Treatment—review of a Medical Concept

Abstract

When Oliver Wendell Holmes (1) wrote, "It, is a physician's privilege to cure seldom, t,o relieve often, and to comfort, always," he was unaware of the t,remendous advances which were about to be made in medical treatment. Today we can aptly paraphrase his statement t,o read: It is t,he physician's privilege to cure often, to relieve almost always, and to comfort always. However, t'he inclination to focus our therapeutic sights on the goal of cure has tended to obscure the fact t,hat t,o give a helping hand and to comfort always are ideals of which tJhe practicing physician can well be proud. In this communication, we present a variety of concepts of treatment, rather than specific processes and procedures. The dynamic significance of certain treatment concepts is likewise explored. Holmes' words serve well as a background for this approach.Contemporary ideas of treatment are by no means completely separated from modes of thought that seem more appropriate for primit,ive or pre-literate societies. The early development of medicine even in civilized communities centered around a priest-doctor. The union in one person of the powers to communicate with the supernatural and to heal was somewhat disrupted by the developments in pathology, chemistry, bacteriology and ot,her scientific achievements. Thus as treatment concepts required more and more appreciation of the biologic and physical sciences, tJhere was a corresponding lessening in the significance of the priest, element in t,he priest-doct'or role. Many of the current development,s in medical philosophy or orientation, centering around such ideas as the comprehensive, ho1ist)ic or t,ot>al-person approach to therapy, are attempts to find a solution for vast numbers of medical problems that are difficult to relate to chemical, structural or physiologic dysfunction. This has led t,o various special branchirigs from t'he mainstream of medical practice, which is "organic" in its focus. Although pyschiatric disorders associated with struct>ural changes have been influenced in general by the concepts of treat,ment, characteristic of medical practice, the so-called functional psychoses and the neuroses have, in addition, been considered from viewpoints which involve varying degrees of philosophic, theologic and psycho-social frames of reference. The priestly content of the priest-doctor role is more in evidence in such treatment concepts as those developed by psychoanalysis, the various psychotherapeutic schools, or existentialism. The doctor who is almost completely devoid of priestly content is personified in the physician who deals with infect,ion and structural changes. In correcting the biochemical malfunctions of the organism he feels that t~he intricacies of the doctor-patient, relationship are not imporhnt for treat,ment aside from the cultivation of a "bedside manner." The physician who does not recognize the problems of the total person may limit treatment to such a narrow * Professor and Chairman, Department of Psychiatry and Neurology. 883 HARRY H. GARNER Vo...

Factors Influencing CVA Patients to Seek Rehabilitative Care

“…In the field of chronic illness, in which early diagnosis and care are widely urged, evidence is increasing that the socioeconomic and be¬ havioral patterns of long-term patients, their families, and their physicians tend to prevent satisfactory use of existing medical knowledge and community facilities (1)(2)(3)(4)(5)(6)(7)(8)(9). In at least some areas of the United States, for example, rehabilitation centers are inefficiently used be¬ cause patients wait too long before applying for admission (7).…”