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I may venture to add one more question: In the surgery of the future the individualist will what occupation does he follow? Wright) of that broader ﬁeld of experimental pathology to which all the medical sciences belong buy cheap femara 2.5mg online womens health protection act. Dr Virginia Ramirez de Barquero Annals of Surgery : () Costa Rica health ofﬁcial We trust the drug companies generic femara 2.5mg with amex menstrual itching. University of California Press, Berkeley () Diseases are the tax on pleasures. English Proverbs Santiago Ramón y Cajal – Spanish physician, professor of histology, and Nobel Prize Theodor Reik – winner German psychoanalyst It is idle to dispute with old men. Charlas de Cafe Attributed · Paul Reznikoff –? Their aims are entirely different—science If you want to get out of medicine the fullest tries to ﬁnd out how, religion deals with why. Attributed Attributed Sydney Ringer – Rhazes (abu-Bakr Muhammed British physician and physiologist ibn-Zakariya al Razi) – A man is a fool who holds two hospital Persian physician (Baghdad school) appointments. When the disease is stronger than the patient, the Quoted in Dictionary of Medical Eponyms (nd edn), p. Attributed French humanist and satirist Everyone complains of his memory, none of his judgment. To preserve one’s health by too strict a regime is in Foreword in Atlas of Nutritional Support Techniques. The doctor has to be within thirty inches Apparatuses are cleverer than men and anyone of the patient. Transactions of the Association of American Physicians : Quoted in Dictionary of Medical Eponyms (nd edn), p. Ross – Viennese pathologist Any fool can cut off a leg—it takes a surgeon to The axiom of medicine is that natural science is its save one. Attributed Handbook of Pathological Anatomy Sir Ronald Ross – Widespread experience in the ﬁeld of pathological British professor of tropical medicine and discoverer of anatomy must be the foundation, unless the the cause of malaria whole procedure is to eventuate in deception. I must have examined the stomachs of a thousand mosquitoes Humphrey Rolleston – by this time. Must I no longer share child mind, the savage mind, and the traditional Good wine or beauties, dark and fair? Churchill Livingstone, Edinburgh () French writer Every man who feels well is a sick man neglecting Francis Peyton Rous – himself. Tumours destroy man in a unique and appalling way, as ﬂesh of his own ﬂesh, which has somehow Romanian proverb been rendered proliferative, rampant, predatory If you wish to die soon, make your physician and ungovernable. Report of the Special Health Commission, transmitted to the A Discourse Upon the Origin and the Foundation of the New York Legislature, February () Inequality Among Mankind Pt () It is common sense to take a method and try it. If Teach him to live rather than avoid death: life is it fails, admit it frankly and try another. Isabel the birth tenderly and with her annointed hands, Hapgood) so that it may be reduced again to a natural birth. Everybody knows how to bring up Letter to Dr David Hosack, August () other people’s children. Address at a Hernia Conference, Newport, Wales, May The Crown of Wild Olive () The work of science is to substitute facts for appearances, and demonstrations for impressions. If I were a medical man, I should prescribe a holiday to any patient who considered Saki (H. British novelist and short story writer The Autobiography of Bertrand Russell Vol. Oxford University Press, Oxford () Robert, Marquis of Salisbury – English statesman and author Frederick Saunders – Doctors are a social cement. The language of the men of medicine is a fearful Science : () concoction of sesquipedalian words, numbered by H. British Journal of Surgery : – () The physician that bringeth love and charity to the sick, if he be good and kind and learned and George Santayana – skilful, none can be better than he. Sayers – Science is nothing but developed perception, British crime writer interpreted intent, common sense rounded out If accidents happen and you are to blame, take and minutely articulated.
