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The History of Pathology 1Address delivered at the opening of Session 1897-98, St. Mungo's College, Glasgow.

The History of Pathology 1Address delivered at the opening of Session 1897-98, St. Mungo's... OF PATHOLOGY.1 THE HISTORY By CHARLES M.D. WORKMAN, in the earliest times of which we can Medicine very get any have record seems to commenced two lines. One of along which we name was the treat- these, might primitive surgery, in ment of caused accident or battle with men or injuries by in this case the cause of the lesions was seen animals; readily and understood. But on the other we find that our hand, forefathers had to deal with conditions of which the many were to them at causes unknown, or, least, absolutely very such conditions were the fever and delirium obscure indeed; the of some and effects wounds, produced by poisons, zymotic These diseases ! conditions were ascribed immediately by them to the malevolent action of the of animals or spirits the interference of the or the of witchcraft men, gods, power the invalid his enemies. And as upon by living brought these two lines of and medicine primitive surgery primitive were soon seen to have close we find in relations, very times that a of medical arose guild practitioners early specially trained to undertake the treatment of both these forms of and as of the diseases which had to treat disease; many they to be due to the of which must be were God, anger supposed this medicine-craft became often amal- sacrifice, appeased by with This was no means gamated priestcraft. by always the as the medicine men in countries remained case, many distinct from the of priests quite religion. Medicine reached this made little having very stage progress at the of Session St. Address delivered 1897-98, opening Mungo's ?College, Glasgow. 340 Dr. Workman?The History of Pathology. for a and we find that races the time, long among savage art is confined to a of medicine men and healing special guild or is in the hands of the to this sorcerers, priests day. The in would seem to have been due delay progress largely to the or reverence for the which hindered dead, superstition from anatomical of the anyone making any investigation bodies of those who had died from disease or and injury; a of the of animals was although knowledge anatomy acquired at a no one that the date, comparatively early supposed information thus obtained could throw on the any light and of man. diseases injuries A advance would to have been made in great appear very times to four thousand in both China (three early years B.C.) and this was advance almost Egypt, though wholly empirical, as little was known in either of human very country anatomy or and it was due to the increase of physiology, apparently of the effects of different on the practical knowledge drugs In considerable was in also, body. Egypt, dexterity acquired the treatment and of of the and of the disease diagnosis eye in of the skin. But which we spite knowledge might expect the of that to have obtained from the people country operation no seems to have been made them of embalming, progress by in or either normal of the internal pathological anatomy organs. The first advance on the lines of seems to have anatomy been made the Greek most of by early physicians, though them made dissections on the bodies of the lower animals. only The advance made seems to have been by Hippocrates brought about his careful clinical observations. chiefly by wonderfully Some three hundred before Christ the medical school years had broken the barrier of reverence or at Alexandria through and and Erasistratus not used Herophilus only superstition, the bodies of the dead for but it would even seem dissection, used condemned criminals for the of vivi- that they purpose section. The latter also to have made (Erasistratus) appears examinations on the bodies of who had persons post-mortem and to have observed and noted certain died from disease, in the due to the as he describes disease, changes organs in the &c. liver, changes four hundred after this time medicine For some years no till the to have made little or is, progress?that appears and of the of time Galen; and, indeed, knowledge anatomy seems rather to have lost than to have pathology ground and medicine advanced in advanced, though practical surgery in advance of an fashion. was much Galen, however, empiric Dr. Workman?The Histoi-y of Pathology. his and not a man of the of time, though type Hippocrates .nor of his in he made considerable ability, yet very progress his dissections of the lower animals. He does anatomy by not seem to have often dissected human for he mentions bodies, with that those who attended the surprise physicians Emperor Marcus Aurelius in his the Germans had campaign against the of the bodies of the barbarians opportunity dissecting slain in battle. His own of the human hand is description taken from that of an with evidently ape undeveloped Galen allowed his notions to opponens pollicis. philosophical the observation of and he endeavoured to nature, outweigh his when he had far too data on systematise knowledge slight in which to found his and thus his we find systems, writings much that is valuable and of interest a mass of false among and confused ideas of and His anatomy physiology. ability and were so and his so vol- great, personal power writings uminous and so much in advance of his that became time, they and remained the text-books of medicine and for a surgery and all medical writers were taken thousand after, years up with and on his works. simply discussing commenting This condition of lasted till the time of Vesalius and things till the of the seventeenth is, beginning century Harvey?that ?and it would seem to have been the of and anatomy study which about the himself Harvey physiology brought