HEALTH NOTES.

New Zealand Mail, Issue 1425, 22 June 1899, Page 16

HEALTH NOTES.

THE FALLACIES OF AMATEUR MEDICINE.

The first doctor was an amateur, and the race is still with us. The irresponsible prescriber confronts us everywhere —in the street, at the club, in the drawing room, on board ship. Go where we will, we cannot escape Kim. Indeed, it is one of the penalties of ill health that we have to listen with courtesy to the medical suggestions of our friends, and sometimes, alas! to pretend that their advice ha 9 been followed! Celebrities are, it is well known, especially badly off, for they are pestered w'hen ill with advice from hundreds of wellmeaning strangers. The l inadequate popular idea of the mental and other processes involved in the treatment of disease is largely responsible for amateurism in medicine. It consists in a hazy theory that for every disease there is a corresponding drug, as for every poison an antidote. Problem: Find out the disease, and then search memory or book for the appropriate remedy. No distinction is made between symptoms and diseases, or betiveen the different stages or degrees of a disease; nor is any attention bestowed upon pecularities of constitution, or upon complications or environment. The syllogism employed is something like this: “My friend had a headache and was cured by iron. I have a headache, therefore I shall be cured by iron.’ But headache is not a disease; it is a symptom, and occurs in a very large number of diseases, of which congestion of the brain, and an a? mi a may be taken as examples. When the name of the disease is substituted for that of the symptom, the syllogism becomes nonsense, thus: “My friend has anaemia, and was cured by iron; I have congestion of the brain therefore I shall be cured by iron.” There is however scarcely a disease which a given drug will cure under all conditions and in all circumstances. But treatment implies a good deal more than the mere administration of. drugs. It involves a knowledge of their physiological action, of dosage, of incompatibilities, and, where a drug otherwise beneficial has an undesirable effect upon a second organ, of the method of neutralizing this effect. To the initiated it seems strange that, whereas few men will set them opinion against that of an artisan in his own trade, many will claim to speak with a kind of authority in this the most difficult of the learned professions, and almost all constitute themselves a final court of appeal competent to decide to what extent, if at all, the advice and directions tendered them shall be followed. The amateur’s reasoning, however, is beset with fallacies on every side. The first is that of diagnosis. If an trroneous opinion of the nature of a disease has been formed, succesful treatment can be scarcely expected. Yet to form a correct diagnosis may require a very wide range of knowledge, such as the position of every organ of the body both in health and disease. The mode of determining changes in them by highlytrained senses, aided by such instruments as the stethoscope, the microscope, the thermometer, the ophthalmoscope and the electric battery; a knowledge of the origin and course of the nerves, veins and arteries; the bearing upon each disease of age, sex, heredity, occupation, climate, etc., etc. Some idea of the extent of the knowldge required may be realised from the fact that enlargement of the liver occurs in no less than fourteen diseases. But even asuming that the diagnosis is correct, another fallacy confronts the amateur—the fallacy of stage. The treatment proper, to one stage of a disease may be useless or injurious in another. A burn, for instance, may present three different degrees—redness, blistering, an skin destruction. Each of these requires special treatment, and no popular remedy for a burn is suitable for all three degrees. Success in medicine, as in everything else, depends largely upon attention to details, and it is precisely in these details that one patient differs from another.