General pathology, as conducive to the establishment of rational principles for the diagnosis and treatment of disease : a course of lectures, delivered at St. Thomas's Hospital, during the summer session of 1850 / by John Simon.
- John Simon
- Date:
- 1852
Licence: Public Domain Mark
Credit: General pathology, as conducive to the establishment of rational principles for the diagnosis and treatment of disease : a course of lectures, delivered at St. Thomas's Hospital, during the summer session of 1850 / by John Simon. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![uniformly and consciously start from this standard: your knowledge of healthy anatomy must precede your power of observing morbid anatomy; your knowledge of healthy function must precede your power of noting the morbid functions or symptoms of disease ; your knowledge of healthy chemistry in the body must precede your power of detecting what is wrong in the chemical products of disease ; your knowledge of all that is quantitative or rhythmical in the healthy body must precede your power of recognizing those changes of increase or diminution, of acceleration or retardation in its phenomena, which occur either in disease, or under the influence of medicines. Further, in every case of disease coming under our care, physiology dictates those questions and observations which are, or ought to be, prior to any attempt at opinion or treatment. By enabling us to decide what are the essential characters (as distinguished from the accidental complications) of disease, by telling us what several com- binations of symptoms may concur with the one first obvious to us, and what different signification would belong to each of such combina- tions, it establishes our means of rational diagnosis, fixes the degrees of our approximation to certitude, and exposes the frivolity of medi- cal guesswork. It would be easy for me to multiply examples of the manner in which the pathologist deals physiologically with such facts and phenomena as are supplied to him, by observations at the bedside, or in the dead-house; but one or two obvious instances will suffi- ciently serve to illustrate to you the course usually taken by the mind in such investigations. [The following instances were here dwelt upon: pathological inquiry into hypertrophy of the heart, as founded on the general laws of muscular growth and development—pathological inquiry into albuminuria, as founded on an insight into the mechanism of the circulation, the structure of glands, and the process of secretion— pathological inquiry into neuralgia, as founded on the physiological conditions of nervous convection and sympathy.] Now, gentlemen, let me beg your attention to another view of the subject. When, in commencing my lecture, I spoke of pathology as the science of disease, I said that I should presently say some- thing on the latter word. What, then, do we mean by the word disease f for as yet I have left it to your own general impression and prejudgment, and perhaps you are hardly prepared to believe that there can be any difficulty in the definition. On examination, however, you will find that it does involve considerable difficulty. Your definition of disease would probably take this direction: Nature (you would say) gives a certain habit and method of working to the body—a certain law or norma of action; any de- parture from this norma—anything abnormal in the actions of the body, constitutes disease. Now, let us try this definition with a case: A man has a tumour in the orbit; it grows larger and larger, displaces the globe of his eye and blinds him; or perhaps it originates in the globe of the eye itself, and presently inflammatorv enlargement of the globe comes](https://iiif.wellcomecollection.org/image/b21154168_0021.jp2/full/800%2C/0/default.jpg)
