Omaha daily bee., 1919-10-26
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NV AuuS Oh nCUHuxs
The medical schools are about to
reopen. A new generation Of stu
dents Ia about to reap the first of
the harvest which has ripened in the
days of war. We are at the begin
ing Of a new era In the prevention
and the knowledge of disease. writes
the medical correspondent Of the
London Times.
To those who have labored long
for recognition of the new ideas, 1t
seems almost as If a miracle had
happened. Views which were scout
nized as fundamental. 1t is worth
while to understand what has
wrought this great change.
Until the war began medicine was
weak in that its findings were not
often put to the test. Opinions
might be expressed and confirmed
without relationship to the necessi-
ties of life. A man, for example, with
a murmur in his heart, might be
told that he had heart disease and
made to live a quiet and easy life.
II he succeeded in keeping alive, a
victory for diagnosis and treatment
was apt to be claimed. In the same
way symptoms Of various kinds
were classified and dealt with, and, if
the victims managed to 60 on, the
results we're regarded as good. 1t
was too often enough to cure aches
and pains and to recognize states in
which no cure could be expected.
But with the war new. demand
was made on medical knowledge.
Blunt questions, for example: is
this man fit for active service?" had
- h. -
answer was going to be written
the man wherever he went. In
month or two it was going to be
proved or disproved.
In that day medical men realized
suddenly how inadequate their
knowledge was in a direction that
was clearly of great Importance.
And then all kinds of unexpected
things happened. Men with appar-
emily sound hearts broke down with
all the Symphonic of cardiac failure;
men whose hearts had aroused anx-
iety, passed easily through fiery
trials These, Of course, were in
stances; in other instances the dag
lnosis given at the beginning proved
to be correct.
1t was a stern test, and it opened
the professional mind. At once the
point of view changed. The i'm
portance of prognosis, that is to say,
of medical prophecy, became evil
dent. But prognosis is built upon
knowledge of what has happened to
other people with the same symp-
toms, not upon mere theoretical
ideas Of what this or that signsmust
mean. 1t was necessary to study
disease from a new angle--its rela-
ton to functional efficiency. No
matter how great a departure from
standard particular symptom
might appear to be, II it did not in
terfere with action, with function,
at the moment and subsequently, it's
significance was small. On the other
hand, Limitation of function point
ed to disease. This might not be
capable of being detected-so that
the man was "organically sound"
from the old point Of view. It was
nevertheless certainly present The
army had no use for the man: it
had use for the man with symptoms
and signs which did not interfere
with his activity.
Investigation later revealed the
great Importance of a history Of in
lection or intoxication-teeth, tom
sis, rheumatic fever, scarlet fever,
typhoid, syphilis. malaria, dysentery,
trench fever, auto-intoxication, and
so on. Victims of infection tended
to become functionally inefficient
without marked sign or symptom. A
new interest was awakened in the
prevention Of infection, in it's cure,
and in the means of increasing bod
lily resistance to it. 20
The issues are clarified now, and
the student will find his medicine
falling naturally into three groups.
First there is the prevention of dis
ease. on which a new stress is being
laid; then there is the search for
| cures OF disease, that word being
used in the sense in which salvar-
san Is a cure for syphilis. Finally
| there are the means by which the
natural powers of the body can be
augmented, so that disease will not
gain a footing or will be expelled.
| At the very bottom Of the list comes
| much Of the medicine of the past,
the attempts to tinker up an already
undermined constitution and the
treatment of symptoms where the
! underlying cause has passed beyond
treatment.