An oration on the classification and nomenclature of diseases, with remarks on diseases due to treatment / by H.D. Rolleston, M.D., F.R.C.P., senior physician to St. George's Hospital; physician, Victoria Hospital for Children.

  • Humphry Rolleston
Date:
[1909]
Catalogue details

Licence: In copyright

Credit: An oration on the classification and nomenclature of diseases, with remarks on diseases due to treatment / by H.D. Rolleston, M.D., F.R.C.P., senior physician to St. George's Hospital; physician, Victoria Hospital for Children. Source: Wellcome Collection.

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    There is, it must be confessed, a certain fascination about the attempt to fit each disease into its appropriate niche in a formal classification ; it recalls our struggles with the “dissected puzzles” of one’s childhood. But at present our knowledge is not sufficiently complete to allow a permanent classification to be constructed. In fact, it is probably more difficult now to attempt such a classification than it was in Cullen’s time, for though knowledge has advanced it has thereby made our ignorance more obvious, and we realise that any scheme of classification adopted for convenience and practical purposes may almost any day be disturbed by a new discovery. As the result of research and analysis new diseases are constantly being described, some of which will take an established place in the list of diseases, whereas others are really only aberrant forms of recognised conditions. At the same time, as the outcome of broader knowledge, some conditions previously regarded as distinct are being shown to be local manifestations of a single underlying morbid process or as different types of essentially the same pathological condition. Thus cerebellar ataxia is not distinct from hereditary ataxia but only a form of it ; just as tabes and general paralysis are two local divisions of a single morbid process (Mott). Or, to take a comparatively old example, granular kidney, failing heart, and cerebral haemorrhage are the peripheral results of the general pathological process which begins as a metabolic disturbance and gives rise to an increased blood pressure and so to arterial sclerosis. Again, the various manifestations of well recognised infections, such as tuberculosis and syphilis, in different parts of the body are grouped together in some systematic works on medicine, and the same process might be adopted with regard to pneumococcal, gonococcal, and other in¬ fections. This is a logical method of classification, but it can scarcely be adopted in its entirety, for it is often more convenient to classify diseases according to the part of the body affected than according to the underlying cause ; thus acute peritonitis is at present more conveniently classified as an abdominal disease due to various causes than as a local manifestation of infection with pneumococci, streptococci, B. coli. Moreover, a strictly etiological classification might be difficult in cases of mixed infection. In some instances it is difficult to classify a disease in any way except as of obscure or doubtful origin. It is at present, therefore, better to be content with a classification based on a compromise of the etiological and regional considerations than to attempt to force all diseases into a rigid scheme, based exclusively either on the etiological factors or on the organs mainly affected. The present official nomenclature, wnatever may be said about its limitations, indeed shows a very open mind in the classification adopted; the divisions are : 1. Infective
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