Suggestions and Criticisms.
Editor Ellingwood's Therapeutist:
In response to your request and query in the April number: "If you could not use but thirty remedies, which would those be," etc., the writer would submit the following briefly and in about the order of prominence and frequency of use:
Gelsemium, bryonia, veratrum, aconite—sedative-febrifuge. Cactus, collinsonia, grindelia, sticta—heart and cough medicines. Macrotys, phytolacca, nux vomica, iris—muscle and gland medicines. Pulsatilla, staphysagria, saw palmetto, rhus aromatica—nerve and mucous membrane soothers. Echinacea, baptisia, sulpho-carbolate of zinc, sulphurous acid—antiseptics. Chloroform, morphine sulphate— anesthesia, pain. Sanguinaria, borax, oil cajuput, iodide lime—throat, local stimulants. Additional, asclepias, viburnum prunifolium, capsicum, quinin. Here are thirty acknowledged remedies—just about the number and selection with which to accomplish prompt favorable results in either acute or chronic disease.
As to ten more supplementary agencies, the writer keeps the following in reach: magnesium sulphate, antacid and laxative. Resorcin—skin. Red pinus, cal. hydras, cocaine—eye remedies. Alcohol, carbolic acid, dialized iron—poisonings and solvent.
It will be noticed that of many written about and extolled, under, we may say, each head, known reliables have been selected and adopted into the practice of the writer. There is no coal tar derivative named. No calomel, no podophyllin, no protonuclein, no antidiphtheritic or other carbolic-acidized serum. In the main, just clean, pure, straight and well proven agents, which if selected according to well defined pathologic lesions, and applied in proper form and amount, will yield, do give the largest results.
So much for the thirty and supplementary medicines. Now a word or so of friendly criticism of some statements to be seen in this same excellent April number of THERAPEUTIST. Why give calomel and podophyllin in combination? Any purgative result is owing only to the mercury. Podophyllin in small doses is so slow that it amounts almost to a checkative. And without the oppression and fulness of tissues, the agent is contra-indicated; indications not present in many cases. Drop the use of the term auto-intoxication. Self-intoxication. Impossibility. Any exudate pathologic, any waste matter, any retrograde metamorphotic product whatsoever, whether deposit is the result of inflammation, whether matter alvine in retention, or whether exudatory is, at the moment of separation from a cell, or gland, foreign matter. If any amount of such product, however much or however little, be, by inexplicable movement, found in the blood current, it, the debrisic element, being foreign, could not by any sort of pathologic caper, play auto. When cells are in homogenial relationship and physiologic, the state of wellness inheres, certainly.
To intoxicate there must be the introduction of foreign matter, element, something. The body can not react upon itself to make itself sick or drunk. Come, brother, brethren, drop the term autointoxication. Pretty term, and sounds full and large, but like so many others and much other straw which have worked way into medical nomenclature, it is empty—meaningless.
The writer may be considered "nutty," but he would not think of prescribing veratrum and aconite in combination. Pulse full, frequent and bounding, fulness of tissues, face dusky red—veratrum. Pulse small, weak, frequent, features pale or pinched—aconite. We need to disparage the use of medicines in combination, when it is found that even a single agent is composed of complex divergent products and principles. Take the nightshade for illustration.
You have, Mr. Editor, in design and effort in THERAPEUTIST, outlined a way which when pursued to ultimate, will land you and your thousands of followers into closest proximity of basic medical truth. And when the goal be reached, will be found to have resolved itself, from the beginning, into the axiom: The single remedy proven and relied upon to produce direct and positive favorable effect as against certain, well defined pathologic reflex-condition.
Allow me to subscribe myself your sympathizing co-worker,
W. L. LEISTER, M. D., Co-Editor American Medical Journal.
COMMENT: In my April number, I asked our readers to send me a list of thirty remedies which they considered the most important; which they would select it they were reduced to that number. I am still desiring replies to that request. Among those I have received I publish only the above now, as it presents facts that I desire to bring forward in this number of my journal. The above statements of Dr. Leister are well worth consideration. I trust many others will yet respond in the same line. Let us have a list from at least one hundred doctors.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.