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May 28, 1938

Treatment of Some Chronic and 'Incurable' Diseases

JAMA. 1938;110(22):1861-1862. doi:10.1001/jama.1938.02790220063034

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The adjectives employed in the title are intended to suggest that the current therapy for these conditions is either unsatisfactory or completely ineffective. Important causes of our ineptitude of therapeutics, the author contends, are the anatomic designations of and outlook on diseases and the struggle for the unification of etiology. Anatomic localizations are correct for traumas but do not help the progress of the therapy of disease, especially chronic disease. One should not say of a patient that he has a disease of the joints but rather "this sick person has maximal symptoms in his joints." The attempt at the unification of etiology is equally obstructive to progress. There are two dicta in etiology which deter therapeutic progress: (1) the like cause, the like effect; (2) all symptoms must be referable to one etiologic event. These are unutterably stupid. The like cause, a wetting, may induce pneumonia in one man

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