Influence Of The Personality In Therapeutics
Though it has seldom been fully realized and has probably never been
appreciated as in our time, one of the most important factors in
therapeutics, in every period of the history of medicine, has been the
personal influence of the physician. Therapeutic fashions have come
and gone, new drugs have been introduced, have had their day and then
been relegated to the limbo of worn-out ideas. At all times, however,
physician
have succeeded in doing good, or at least using, with
apparent success, the therapeutic means of their own time, however
crude and inadequate these afterwards proved to be. They have
succeeded in shortening the progress of disease as well as increasing
the patient's resistive vitality and thus enabled him not infrequently
to survive where otherwise a fatal termination might have occurred.
All unsuspected during most of the time, it was the personal influence
of the physician that counted for most in all of the historical
vicissitudes of therapeusis. It mattered not that the means he
employed might seem absurd to the second succeeding generation, as was
so often, indeed almost invariably, the case, his personal influence
has at all times overshadowed his available therapeutic auxiliaries.
In spite of all our advance in scientific medicine, to a considerable
degree this remains true even at the present time, and to fail
properly to use this important auxiliary is to cripple medical
practice.
Place of Personal Influence.--When the antitoxins and directly
curative serums seemed about to make for themselves a place in
therapeusis, it looked for a time as though this personal element
might be entirely superseded. It seemed that all other therapeutic
factors must give way to definitely accurate doses of antitoxic
principles, directly opposed to the toxins of disease and capable
of conquering it. With the success of diphtheria serum, the prospects
for scientific therapeutics from the biological standpoint became very
promising. Unfortunately, our further experience with antitoxins and
therapeutic sera of various kinds has not been satisfactory, and now
the medical world is looking elsewhere for progress in therapeutics.
This throws us back once more on the old-time therapeutics, and we
have to learn to use all their elements. One of the most important of
these, if not, as we have suggested, absolutely the most important,
the one that in all the many variations of therapeusis has maintained
itself, is the personal influence of the physician by which he is able
to soothe the patient's fears, allay his anxieties, make him face the
situation calmly so that he may not use up any of his vital force in
useless worry, but on the contrary employ all his available psychic
energy in helping nature to overcome whatever disturbance there is
within the organism. This personal influence was for several centuries
spoken of as personal magnetism, not merely in the figurative sense in
which we now employ that term, but in a literal sense. The implication
was that some men possessed within themselves a reservoir of
superfluous energy, vital in character, but thought to be related to
the force exhibited by the magnet, when it attracted bodies to itself,
and made metals for a time magnetic like itself, and which actually
passed over from the physician to his patient. We have gotten away
from the idea of any physical force flowing from physician to patient,
but we know very well that certain physicians are much more capable
than others of arousing the vital energies of the patient, sometimes
to the extent of making him feel, after treatment, that he has more
force than before. The patient feels that something must have been
added to his natural powers, though he has only been brought into a
state of mind where he can better use his own powers.
It is the men whose presence created this impression in patients, an
impression that is justified by the fact that somehow he enabled them
to vitalize themselves better than before, who have been most
successful in the treatment of patients. In all ages the men of
reputation for healing have had this. A careful study of their lives
shows that this counted for more in many of the experiences of their
healing than the drugs and remedies which they employed. The men who
have been the most sought by patients have not as a rule left us great
therapeutic secrets; on the contrary, they have only employed the
conventional remedies of their times with reasonable common-sense and
have added to them their own personal influences. On the other hand,
the men who have made discoveries in therapeutics, and in medicine,
have not always been popular as physicians. They have known too much
of their own lack of knowledge to be quite confident in their use of
remedies, and this has hurt something of their personal influence over
patients.