Aphorism 58

The Aphorism 58:

§ 58

If, in estimating the value of this mode of employing medicines, we should even pass over the circumstance that it is an extremely faulty symptomatic treatment (v. note to § 7), wherein the practitioner devotes his attention in a merely one-sided manner to a single symptom, consequently to only a small part of the whole, whereby relief for the totality of the disease, which is what the patient desires, cannot evidently be expected, – we must, on the other hand, demand of experience if, in one single case where such antipathic employment of medicine was made use of in a chronic or persisting affection, after the transient amelioration there did not ensue an increased aggravation of the symptom which was subdued at first in a palliative manner, an aggravation, indeed, of the whole disease? And every attentive observer will agree that, after such short antipathic amelioration, aggravation follows in every case without exception, although the ordinary physician is in the habit of giving his patient another explanation of this subsequent aggravation, and ascribes it to malignancy of the original disease, now for the first time showing itself, or to the occurrence of quite a new disease1.

1 Little as physicians have hitherto been in the habit of observing accurately, the aggravation that so certainly follows such palliative treatment could not altogether escape their notice. A striking example of this is to be found in J. H. Schulze’s Diss. qua corporis humani momentanearum alterationum specimina quoedam expenduntur, Hale, 1741, § 28. Willis bears testimony to something similar (Pharm. rat., § 7, cap. I, p.298): Opiata dolores atroscissimos plerumque sedant atque indolentiam – procurant, camque – aliquamdiu et pro stato quodam tempore continuant, quo spatio elapso dolores mox recrusescunt et brevi ad sol itam ferociam augentur. And also at page 295: Exactis opii viribus illico redeunt tormina, nec atrocitatem suam remittunt, nisi dum ab eodem pharmaco rursus incantuntur. In like manner J. Hunter (On the Venereal Disease, p.13) says that wine and cordials given to the weak increase the action without giving real strength, and the powers of the body are afterwards sunk proportionally as they have been raised, by which nothing can be gained, but a great deal may be lost.

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