Dynamic factors pertaining especially to the patient are chiefly these:.
1. The genius of the present infection, or epidemic, if any. This may suggest the remedy when the personal distinctions are lacking.
2. The history of the causal incidents or surroundings.
3. the miasms; to be observed after the primary infection is antidoted and progress comes to a stop or when the duration is protracted by the quickening of a latent or chronic constitutional state, such as psora, syphilis or sycosis.
4. Chronic or constitutional states of the same infection (the Tuberculinums should especially be considered).
5. The effects of drugging, such as dosing with aspirin or the effects of an old quinine-malarial combination.
6. Mental shock or fear.
7. Pure nervous shock from carrying the load, the Lecithins or Scopalamine states, for instance (fatigue remedies).
It all sounds rather complicated but it really is simple because one does not meet many of the dynamic factors of the patient at one time, and it should not be difficult to see which factors are most peculiar, characteristic and striking, for they stand out prominently in most cases.
There is, however, one important exception, the eruption of sublimated (even through former generations) miasmatic states. If after the primary infection is antidoted progress comes to a stop, or the duration is protracted, or even when, as sometimes happens, characteristic symptoms fail to point the way to favorable reactions, a latent constitutional state such as psora, syphilis or sycosis has become quickened. Now if one is guided by the laboratory man who says that the syphilitic taint is not found in pneumonia, some cases will be lost that would otherwise make brilliant recoveries.
In this situation the laboratory is useless because influences deeper than the present laboratory findings are at work. The syphilitic miasm in such instances is especially vicious and sudden. The thing to do is to search for the finer characteristic that may have crept into the case almost unnoticed; search especially for the most persistent, individual and recent ones. These will be found to be reactable and a quick recovery will result.
Finally, a word on personal domination. By this is meant no priestly domination, nor pretty oversight of attendants and surroundings, but domination through the positive effects of prescribing, felt keenly by the patient and apparent to all.
The therapeutic management of pneumonia is first of all a game. It is often a quick and sharp game, giving an opportunity to stand up and put ones nerve, principles and wits into buoyant use. For this reason it is always best to play the game alone. It is my own rule to refuse consultation and to this rule only three exceptions can be called. It is absolutely necessary to keep the vision of the game clear and the grip on the patient undisturbed. Effective prescribing convinces all that it is primarily a game of medicine and if its management is not left to the prescriber, he has no place in the line-up.
As to the patient, there is a mental coup which I have used in rare circumstances, and I cannot do better than to quote from a former article:.
As a rule I care not whether a patient has any faith in medicine or in his doctor so long as his remedy is in sight. But sometimes a situation arises in which the patient is struggling along but is either indifferent to life or needs a decisive outlook and resolution of spirit which remedies have not given. I then make the request to speak with him alone and I ask him how he feels about his case and how he feels as to the prospects of recovery. Whatever his answer I then tell him that he is very sick and that I cannot promise life, but that he has a goodly store of latent vitality, plenty to carry him through if he will but resolve to hold on a while longer. This has invariably a good effect. By being directed to envision the issue, the patient chooses, as it were, the right direction.
WATERBURY, CONN.
Born in Torrington, Litchfield, Connecticut, USA on 20 Oct 1871 to Royal Edmund Hayes and Harriet E Merriman. He had at least 4 sons and 1 daughter with Miriam Martha Phillips. He lived in Torrington, Litchfield, Connecticut, United States in 1880. He died on 20 July 1952, in Waterbury, New Haven, Connecticut, United States, at the age of 80, and was buried in Waterbury, New Haven, Connecticut, United States.