GENERAL THERAPEUTICS IN DISEASES OF CHILDREN It is true that during the last decade, with the increase of our clin ical knowledge, which has been accompanied by a refinement of diag nostic methods and a better understanding of the etiology of disease, some progress has also been made in the treatment of disease. But in spite of all this, the great and intricate apparatus of our modern therapy must even now be virtually content to improve and alleviate the condi tion. When, through disease of a greater or lesser organ complex, the Physiological limits have been transgressed, it becomes the task of therapy in general to cause a return to those limits. The stimuli which are supposed to be the cause of all vital energy are capable of percepti ble increase or diminution. It would be necessary merely to discriminate between the unnatural and the natural stimuli, were it not for the evil influences of the environment with which, for all time, we have been surrounded and which therefore, up to a certain point, become physio logical. These influences are not to be looked upon solely as a menace to the human organism; but also as an agent for hardening and ele vating the powers, especially during the period of development.
In the practical application of the foregoing, by means of the etio logical factors, we will always differentiate between extraneous chemical and physical stimuli, and an abnormal increase or diminution of physio logical stimuli. Thus, the functions of the intestines may be disturbed on the one hand by the ingestion of decomposed food or even poison, and on the other by an overloading with ordinary food. In the one case the foreign ingcsta will he removed or neutralized, and in the other the usual supply of food will be decreased. The principle involved in the removal of external irritation, of either a chemical or a physical nature, being readily understood, it is unnecessary to dwell upon it further.
The treatment of functional abnormalities (to which, after all, it is possible to refer all diseases) must take into consideration the follow ing limitations of therapeutic stimuli: In the first place, the functional activity of the developmental period of the human organism must be regarded differently from the later period.
The sensitiveness of the intestinal tract in infancy, and of the nervous system in infancy and at the time. Of puberty, should be remembered.
Secondly, owing to heredity, it is not infrequently the case that the functions of certain organs or systems are front the beginning irritable in an abnormal degree, and these may show morphological changes, or even degenerations. The nervous system furnishes particularly good examples of functional itwompetency.
Thirdly, the irritability of a system may be entirely changed from the normal, whether through habit or as a result of disease, without the system necessarily being functionally incompetent. This is illustrated by the skin, where a tendency to sweating may occur, owing to exposure to the heat of summer, or to the various procedures used in the produc tion of diaphoresis, or after rheumatism. This tendency is apt to create a sensitiveness to a rapid cooling off; but, on the other hand, by insti tuting proper measures for hardening the system, this can be overcome.
Fourthly, and lastly, the abnormal irritability which exists during disease must be taken into consideration, in so far as it may influence the strength of the reactions of the therapeutic stimuli. Disturbance of function manifests itself, as a rule, by an increased irritability, whereas a paralysis of function is the forerunner of certain death of the organ. In the stage of diminished irritability, stimuli which ordinarily have no perceptible effect that can be roughly demonstrated, may under certain favorable circumstances have a distinct action, usually physiological; and, in a more marked degree, abnormally strong stimuli may injure or even destroy function.