Therapeutics

“It was in the late 1860s and the 1870s that medical therapeutics in America in some respects began to look more like the practice of the early twentieth century than that of the early nineteenth. This gradual transformation involved no sharp break with past practices. Such new remedies as chloral hydrate, the bromides, and the salicylates came into common use, as did hypodermic injections and a revived enthusiasm for the therapeutic uses of electricity, but new drugs and techniques seldom fully replaced older ones. . . . A portion of the physician’s exhibition of activity in controlling disease was transferred from therapeutic intervention to a self-consciously active vigilance. Treatment was gradually redirected toward altering specific physiological processes rather than changing the general equilibrium of the body. . . . In general, physicians used fewer drugs but aimed them more narrowly at manipulating specific physiological processes. . . during the 1870s and 1880s many physicians became preoccupied with temperature. . . Many physicians became absorbed with normalizing high temperature. . . The therapies commonly employed in the 1870s and 1880s gave physicians more sensitive control of many physiological processes than they had possessed early in the century. Salicylic acid and subcutaneous injections of morphia mitigated pain; chloral hydrate and the bromides produced sleep; and aconite slowed the pulse. Furthermore, the physician could monitor bodily processes and identify deviations from the norm not only by measurements of temperature, respiration, and pulse and by such techniques as sphygmographic tracings, but also by quantifying, for example, chemical constituents of urine” (Warner II, 100-102).