Transcriber’s Note:
The cover image was created by the transcriber and is placed in the public domain.
I have long formed the opinion that the prevailing method ofdetermining the value of any particular medicine or mode oftreatment is essentially faulty. Practitioners, after watching afew cases, form a favourable opinion of this or that mode ofprocedure; they then publish their views, supporting them withtheir successful cases, and strongly recommend them to the considerationof their medical brethren. Then follow trials more orless numerous by others, some of whom think the method recommendedgood, whilst others find it useless or injurious. Sucha system is characteristic of an imperfect acquaintance with medicine,and during the progress of many centuries, while it has ledto some valuable knowledge, has for the most part only tendedto superficiality and the utmost contrariety in medical practice.What seems to be necessary at present for determining the realvalue of any kind of treatment is—
1st. Rigid accuracy in the diagnosis of the case.
2582d. A clear comprehension of the nature of the pathologicalcondition treated.
3d. An acquaintance with the natural progress of the disease.
And
4th. A tabulated account of the cases treated, showing thecare with which they were observed, and their chief symptoms,including the time they were under treatment, andthe termination in success or failure.
Doubtless this method of determining the value of any treatmentrequires a high degree of medical knowledge, and sometrouble; but I would suggest that it is the only one capable ofinspiring confidence and permanently advancing the interests ofthe medical art. If it cannot be carried out during the exigenciesof every-day practice, there is nothing to prevent itsprosecution in our public hospitals, where the patients are underconstant observation, and where there are in many of them astaff of assistants whose business it is to make the necessaryrecords.
The chief obstacle to obtaining accuracy in result is the generalconviction among medical practitioners that a different treatmentis required, even in fixed morbid conditions, according to thesymptoms which may be present. The progress of diseases isnever absolutely uniform, and no doubt the occurrence of particularphenomena often require special interference. Thissecondary treatment of symptoms, however, should never beallowed to interfere with the primary management of the morbidcondition; and it is the neglect of this rule which has led to suchinjurious results in the treatment of many diseases. If, forexample, in order to relieve cough in phthisis we give opiatesand expectorants, how can we maintain the appetite and improvethe tone and digestibility of the stomach, on which the assimilationof food, cod-liver oil, and nutrition essentially depend?
Since the publication of my papers and treatise on the RestorativeTreatment