Volume 1

A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae.

Date:
1907-10
Catalogue details

Licence: In copyright

Credit: A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    association of various forms of disease of tlie kidney with anasarca and albuminous urine. In no direction was the harvest of this combined study more abundant than in the complicated and coid'used subject of fever. The work of Louis and of his pu])ils, W. W. (icrhard and others, revealeil the distinction between ty])hus and ty])hoid fever, and so cleared up one of the most obscure problems in i)athology. Throughout the nineteenth century this clinico-pathological investiga- tion of disease has widened enormously our diagnostic powers, and the |)hysician today who wishes to obtain a sound knowledge of the natural history of disease must adopt Morgagni’s method of “anatomical thinking.” Skoda in Vienna, Schoenlein in Berlin, Graves and Stokes in Dublin, Marshall Hall, C. J. B. Williams, and many others introduced the new and exaet methods of the French and created a new clinical medicine. A very strong impetus was given by the researches of Virchow on cellular pathology, which removed the seat of disease from the ti.ssues, as taught by Bichat, to the individual elements, the cells. The introduction of the use of the microscope in clinical work widened greatly our powers of diagnosis, and we obtained thereby a very much clearer conception of the actual processes of disease. In another way, too, medicine was greatly helped by the rise of experimental pathology, which had been introduced by John Hunter, was carried along by Magendie and others, and reached its culmination in the epoch-making researches of Claude Bernard. Not only were valuable studies made on the action of drugs, but also our knowledge of cardiac pathology was revolutionized by the work of Traube, Cohnheim, and others. In no direction did the experimental method effect such a revolution as in our knowledge of the functions of the brain. Clinical neurology, which had received a great impetus by the studies of Todd, Romberg, Lockhart, Clarke, Duchenne and Weir Mitchell, was completely revolutionized by the experimental work of Hitzig, Fritsch and Ferrier. Under Charcot the school of French neurologists gave great accuracy to the diagnosis of obscure affections of the brain and spinal cord, and the combined results of the new anatomical, physiological, and experimental work have rendered clear and definite what was formerly the most obscure and complicated section of internal medicine. The latter jiart of the nmeteenth century saw a conijilete revolution in our conception of the etiology of infectious di.seases. The idea of a coiitagiiim vivum, of a living agent which multiplied in the body and cau.sed the symptoms of disea.se, had long been entertained, and the analogies between the fermentation of fluids and disease had been fre- cpiently suggested. The brilliant researches of Pasteur placed the bacterial origin of certain disea.ses on a firm scientific basis. Grasping the idea that the putrefactive and suppurative processes in wounds were due to bacteria, luster revolutionized surgery, and has made possible operations which have widened enormously the work of surgeons, with a result that today our art is more medico-chirurgical than it has ever been before. But the full importance of the new .studies was not realized until Robert Koch discovered in rajiid succession the causes of several of the most destructive of epidemic diseases. Then with Laveran’s description of the malarial parasite came the recognition of the importance of protozoa as cau.ses of di.sea.se. All this work has modified clinical medicine in several important directions. The detection of specific j)arasites has been