On Some Points in the Pathology and Treatment of Typhoid Fever (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: LECTUEE III. Treatment. In estimating the value of any particular mode of treatment, we base our judgment on two classes of facts. First, by the observation of individual cases we see whether it appears to relieve the symptoms and exercise a favourable influence on the course of the disease. Secondly, we apply the test of statistics, and by collecting a great number of instances, we ascertain the effect on the general rate of mortality. Now, both these methods are open to many fallacies. In the first place, if the observer be not familiar with the natural course of the disease, and the various deviations which are liable to occur, he is apt to ascribe to his remedies what is really the unaided effect of nature; secondly, he may confound temporary amelioration with permanent benefit, and may thus incur the danger of relieving urgent symptoms at the expense of diminishing the chances of ultimate recovery. Both these mistakes have frequently been committed in the treatment of typhoid fever. Thus the early recovery of the abortive forms has repeatedly been ascribed to the effects of remedies, as calomel oremetics. Again, the great relief which bleeding often gives to the urgent symptoms of this as of other acute febrile diseases has in former times caused it to be extensively practised, with the effect of greatly increasing the mortality. The second method is still more open to fallacy, so that it is often said in opprobium that anything may be proved by statistics. But, nevertheless, they form the final test by which all modes of treatment must at last be decided. The fallacies of statistics depend on two main errors; first, an insufficient collection of facts; secondly, the comparing together of unlike instances. We must, therefore, in applying this test, talce care to comp...