worthless or irrational, its composition may be secret or indefinite, or it may be exploited under exaggerated or unwarranted claims or in a way otherwise detrimental to the public health and scientific medicine. ”

“ 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. ”

“ Pharmacy cures sickness by drugs, surgery heals by the use of knife and cautery, the species concerned with diet prescribes a regimen for the removal of disease, that concerned with diagnosis proceeds by determining the nature of the ailment, that concerned with remedies by prescribing for the immediate removal of the pain. The species of medicine, then, are pharmacy, surgery, diet and regimen, diagnosis, prescription of remedies. ”

“ It is extremely hazardous for a second or third person to change the doses of a physician's medicine, either by the omission or addition of an ingredient. It would be safer—very much safer—to omit every thing, and leave the disease wholly to nature. The true course, however, in all cases, is to follow the prescription of the physician, to the best of our abilities, or else dismiss him. ”

“ This manner of administering drugs can be taken advantage of by the man who wishes to carry with him upon his outing a supply of remedies for the relief of such ailments as may befall him.
Oliver Wendell Holmes once said in delivering an address to the graduating medical class of Harvard, "Young men, you have been taught here at least twenty remedies for every disease; after you have practiced medicine twenty years you will have one remedy for twenty diseases." ”

“ Now the patient is ashamed to tell the whole truth, the doctor has yet to learn what drugs are rankling in the system, and the disease is often protracted thereby ten times as long as it need have been, had the man at the outset sought the advice of a respectable physician. This is an every-day occurrence. I knew a young man who recently went into consumption from having a comparatively simple case prolonged by this apotheco-medical interference. ”

“ It is not one of those certain or exact sciences in which truths become established and fixed, but is essentially progressive in its nature, enlarging with the growth of human experience, and subject to those changes and revolutions incident to any branch of human inquiry, the laws of which are not fully ascertained. The labors of the anatomist, the physiologist, and the chemist have contributed an immense storehouse of facts; but the manner in which this knowledge is to be applied in the treatment and cure of diseases has been, and will probably continue to be, open to diversity of opinion. ”

“ They do not expect that, day after day, active drugs are required; but, according to their own precognition of the case, they think it necessary for their safety that their medical adviser make his regular visits and observations, carefully examine the various excretions, and so be able to judge accurately of the character of the case, and prepare the patient by delay, diet, and diluents, &c. ”

“ It cannot be denied that the present system of medicine is a burning shame to its professors, if indeed a series of vague and uncertain incongruities deserves to be called by that name. How rarely do our medicines do good! How often do they make our patients really worse! I fearlessly assert, that in most cases the sufferer would be safer without a physician than with one. ”

“ Of the accidents most to be guarded against, not a few are, in a great measure, the natural consequence of the medicine itself. Although, in some constitutions, and with particular treatment, they will arise more readily than in others; yet they may happen in any constitution, and with any treatment. ”

“ All drugs are more or less adulterated; and as not more than one physician in a hundred has sufficient knowledge in chemistry to detect impurities, the physician seldom knows just how much of a remedy he is prescribing. ”

“ It often happens that there is more than one point of view from which the action of a medicine may be regarded. For many medicines are numbered under several distinct heads, being included in different groups on account of the several phases of their operation. There are three stages in the progress of the remedy through the system, at each of which it may exert a special action. ”

“ When it is occasioned by any error in the patient’s regimen, an opposite course to that which induced the disorder must be pursued, and such medicines taken as have a tendency to restrain the flux, and counteract the morbid affections of the system from whence it proceeds. ”

“ Hence, without illustrating the subject further, it seems evident that all the science one may possess can furnish him with nothing more than a bare foundation on which to build the treatment of individual cases. All cases are complex, no two are precisely alike in their pathological elements, no two patients are identical in their susceptibilities and tendencies, or in the manner and degree in which medicines affect them. ”

“ Modern medicine, on the other hand, declares that disease must be studied in the living person of the patient. And the same disease may require different treatment, if the condition of the patient is different. ”

“ The medicine which to-day would be proper, by a change in the disease, may to-morrow be the reverse;–and, in short, so many objections will occur to any reflecting mind against the indiscriminate use of remedies, that the greatest caution should be exercised, lest in tampering with disease you destroy health. There is so much adulteration in drugs, so many quack nostrums, pills and impositions, that in all cases of doubt and difficulty, the safer rule is to trust the advice of an intelligent physician. ”

“ In the administration of medicine or any other remedy for a disease, the conditions are different. The doctor applies the remedy and watches the result, and if he has a large practice he thereby obtains knowledge and experience which no other persons possess. ”

“ There are doctors doping people with powerful drugs, who couldn't tell whether a patient had a case of cholera-morbus or was afflicted with an incurable itch for office—who have acquired their medical information from the almanacs and could not distinguish between a bunion and a stone-bruise or find the joints in a string of sausage with a search- warrant. ”

“ 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. ”

“ It appears from these reports that not only is the importance of medico-legal science appreciated, but that in the majority of our medical schools the distinction between medical jurisprudence and forensic medicine is recognized in the fact that the instructor is a lawyer, who presumably teaches medical jurisprudence, while the different branches of forensic medicine and toxicology are taught by the specialists most competent to deal with them. ”