For the system, the outlines of which I am about to present, I use the term Therapeutics in its original and broadest sense. i take it as embracing all the means and measures, all the facts and principles involved in the direct or indirect removal of the causes, workings and products of all the health disturbances and injuries incident to mankind. In short, it covers the entire hygienic and curative effort of the healing art.
I being to the class which cannot rest upon the supernatural, and feels the daily need of something more reliable and forward- reaching than the simply empirical. I regard the scientific as the only rational and promising method of therapeutics.
The scientific method I understand as that, which gathers facts by observation and experiment, exercising all care and skill to separate the real from the species; and us that, which classifies the data thus obtained, till from them logically come the principles which point on before, leading the studious practitioner far in advance of his actual experience.
I have the utmost confidence in the coming unity of all educated and determined therapeutics, as of all educated chemists and astronomers, upon a basic of natural laws. RISE AND PROGRESS OF THERAPEUTICS.
It is my purpose here, to sketch the wider boundaries and some of the divisions and sub-divisions, of what may be regarded as the science of Therapeutics.
In doing so, I shall endeavor to represent exclusively the views of no particular author; but rather, the results of thirty years study and practical trial of the teachings of many authors brought into a concise, yet comprehensive, system.
The fruits of research and discovery, accumulating from age, to age can be the peculiar property of no individual, but must forever remain free to all who may choose to systematize or apply them in practice.
The time has gone by for heaven-revealed principles and heaven- ordained masters in the medical line. In place of priests, at medical altars, and dicta or dogmas in medical books, we now look for physicians trained by diligent study, and for principles logically deducted from facts.
We recognize no canon law in medicine; we must have laws of science.
In the progress of knowledge, concerning human ailments and their remedies, first came facts, isolated data, developed by human experience; and then came the groupings of data thus obtained, furnishing the elements of Pathology, or the science of disease, on the one hand, and of Materia Medica, or the knowledge of remedies, on the other.
The application of remedies for the relief of suffering and preservation of life, commencing with single experiences, became, through the same process of grouping or classification, the beginning of the science of Therapeutics. At first the observations regarding various diseases and injuries, were very meagre, embracing only the most obvious symptoms presented; and so, likewise, those relating to remedial means and measures were quite limited in their scope. giving only the commonest characteristics.
The therapeutics, as well as the pathology and the materia medica, was exceedingly brief and superficial, from the fact that therapeutic are sought only to apply, in each case, that remedy which had been most efficient in a similar case.
The comparison instituted called for no profound research as to the organs and tissues affected; not as to the causes of the positive powers or minute effects of the remedial means to be employed.
As the fruits of experience became more abundant, and their classifications more numerous and thorough, therapeutics grew apace, taking in more and more agents and influences from the different kingdoms of nature, and evolving one theory after another, and system after system, as shown in the history of medicine.
My present undertaking does not allow me to notice the various theories and systems which have prevailed, at different periods, in the medical world. Taking the best fruits of them all, so far as they have survived decay and come down to us, I desire to bring them into some systematic shape, in order that they may guide our way in the science as well as art of healing.
As the highest object of the medical profession is to employ the best means, in the most efficient manner, any arrangement of the principles deduced from medical, hygienic and surgical experience, at once simple and sound, must be a desideratum of no small value. Much confusion has existed, and still exists, as to the proper places occupied by different remedial measures, and as to the principles ho governing them; some writers adhering to one general law as sufficient for the whole domain of therapeutics, and others recognizing a number of laws of independent, if not co-equal, importance.
Some speak of remedies indicated, and also of “adjuvants,” always advancing the former to a higher rank and degree of importance than may be conceded to the latter. The “indicated” remedies they propose to use under the rigid requirements of “the law,” while the “adjuvants” seem to come in, if at all as the creatures and subjects of fancy, with no special laws for their guidance.
What I desire is to assign to every principle and every measure its own place and share of importance in therapeutics.
The tendency of the medical world, influenced by the asperity of controversy, has unfortunately been to extremes in favor of certain pet ideas and in opposition to all others.
Much error has thus been fostered, and many truths neglected.
Systems, once discarded, have dragged into long forgetfulness many good things, in one way or another, related to them.
It is the spirit of science, to-day, to espouse the cause of no theory to the entire exclusion of others, to engrave upon stone, as unalterable, no systems or creeds, but to examine the claims of all with an earnest desire to know the truth.
And the philosopher, as well as honest doer, now stands ready, not only to examine, but also to accept all that proves best, regardless of source. Assuming such as attitude, and in such a spirit, let us now look for the outlines of the Science of Therapeutics.
TWO GRAND DIVISIONS OF THERAPEUTICS.
Surveying the accumulated stores of medical experience, we are led, at the outset, to recognize a well marked line running through the great field, having on the one side all those means and measures which are relied upon to relieve suffering and restore health without the institution of a pathological condition, and, on the other, such as are employed “to institute those new pathological conditions which are most conducive to health.”
We might, very properly, designate one side of the field the Physiological, and the other the Pathogenetic or Pathological.
It is an obvious fact that, all the curative influences brought to bear upon the invalid, which are not disease-producing, must be governed, in great part at least, by the laws of physiology. the principles regulating the deficiency or excess of things requisite in health and dictating measures for the direct removal of the factors and products of disease.
Physiology has to do with the tissue pabula and excitants, as well as the whole environment, of healthy life, for its support and protection.
On the other hand, Pathology, and more especially Pathogenesy, as concerned in the employment of curative means, has to do with those influences which, in the language of Dr. Martyn Payne,1 “substitute one pathological state for another in the cure of disease,” or, as written by Hahnemann,” such as possess the power of producing in the human body an artificial disease.”
But, for practical purpose, I have preferred and already used, in my lectures before my class in Philadelphia, other and less technical names for the two grand divisions of the field of therapeutic practice, namely:
1 – GENERAL THERAPEUTICS. (Paines Institute p.665, edition 1847.)
2 – SPECIAL THERAPEUTICS. (Hahnemanns Organon, p.19, Third American edition.
In the first division are to be found all means and measures of which I have just spoken, as coming, chiefly, under the direction of the laws of physiology; while in the second division are those means alone, which are capable of inducing affections, “artificial diseases,” which shall supplant those existing, and then, themselves, yield to the recuperative energies of the organism.
II.
GENERAL THERAPEUTICS.
In looking over the grand divisions of the therapeutics field more closely, we observe certain interior lines, marking sub- divisions of more or less importance.
In attending upon, or serving, the sick or the injured, as indicated by the term Oepaneuw especially in the use of means not pathogenetic, we must recognize different kinds or classes of forces, each impressing and actuating the organism, or altering its circumstances, in ways peculiar to itself.
One class, having a wide scope; we may term –
1. HYGIENIC.
This embraces agents or influences concerned in the support and protection of normal life, such as –
a. Air breathed-is quality and quantity; b. Food eaten-its quality and quantity;
