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The American Therapist.
A MONTHLY RECORD OF MODERN THERAPEUTICS,
WITH PRACTICAL SUGGESTIONS RELATING TO THE CLINICAL APPLICATIONS OF
DRUGS.
* * * * *
VOL. II. NEW YORK, JANUARY 15th, 1894. NO. 7.
Original Articles.
_NOTES ON RECENT THERAPEUTICS._
By OSCAR H. MERRILL, M. D.
Whoever reads the history of Therapeutics will find there records of
much faithful work in many directions—records not infrequently of hope
deferred. He will find there also a tolerably full account of human
credulity, of human weakness and of human cupidity. The same faulty
methods of reasoning are followed century after century. _Post hoc ergo
propter hoc_, wrecks as many therapeutists to-day as it ever did,
notwithstanding its fallacies have been demonstrated so often as to make
mention of the subject distressing. It might be expected that half
educated physicians, without preliminary, scientific training, would
fall into this error; but when some of the brightest men in the
profession—men who have presumably travelled the paths of logic and
induction all their lives, go the same way, it shows pretty plainly what
must be the inherent difficulties of the subject; and that for the
proper discussion of therapeutic questions, no caution can be quite
great enough and no learning quite profound enough.
The list of dead theories and abandoned remedies grows longer each year,
and the experience of the past is as little heeded in the medical as in
the financial world.
Acuteness of intellect and extent of education can, it seems, no more
keep a man straight in medicine, than they can in religion or politics.
Men, who for years have been esteemed well balanced authors and
practitioners, become “a little crazy” on some one therapeutic measure
and enthusiastically advocate its employment in all sorts of unsuitable
cases. Good illustrations of this form of mental activity may be found
in the literature of hydrotherapy and of electricity.
Thus, it has been stated that every case of typhoid fever may be made to
end in recovery by the proper use of cold baths; and yet this writer
knew in how many ways the disease may kill the patient—some of them
almost accidental in their nature; he knew that perforation has occurred
many days after the disappearance of pyrexia; he knew that in some fatal
cases the temperature never exceeded 100°F.
Occasionally such a man after sowing dogmatic statements broad cast for
a few years becomes insane enough to be confined in an asylum; sometimes
advancing age with its mental deterioration is the evident cause;
sometimes these acts are the work of advertising schemers; but generally
the explanation is to be found in that mental substratum which permits
otherwise sane and well educated persons to entertain monstrous opinions
concerning the most ordinary matters.
The best work in Therapeutics is now carried on quietly without brass
bands or sensational announcements. A few earnest men in each civilized
country are patiently working out the physiological action of drugs, as
a basis for a more rational therapy. The significance of much of this
work, is not always manifest on superficial examination; but it already
forms an important part of our working knowledge, and is gradually
crowding out venerable empiricism which has heretofore occupied so
prominent a place in medical practice, whether regular or irregular.
MANUFACTURING CHEMISTS.
No one will deny the value of some of the work done by the manufacturing
chemists. Some synthetic compounds have been produced by chemical
processes which we should not like to give up, and some improved forms
of administering the older remedies are due, at least in part, to their
ingenuity. Nevertheless, let any one not accustomed to it read patiently
for a few months, the current numbers of half a dozen of what have been
called “the minor medical journals,” or let a careful inspection of the
advertising pages of the major journals be made, and it will be seen
that large classes of medical men—perhaps a majority—have been
completely deceived by these shrewd fellows. They have reached a
refinement and a delicacy in their commercialism which will compare
favorably with the court intrigues of oriental countries. Every
prejudice, every weakness, every conceit of “the under medical world” is
played upon with consummate skill and with amazing success.
Take, for instance, acetanilid, which, on account for its cheapness has
been made to enter into numberless compounds, and every known language
is ransacked in the search after new compound names which may be
trade-marked. It is not alone the laity that is deceived, but graduates
of reputable medical schools are prescribing, and, indeed, dispensing
tons of this stuff, and often without knowing its composition.