THE LIMITATIONS OF THE HEALING ART. 79 



sided under its application, have had a direct effect on the prog- 

 ress of the inflammation. Although it may appear to be so, it 

 is no way demonstrated. It is the same also with chronic inflam- 

 matory processes. The subsidence of single favorably localized 

 forms may perhaps be promoted by such measures as massage, 

 gymnastics, electricity, special baths, etc. ; but of them all it can 

 only be said that they promote absorption; but no immediate 

 influence on the organism, no cure of the processes, is worked by 

 them. It may be all the same to the patient whether massage 

 controls the restorative process directly or indirectly, so that it 

 makes him well. In many other instances the application of simi- 

 lar methods in favorable cases may overcome individual symp- 

 toms, and remove the products of the disease, without yet having 

 any essential influence upon its progress. The various diseases 

 of the blood, metabolic derangements, and the inexhaustible multi- 

 tude of disorders of the nervous system, to this time have fur- 

 nished no more opportunities for a real cure than the soil of 

 Alaska for the successful cultivation of the date palm. Among 

 infectious diseases we admit only that in typhus, scarlet fever, 

 measles, dysentery, cholera, and the long, dangerous host of such 

 contracting diseases, medical art can contribute much to a favor- 

 able outcome by counteracting dangerous symptoms, and through 

 general hygienic measures and a judicious direction of nourish- 

 ment. But in only two, perhaps three, of these diseases can medi- 

 cine induce a cure by direct influence upon the pathological 

 processes viz., on malaria, syphilis, and acuta rheumatism. 

 Of the last, we only know that the salicylic treatment allays 

 the fever and the joint affection, but is without influence on the 

 dangerous endocarditis, with its following of disordered heart- 

 rhythm. And all other infections, when they have become out- 

 broken and developed illness, can not to this day be cured in the 

 sense in which science uses that word. Whichever way one turns 

 he will everywhere strike limits. In fact, a diseased condition is 

 susceptible of cure only so long as it is attacked while still ad- 

 vancing; as soon as it has reached a definite culmination, no 

 more ; there then remain deformations, atrophies, hypertrophies, 

 and other resultants of most various kinds. In most cases these 

 are out of the reach of therapeutic influence and restorative pro- 

 cess, except occasionally through a mechanical measure or the 

 knife of the surgeon. An acute pleurisy is curable, but not its 

 residues. The metabolic anomalies which lead to the formation 

 of calculus in the kidneys can be influenced in the beginning, 

 but the stone when it is formed can be removed only by the 

 surgeon. The possibility of therapeutic effect is in many cases 

 determined by the locality of the process, and, further, by the 

 circumstance whether the cause of disease accrued suddenly or 



