The principles and practice of medicine / By John Elliotson ... Edited by Nathaniel Rogers ... and Alexander Cooper Lee.

  • John Elliotson
Date:
1844
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Licence: Public Domain Mark

Credit: The principles and practice of medicine / By John Elliotson ... Edited by Nathaniel Rogers ... and Alexander Cooper Lee. Source: Wellcome Collection.

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    ‘is to be improved, not only by a better acquaintance with the symptoms and history of diseases, but by a better sequelae’ with Morbid Anatomy; so that the cor- respondence between symptoms and local lesions may be established, and thus the affection clearly ascertained. As Healthy Anatomy is the foundation of Morbid Anatomy, and Physiology is the foundation of Pathology, the importance of these also to improvements in diagnosis is apparent. 7 Laennec’s Discoveries.—The discoveries made by Laennec with respect to dis- eases of the heart and lungs,* are great enough to entitle him to all the honours which have ever been acquired in our profession. He has enabled us to judge of diseases, which are otherwise often not distinguishable with certainty, or even at all; and this with an accuracy inconceivable to those who are unacquainted with his inves- tigations. He has enabled us to distinguish diseases of the heart, which were for- merly, and are still, too often either all expressed by the easy term—‘‘disease of the heart,”’—without any specification of the part of this complicated organ affected; or are as often passed over entirely;—the case being mistaken for hydrothorax, or some pulmonary affection. He has also enabled us to distinguish diseases of the lungs which, in many cases, could not be pronounced upon with accuracy; and others of which the diagnosis was always uncertain. Moreover, we can point out the very part affected. We are asked—**Cui bono?” (*sOf what use are they?”’) ‘The answer is plain. It is universally allowed that every disease should be described, and its nature ascer- tained, as accurately as possible. Now, with every advance in accuracy of descrip- tion, and in knowledge of the source of symptoms, diagnosis imperceptibly and inevitably becomes more accurate. ‘Co condemn accurate diagnosis, therefore, is to condemn accurate knowledge;—to rest satisfied with imperfect information, when industry would give us more;—to admire ignorance, when knowledge is within our reach, | ‘The art of diagnosis ought to be universally cultivated, without reference to its utility in particular instances. It is part of our science; every part must be culti- vated for the perfection of the whole; and what may not be practically useful to- day, may become so to-morrow. How many discoveries in Chemistry and Phy- sics appeared, at first, to be objects of mere curiosity; but have afterwards been applied to the most important purposes! Plato possessed so exalted a feeling for science on its own account, that he considered the applications of geometry to prac- tical purposes, as far inferior to its philosophy;” and those who may see no reason for being so deeply enamoured of science as that, must allow that there is every reason to remember the words of Jesus, the son of Sirach:—‘*None may say— ‘What is this??—--Wherefore is that??—for, at time convenient, they shall all be sought out.’’* In improving diagnosis, it is impossible to discover only what is ob- viously useful. The research must be made generally; and what is at-once useful, and what is not, must turn up together. In the diseases of other organs, we always aim at accuracy of diagnosis, without any hope of utility. When a solid tumour exists in the abdomen, we endeavour to ascertain whether it is the liver, the * See his celebrated Treatise, entitled—De ]’Auscultation Mediate; ou Traité du Diag- nostic des Maladies des Poumons et du Coeur; fondé principalement sur ce Nouveau Moyen Exploration.” (“Treatise on the Diagnosis of Diseases of the Lungs and Heart; chiefly founded on a New Mode of Investigation,—Mediate Auscultation.”) This work is princi- pally known tothe English reader through the medium of Dr. Forbes’s Translation;—a work which is enriched with many valuable notes. » Odmody ef evovriay dvayndler Osdoracbat, meortner, ef ME yévecw, ob meorhner. do ye wedrrovres Te nal Medtems Evena mdvras Tous Aéyous Mooveeevorh ALyourt, TETeaywviCely TE nal Wagatevey nal weoortiBevat, nat Tavera wuTe pleyysuevor® 73 orl mov ray 7) edOnua wacems Evena ervrndevdeevov.—TOAITEIA. Liber vii. (“We must not, therefore, if compelled to contemplate, on the one hand, an actual being, say—‘It is fitting; and if we contemplate, on the one hand, the origin of that being, say— fi It is not fitting;’ for they speakas intriguing advocates, who utter a]l their speeches with a sinister design;—squaring, stretching, adding, and asseverating without scruple; but every scientific pursuit is cultivated for the sake of knowledge.”) e “Ecclesiasticus;” Chapter 39; Verse 17. ‘
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