Memoirs of John Abernethy: With a View of His Lectures, His Writings, and Character; with Additional Extracts from Original Documents, Now First PublishedMacilwain, George
Science
Memoirs of John Abernethy: With a View of His Lectures, His Writings, and Character; with Additional Extracts from Original Documents, Now First Published
Macilwain, George
Abernethy, John, 1764-1831; Physicians -- Great Britain -- Biography
I cannot go on with the multitudinous illustrations of these
principles. The law is to determine injurious influences to the
surface. Deposition in the cellular tissue of the lung is bad enough;
but it is better—that is, less certainly fatal—there, than in the
respiratory tubes: and that is the explanation.
But now comes the practical point. How is the primary organ to be
got at? because that is the way to carry out the removal of the
impediments to the sanative processes of nature, which, in many cases,
no _mere general_ treatment can accomplish. This is to be found by an
examination into the _whole_ (that is, the former _as well as_ the more
recent) history of the case, and adding the further test of a real and
careful observation of all the secretions.
By going back to the former life of the patient, we shall seldom fail
to discover the various influences to which he has been subjected, and
the organs to which they have been originally addressed. Having made up
our minds, from our previous knowledge of injurious influences, on what
organ they will most probably have acted, we now test this, not merely
by inquiry after symptoms—and it may be not by symptoms at all—but
by careful observation of the _actual work_ of the suspected organ.
In this way we almost certainly discover the real offender; in other
words, the organ primarily affected. This is of immense importance;
for we confidently affirm that _one single beneficial impression made
on it_ will do more in a short time—nay, in some rare instances,
_in a single day_—than years of routine treatment, that has been,
nevertheless, of good _general_ tendency.
In treating it—_i. e._ the primary organ—however, great
discrimination is necessary. If it be already organically affected,
that treatment which would be, under _other circumstances_, necessary,
becomes either objectionable, or requiring the utmost caution.
For although an organ _diseased in structure_ will, under some
circumstances, as Abernethy long ago observed, yield its characteristic
secretion, yet, unless we know the _extent_ of the disease, which is
just the thing we can almost never be certain about, excitement of
it is _never without danger_. We should therefore excite the primary
organ with more or less energy, with more or less caution, or _not at
all_, according to circumstances. If we determine on not exciting it,
we should then act on organs _with_ which it has ordinarily closest
_community_ of function, or on whose integrity we can most depend.
For choice, we prefer organs which, in a natural state, have nearest
identity of function, as having the readiest sympathy, it may be, with
each other. Yet so universal is the sympathy between all the organs,
that there is no one that will not, under certain circumstances, or
which may not be induced, perhaps, by judicious management, to take on
_compensating_ actions.
Public-domain text, read in full here on John Shaqi.
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