duce. In the first order is the physician who intelligently studies physiology, who recognizes in pathology what I would, for the moment call an eccentric physiology; who says to himself when contemplating disease: "I here see such and such organs of the body out of order, such and such functions imperfectly performed; let me try to place these organs at rest, so that they may recover themselves (where recovery is possible) and perform, perhaps, in time their functions as heretofore"; who appreciates that in pneumonia the tendency is toward recovery when not interfered with, if the patient's strength is so supported that he can tide over the period during which the lung recovers itself; who sees in typhoid fever the same necessity for support, with the additional one of resting the intestine until the ulceration has time to heal; who, in the case of diseased kidneys, rests these organs by putting their work on to other organs, such as the skin and intestines, and allows no food which requires the special exercise of the kidneys for purposes of elimination. Similar management with other diseased organs. Here knowledge of physiology precedes knowledge of disease, and disease means to this physician disorded physiology. How different from the meddlesome apothecary of not long ago—never easy without he was pouring his medicines into his patient every few hours, having for every symptom a fresh drug which added to his patient's difficulties, and for every pain some outward application which increased his discomfort! Now, his modern counterpart is he who has learned chiefly from books and untrained observation what he knows of disease; for, please observe, that constantly seeing patients by no means implies that the faculty of accurately observing has been attained, and if this faculty is not acquired by a man early in life he will blunder on into old age. Such a one does much the same as his predecessor in a milder way when his first consideration takes the form of the inquiry, What is a good medicine for this, and what for that? He knows what will cure something or other, and so prescribes it. So well is what I am saying beginning to be understood that the very expression "cure," unless applied with a special meaning, as to an aneurism, a hernia, or the like, has become almost offensive, and will ere long be used only by the ignorant and pretentious. The physician does not pretend to cure his patients; he places them in the conditions most favorable to recovery, and is thus often the means of averting death and conducting them to health. You must not think that I am underrating the value of medicines; a large number of drugs we know well to be most useful and often necessaries in the treatment of disease, but the practice of ordering medicines to every patient who applies for relief is no longer the practice of physicians, although perhaps it may be followed by those who would on occasions be the last to resort to it, if they had the courage of their opinions. But pathology is better understood than it was a few years since, and with a more complete knowledge of morbid processes has
Page:Popular Science Monthly Volume 16.djvu/213
Jump to navigation
Jump to search
This page has been validated.
FIRST-HAND AND SECOND-HAND KNOWLEDGE.
199
![](http://upload.wikimedia.org/wikipedia/commons/thumb/e/ed/Popular_Science_Monthly_Volume_16.djvu/page213-1024px-Popular_Science_Monthly_Volume_16.djvu.jpg)