Medicine: Block That Pain

Quacks have always preyed on those who believe that banishing the malaise cures the malady. But to doctors nowadays, concerned with basic cause and cure, "mere relief of a symptom looks petty and the problem . . . seems a bore."

So says Dr. Walter Modell of Cornell in The Relief of Symptoms (W. B. Saunders Co.). The book's point: doctors must try not only to find a long-range cure but to give immediate relief. Otherwise, patients may be driven to the charlatan. Author Modell lists symptoms that should be treated at once, whether or not the basic trouble can be cured. Samples:

Insomnia, one of the most common complaints, usually originates in the mind rather than the body. Occasional bouts can be treated with drugs (which have become so popular that a woman patient debated: "I don't know whether to take a Benzedrine and go to a party or take a Seconal and go to bed"). But the chronic variety requires a plumbing of the patient's psychological difficulties. Modell also suggests some nonmedical remedies: changing sleeping habits, eating before bedtime, swigging a nightcap, reading in bed. Counting sheep is not much help.

Gas in the intestines is perhaps the least polite symptom doctors have to deal with, and one for which, says Modell, there is no precise term now in decent usage. When, as commonly, it is caused by swallowing air, it is simply embarrassing. But it may also indicate loss of intestinal muscle tone, especially when vomiting or excessive belching results. In such cases it can usually be relieved by heat applications, enemas or drugs.

Difficulty in breathing (dyspnea) is one of the most disturbing symptoms, and may indicate serious disease, e.g., asthma, pneumonia, congestive heart failure, anemia. Morphine provides quick relief, but may be dangerous. Other remedies, depending on the cause: adrenaline, blood transfusions, oxygen, removing obstructions from the windpipe.