change. the value of careful for he realised observation, pathological that he considered the dissection of one dead of states body the or of disease of more value than phthisis any lingering dissection of ten hanged people. studies the An immense was to these impetus given by as an made about this time in the microscope improvement instrument of the means of which such men as precision, by and added to the Hooke, Loewenhoek, Malpighi enormously of and Loewenhoek be considered histology; may knowledge discoverer of those most wonderful the bacteria the creatures, infusoria. and In the shows itself first the improvement by pathology of and their relation careful noting post-mortem appearances clinical found in the works of to Bonetus, Valsalva, symptoms all of of who well be called and above Forli, may Morgagni of for his careful of clinical the father descriptions pathology, and of the related are of post-mortem appearances symptoms interest and value even to this His book the day. greatest and Causes Disease is a model of careful on The Seats of well worth study. investigation your Battista was born in 1682. Giovanni Following, Morgagni 342 Dr. Workman?The History of Pathology, and the works of William and perhaps inspired by, Morgagni, John Hunter set about the most careful making observations, the first in the latter more in and, chiefly anatomy, pathology, at the same saw the not of time, they importance only their observations but of collections publishing forming the and the facts which made, illustrating experiments they had discovered. These collections remain as a they grand memorial of their labours in the Hunterian Museums of and London. Glasgow The Senate of the of has shown but University Glasgow little of the treasure left to its care William appreciation by as it is now to the collection in Hunter, only beginning put and make it available to our and the collection order, students; is even in a in a heated yet very unsatisfactory position badly and loft. It is also inefficiently lighted only by special grace that students can admission to the collection. The gain museum of a institution such as the should public University be thrown not to the students and teachers but to open only the without fee or as in this their value public charge, way become more and have would those who the known, generally would the more add to them and subscribe opportunity readily for their better and exhibition. money preservation time in Since the of the who were born the Hunters, early of the John in 1728, part eighteenth very century, steady has been made in the and treat- progress etiology, pathology, ment of disease. It is curious to note that this revival of scientific was first started in investigation Italy by Morgagni, from which the to and country impulse passed England while for after made no advance France, ; Italy, long Morgagni, then the seems to have and the to impulse passed Germany, in names and with great practical experimental pathology which we now are German. conjure A few of these are of such that be importance they may mentioned. of who has made his Cohnheim, specially Leipzig, name known his book on General and the Pathology, by by work done in of he has the the experimental investigation Robert the who has Koch, subject; bacteriologist gained world-wide fame his of the bacillus tuberculosis by discovery and of the of above cholera; and, all, spirillum Rudolph of who has done such work as is Virchow, Berlin, splendid evidenced in his books on and Cellular Die Pathology as well as in for Geschwiilste, Krankhaften editing many years the which is known his Virchoiv's Archives. name, magazine by He is far the in addition to and, by greatest living pathologist, all his labours in this line and as in the of professor University Dr. Workman?The History of Pathology. he is a and orator on the Berlin, side of free politician thought and liberalism in the German Reichstag. Another name is one much less known in this country, Bernard von who was a to his Gudden, in martyr profession when on the late of Bavaria he that, attending King Ludwig him was drowned in the Lake. His name is by Stranberg his microtome for brain known, perhaps, mostly by making but he did enormous work in the of sections, the pioneer study nervous and its and was the first to use the diseases, system method of the or want of following up degeneration develop- ment which follows the removal of a limb or and thus organ, out the nervous centres which are connected with the mapping functions of the removed. He at the same was, time, part in most earnest and endeavours for the of philanthropic good the insane under his care in the at Munich. The asylum name and follies of the who drowned him will king probably remembered after his name has faded into the be infinite long the azure of past." I wish to call fellow-students of St. upon you, my Mungo's a teacher I am I fellow- still, (for though hope, your College to take the for not to rest Scotland, student), up gauntlet on the laurels of but to determine that your idly predecessors, in shall be more more the next scientific, generation Glasgow than the more brilliant hopeful, past. done in the of To turn now to the work investigation medical the One of the questions during present century. most is as our view of the causation regards important changes of some forms of and from this to a certain disease, degree a considerable in the method of treat- there has been change ment. few was till a heredity thought comparatively years ago Up in the causation of such diseases to a very important part play and as well as as consumption (phthisis pulmonalis) leprosy, considered if in cancer and which are still sarcoma, by many, the result of to be not most, hereditary greatly pathologists it was believed In the earlier half of this century tendency. transmission of a