The Health Blog

Thus you see that drugs are inseparable from medicine. With only a few of them does the profession expect a cure. In the case of many diseases which have increased in importance, while the infections have taken a back seat, the most we claim to do is to help. We do not cure heart disease with digitalis, but by slowing and strengthening the beat we give the heart rest and help it to work more efficiently. There are many good drugs which are not used to influence disease directly. Such are the anesthetics, the pain killers, and those which quiet the nerves.

It is difficult for the individual physician to form correct judgments as to the value of drugs. Impressions are not reliable. Any “herb woman,” such as Mrs. Todd in Sarah Orne Jewett’s Country of the Pointed Firs, has great certainty as to the value of her simples and may be perfectly genuine in her beliefs. The greater number of human diseases is self-limited and a few happy coincidences after taking medicines are unduly convincing. Long series of cases, careful observations, and good recording are necessary before conclusions can be reached.

The conscientious physician may get great help from the Council on Pharmacy and Chemistry of the American Medical Association. Practically all members of this group are professors in leading medical schools. Conscienceless quacks and also well-meaning, over-enthusiastic physicians are forever reporting the virtues of new medicines. The Council investigates most of these.  The quacks usually have mixtures of no virtue but also of little harmful quality. It would be dangerous to poison their “clients.” Honest men may be wrong, however, so the Council checks on them. There is a weekly report in the Journal of the American Medical Association and also a book of New and Unofficial Remedies.

The great mistake of the therapeutic nihilist who decries the use of nearly all drugs is that he ignores what has long been spoken of as the influence of mind over matter. What nearly every human being, whatever is wrong with him, believes is that the proper medicine, if it can be found, will help him out of his difficulties. So, when he goes to a doctor, he expects that doctor to make a try for the correct drug. There is no folderol in his mind about self-limited diseases and the healing power of nature. The doctor knows that, and he, himself, being human, has the same feeling. So he writes a prescription or two, which in these days involves no picayune financial transaction. The doctor is not so foolish as I may have made him seem. There is a school of thought that feels that all protective devices of the body are largely dominated by the mind. Long ago Dr. Walter B. Cannon, in his Bodily Changes in Pain, Hunger, Fear, and Rage, laid the foundation for this. The theory has been much elaborated since. Although the whole system takes part, the brain, pituitary, and adrenals seem to play the leading parts. The doctor, with his confident ordering of medicines, appeals to the patient’s mind and sends him optimistically into battle.

An interesting commentary on all this has just come to me in a recent number of the Journal of the American Medical Association. Dr. Emil Novak, the eminent Johns Hopkins gynecologist, wrote an article suggesting that few women need a sex hormone for the symptoms of the menopause, and those who do should take them by mouth rather than by injection. A physician wrote in to the editor taking exception to Dr. Novak’s ideas and outlining his own handling of such cases. This was most definitely psychotherapy with numerous visits for education and reassurance. He concluded: “Why not do all this without the injection? First of all, in the beginning, the patient would not return. The ‘shot’ gives a ‘respectable’ hook on which to hang the visit to the doctor and it is up to the physician to give the proper weight to the injection.”  The letter, only a small part of which I have given you, suggested a conscientious, earnest physician, and I am sure that his patient was in good hands. But one cannot help feeling that psychotherapy could be used without such adjuncts.

This discussion has had to do with the using of drugs by physicians. What about the many millions of dollars worth purchased by the public on their own (and the cost added to the statistics on the high cost of medical care)? Naturally physicians do not approve. When their automobile engines act badly, they turn them over to mechanics, skilled in such matters. They argue that the human body is fully as valuable as an auto engine and its complicated mechanism more difficult to adjust. But I am afraid that they are not credited with pure disinterestedness. The president of a large university remarked to me a few years ago: “I see that now that the public can get without a prescription an antihistaminic to use against colds, the profession finds objections to its use.” Anti-histaminics have not fulfilled their promise, but I still feel that the president knows a lot about education. My own feeling is that as we approach the millennium and you stop dosing yourselves, you will then require mighty little doctoring.

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GENERAL HEALTH