THE MEDICAL CONGRESS.

Otago Daily Times, Issue 10599, 20 February 1896, Page 7

THE MEDICAL CONGRESS.

TO THB EDETOB. Silt,—There has been much reference of late in your columns to the recent Medical Congress, but perhaps there may be space for some fur- ■' ther comments. On the topit of alcohol there was much confusion of the use aod abuse of ths articlo. 'The majority find its use in moderation beneficial, but that the formidable list of .ills compiled by Dr Chappie may result from its abuse was not denied by any of the aftei speakers. I believe, however, no mention was mads 'of the most serious■; consequence ol alcoholic excess so far as the community at Urge' is concerned. I refer to the consequences of alcoholism to the offspring of the excessive I drinker. There is no doubt tnut many nervous ailments— e.g., severe headaches, hysteria, ancl mental diseases of every variety—may be the direct or indirect consequences of alcoholism in the parents of the sufferers. . Example! of this will come under the observation of most individuals. I believe that, the cure for tha present abuse of alcehollias in the State regulation oi the liquor traffic on the lines of the Gothenburg system,

On the subject of hygiene and sanitation many eloquent and practical words of wisdom were spoken, but of therapeutics—tbe medical treatment'of disease —we heard little or nothing. Tho full reports of the proceedings of the various sections are not yet to hand, bui the sjibject of ..the "cure of diseases by drugs'" appears to have been moat conspicuous by ita absence from the discussions of tho congress, and yet this is the one subject which is supposed, to be the principal part of a medical man's work. It is also the one subject on which the profession apparently bestow the lost zeal anil enthusiasm. The same curious phenomenon is very noticeable at all the larger and most active medical schools and universities. The students' time and energies and that of tbeir best teachers are devoted almost exclusively during their curriculum to such subjects as anatomy, the classification of diseases, the study of diseased tissues (microscopic or otherwise), and with tbe diagnosis of a case all interest, from a medico-scientific point of view, begins and ends. The treatment, unless Mirgicjli is referred to briefly, or not at all. Tbe reason of tbis peculiar utate of things is, after all, cl«ar enough; AVhilst surgery, pathology, and other branches of medicine have been placed on a,scientific foundation, the drug treatment of disease as commonly practised remains irrational and empirical. It consequently eScites but scant interest amongst a large section of the profession, who have become sceptico! as to the value of drugs at aU except in the case of a few specifics.

Dr P..H. Pye Smith, in an address on " Rational Therapeutics" before the Hnnteriani Society of London,' commences by the assertion " Medicine always hfis.been and always-mußtbe an art—not a science."

- As the authors of the "Medical Annual" io. 1895 say, " The same expression of opinion bas been frequently made before. We should like to interpolate the words 'in the light of our prrseut knowledge,' because if we comfortably st-ttla down to the belief that therapeutics mnst always remain in a state of chaos, if we have beforehand made up our minds, to regard,;as irrational all physicians who endeavour to bring the facts within our knowledge into a definite sistetp, who try, however unsuccessful, to elevate the arts of medicine to a science, we are hindering rather than advancing an endwjhich. eveu those who regard it as unattainable de« voutly.'wish for."

Dr Pje Smith includes among rational remedifeJ thono wbich may be termed physiological—i.e., emetics, purgatives, diuretics, hypnotics, and to on " it may be said of any ona of'the drugs included under -these names that they are capuble of exercising effects directly the opposite of that which their classification implies, and tbat in.no case docs the word purgative, emetic, or hypnotic imply the foil quality or capacity of the drug. Tie opium eater does not take opium as an hypnotic, but as an agent which temporarily stimulates the mental and physical powers., It is the emetics which are of very frequent service in checking vomiting, the purgative in checking diarrhoea; but they must be used iv doses proportionate to the effects required of them.

"Are such facts simply accident—is there no natural or physiological cause for them ? Or is "it that nature, acting on definite laws in all ofcher matters, is only paradoxical when medical treatment is concerned ? It is titia. which appears to be the strongest argument in favour of the possibility of law and order in therapeutic science.

