768  Value  of  Drugs  in  Internal  Medicine.  { Am"^ovr'i92iarm" 
only  toward  single  symptoms  that  injure  or  torment  him,  this  ther- 
apy is  highly  important  for  the  patient,  and,  when  successful,  is  the 
ground  for  much  gratitude  on  his  part.  There  is  scarcely  a  symptom 
that  is  complained  of  by  patients  that  physicians  have  not  attempted 
to  influence  by  pharmacotherapeutic  methods.  And  the  relief  that 
can  be  afforded  in  many  instances  thoroughly  justifies  the  attention 
that  is  given  to  the  indicatio  symptomatica. 
It  is  above  all  in  the  relief  of  pain  and  of  various  forms  of  men- 
tal and  bodily  discomfort  that  this  is  true.  We  would  not  willingly 
neglect  the  administration  of  morphin  in  renal  colic ;  of  acetylsalicylic 
acid  in  the  arthralgias;  of  wine  or  beer  to  paralyze  certain  patho- 
logic inhibitions  and  to  bring  needed  relaxation ;  of  heroin  and  codein 
in  the  racking  cough  of  pneumonia ;  or  of  the  various  analgesics  that 
are  effective  in  migraine,  in  neuralgias,  and  in  the  lancinating  pains 
of  tabes.  Though  we  may  deplore  the  abuses  of  alcohol  as  a  bever- 
age, of  purgatives  in  habitual  constipation,  of  sedatives  in  the  neu- 
roses, and  of  hypnotics  in  insomnia,  we  all  will  admit  that  after 
causal,  functional  and  regulatory  indications  have  been  as  fully  met 
as  our  science,  permits  of,  there  will  be  occasions  when  the  merely 
symptomatic  indication  dare  not  be  ignored. 
CONCLUSION. 
It  will  be  clear  from  what  I  have  said  that  the  internist  looks 
on  the  use  of  drugs  in  therapy  more  hopefully  now,  perhaps,  than 
ever  before.  Available  drugs  are  of  real  value  in  curing,  in  amelio- 
rating and  in  preventing  disease,  and  new  drugs  that  are  useful  are 
steadily  being  discovered. 
Adequately  to  make  use  of  the  pharmacotherapeutic  means  at 
his  disposal  for  meeting  etiologic,  functional,  regulatory  and  symp- 
tomatic indications,  the  internist  must,  it  is  true,  have  mastery  over 
a  large  body  of  facts.  He  must  be  well  trained  in  normal  and  patho- 
logic physiology  and  should  have  become  acquainted  with  the  known 
facts  of  etiology  and  pathogenesis.  He  should  have  learned  in  the 
pharmacologic  laboratory  the  effects  of  the  more  important  drugs  on 
the  normal  animal  body ;  and  he  should  have  had  opportunity  in  the 
hospital  wards,  and  in  the  laboratory  of  experimental  pathology  and 
therapy,  to  observe  the  changes  that  can  be  produced  by  drugs  in 
disease.  Very  few  have  as  yet  had  opportunity  for  the  latter,  but 
the  medical  schools  should  provide  for  it  in  the  future. 
