34 MEDICINE 



the cause of disease, either destroying it or opposing its action. In 

 the second, the remedial agents are used not with the view of exert- 

 ing any specific action against the cause of disease, nor even in assist- 

 ing in the restoration of the tissue which has been injured, but 

 with the view of restoring function. Any agent acting as a cause of 

 disease produces injury of the tissue, and the effect of this is altera- 

 tion, or diminution, or destruction of function. There is a close in- 

 terrelation of function, that of one organ depending upon the others. 

 The effect of the alteration of function is seen in the supervention of 

 phenomena, which differ from the ordinary. The effect of impaired 

 function may be remedied by supplying the body with some sub- 

 stance which was formed by the impaired organ. Substances directly 

 derived from glands in the animal body, such as thyroid and pancre- 

 atic extract, may be supplied. Or the functional activity of an 

 organ may be increased by direct stimulation or increasing its blood 

 supply. Or the function of some other organ nearly related to the 

 organ affected may, by increased function, be caused to supply the 

 deficiency. 



Therapeutics acts either as a guard against, or as a caretaker 

 of the body in disease. Its greatest triumphs are in prevention. 

 When the injury has once been produced, its effects are minimized 

 by the capacity of the body to adapt itself to new conditions. There 

 is a third use of therapeutics in the case in which the disease pro- 

 duces so much pain and discomfort that the remedial agent is used 

 for the purpose of diminishing the effect of sense-impression on the 

 central nervous system. It is clear how complicated the questions 

 are, and how much greater is the task presented to the physician 

 than to the surgeon. The surgeon acts directly, either adjusting 

 parts which are deranged or by removing tissue which is diseased. 

 The study of medical literature shows the mistakes and follies 

 which have been and are being perpetrated in therapeutics. The 

 more obscure the disease, the greater the number of remedies; the 

 more ignorant the practitioner the more confidence that certain 

 drugs will act as remedies in all diseases. Each year has served to 

 discard some remedy considered infallible and to substitute for 

 it another equally infallible. The discontent of the general public 

 with such therapeutics is shown in the success of charlatans who 

 advertise nostrums for the cure of all diseases. It is just as easy 

 for them to obtain certificates of cures by the nostrums as it is for 

 the practitioner to become convinced of cures effected by certain 

 favorite drugs. 



The greater knowledge of the infectious diseases which has come 

 with their experimental study has especially served to place thera- 

 peutics upon a proper basis. It has become apparent that many 

 diseases are self-limited and tend to recover under any treatment, 