Train a man in the popular belief of idiosyncrasies generic femara 2.5mg on-line menstrual after menopause, inscrutable providences purchase femara 2.5 mg visa menstruation cycle calendar, et id omne, and why should he give much thought to the study of disease. This prescribing for the sick is a random business at best, and he fires his Materia Medica at his patients, expecting by some lucky shot to hit the disease; if he should happen to knock the patient into the next world - is there not an inscrutable Providence? But the physician need not fire wholly at random, he may fire in platoons - fire and fall back. For instance, in all diseases, excepting those attended with diarrhœa, he may fire the class cathartics at his patient, and continue so long as the patient has bowels to respond. He will find on turning to his text-books, a mass of authority to sustain him in this course, much further indeed than he dare go. Or he may charge his patient with emetics, supplement these with diaphoretics and diuretics, with a skirmish line of Quinine and Opium. Or he may make a hodge-podge of them all - a grand corps de battaile - and assault the enemy flank and rear. Of course the patient has no need of stomach and bowels for the digestion of food whilst sick. As he is sick, the unpleasant sensations that attend and follow such giving of medicine, need not be taken into account. As there is disturbance of all the vegetative and vital functions in disease, the additional disturbance by medicine is a matter of small moment. Have we not the testimony of ages of authority - that “this is the way, the truth and the life? But it is not of random medication that we want to talk, further than to adorn our moral and point this tale. The absurdities of old physic are patent to all, a matter of every-day experience; we want to learn a better way, if there is one. The first phase of Specific Medication is so plain, “that he who runs may read;” it appeals directly to every man’s experience and better judgment; and it needs but a clear presentation to obtain the assent of every man, not governed by prejudice. This unit of life that constitutes a living man is clearly divisible, and is divided by physiologists into several parts, which may be studied separately, and for each of which we have a standard of healthy life. Thus, we study the circulation of the blood, respiration, digestion and blood-making, nutrition, waste and excretion, as well as the structure of the blood, and the solids, and the essential conditions of life - heat and electricity. And as we study these separately in health, that we may fix in our mind a healthy standard of life, so we study them separately in disease that we may know its exact character. We see that the departure from health must be in one of three directions - above, below, from - or according to the classification of Dr. The first lesson in specific diagnosis is to recognize the separate lesions which compose a disease, and classify them as named above. We say, that at once a rational treatment is suggested, but this is only so, to one who has given the subject some thought; the old therapeutics shed but little light upon it. Now, it is but a simple application of common sense to say, that if we desire to influence the circulation of the blood, we shall select a remedy that acts upon the circulatory system, and not one that acts upon the bowels, skin, kidneys, brain, or other parts. And it is only one step farther to say, that the remedy should be selected with regard to the character of the lesion - if in excess, that it will bring it down - if defective, that it will bring it up - if perverted, that it will correct it. This, the reader will see, is but the application of logic to the practice of medicine. We want precision of observation, and thus applying the unvarying rules of logic, we reason to correct conclusions; and a practice thus based must be right. You can’t call this theorizing - it is plain matter-of-fact - clearly demonstrable in its premises and conclusions - and as absolutely true at the bedside as in the lecture-room. The second lesson in specific diagnosis is to determine the relative importance of these lesions. We want to know which stands first, and serves as a basis - we might properly call this the basic lesion - and then the relative importance of others which have grown upon it. When we come to study the “second phase” of specific medication we will find this to be a principal feature. We can best illustrate this lesson, by reference to cases: - For instance, many simple fevers and inflammations have as a basic lesion, the disturbance of the circulation, and the increase of temperature; arrest of secretion, loss of appetite, digestion and nutrition, depravation of the blood, and derangement of innervation, are based upon them.
