London medical gazette : being a weekly journal of medicine and the collateral sciences. Saturday, September 8, 1832.
- Date:
- 1832
Licence: Public Domain Mark
Credit: London medical gazette : being a weekly journal of medicine and the collateral sciences. Saturday, September 8, 1832. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
17/32 (page 737)
![?37 is it finished, when forth comes the Diction- naire Abrggi, in which those principles pre- dominate to such a degree, that they abso- lutely make up the greater part of its bulk. In the great Dictionary, fevers are still es~ sential ; they are but symptomatic in the Dictionary abridged 3 and the Dictionary in 18 volumes, which comes next in order, re- duces those fevers considerably, and, more- over, every where displays the banner of the doctrine which the Examen advocates. [M. Broussais then proceeds to notice other works of his, and among them his re- cent tract on the Cholera 3 after which he goes on :—] But, gentlemen, it is time to give you a summary and comprehensive view of the method we follow in the distinction and treatment of diseases, which we shall now attempt to do in the most succinct manner we are able. This method has for its guides two phe- nomena which never abandon it at the bed- side of the sick—motion and sensation. In fact, as long as the individual is alive, his animal substance will be affected by the in- fluence of external agents, and hence will result, under given circumstances, certain perceptions for his consciousness. The sick man suffers; but as sure as he suffers, ob- servation descries in his suffering organs movements different from those of the sound state ! The sick man takes a remedy which does him a service—his sufferings diminish 3 and vice versa: but in the former case, his organs will be less disordered—they will more nearly approach the hormal rhythm ; while in the latter, they will tend to more and more disorder, and the disturbance will spread from the first organ to several others. This being settled, the bases of medicine are settled also. No disease is ever in the first instance general 3 it always begins in some one organ, and often in a single tissue of that organ, even when it depends on a cause which has effected an alteration in the fluids—as in the case of small-pox. If, then, the practitioner make use of his senses, and find out the primitive seat of the disorder, and if especially he ascertain the exciting cause of this rising disturbance, he succeeds most usually in arresting it, and the malady is stifled in its cradle. It is thus that the new French method has reduced, in a man- ner truly wonderful, the number of severe fevers, or rather of those bad symptoms which are indeed now seldom met with, ex- cept where assistance has been tardily given, or where it has been entirely rejected. This is a fact well known 3 it is attested by all practitioners who have to deal with fever in the hospitals, civil and military. Tt is rare now to find among them any general or es- sential fevers ; they are all reduced to affec- tions simply local. But what particularly distinguishes this 249.—x. method is, that it rejects no means, how em- pirical or powerful soever they may appear. We do not become bound to employ only one kind of remedy, for we believe that all kinds have their proper uses ; but we take pains to appreciate their effect, and to accommodate them to the susceptibility of the organs dis- turbed. The action of the modifiers of the constitution is our constant study, and their effects on motion and sensation, our guide in estimating their value. Whatever is inju- rious to the case in hand is thrown aside ; but we do not reject its possible use in other cases. Thus we have no system a priori, no pre- conceived ideas, no oath in verba magistri. If we have adopted for our guide the irrita- tion and ab-irritation of the tissues, it is be- cause we cannot by any possibility find others better. We intreat you, gentlemen, that you will each individually reflect upon this subject, and ask yourselves how you generally judge that the prescription of your physician is or is not suited to your complaints : if you feel more fever, more agitation, less repose, and more suffering, you say to him, “ your re- medy, sir, does not appear to me to be suited to my case ;” if you feel, on the contrary, more calm, less agitation, and less suffering, you say to him just the reverse, and express all your gratitude. Well, then, gentlemen, these modifications, which you have each of you experienced, resolve themselves ulti- mately into the simple facts of motion and sensation, (le mouvement et le sentiment') and the system which we pursue is nothing more than the interpreting their indications in maladies. But perhaps you will say, have we not had this system from the earliest times, and has it not been practised by all the sects ? Common sense would suggest such a question : the truth, however, must be told—it has not been so. In a large num- ber of cases it was usual to say to the sick, “ have patience, it is the remedy that is operating.” In others, as in the gout, for example, the expression was, “ I can give you no relief—your sufferings are necessary for nature’s purpose, and you must bear them.” In divers acute diseases, where the remedies only augmented the fever, and the other bad symptoms, in place of soothing him, the practitioner would congratulate the patient, and tell him that it was necessary to keep up the natural powers, in order to effect a salutary crisis. How often have unfortu- nate creatures, parching with thirst, and dying for cold drinks been obliged to gorge themselves with hot draughts, which they rejected with horror ! This has been the practice, gentlemen, not very far away from you. Before the cholera reached France, it was treated in this way : it was only with the greatest difficulty, and by dint of unde- niable success, that the physicians of the 3 B](https://iiif.wellcomecollection.org/image/b22394448_0019.jp2/full/800%2C/0/default.jpg)