tend- was not the that this merely heredity but that the actual the diseases or to leprosy, ency phthisis the time was as at cause transmitted, just present exciting to his child transmit it is believed that a father may syphilis Hutchinson infected. Johnathan without the mother being for this is a has stated that way syphilis frequent quite lately This in the case from to child. to be transmitted idea, parent and others before the Cohnheim of was combated phthisis, by Koch and had been demonstrated of the disease by germ Dr. Workman?The History of Pathology, and he came to this conclusion from his Baumgarten, largely on He was so convinced animals. of the experiments purely nature of the disease that he was able to infectious prophesy a would be found to be the cause some time that before germ tuberculosis was Other the bacillus discovered. pathologists came to much the same conclusion as the of regards fallacy view that was the cause of that disease from the heredity very different data. Professor from teacher, Redfern, My argued, his that the disease was produced by experience, unhealthy for if breed rabbits in surroundings, you damp unhealthy hutches numbers are sure to die from this while disease, great are bred in hutches the is if dry they mortality greatly he believed from this and from his and observations reduced, of that where the disease to be transmitted appeared patients husband to or vice this was due to the from wife, versa, damp as is caused well known to by sweating, profuse perspiration a common feature in this disease. We now know that in be the direct transmission of the far such a case is more germ the but the remains cause, argument against heredity probably the same. father of Sir William the an old and MacCormac, Again, educated Belfast held the view that the physician, highly this disease was rebreathed cause of that air, practically it was due to excess of carbonic and he recommended acid, to with the windows of their rooms everyone sleep open and in order that fresh both above below, oxygen might admitted. And I remember well his when be me, telling his attention to the of the I called bacilli in discovery the that these must be as he had accidental, only sputum, the in a number of cases and examined had great sputum a He did not seem to never seen such realise that the thing. he had used was too nor did he understand the low, power of but he had from a wide come, importance proper staining, the cause to see that was from and that without, experience, was not a one. And to crown the disease now, hereditary all, clear evidence that this we have the disease can experimental the inoculation of a cultivation of the be by pure produced so that it is almost believed that bacillus, universally heredity in this disease a can act weakness of the only by producing and that a suitable soil is thus in his individual, produced the and of the for lungs growth development germ. the In the same to was time, way, up present heredity to be a factor in the causation of but believed prime leprosy, certain that this disease is a it is almost produced by very and to that of that the reason similar tubercle, organism why Dr. Workman?The History of Pathology. infective nature was its so obscured was the long simply very incubation This incubation has been prolonged stage. stage found to last several years. In one case a soldier who had been in and was India, there, to a or two after infection, probably, exposed year returning was to Ireland attacked the and died disease, by ultimately from it. a friend with whom he had been Afterwards, living, but who had never been out of Ireland, developed leprosy. number of similar cases have been lately published, notably of Father which all that to the infectious Damien, go prove disease and character of the its nature. non-hereditary In the case of the tumours the is a much malignant question more difficult even here the of one, yet importance heredity, even as a is to be for cause, doubted, predisposing coming if as Snow to the of that, argues you inquire family history have as evidence of cancer as healthy persons you great you will find in the histories of those who are cancerous. family the fact is that has some of Practically, everyone history disease if the records be investi- malignant family thoroughly gated. On the am inclined to the view that we whole, strongly cannot blame our forefathers with our infirmities and diseases, but must them down to some of the laws of put breaking either in ourselves or in our so that we health, neighbours, become with disease of some kind. infected In advance has our of diseases knowledge epidemic great their been made within the last half both as century, regards causation and the best means of a to their putting stop spread. In olden time of the treatment any systematic regulation of the or of the bodies of those who had died plague-stricken from the disease was rendered the insane terror by impossible of inhabitants of affected which took the town, any possession as of the Attic be well seen from the plague may description who was himself a the Greek historian, given by Thucydides, when cholera attacked and even a few sufferer; years ago, authorities when the with the Naples, people fought sanitary for better to remove the sick to they attempted hospital in and a similar was treatment; difficulty experienced Bombay the occurrence of this the to hide endeavouring year, people cases of bubonic for fear of the sanitary regulations. plague have come to in civilised countries the Now, people generally such realise that the of a is by only encouraged spread plague is and that their individual demoralisation, enormously danger for such a increased so that it would be it, impossible by was condition of to occur and this us, among advantage things 346 Dr. Workman?The History of Pathology. well seen a or