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Rules for Recovery from Pulmonary Tuberculosis: A Layman's Handbook of Treatment
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Internal medicine deals with the prevent...)
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Internal medicine deals with the prevention, diagnosis, and treatment of adult diseases. These physicians (Internists) are skilled in managing patients who have undifferentiated or multi-system diseases. Internists are responsible for hospitalized and ambulatory patients, and often take major roles in teaching and research. Internists do much of their work in hospitals, as their patients are often seriously ill and require specialized equipment.
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Rules for recovery from pulmonary tuberculosis; a layman's handbook of treatment
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Rules for Recovery from Pulmonary Tuberculosis, a Layman's Handbook of Treatment. Third Edition, Thoroughly Revised
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Dr. Lawrason Brown was and an American physician and tuberculosis specialist. He was a resident physician at the Adirondack Cottage Sanitarium and became an internationally known specialist in tuberculosis.
Background
Lawrason Brown was born on September 29, 1871 in Baltimore, Maryland, the oldest of four children of William Judson and Mary Louise (Lawrason) Brown. He was of English and North Irish descent on his father's side and German and North Irish on his mother's. His grandfather, Charles Brown, had served as a captain in the Confederate Army. His father was a commission merchant in comfortable circumstances.
Education
After attending public schools in Baltimore, young Brown entered the Johns Hopkins University, from which he graduated, A. B. , in 1895 with academic honors and a notable record in athletics. Going on to the Johns Hopkins Medical School, he came under the influence of two distinguished teachers and leaders in American medicine, William Osler and William Henry Welch, who recognized his unusual capacity and helped to mold his professional and scholarly interests. Brown's choice of a medical specialty was determined by a break in his own health. During the third year of his medical course he was found to have developed pulmonary tuberculosis.
His faculty advisers sent him to the Adirondack Cottage Sanitarium near Saranac Lake, New York, where he became a patient of America's pioneer student of the treatment of tuberculosis, Edward Livingston Trudeau. After a year of rest, during which he himself acquired proficiency in the diagnosis and treatment of the disease, Brown returned to the Johns Hopkins Medical School, where he graduated with the M. D. degree in 1900.
Career
Lawrason Brown returned immediately to the institution where his health had been saved, to become its assistant resident physician. Promotion followed rapidly, and he soon became the dominating intellectual and professional force in this pioneer sanatorium, whose methods, developed in large measure by Brown himself, set standards in the care of tuberculosis for the rest of the country. He insisted on detailed clinical records for all patients, with accurate classification of the salient features of their illness.
He established a follow-up system for periodic observation of their progress in post-sanatorium years which made possible precise analysis of the factors responsible for their favorable or unfavorable course and served as a model for other institutions. He maintained a continuing spirit of research in clinical work and established the first sanatorial workshop of occupational therapy for tuberculous patients.
One of his principal achievements was the training of young men and women as physicians and nurses. He took special pleasure in instructing students in the Trudeau School of Tuberculosis, a graduate tuberculosis course conducted annually at Saranac Lake for physicians specializing in the disease, in which he took part up to the late years of his life. He was an able teacher, with a special gift for stimulating interest in clinical problems. Devotion to his chosen work, personal skill, and indefatigable industry all contributed to Brown's success. His industry, however, prevented him from ever achieving complete restoration to health. He was unsparing of himself in his duties, never deviating from the high standards of medical practice he set for himself and others. He resigned from his position as resident physician of the sanatorium in 1912, opening an office in the village of Saranac Lake, in order to devote his strength to his gathering national responsibilities and to the care of patients, who came to him from all parts of the country. He continued as visiting and consulting physician to the sanatorium, however, for seventeen years more, inspiring the staff and stimulating its contributions to medical science. During the years when he was by common consent dean of tuberculosis specialists at Saranac Lake, Brown had become a leader in the control of tuberculosis in the United States. He was one of the founders of the National Tuberculosis Association in 1904 and its president in 1922-23. He was a founder and guiding spirit of the closely related American Sanatorium Association and its president from 1919 to 1923. This association, largely under his stimulus, advanced clinical research and improved the quality of tuberculosis treatment in all American sanatoria.
Brown was a pioneer in the roentgenogra-phic diagnosis of pulmonary and intestinal tuberculosis. His emphasis on the frequent symptomless character of tuberculosis of the bowel led to notable advance in the diagnosis of this common complication of the pulmonary disease. He contributed about 150 articles to medical journals and texts. Among his most influential writings were several for tuberculosis patients.
He organized in 1904 a journal for patients, the Journal of the Outdoor Life (later the official organ of the National Tuberculosis Association), and wrote a small, widely-read treatise entitled Rules for Recovery from Pulmonary Tuberculosis (1915), which passed through six editions. His scholarly interests were expressed in an historical work, The Story of Clinical Pulmonary Tuberculosis, published posthumously in 1941. He also contributed to medical knowledge by collecting funds for the publication of the important monograph The Lung (1937) by William Snow Miller.
Brown was a strong character, decisive in opinion and action, encouraging clear thinking and short with vacillation.
Brown died at Saranac Lake of his long-standing tuberculosis at the age of sixty-six and was buried in Pine Ridge Cemetery there.
Lawrason Brown was a firm disciplinarian in the enforcement of rules for hygiene, rest, and regularity of treatment. Brown's professional skill was supported by an unusual capacity for organization. He not only directed the medical activities of the sanatorium (later renamed the Trudeau Sanatorium, in honor of its founder) but increased the effectiveness of its fiscal management and clinical record system.
Believing it important that patients taking the rest cure keep their minds occupied, Brown encouraged them to study ornithology, botany, and various crafts; to further the latter aim, in 1905 he established an open-air workshop at the sanitarium where crafts and bookbinding were taught.
Quotations:
Commenting on the letter Dr. Brown said, "Personally I have been opposed, on account of patients, to limiting the sale of heroin. Nothing is so effective for treatment of cough, but we can, of course, get along without it. "
"Ten ounces of alcohol will kill one man; ten ounces of heroin will kill 3, 000 men. Ten ounces of alcohol distributed over a week can scarcely cause the beginnings of drunkenness in even youth; ten ounces of heroin in even 1 youth; ten ounces of heroin applied over a week can produce incurable addiction in thousands of youths. The profits that urge on the traffic are hundreds of percent for alcohol, but are thousands of percent for narcotic drugs. Drug addiction is secretive. Even well informed people never heard of heroin. Detected offenses against the Federal Narcotic Laws were about 1, 000 in 1917, in 1925 they were 10, 138. The people must know about this newest and deadliest enemy that lies in wait for the youth of the land, 'hooking' them by the tens of thousands because of their ignorance. "
Membership
Lawrason Brown was a member of the American Clinical and Climatological Association and of the American Sanatorium Association.
Personality
Lawrason Brown was optimistic and jovial in spite of his poor health. He promoted progress in control of tuberculosis as much by his forceful personality and stirring example as by his writings.
Connections
On October 8, 1914, Lawrason Brown married Martha Lewis Harris of Baltimore, and their home was noted for its hospitality. They had no children.