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LIST OF CONTRIBUTORS
W. C. ABBOTT, M.D., of Chicago.
EPHRAIM CUTTER, LL.D., M.D., of New York.
CHARLES F. D’ARTOIS FRANCIS, M.D., of Brooklyn, N. Y.
E. B. GLEASON, M.D., of Philadelphia.
ARTHUR E. GUE, M.D., of Detroit, Mich.
J. L. MANASSES, M.D., of Philadelphia.
J. P. MANN, M.D., of Philadelphia.
JOHN V. SHOEMAKER, M.D., of Philadelphia.
HERBERT J. SMITH, M.D., of Philadelphia.
M. CLAYTON THRUSH, M. D., of Philadelphia.
H. E. WAITE, M.D., of New York City.
JOHN A. WITHERSPOON, M.D., of Nashville, Tenn.
The investigation of the properties of drugs, and their effects in health and dis
ease, and especially their utilization in THE SCIENTIFIC FOUNDATION OF
clinical medicine, is a vast subject, full of MODERN TREATMENT OF
details of the highest importance to you as DISEASE.
physicians. It may, at first sight, seem alBy John V. SHOEMAKER, M.D., LL.D. most an impossibility for the human mind Professor of Materia Medica, Therapeutics,
to acquire a good working knowledge of Clinical Medicine and Diseases of the the materia medica in the comparatively Skin in the Medico-Chirurgical
brief period that you can devote to it in College and Hospital.
connection with your numerous other stuMR. PRESIDENT, MEMBERS OF THE BOARD
dies. Nevertheless, it can be done if the OF TRUSTEES, COLLEAGUES, AND STUDENTS.
work is performed faithfully and systematiGENTLEMEN : Before taking up in a sys- cally. In order to make the greatest possitematic manner the subject of “Therapeu- ble progress in the time at our disposal, tics,” which we shall study together during therefore, several things will be necessary the present term, I wish to say a few words
on your part. The first of these is faithful to you about the methods which long experi- attendance; to keep up with the class, you ence in teaching has led me to adopt in this
cannot afford to miss a single lecture. The class-room, and in which I will expect to
second of these is punctuality; and to enhave your coöperation. I am very much
courage this, I will call the roster of the gratified by seeing among you some whose
class at the beginning of each lecture. The intelligent and interested faces have been
third is close attention, and to insure this impressed upon me by their faithful at
there will be frequent quizzing upon the tendance during a former term. As they subjects of the lectures, both by myself and are already familiar with our methods of
my assistants. In addition to the present procedure here, I depend upon them to set
didactic course, I shall hold clinical confera good example to all others and to strive
ences at appointed times during the winter, to maintain the good reputation of the
in which I shall assign patients to certain class by their punctuality and deportment. members of the senior class, who will make To those who appear here for the first time, the diagnoses, explain the pathology, and I extend a cordial welcome, and bid them
write appropriate prescriptions suited to not to be discouraged by the difficulty of the conditions in the respective cases. the task that is before them.
They will also be expected to defend their
therapeutic opinions in the amphitheatre. * Delivered at the opening of the MedicoChirurgical College in the Clinical Amphithea
Finally, I will follow the same course as tre, Medico-Chirurgical Hospital, Philadelphia.
in previous years, of making my clinical teaching very practical, so that it will sup- disease. In other words, to take the best plement and fasten in your minds the les- care of him. sons of the class-room and laboratory. My The subject of our study in the concrete methods of teaching, therefore, are based is the human being in a state which is more upon an intimate combination of theory or less of a departure from the physiologiwith practice; the ascertained facts regard- cal or normal standard. I will not stop to ing the action of drugs are, by means of affirm the reality of disease, which a modclinical illustration, correlated with their ern sect of crazy egotists have foolishly detherapeutic application; and, on the other nied. As we cannot refuse to believe the hand, the curative effects are constantly testimony of our own senses as to the eviexplained by referring to the physiological dence daily presented to us in our hospital action of remedies. In this way, the vital and dispensary service, and in our individconnection between the science and the art ual experience, and also derived from our of therapeutics is kept constantly in mind. knowledge of infection, we must take the
Let me dwell for a moment upon the existence of disease, as a real problem in word therapeutics in order to bring out its human life, for granted. As regards the meaning. It comes from the Greek verb, essential nature of disease, we now know “theraperio,” which means "to care for" or that Hippocrates was right in making his “take care of those who are ill.” The celebrated declaration that “there is no Latin word "curo” means almost precisely sacred disease, and diseases arise from natthe same thing, whence comes our word ural causes.” Modern medical science, incurator, a care-taker. Ambroise Paré, deed, is distinguished preëminently above therefore, in saying that he did not cure that of preceding eras of medical history his patients (“Je les panse, Dieu les by its knowledge of the intimate causes of guerit'') erred on the side of excessive mod- diseases. The flood of light which has been esty. He was more pious than righteous. thrown upon this subject by the growth of Any real service rendered to the sick is, biological chemistry and the discoveries