two when the cholera invaded year ago and caused terrible was not looked Hamburg mortality?it as some dreadful from upon incomprehensible scourge coming the Mars or from and from which there elsewhere, planet could be no but in The was escape flight. plague calmly and means taken to it out. investigated, proper stamp Very soon this was and the which seemed accomplished, epidemic about to over all was confined to the narrow spread Europe limits of and Altona. Hamburg In the of the but little was known of early part century the fevers and and were enteric, typhus, relapsing, they very confused with one this be seen from completely another; may our old where I find a case in 1852 pathological reports, put down as on the account of the which, typhus reading post- mortem found in the intestine with the appearances along of the was a case of report life, symptoms during evidently most enteric. In those to pronounced days typhus appears have been common in and all cities of like very Glasgow while that better have been size, now, sanitary arrangements both that disease and fever are rare obtained, relapsing very so much is this the case that indeed; you may probably course as students and obtain pass through your your diploma without ever seen a case of either and disease, having yet even in student in which are not Belfast, my days very long I saw cases of past, many typhus. I am that we cannot of a similar sorry speak improvement with to enteric which is still fever, regard fearfully prevalent in of all our and spite sanitary regulations precautions, especi- when are not carried as has been the case out, ally they just now at Maidstone. And here I should like to call attention to a rather your remarkable fact which or not have some causal may may relation to this difference in the results obtained. In enteric fever a definite has been found?the bacillus germ of Eberth?which has been almost to be the certainly proved cause of that in the other exanthe- while disease, exciting matous and measles? scarlatina, fevers?typhus, small-pox, no has been found which with show of reason can germ any be considered be the cause of the disease. with this to Along does it seems to me remarkable that enteric fever not fact, such a from a second attack as we give immunity pronounced find in these other and it does not seem to rise diseases, give to direct but the disease almost to infection, appears always be means of food or drink. by spread Before from the of the I should fevers, subject passing Dr. Workman?The 347 History of Pathology. out a in as to direct change opinion among point pathologists infection. in his states he that book, Morgagni, always avoided examinations in such cases for making post-mortem fear of and this fear seems to have hindered infection, many other earnest students as well as him from such investigations. on the other such an as Now, hand, experienced physician of who was to Dr. Wilks, London, formerly pathologist Guy's stated that he had never known an disease infectious Hospital, to be transmitted from a dead examina- body by post-mortem and for I should not fear to make an tion, myself certainly on disease that I ever heard of or saw. any inspection Enormous advance has been made of late in our years nervous as I have indicated in of diseases, knowledge already von This has of old Professor Gudden. teacher, speaking my in various been the of the seat of way localising specially brain and thus interference to be diseases, enabling surgical of use. As I have Gudden was a in this indicated, pioneer but his work was followed and direction, up improved upon Munk in and Ferrier in this until by Germany by country, has so common means of now brain become and, surgery by as be a and so safe almost to considered anaesthetics, aseptics minor operation. in Just a new line of research has been lately opened nervous disease the studies of Charcot and others into by nature of and allied the somnambulism, states, hypnotism, lead to an advance in our of and this knowledge pschy- may which has been almost and mental disease, cology hopelessly I in an address at obscure. remember Belfast, Huxley, as a useless for one of might metaphysics study, speaking himself the band of his trousers as as well to lift try by hope If it is to that one uses a any light by study. pulley get it is to raise oneself the and by bellyband, just possible find a that in and its allied states we hypnotism may possible to raise us from our suitable ignorance. pulley is remarkable that there are remnants of ancient It patho- and ideas still not prevalent only among logical philosophies and but even well-educated the uneducated, among physicians surgeons. us back to often still hear ideas that take We propounded and his four humours. We hear even doctors Galen speaking out evil medicines that or close the thus to let of pores, open how or to hinder the loss of ones. And humours good very the liver we hear both doctors and talk of often do laymen our were some evil demon within us to as if it placed destroy liver or and medicines are to the to given purge happiness, 348 Dr. Workman?The History of Pathology. soothe the and men talk as if the whole function of this liver, was to while tell us that bile, organ produce physiologists the of this secretion is a and production only very slight of its and as to the nature and duties, insignificant part method of its real work we are still in the dark. When sadly men their liver all is of out of that meant order, speak being is that are from one of the forms of they suffering many stomach or intestinal The of the indigestion. plan blaming liver be a nice of and our may very way soothing patients but we should never let it blind us to the them, comforting fact that it is a cloak for our and though merely ignorance, we we should endeavour calm our this means, may patients by if to