We want a competent materia medica; the fewer the remedies the better cheap 2.5 mg femara with mastercard bendigo base hospital women's health, so they answer our purposes buy femara 2.5mg low cost womens health littleton. We want each to have a well-defined, direct influence, so closely associated with expressions of disease, that the idea of the remedy is at once suggested by disease expression. If I were to designate a common obstetric materia medica, or remedies for an obstetric medicine case, it would be - Nux Vomica, Aconite, Macrotys, Pulsatilla, Lobelia, Gelseminum, Chloroform, Ergot, Tincture of Oil of Cinnamon, Chlorate of Potash and Phytolacca, with possibly Fluid Extract of Jalap and Senna. Here is brevity, and here is certainty as well; and whilst we can count the agents upon our fingers, a knowledge of their use will give more than ordinary success. If we commence with the functional wrongs of the reproductive apparatus that prevent conception, we will find in the first four the means that will bring about the desired result. The same prescription relieves the common menstrual suppression, tardy menstruation, insufficient menstruation, or irregular menstruation. The sub-inflammatory condition of the ovaries and uterus, that follows marriage, or is brought on by sexual excess, is usually relieved promptly by - ℞ Tincture Aconite, gtt. The unpleasant feeling of fullness and weight in the pelvis, with hypogastric pain, that is associated with menstrual irregularity, is cured by - ℞ Tinct. Thus we have remedies that rectify the usual functional wrongs that prevent conception, and having thus made a good commencement, we are ready to look after the ills of pregnancy. The first and most prominent of them is “morning sickness,” which sometimes goes on to persistent nausea and vomiting, endangering the health, if not the life of the patient. For the unpleasantnesses that arise during gestation, we find remedies in the same group. For pain in back and hips, extending down the thighs, we frequently prescribe - ℞ Tincture Pulsatilla, Tinct. If these pains are associated with a sense of muscular debility, we substitute Nux, as - ℞ Tincture Nux, gtt. For the unpleasant sensation of weight and dragging in the abdomen and pelvis, we use Lobelia, as we do for oppression of the respiratory apparatus, and especially præcordial oppression. False pains will be relieved by Aconite and Macrotys, or Pulsatilla and Macrotys, selecting the one or the other as heretofore named. For rigid os or perineum, we have Lobelia and Gelseminum, Lobelia if the parts feel full, Gelseminum if they are thin and rigid. Lobelia is the remedy commonly indicated, and whether the parts are full and hard or full and doughy, its influence is direct and very certain. And there is this beauty in its action - that whilst it puts the structures in better condition, both as to dilatation and increase of mucous secretion, it favorably influences uterine contraction, so that whilst more efficient, it is less painful. If there is any one remedy in obstetric medicine more useful than another, it is Lobelia (a tincture of the seed). Gelseminum is employed when the tissues are thin and tense, with want of secretion, uterine contractions being painful; and in this case it will be found to give excellent results. Unequal or irregular uterine contractions - giving tedious labors - are relieved by Macrotys; Aconite and Macrotys, if there is an excited circulation; Pulsatilla and Macrotys, if the patient is nervous and has unpleasant sensations of dizziness, or feels that “there is something wrong with the child;” Lobelia and Macrotys, if there is fullness and oppression of pulse; Nux and Macrotys, if there is constant complaint of the back, “as if it would break. Want of pain, or tardy pains, are met by Lobelia in some cases, and by Macrotys in others, the selection being made as heretofore named. The use of Ergot is restricted to the second stage of labor, and to cases of deficient contraction, want of pain, or inefficient pains. It is very certain in its action, and rarely fails to do all that a medicine will do. Ergot may be used when there is marked want of uterine contraction, though the cases are very rare. It will not do, however, to substitute medicine for the necessary attention - the removal of the placenta, the hand upon the uterine globe until firm contraction, and quiet in the recumbent position. After-pains are best met with minute doses of Macrotys, in combination with either Aconite or Pulsatilla, as may be indicated. Of course this does not arrest them, as would an opiate, but simply makes them more bearable; but the mother will get up much better than when the opiate is employed. Aconite is the remedy for milk fever; though a motion of the bowels may be solicited by any of the common means, or by the fluid extract of Jalap and Senna, named in our list. For caked breast, pains in the breast, mammary inflammation, chapped nipples, etc. For scanty or suppressed lochia, we have Aconite, Macrotys, Pulsatilla, selected according to the indications heretofore given.