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- Herausgeber: Science & Technology Publishing
- Kategorie: Geisteswissenschaft
- Sprache: Englisch
The American Therapist Vol. II. No. 7, dated January 15th, 1894, is a fascinating historical periodical that offers a comprehensive monthly record of modern therapeutics as understood at the close of the 19th century. This issue, part of a respected series, serves as an invaluable resource for medical professionals, historians, and enthusiasts interested in the evolution of clinical medicine and pharmacology. Within its pages, readers will find a wealth of practical suggestions and detailed discussions relating to the clinical applications of drugs, reflecting the medical knowledge and practices of the era. The publication features a variety of articles, case studies, and editorials contributed by leading physicians and medical thinkers of the time. Topics range from the latest advancements in drug therapy and innovative treatment methods to critical reviews of new pharmaceuticals and their efficacy in clinical settings. The journal also includes correspondence from practitioners across the country, sharing their experiences and insights on therapeutic challenges and successes. In addition to its focus on drug therapy, The American Therapist provides updates on medical conferences, book reviews, and news relevant to the medical community. The writing style is both scholarly and accessible, aiming to bridge the gap between academic research and everyday clinical practice. This issue captures the spirit of medical inquiry and progress that characterized the late 19th century, making it a valuable snapshot of the period’s medical landscape. For modern readers, The American Therapist Vol. II. No. 7 offers not only a window into the historical context of therapeutic practices but also a reminder of the ongoing quest for knowledge and improvement in the field of medicine. Its detailed accounts and practical advice continue to resonate, providing insight into the foundations upon which contemporary therapeutics are built.
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Transcriber’s Note:
The cover image was created by the transcriber and is placed in the public domain.
The American Therapist.A MONTHLY RECORD OF MODERN THERAPEUTICS,WITH PRACTICAL SUGGESTIONS RELATING TO THE CLINICAL APPLICATIONS OF DRUGS.
Original Articles.
NOTES ON RECENT THERAPEUTICS.
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.
Animal Extracts.
For thousands of years animal substances of various degrees of nastiness have been used as medicines. In fact some of the darkest chapters of human history are those relating to this subject. Sundry cognate superstitions are extant to this day, even among the nobility of civilized countries. In ancient times weird ceremony and occultism lent their charms to keep up interest in the matter; while in these “scientific times” the influence of a great hyphenated name has rekindled a fire which was merely flickering and which seemed to be in danger of going out altogether.
Since Brown-Sequard made himself young again by his well known treatment of senility great attention has been paid to the subject of animal extracts. From every corner of the earth have come workmen—some of them skilled workmen—to cultivate this promising field. One result of their labor is a mass of literature which contains much that is premature, much that is fantastic, much that is commercial; and it is difficult not to believe that some of it is closely connected with unsoundness of mind.
Another result is the new method of treating myxedema by the administration of thyroid glands—raw, cooked, desiccated, or in the form of extracts. Recently this treatment has been used in several cases with marked success, and already the air is full of rumors. One writer said a few months ago: “The success of this treatment is sure to create a ‘boom’ in animal extracts for various diseases.” He proved to be a true prophet, and we are in the midst of this boom.
It may perhaps be open to question whether there was need of any more “booms.” We have had “booms” in tuberculin, in coal-tar, in ovariotomy, if not in common sense. Some of them are still with us, though not in very good condition. After the boomers and the seekers after notoriety have done their worst with animal extracts, the final accounting will probably show some increase of positive knowledge in physiology as well as in therapeutics.
Bacteriology.
Bacteriology having now emerged from noisy babyhood into promising youth, it may not be amiss to ask how far therapeutics has been advanced by its discoveries and what the outlook is for the future. It has been alleged by some clinicians that the bacteriologists have been a little dictatorial, and have carried on their propaganda somewhat after the manner of the Salvation army. Be that as it may, the amount of conscientious and unremunerated work which has been devoted to the subject during the past twelve years is probably beyond the power of conception of any one man.