find out what is relieve it. and, really wrong possible, Another form in which ancient medicine remains with us is in the idea are taken that either sthenic or asthenic, patients from the medical of whose view was that Brown, philosophy disease is caused either the fact that the vital force is in by case to be excess of or below the mean of health?in the first treated and in the other case to be by blood-letting purging; treated food and This view has a stimulants. by probably in in cases of certain amount of truth at least certain it, disease. But it led to when great injury frequent probably was as it used be even a of a to in, bleeding indulged quarter century ago. The medical of the de siecle to be Jin appears philosophy the almost all diseases and their treatment microbic of origin in various kinds of antitoxic serum. Do be not, however, by too a to conclude that when have found a great hurry you in the or a blood tissues of special organism patient suffering in from a and that can cultivate it disease, peculiar you pure or and that inoculation of the further, pure gelatine agar, by of the cultivation can similar to those you produce symptoms in men or animals that have found inoculated, you patient out all that can be known of the disease and its causes; the future show us that when we have found years may germ we have reached the bottom of a ladder. very long only rung The at to stretch before which seems also, prospect, present and then that we must have our children vaccinated us, with anti- antirabic, injected antisyphilitic, antidiphtheritic, one knows what other antitoxic is to and no serums, mallic, to look mind but and comes very my anything reassuring, ideas much as if we were back to the old Galenical trending and humours. of bad good in serum we as this craze, Gentlemen, sometimes, although .are to faster than our or our knowledge experiments apt go Dr. Findlay?Presidential Address. 340 would on the in the course of the I warrant, whole, yet, ages that is and am convinced that made, gradual progress being a freedom from illness we much and from enjoy greater of than did our forefathers two hundred anxiety years ago, in in of the fact that our civilisation has added progress spite new as well as us realise more dangers, making many clearly which surrounded them and still surround us in the dangers for existence. the struggle and of A few words now of welcome to those of warning studies in who are the medical just commencing your you You are on a serious life which work, entering profession. to cause or sore is almost certain you great happiness suffering, I that of would take such a for cannot think any you up the of If for profession simply purpose pecuniary gain. you in the school and in the are well studies equipped by your can will have in the to wards, joy help you give your you if while have idled fellow-creatures; you away suffering will have the sorrow of student great seeing your years, you have aided those should suffering through your ignorance. you Geh ! meinen Winken, gehorche deine Nutze jungen Tage, sein Lerne zeitig kliiger ; Auf des Gliickes Wage grosser Steht die selten ein; zunge Du rausst oder sinken, steigen herrschen und Du musst gewinnen, und Oder dienen Yerlieren, Leiden oder triumphieren, Ambos oder Hammer sein."?Goethe. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Glasgow Medical Journal Pubmed Central

The History of Pathology 1Address delivered at the opening of Session 1897-98, St. Mungo's College, Glasgow.

Workman, Charles
Glasgow Medical Journal , Volume 48 (5) – Nov 1, 1897
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OF PATHOLOGY.1 THE HISTORY By CHARLES M.D. WORKMAN, in the earliest times of which we can Medicine very get any have record seems to commenced two lines. One of along which we name was the treat- these, might primitive surgery, in ment of caused accident or battle with men or injuries by in this case the cause of the lesions was seen animals; readily and understood. But on the other we find that our hand, forefathers had to deal with conditions of which the many were to them at causes unknown, or, least, absolutely very such conditions were the fever and delirium obscure indeed; the of some and effects wounds, produced by poisons, zymotic These diseases ! conditions were ascribed immediately by them to the malevolent action of the of animals or spirits the interference of the or the of witchcraft men, gods, power the invalid his enemies. And as upon by living brought these two lines of and medicine primitive surgery primitive were soon seen to have close we find in relations, very times that a of medical arose guild practitioners early specially trained to undertake the treatment of both these forms of and as of the diseases which had to treat disease; many they to be due to the of which must be were God, anger supposed this medicine-craft became often amal- sacrifice, appeased by with This was no means gamated priestcraft. by always the as the medicine men in countries remained case, many distinct from the of priests quite religion. Medicine reached this made little having very stage progress at the of Session St. Address delivered 1897-98, opening Mungo's ?College, Glasgow. 