of strictly speaking, curative. It has no bacteriology has demonstrated the true nanecessary relation or connection with the ture of many diseases, and has placed recovery of the patient, or the ultimate re- therapeutics upon a solid and enduring scisult of the treatment. In fact, “No cure, entific foundation. no pay” is a perfectly equitable arrange- As regards the relation which therapeument from the etymological standpoint. tics bears to your other medical studies, it On account, however, of the popular error is evident, as the late J. Miener Fothergill which prevails as to the meanirg of the observed, that it is “the superstructure of word "cure," it is not advisable, for the the building”; all others are subsidiary, and present at least, to place this legend upon of secondary importance. Medicine is your coat of arms, or inscribe it on your properly called the ars medendi, or the door-plates. It is true that in many cases healing art. Anatomy, physiology, patholwe cannot predict, and much less promise, ogy, bacteriology, and all other branches of the restoration of the patient to health, special study are acknowledged beyond all which is the common idea of what is meant question in themselves to be both interestby a cure; but we can declare what are the ing and instructive; but they derive their most favorable conditions to facilitate his greatest importance, as everyone must adrecovery, and at the same time administer mit, from the fact that they are contriburemedies which will lessen his suffering and tory to therapeutics. disability, and, perhaps, remove the cause In its relation to the other natural sciand materially shorten the duration of the ences, therapeutics has an assured position.
Did not Lord Bacon say that the end which horses, and the ocean in ships which sail he proposed for his philosophy was the against the wind. These are but a part of, multiplying of human enjoyments, and the its fruits and of its first fruits. For it is mitigation of human sufferings? Thera- a philosophy which never rests, which is peutics, then, may justly claim a prominent never perfect. Its law is progress. A position in the great system of philosophy, point which was yesterday invisible is its which has become generally accepted, and goal to-day, and will be its starting post towhich has accomplished so much for the morrow." Since these eloquent words were advancement of civilization. In the words penned, half a century has passed, during of a writer in the Edinburgh Review, the which the prophecy of continued progress “new philosophy,” as it was called in the has been abundantly fulfilled. Therapeutime of Charles the Second, has effected tics itself has been greatly advanced, notagreat advantages for mankind, foremost bly in two directions: first, in our exact among which he cites the lengthening of knowledge of etiology, or the causes of dislife, the mitigation of pain, the extinction ease, and consequently in the means of preof diseases; in other words, the objects of venting them; and, secondly, in our posiour study. The distinction between an- tive and demonstrable information as recient philosophy and modern is a radical gards the physiological action of drugs, in
The philosophy which Bacon taught consequence of which the problem of treatwas essentially new; its object was the good ment is greatly simplified. of mankind. The aim of the Platonic phil- This class is very fortunate in one reosophy was the impossible task of exalting spect, and that is that the Eighth Revision man to be a God. The aim of the Baconian of the Pharmacopæia was completed just philosophy was to supply the wants of man a year ago, and is now the established auwhile he continued to be a man.
thority and standard which we shall follow A few of the benefits of the inductive in all our class-room and laboratory work. system are so well summarized in the arti- It required a little time to become accuscle just referred to that I cannot forbear tomed to the changes from the preceding quoting the concluding paragraph: “It edition; but they have now been everyhas lengthened life; it has mitigated pain; where accepted, and we have settled down it has extinguished diseases; it has in- to the new order of things. The new memcreased the fertility of the soil; it has given bers of the class are especially fortunate, new securities to the mariner; it has inasmuch as they have nothing to unlearn, spanned great rivers and estuaries with but commence their studies with the new bridges of form unknown to our fathers; Pharmacopæia. it has guided the thunderbolt innocuously In addition to the remedies officially from heaven to earth; it has lighted up the recognized by the United States Pharmanight with the splendor of the day; it has copæia, there are a large number of extraextended the range of human vision; it has pharmacopæial or unofficial preparations. multiplied the power of human muscles; it New drugs are being constantly added to has accelerated motion; it has annihilated the materia medica in the progress of phardistance; it has facilitated intercourse, cor- macology, a few of which, being of real respondence, all friendly offices, all dis-value, will find their way ultimately into a patch of business; it has enabled man to subsequent revision of the Pharmacopeia; descend to the depths of the sea, to soar but the very great majority of them will into the air, to penetrate securely into the not stand the test of experience, and will noxious recesses of the earth, to traverse erentually be left behind and become obsothe land with cars that whirl along without lete. Each revision, therefore, may be re