"It may appear rational at the end of this century to cure sleeplessness with an hypnotic, . fever with an antipyretic, constipation with a purgative!' Will all this appeal equally' ; reasonable to our successors at tfce end of the next ? Will they not consider the use .of snch agents as a mere masking of the symptoms—an abolition of the signs put. forward by Nature to warn us of the patient's danger ? At present we subdue nervous excitement by s doss of bromide of potassium, and as the result is satisfactory, we consider that we are practising rational therapeutics.. Physiologically, we are only further exhausting a weak nerve, and thereby throwing it temporarily out of action. The symptom is removed, but the disorder is none the better. If w« acted physiologically, it is not the dose ol bromide which would suggest itself, bat some nerve reniedy given in a dose that would restore the exhausted nerve without exciting it."

So much for the rational therapeutics of the present day. Dr Pye Smith hus also something to say on the irrational therapeutics of the past, by which he means "curing by magic, by the method of sympathy, by the system of signature, by swallowing prescriptions, by hypnotism, by pads of bitter herbs laid oil the stomach, by wearing inert girdles round the body, or by travelling long distances to bathe in warm wster, or to drink solutions of common salt. AVhen the history of the present era of medicine comes to be written, it may be1 suggested that Dr Pye-Smith need not have gone back to tho age of mystery and supernaturalism.for instances of irrntionalism ia therapeutics. Tbe doctrine of signatures belongs to a comparatively modern period of medical history, and was held not less strongly, nor asserted less'dogmatically, than any other theory thtt finds general acceptance at the present moment. According to this doctrine, the use of any herb for the cure of disease, which neither iu'its leaf, flower, nor root bore resemblance to tbq organ of the human body for the cure of wbich it was administered, belonged to " irrational therapeutics." There are many common herbs wbich bore a great reputation in the cure of disease,- bat which were rejected from the Pharmacopoeia because they did not fit themselve. into a place in tbis particular theory ; and it is curious that although ' the theory has been forgotten, thsse rtijanted medicaments have never been restored to their place in medicine, although their reputation bas been kept alhr6 in folk-lore. Tbe irrational method of therapeutics of to-day may ba considered most rational in the uaz.'.; decade, while many of these methods which the lecturer quotes as illustrations of rational therapeutics may ba Bi\ii aside with a sneer by some future Hunterian lecturer. The travelling, of long distances to bathe in solutions iv warm water or to drink solutions of common salt may be irrational to the scientific' mind of phe day; but the lecturer is speaking o? a'form of treatment which bad endured for centuries before Hypocrates was born, and which, through all the chauges of view which have taken place among the professors of the healing art, has continued, and still continues, in greater popularity than at any other period in medical history, True it has been proved scientifically that the mineral water is not absorbed by the skin during the bath, and therefore the water can do no more good than ordinary water artißcally heated.

Theoretically Dr Pye Smith is right, but the simple assertion th&t the practice is irrational does not explain why rational men of all ages and all countries believe in the efficacy ol mineral baths, or accoant for the cures annually effected of patients who have tried all previous methods in vain. The evidence rather pointt to some error in our scientific theory.

Under the. prevailing regime of therapeutit disorder, every man is a law unto himself, with EOme remarkable results. There most always be cases where cure is out of the question and where the only business of the physician is ta relieved Bnt in the theraoeutic system of ths future, the complex of symptoms which represent the disease in each individual case will ba met by some remedy, the disoovery of which will be a problem capable of solution with mathematical accuracy. Hahnemann has already indicated the lines on which this dc velopment will take place.—l am, tos., Feb. 19. K. S. Stephenson, M.B.C.M.

— A careful analysis of the 69 clergymen and ministers who were announced to preach recently in favour of opening museums on the Sabbath*gives the following results: 3D Unitarian ministers, 22 Church of England clergymen, 2 Ethical preachers, 1 Scotch clergyman, 1 Congregational minister, 1 General Baptist minister, 1 Theistic preacher, 1 Positivist preacher. — There has racent-ly been unearthed among the Pompeitan remains in the Naples Museum a metal nrn which seems to be the lineal ancestbr of the wates-fcube boiler. Itris, in fact, nothing less than such a boiler in miniature, having a eeat little firebox inside, with three tabes passing through it. The joints are admirably sob dered, and the apparatus shows considerable technical skill, as weU,-s*- knnwledch-of: t-M methodi.t-.. dxcalaSiom.,