24 Introduction 



MYSTERY HAS ABSOLUTELY NO PLACE IN 

 THERAPEUTICS 



If you don't know what a drug does, leave it 

 alone. We no longer "cure" our patients with 

 drugs. Our work is case-management, in which 

 some drug or drugs may play a major or minor role. 



We no longer expect to get some mysterious 

 curative effect from a drug. 



Fitting drugs to symptoms is a forlorn hope of 

 the incompetent doctor. Modern medicine makes, 

 first of all, a diagnosis. This made, a plan of cam- 

 paign must be laid out, which may demand much 

 nursing, careful dieting, stomach washing, and no 

 drugs at all. Or it may, as the prominent factor, 

 demand the most intensive of medication, with 

 little else besides. In modern case-management we 

 demand drugs to do certain defined things, and we 

 don't expect more of them than just that. A doctor 

 must know disease. If he does, he can readily select 

 the drug needed; but he may be intimately ac- 

 quainted with the whole range of materia medica 

 and still be utterly useless in the sick-room, because 

 he does not recognize the signs of septic infection, 

 the sudden incidence of appendicitis, a failure in 

 cardiac compensation, or have the laboratory find- 

 ings before him. 



So, gentlemen and fellow practitioners, we must 

 eliminate the useless in drug treatment, or be elim- 

 inated ourselves. 



DOSAGE 



There is no all-embracing and scientific system 

 of dosage. The large intravenous dose of arsenic in 

 the form of salvarsan and given in the treatment 



