Page:Transactions of the Provincial Medical and Surgical Association, volume 1.djvu/39

 Between the first deviation from a state of health, and the generation of a special malady, a most important period intervenes, which has received very little attention.

The combinations of nervous and vascular derangements, too, their mutual influence on each other, and the modifications of treatment required, according as either obtains the ascendancy, furnish matter for observation and inquiry of the highest moment. In the present state of our knowledge, there is too much tendency to view these states as radically distinct from each other, if not directly opposed; to infer that if one prevail the other cannot co-exist; and, under the influence of an exclusive theory, to adapt the treatment to the partial character thus assigned. Diseases of inflammatory action require depletory treatment and anti-phlogistic regimen. Nervous excitement, when not dependent on increased vascular action, is, oftentimes, best allayed by stimulants and narcotics. To combine these opposite remedies, so as to obtain from each class its beneficial effects, is essential to successful practice. Experience teaches this; many practise it; and to this knowledge may be traced much of the tact by which the experienced practitioner is often distinguished. But theory has not yet developed the principles on which it is founded, so as to render them clear to those who are entering on the practice of their art, or who have not had opportunity for forming their own experience. There is reason to believe that the vascular and nervous derangements continually co-exist, and are intermixed in every conceivable proportion; and if, in the treatment,