Page:Popular Science Monthly Volume 41.djvu/91

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THE LIMITATIONS OF THE HEALING ART.
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affect the processes which play in hallucinations their wild pranks in the ganglion-cells and associative paths.

We can certainly by the application of certain substances cause changes in particular cells which are expressed, albeit in some unknown way, by physiological effects. Thus many alkaloids, alcohol, ether, chloroform, bromine, curare, digitalis, etc., operate directly on particular cell-groups, and bundles of nerves and muscles; pilocarpine, arsenic, and iodine on certain glands; phosphorus on growth processes in the bones. When the cases at present known are analyzed, it is found that bromine restrains the paroxysms of epilepsy for a short time, but does not remove the processes in the central nervous system from which they originate. Alcohol in moderate doses temporarily excites the brain and heart to activity, but does not cure a single pathological condition the presence of which made the administration of alcohol necessary. Morphine alleviates the pains of neuralgia, but does not effect any fundamental change in the disease. Sometimes effects appear like those of iodine in certain diseases corresponding with a real cure brought about by the means itself; but it is still the last experience of medical art that the restoration from the diseased condition, in the true sense of the word, must come to pass through the organism itself. Whether an order of thoughts like that which Robert Koch developed in his studies of tuberculin will lead to this end must be learned by clinical experiment. It may be that the healing art will make its advance in this way. For the present we must learn, the more impressively as medical knowledge becomes more perfect, that the doctor is only the servant of Nature, not its master.

Although the expectation and the possibility of controlling the fundamentals of pathological processes are so limited, the healing art is nevertheless not doomed to vain contemplation and inactive dallying. While art can not master Nature, it can follow it with diligent observation. The truth of this remark covers a genuine progress, and furnishes the key to the secret of the success of really great physicians. To investigate the exact origin of pathological changes, to ascertain by what methods and under what conditions disturbances of the organism are most easily overcome or counterbalanced, deliberately to support and imitate these methods if possible, and before everything to do no harm, is the way by which the healing art can accomplish something important and good. History proves incontestably that practical efficiency at the sick-bed goes in an exactly parallel line with the cultivation of scientific methods. Medicine to-day, without yet being able directly to cure the pathological condition, reaches, simply by following the principles here laid down, incomparably more favorable results than formerly. It has learned, first of all,