The Administration of Medicines.
We may lay it down as an axiom, from which it is never safe to depart, that—No medicine should be given, unless the pathological condition and the indications for its use are clearly defined. It is much better to employ a placebo, than run the risk of doing harm by medication.
Good nursing is an essential element in the successful practice of medicine, and always requires direction by the physician; keeping the stomach in good condition for the reception of food and medicine, is of first importance, and requires attention. Following this is the selection of proper food, its preparation, and the time for its administration. These alone very well repay the careful attention and thought of the physician, even if he can not see an indication for the employment of remedies.
When we recollect that the cause of disease is always depressing, and a source of constant renewal, we will see that the removal of the cause from the patient or the patient from the cause, or the antagonism of remedies to remove the cause, is a proper field for our efforts. If we can see clearly that the condition of disease is one of depression—that in proportion as a man is sick, his vitality is lessened, such means as will increase the power to live, or the resistance of the body to death, will be suggested.
As we have stated before, we make an analysis of the disease and divide it into its component parts, before making a prescription of medicine. There are certain basic functions or conditions upon which all others rest, and which are essential to life. These demand our first consideration. Thus the circulation of the blood, the temperature, the condition of the nervous system, waste, excretion, the condition of the blood, blood-making and nutrition, are examined separately. Determining the lesion of these, we prescribe such remedy as antagonizes it, and brings the function toward the healthy standard. Some one of them will stand first in the series of pathological changes, and will serve as a basis for others, and this will receive first attention. Thus we prescribe at the other lesions, in the order in which they seem to be arranged.
As a rule, it is best to do one thing at a time. We prescribe first for that lesion which is first in the chain of morbid action. Then maintaining the influence obtained by a continuation of the remedy, we do that second which is second, and that third which is third, and so on.
In the cure of disease time is an important element, and it is never best to be in a hurry. Here, the old proverb "haste makes waste," is a very true one. As a rule, the severer the disease, the slower its development; the slower the departure from health the greater the impairment of function and structure, and necessarily the slower its restoration.
The manifestations of life in man are from a highly developed organism, the perfection of which is a work of time. Every manifestation of life necessitates a continued renewal of structure, requiring an expenditure of that force we know as vital. Therefore, when the manifestations of life are abnormal (disease), we must necessarily allow time for the development of the organism, increased because the vital force is impaired.
As a. rule, it is best to change the manifestations of diseased life slowly, giving sufficient time for the organism to adapt itself to the change, and gain increased strength as it returns to the condition of health. It will never do to suppress a process of disease at the risk of suppressing the organism upon which natural function depends.
As a rule, it is best to effect these changes insensibly, or without shock to an organ or to the entire body. In this, as in all other things, it is the slow but continued application of an opposing force, that accomplishes the greatest results. Many thousands of sick have been hurried to their graves by the sudden and forcible efforts of the physician to remove disease. This is one of the most prominent errors of the old practice, and will require considerable effort to avoid.
As a rule, it is best to employ remedies singly, or in simple combination of remedies acting in the same way. The reasons for this rule are obvious. It prevents random or scattering prescriptions. We either know a single remedy that will accomplish the object, or we know nothing and have no right to make a prescription. There can not be anything in a combination that is not in the individual articles composing it, and in some one of them par excellence: this is the remedy to use. In direct medication we want no modifying influences; we want the plain and constant action of a simple remedy.
Specific Medication and Specific Medicines, 1870, was written by John M. Scudder, M.D.