In spite of numerous mistakes, exaggerations and ludicrous attempts to re-organize therapeutics the bacteriologists have made great additions to our knowledge. The question of bacilliary disease is, however, enormously complex, and can not be settled by a few cultures and a few hasty deductions. Points that were supposed to be settled a few years ago are now under discussion again, and with regard to many of the problems it is still impossible to say just where the truth lies. Many thoughtful men have lately been turning their eyes from the microscope toward the bedside, and are asking themselves whether after all the condition of the soil is not fully as important as the germs which grow there, and they are consequently spending less time searching after germicides. One eminent physician predicts that the very language now used will be unintelligible jargon to future generations of germ seekers, and that the whole subject will have to be recast. Whether this be too strong language or not, it is doubtless true that we are, as yet, only on the threshold of this department of science, and that exact truth can be established only by a closer union of clinical medicine with bacteriological studies. The success of modern methods of preventing disease and the comparative failure of antiseptic and germicidal remedies in the treatment of well developed disease show that the human body is more than a test-tube, even though numerous theories have been tested therein to the discomfiture of the testers.
Creosote.
Creosote still refuses to move on into obscurity with the numerous “cures” for consumption which have recently made their exit from the therapeutic stage. On the contrary it is used to a greater extent than ever before, and the testimony as to its value gets stronger each year. It is interesting to note here that a writer who is by many regarded as the leading American authority on therapeutics feels justified in ignoring the whole matter in the last edition of his work recently published. Such is the perversity of the human mind—or at least of his human mind.
In giving creosote, it will be found that most patients take it in the form of sugar-coated pills more readily than in capsules or liquid mixtures. This statement is deliberately made after thoroughly trying every known method of administration in a large number of cases during a period of eight years.
Patients who have sensitive stomachs can frequently take, at first, only one or two minims per day; but by slowly and carefully increasing the dose, they eventually consume twelve to fifteen minims each day without suffering from gastric irritation.
The success of the creosote treatment is seen most plainly in those patients who have taken it uninterruptedly and in full doses for several years. Many of these people improve in health from year to year, without, however, losing all their symptoms.
Coal Tar.
It has sometimes been claimed by metropolitan physicians that the rural brethren are slow to avail themselves of the various discoveries in medicine and surgery, and that they go on very much as their grand mothers did. Here as elsewhere in the universe there are compensations. Your country doctor can now look back a little, and with regard to many of the startling advances of these latter years he can see that the “advance” has been backward; and he is not quite sorry that his bucolic inertia has kept him from doing urban oöphorectomy upon all his hysterical female acquaintances.
On other occasions he accepts the dicta of the medical centers with alacrity, and refuses to be called off when the fashion changes. This was seen in the case of coal tar. No sooner had the chemists, private docents, assistant physicians, and royal and imperial professors of Germany and Austria, announced the mighty powers of antipyrine, than he began to employ it, and a little later its congeners, to drive fever and pain out of the world.
In many a remote country village this policy is still followed so vigorously that fever patients are kept blue and sometimes black by frequent and heroic doses of coal tar; and yet the great majority survive in spite of the disease and the antipyretic.
Very lately a rampant enemy of coal tar wrote: “While in the medical centers the coal tar antipyretics are being reluctantly abandoned, it will be long ere less enlightened rural practitioner will let this comforting drug slip from his fond grasp.”
Here then we have the two extremes; and here again sound practice lies about midway between them.
These antipyretics when used with skill and caution can be made, in many cases, to replace with advantage, morphine on the one hand, and cold baths on the other. Surely, medicines capable of playing such a part in therapeutics, deserve careful consideration.
Effects of Morphine on the Female Organs.—In a paper recently read before the Obstetric Society of St. Petersburg, Passower related the history of two cases, which confirms the opinion already supported by the observation of others, that the long continued use of morphine eventually leads to atrophy of the female generative organs. In both cases amenorrhœa was present; intra-uterine measurements taken during a period of two years showed a diminution in the size of its cavity from 5.1 to 1.9 inches.—Exchange.
