c. Fluids drank-their quality and quantity;
d. Clothing worn-its kind and quality.
e. Dwelling occupied-it character and situation;
f. Business followed-its character and influence;
g. Habits formed-their character and tendency;
h. District inhabited-its disease tendencies;
And each of these sub-divisions we find again divisible, as I will briefly indicate.
The air breathed. The research in physiology have discovered. with considerable exactitude, the properties of atmosphere requisite to health. The preponderance of one or another of its constituents has been found to result in disease and death; and so likewise the presence in it of certain vapors and impalpable contagia and miasmata. Again, the temperature weight, as well as the humidity and electrical states of the atmosphere, have been found to vary the conditions of human health, and so like-wise its stillness and motion. The therapeutist must recognize all these facts and prescribe accordingly, or, as directed by the most approved hygienic principles relating thereto.
The food eaten. Although the adaptability of the human apparatus for food digestion and assimilation is very great, and although in different circumstances men may live on vegetables alone. or meats and animal oils alone, there are, yet, certain kinds and qualities of food demanded, for the best development and support of the human organism, which may not be ignored.
Errors, in the selection and use of food, as to quality and quantity, and manner and times of eating, have, probably, occasioned more sickness than any other class of errors recognized in the wide domain of aetiology. The therapeutist who does not take notice these, and give need to the principles regulating them, is unworthy of his calling, however much he may know of medicines and their uses.
The fluids drank. Much of human misery, as well as human health, depends upon the fluids imbibed. Late investigations have shown quite clearly the tendency of the leading articles of drink in use among men-the good of some, the evil of many-so that beverage principle are not wanting. Immense good, in the restoration as well as the preservation of health, may be effected by the physician who recognizes and enforces these principles, in reference to water, tea, coffee and alcoholic stimulants among his clients.
The clothing worn. It is well known, among those who observe the progress of physiological discovery, that the bodily condition of man is variously influenced by the color, texture and cut, as well as the kind and weight of clothing worn.
The protection of the extremities, the allowance of room for chest expansion, the right action of the abdominal viscera, and the ready transmission of the fluids of the body, through their channels, as well as the preservation of normal temperature, must be provided for by the regulation of the clothing worn, according to principles now quite well defined.
The dwelling occupied. The search for the causes of sickness has led to the consideration of the materials composing the walls and floors of dwellings, and their provisions for light, heat, air and drainage, as well as their sites and surroundings.
The medical adviser must be prepared to consider the house of his patient, as to its probable influence upon health, and to prescribe necessary changes.
Business followed. Long observation and the gathering of statistics have done much to determine the comparative healthfulness and special tendencies of the various occupations followed by mankind. It is the business of the therapeutist to understand these, and to prescribe accordingly for persons under medical care.
A change, from one occupation to another, may be all that is required to restore an invalid to health.
Habits contracted. Under the influence of various and, often, morbid desires, habits are contracted and practices followed by individuals, much to the injury of health. Things hurtful have thus come into daily use, and things proper have been greatly abused or sadly neglected. Irregularities have crept in till life has become demoralized and destroyed. Cheerfulness has given way to gloom, and often the laugh of innocence to the moody silence of remorse or the shrieks of despair.
The medical friend and adviser must observe these, and devise measures for their correction.
Mental diversion for the worn-down student, cheerful company of the grief-ridden, and a pure life for the dissolute, may be of more importance than all the drugs in the materia medica.
District inhabited. Local causes of sickness are now quite successfully studied, furnishing the geography of diseases, the haunts and routes of travel peculiar to certain epidemics, and the measures necessary for the protection of health in different localities.
Every year more of these things are discussed in medical books land journals, as well as by the public press.
Boards of health and other organizations, as well as numerous individuals, professional and lay, are investigating and publishing facts and principles relating to public as well as individual hygiene.
Another class of forces, bearing upon the human organism, and called into use by its necessities, we may term the –
2. CHEMICAL.
This embraces all the agents employed under the especial direction of chemical laws, such as –
Elements requisite { a. When deficient.
{ b. When in excess.
Agents hurtful { a. Internal, requiring antidotes
{ b. External, requiring disinfectants.
It is hardly necessary for me to enlarge upon the divisions and sub-divisions of these chemical measures and means, now generally recognized in the domain of domestic as well as professional therapeutics.
The practitioner cannot afford to be ignorant of them, and especially of their proper uses, in the support and protection of human life.
It is not safe for him to proceed in the treatment of cases to which he may be called, till his diagnosis has informed him, if the causa morbi be a poison within, calling for an emetic or an antidote, or a poison without, calling for disinfectants, which chemistry alone may be able to point out. To prescribe “mint tea”, and “epigastric sinapism,” or “arsenicum album. in a case of poisoning by arsenious acid; or to prescribe “paregoric,” black berry tea,” or “croton tig,” where croton oil has been taken in excess, would enhance the reputation of the prescriber about as much as would his administration of “ammonia” or “lachesis,” to one asphyxiated in the bottom of a foul well, or of “dialysed iron” or “china pills,” to the pauper dying of the anaemia of hunger and thirst.
It is true chemists have dabbled much in things medicinal, putting forth remedies theoretically unsound and practically worthless. They have often overlooked the might and cunning of the vital force, while dealing with the human body and its organs, as so many combinations of elements, subject only to the laws which govern in the retorts and receivers of the laboratory.
This is not the place to review such errors, but I cannot pass without admitting their existence and saying that while advocating due allegiance to chemical laws, we must insist upon their practical confinement within the domain of chemistry.
Toxicology, with its wide gleanings and its generalizations, a great science of itself, brings to view a multitude of agents, antidotal as well as toxical, with which the therapeutist should be well acquainted.
We pass on to mention another class of forces acting upon the human body and upon its surroundings for the protection and restoration of health, which we must recognize as –
3. MECHANICAL.
This class embraces all such agents as bear upon the organism under the laws of mechanics, such as –
a. Force capable of changing the position of the body, or of some of its parts.
b. Force capable of changing the locality or the relations of the body;
c. Force that may overcome obstructions to the normal action of organs and motion of fluids in the body; or that may be required to increase such action or quicken such motion:
d. Force applied to reduce dislocations and fractures, to restore parts lacerated, and to correct deformities;
e. Force employed to remove foreign bodies from organs and tissues suffering on account of their presence; and again, to remove morbid growths and products, or parts of the body on longer fit of safe to remain.
In the divisions and sub-divisions of this class, we recognize the measures and means prescribed by the advocated of physical exercise-the walking, the riding, the climbing, the gymnastics, the massage, the health-lift, and also the means and methods of operative and reparative surgery, in all its extended and useful ministry.
This department of general therapeutics is wide and important, and its measures are exceedingly varied; yet they are all subject to the well-known laws of mechanics, and must be studied and directed from the mechanical, as well as physiological stand- point.
One more class I must present before leaving the field of general therapeutics, the –
4 ANTIPARASITIC.
This class embraces all agents employed for the destruction or removal of the parasites which live upon the human body, such as
