AmNo°vU^92hiarra' }  Value  of  Drugs  in  Internal  Medicine.  761 
ment  against  the  indiscriminate  and  noncritical  use  of  drugs,  to  the 
relative  exclusion  of  other  and  often  more  efficacious  methods -of 
therapeutic  intervention,  was  necessary  and  timely,  in  order  that 
the  more  rational  therapy  of  our  period  might  emerge. 
In  the  therapy  of  today,  based  on  more  accurate  diagnosis  and 
on  enlarged  conceptions  of  pathologic  physiology,  etiology  and 
pathogenesis,  a  new  hopefulness  prevails.  We  make  use  now  of  a 
host  of  methods  that  are  found  to  be  trustworthy  for  healing,  for 
palliating  and  for  preventing.  Along  with  diet,  baths,  climate,  air, 
light,  heat,  exercise,  massage,  electricity,  roentgen  rays,  radium, 
serums,  vaccines,  mechanical  appliances,  surgery,  nursing,  and 
psychic  and  social  influences,  drugs  are  gradually  finding  their  proper 
place  in  the  therapeutic  armamentarium  of  the  medical  practitioner. 
For  among  the  drugs  of  various  sorts,  including  both  natural  sub- 
stances and  pure  chemicals  provided  by  separation  or  by  synthesis, 
there  are  agents  that  can  now  be  employed  with  great  confidence  and 
often  with  the  happiest  results. 
DUTY  OF  THE  INTERNIST. 
In  the  management  of  patients  and  in  the  treatment  of  their 
diseases,  it  is  our  duty  as  physicians  to  see  to  it  that  we  do  not  ne- 
glect to  make  application  of  any  of  the  agents  at  our  disposal  that 
may  reasonably  be  expected  to  help.  Briefly  to  survey  the  help 
offered  to  the  physician  in  his  daily  work  by  modern  pharmaco- 
therapy is  the  object  of  the  present  symposium.  The  time  allotted 
will,  of  course,  not  permit  of  any  detailed  discussion  of  the  use  of 
single  drugs.  It  is,  I  take  it,  the  intention  of  those  who  planned  the 
symposium  that  it  should  deal  rather  with  the  general  principles  that 
underlie  the  use  of  drugs  in  therapy,  and  with  certain  examples  of 
the  application  of  these  principles  in  practice.  Others  are  to  speak 
of  the  use  of  drugs  by  surgeons  and  by  specialists;  this  paper  has 
to  do  with  their  use  by  the  internist. 
Man  desiring  to  help  his  suffering  fellow  man  must  not  lack — > 
indeed,  has  never  lacked — courage.  Think,  for  example,  of  the 
boldness  of  the  surgeon  who  annihilates  the  consciousness  of  his 
patient  and  then,  without  trepidation,  cuts  into  the  abdomen,  or  ex- 
cises a  goiter,  or  removes  a  brain  tumor !  The  physician  also  must 
have  bravery,  one  might  almost  say  audacity,  when  he  attempts,  by 
the  use  of  a  drug,  to  intervene  favorable  in  the  disturbed  physical, 
chemical  and  biologic  processes  of  the  human  body  in  disease. 
