The same form of irritation may quiet, excite, or paralyze the action of an organ, according to the size of the dose. This point must be given equal attention, whether the treatment be dietetic, physical, or medicinal. A morbid increase in function does not as a rule lead to an increase of the combined activities of the organism. Treatment will usually diminish the function in the beginning. In general, then, the lessened activity of the organ will result in its regulating its own activity. Later, this is accomplished by diverting work to other systems, whose activities become greater. The removal of the irregular, disease-pro ducing stimuli, on the other hand, permits of an increase of the func tional ability of the diseased organs through use. It is particularly characteristic of the youthful organism that its functional ability fluc tuates in far greater amplitude around the normal than does that of the adult, inasmuch as its activities may be considerably increased without injury. The organism, by making use of this, brings about it permanent augmentation of its There is also a far greater power of regeneration in the diseased organs than exists in the adult.
Even though the therapeutist is compelled to hold to these theoret ical explanations, they do not give him any information regarding the measures which should be taken. The mutual relations of the different functions of a single organ, and the relations which exist between the functions of the different organs, are too much involved to allow their scientific basis to be of much use for practical deductions. Since therapy as a rule emanates from empiricism, confusion and uncertainty will exist for a time; meanwhile, the estimation of individual methods of treatment fluctuates between high favor and neglect.
To him whose highest aim continues to be the curing of the sick, however, it would be as difficult to give up the striving for scientific knowledge as it would be for a lover of theory to give up a remedy which has given him good results, because its mode of action is not thoroughly understood. Careful observation must, in every instance, ascertain the mode of action and the strength of the remedy, due con sideration being given on the one hand to the strength of the drug and method of administration, and on the other to the age and individuality of the patient and the character of the disease. As a rule, drugs should not be combined in such a manner as to interfere with the action of any one of them. The desired insight into the action of the treatment is usually more readily obtained with physical than with chemical methods; and in any ease, with the latter one should avoid unnecessary and un certain combinations. There are no remedies which are harmless in all cases. When a remedy is in general capable of causing irritation, it is possible, by using too large a dose in relation to the reactive powers of the patient, to injure the vitality of the organism. This holds true not only for chemical and physical remedies. but for physiological stimuli (atmospheric influences) and for external stimuli generally.
In childhood much more than in adult life, does the success of a favored method of treatment depend upon the accidental surrounding condition of the patient. For example, it is possible to obtain the effects of a drug prescribed for internal use only if the drug can be administered so that it will be retained and not be expelled by vomiting. Even then failure may occur if the taste of the drug is such as to cause loss of appe tite. The successful treatment of sick children is possible only through broad and practical experience in this department. reaching beyond the limits of mere care of the patient. A more intimate knowledge of the child's mental state. and its practical application in the field of pedagogy is particularly important. In the treatment of the child, the physician is dependant upon the cooperation of the adult who accom panies the patient. If ignorance is the greatest danger to health, then it is present here in a most marked degree. In just the measure in which those who surround the child can be freed from bigotry and error and can be led to the observation of the objective symptoms. the treatment will be sought at the proper time, and the measures will he carried out to prescription and eontinued for a suflieiently long time. The physician can and should, during the treatment of the child, do his share by advice and practical instruction in this regard.
We will flow take up the general subject of the treat ment of chil dren's diseases, in the following regular order: Noinishment, Nursing, Psychotherapy, Physical Treatment (particularly climatic, and hydro therapy and halneotherapy), Mechanotherapy, combined Physical Therapy, and, filially, Pharmacotherapy.
N ourishment.—Nouritmient is an important factor, not only in diseases of the gastro-intestinal tract, hut in a greater or less degree in all diseases. Very young, and feeble children, particularly when ill, suffer from defective or deficient nourishment. The general condition is improved by an abundance of food, which produces an improvement in the circulation and innervation, and an increase in metabolism, and causes the secretory and excretory functions to approach the normal. The nutrition of one organ being improved, the diseased organ often shares in it, and in this way is supported and is helped to fight against the harmful effects of the disease. Moreover, it must not be forgotten that an improvement of the symptoms during ihe course of a disease or of a disease symptom (such as fever) may not he due to the improved nutrition; but that, on the contrary, the improved nutrition must be looked upon as the indirect result of the improvement of the symptoms. Whenever in such a case there is improvement in the appetite, and the increase in weight begins only after an improvement in the symptoms of the disease, the connection existing between cause and effect is often indistinct, or perhaps cannot be distinguished at all, and the significance of the nourishment may lie falsely interpreted.