Page:The New International Encyclopædia 1st ed. v. 19.djvu/252

* THERAPEUTICS. 208 THERAPEUTICS. of securing the good from all the remedies recommended. A natural reaction set in which resulted in the establishment of homoeopathy, an outgrowth of the reactionary doctrine of "vital- ism.' Later there arose the therapeutic nihil- ists, prominent among whom were Van Swieten and Skoda. This school rejected drug treatment altogether. Modern therapeutics may be said to have begun with the discovery of morphine, an alka- loid of opium, in 1817. The present method of treatment is embodied in rational therapeu- tics, which implies the use of remedies based on a knowledge of the diseased condition present in the patient, a knowledge of the nature of disease itself, and of the physiological action of the agent employed, as determined by ex- perimental investigation on animals, from which may be deduced the action on men. The knowl- edge of the action of drugs must include the manner in which they affect the nerve cen- tres, the respiration, the circulation, and es- pecially their influence on blood pressure, and on body temperature. The range of medicinal dosage, as well as the minimum and maximum fatal dosage, must also be determined. In treat- ing disease it is the aim of the physician to seek the cause of the condition present and to endeavor from a true appreciation of the knowl- edge of drug action to administer such remedies as will effect a cure. A remedy which possesses the influence of curing positively a certain dis- ease is called a specific. Such is the action of mercury in syphilis and quinine in malaria. Empirical therapeutics was based on the cumula- tive evidence that certain drugs were of ser- vice in certain conditions, and experiment was the sure guide. Symptomatic treatment aims to relieve the symptoms of disease irrespective of their cause. Rational or scientific therapeu- tics recognizes that both these previous meth- ods may have to be followed at times, but it aims especially at the removal of the cause of disease by appropriate treatment of whatever sort. It has been developed by the increased knowledge of disease which we have acquired through the growth of the sciences of pathology and bacteriology. Materia medica comprises a knowledge of the remedies employed in medi- cine ; while the methods by which drugs are pre- pared and combined for administration, as well as the separation of the active principles of drugs, belongs to the department of therapeutics known as pharmacy. It is essential that there should be a uniform standard of strength and purity of medicinal products, as well as uni- formity in their preparation, and to attain this object the various countries have standards established by law or by professional authority, to which the drugs prepared by the pharmacists must conform. These standards are published by each nation in works known as Pharma- copoeias. The first United States Pharmacopoeia was published in 1820, previous to which time European works were mainly used as authori- ties. This work is revised every ten years by a committee of physicians and pharmacists. Those preparations which follow its direction and are named in the work are called official. Unofficial preparations, including many newer drugs, are in use. The best of these are finally included in the Pharmacopoeia, provided they are regarded of sufficient value. The term thera- peutics is usually restricted to the administra- tion of medicinal drugs, but in its broadest sense, general tlierapeutics, it includes every form of treatment. Natural therapeutics is the healing power of nature to cure disease througk the operation of the .so-called vis medicatrix nalurce. In what is known as expectant treat- ment the physician depends solely on this force and sustains the patient's strength by food and nursing. Treatment by surgical means is re- garded as a special and separate department of medicine. A large number of other means than treatment by drugs is in use and each is designated by an appropriate prefix. Electro- therapeutics, the use of electricity as a heal- ing agent, is especially valuable in certain cases of disease of the nervous system or local injury to a nerve. By this means the nutrition of para- lyzed muscles may be maintained by electrical stimulation until the nerve is in a condition to resume its function. Radiotherapy or X-ray therapy is the use of the Roentgen rays for the purpose of treatment. Hydrotherapy is the treatment of disease by the application of water, either as baths of various temperatures (balneo- therapeutics) or by drinking, douching, spray- ing, etc. Suggestive therapeutics is the name given to treatment in tlie form of suggestion made to the patient while in an induced hypnotic state, with the object of the patient's following the suggestion when awakened from the hypnotic sleep. This treatment is of limited utility in a few varieties of nervous disease of so-called functional origin, in which no organic disease exists. Climate-therapeutics is the utilization of certain locations on account of their peculiar adaptability to the patient's condition ; as the sending of patients suffering with consumption to high altitudes and dry climates. Therapeutics fully recognizes the value of diet in disease in an important department of the subject known as dietetics or dietotherapeutics. The use of extracts of various glands of the body, especially of the thyroid and the suprarenal glands, has of late been attracting considerable attention. This department of therapeutics is called opo-therapy and promises wide usefulness. Massage and various allied measures have a prominent place in the treatment of certain conditions and assist in sustaining the nutrition of the muscles. This is sometimes called masso-therapeutics. There have been a number of methods of class- ifying remedies followed by various authorities, but none of these is entirely satisfactory. The most important are: (1) the botanical method, which groups the vegetable remedies according to the botanical classifications: and (2) the ar- rangement according to the therapeutic action of drugs. Many drugs, however, are used for a number of purposes, and it is undesirable to de- scribe them under more than one heading. Finally, there is (3) the pharmacological classifi- cation, which arranges drugs according to their action on living matter. This method does not take into account the chemical composition or tlierapeutic action of drugs, but those having the most characteristics in common are placed together. The groups are named for the most prominent member or from some marked prop- ert.v possessed by all. The chief divisions, under which are included many sub-groups, are thus