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,

physicians 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might be entirely superseded.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.





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