Selection of the Remedy.
Selected writings of John M. Scudder.
No medicine, rather than one not indicated, was the teaching of the apostle of specific medication. So great was his faith in, the definite action of medicines that he believed only in administering that drug for which direct indications were known. He was extremely cautious In the recommendation or use of new medicines until by long experience their exact place in his definite system of prescribing had been found. Rash prescribing he considered one of the greatest of medical evils.—Ed. Gleaner.
SELECTION OF THE REMEDY.—As I grow older I want more evidence that the right remedy is being given, and I have a greater distrust of the wrong medicine. Medicine works good or ill. It is rarely that innocent thing that does neither, however simple it may be. It is well to have a medical conscience, like the old "theological conscience" that is ever alert to tell of wrong-doing. It may not be pleasant for the doctor, but it is certainly good for the sick. As these are camp-meeting times, I might phrase it in this way: "Oh for a medical conscience that would smite the careless, those who run in old ruts who do not think; let them be smitten hip and thigh like the Amalekites."
I want to be reasonably certain of my remedy. Once in a while it will do to know "that it has proven serviceable in this disease" heretofore. It is well to know that others "have used it with advantage." I want to know of myself "that there are symptoms in the case pointing to this individual remedy." These should be satisfactory, but at once the mind takes up the physiological problem, and will have it explained why the remedy will prove curative.
I can no more stop this mental process than I could stop Niagara; the reasoning goes on whether I will or no. The process may be bad, the facts incomplete, knowledge imperfect, but nevertheless I will be influenced by the result. I suspect others have a like experience, either under this influence of the will or unconsciously.
With reference to new remedies I find this reasoning as to the "why they should be of use to the sick and why dangerous," so certain and so imperative that I can not resist the conclusion, and do not try the drugs. Take the case of arsenite of copper, of which we have recently had such strong recommendation. I do not give it. Many of the coal-tar products come in the same list, and in the doses and for the purposes named, I can not give them. The use of bichloride of mercury as an antiseptic, and especially its use as an infra-uterine injection, was forbidden by my medical conscience.
I think the physician should keep his mental apparatus well under the influence of his will, yet still not neglect the results of its automatic action. In the selection of the remedy I want to know if the symptoms point to it, in other words, if it is the "indicated remedy." I want next to know if the action of the remedy is opposed to the diseased action, and looks towards healthy function—if the tendency is to strengthen life rather than the reverse. Of course this supposes a knowledge of the pathological condition, the morbid activities, and nature's method of restoration to health. If now we have the additional knowledge that it has been successfully used in such cases, our medical conscience can be fairly well satisfied.—SCUDDER, Eclectic Medical Journal, 1890.
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"In disease there is always impairment of life, therefore remedies should always conserve the life and increase the patient's power to resist disease and regain his normal condition."—Scudder's Materia Medica, p. 34.