340 Dr. Workman?The History of Pathology. for a and we find that races the time, long among savage art is confined to a of medicine men and healing special guild or is in the hands of the to this sorcerers, priests day. The in would seem to have been due delay progress largely to the or reverence for the which hindered dead, superstition from anatomical of the anyone making any investigation bodies of those who had died from disease or and injury; a of the of animals was although knowledge anatomy acquired at a no one that the date, comparatively early supposed information thus obtained could throw on the any light and of man. diseases injuries A advance would to have been made in great appear very times to four thousand in both China (three early years B.C.) and this was advance almost Egypt, though wholly empirical, as little was known in either of human very country anatomy or and it was due to the increase of physiology, apparently of the effects of different on the practical knowledge drugs In considerable was in also, body. Egypt, dexterity acquired the treatment and of of the and of the disease diagnosis eye in of the skin. But which we spite knowledge might expect the of that to have obtained from the people country operation no seems to have been made them of embalming, progress by in or either normal of the internal pathological anatomy organs. The first advance on the lines of seems to have anatomy been made the Greek most of by early physicians, though them made dissections on the bodies of the lower animals. only The advance made seems to have been by Hippocrates brought about his careful clinical observations. chiefly by wonderfully Some three hundred before Christ the medical school years had broken the barrier of reverence or at Alexandria through and and Erasistratus not used Herophilus only superstition, the bodies of the dead for but it would even seem dissection, used condemned criminals for the of vivi- that they purpose section. The latter also to have made (Erasistratus) appears examinations on the bodies of who had persons post-mortem and to have observed and noted certain died from disease, in the due to the as he describes disease, changes organs in the &c. liver, changes four hundred after this time medicine For some years no till the to have made little or is, progress?that appears and of the of time Galen; and, indeed, knowledge anatomy seems rather to have lost than to have pathology ground and medicine advanced in advanced, though practical surgery in advance of an fashion. was much Galen, however, empiric Dr. Workman?The Histoi-y of Pathology. his and not a man of the of time, though type Hippocrates .nor of his in he made considerable ability, yet very progress his dissections of the lower animals. He does anatomy by not seem to have often dissected human for he mentions bodies, with that those who attended the surprise physicians Emperor Marcus Aurelius in his the Germans had campaign against the of the bodies of the barbarians opportunity dissecting slain in battle. His own of the human hand is description taken from that of an with evidently ape undeveloped Galen allowed his notions to opponens pollicis. philosophical the observation of and he endeavoured to nature, outweigh his when he had far too data on systematise knowledge slight in which to found his and thus his we find systems, writings much that is valuable and of interest a mass of false among and confused ideas of and His anatomy physiology. ability and were so and his so vol- great, personal power writings uminous and so much in advance of his that became time, they and remained the text-books of medicine and for a surgery and all medical writers were taken thousand after, years up with and on his works. simply discussing commenting This condition of lasted till the time of Vesalius and things till the of the seventeenth is, beginning century Harvey?that ?and it would seem to have been the of and anatomy study which about the himself Harvey physiology brought change. the value of careful for he realised observation, pathological that he considered the dissection of one dead of states body the or of disease of more value than phthisis any lingering dissection of ten hanged people. studies the An immense was to these impetus given by as an made about this time in the microscope improvement instrument of the means of which such men as precision, by and added to the Hooke, Loewenhoek, Malpighi enormously of and Loewenhoek be considered histology; may knowledge discoverer of those most wonderful the bacteria the creatures, infusoria. and In the shows itself first the improvement by pathology of and their relation careful noting post-mortem appearances clinical found in the works of to Bonetus, Valsalva, symptoms all of of who well be called and above Forli, may Morgagni of for his careful of clinical the father descriptions pathology, and of the related are of post-mortem appearances symptoms interest and value even to this His book the day. greatest and Causes Disease is a model of careful on The Seats of well worth study. investigation your Battista was born in 1682. Giovanni Following, Morgagni 342 Dr. Workman?The History of Pathology, and the works of William and perhaps inspired by, Morgagni, John Hunter set about the most careful making observations, the first in the latter more in and, chiefly anatomy, pathology, at the same saw the not of time, they importance only their observations but of collections publishing forming the and the facts which made, illustrating experiments they had discovered. These collections remain as a they grand memorial of their labours in the Hunterian Museums of and London. Glasgow The Senate of the of has shown but University Glasgow little of the treasure left to its care William appreciation by as it is now to the collection in Hunter, only beginning put and make it available to our and the collection order, students; is even in a in a heated yet very unsatisfactory position badly and loft. It is also inefficiently lighted only by special grace that students can admission to the collection. The gain museum of a institution such as the should public University be thrown not to the students and teachers but to open only the without fee or as in this their value public charge, way become more and have would those who the known, generally would the more add to them and subscribe opportunity readily for their better and exhibition. money preservation time in Since the of the who were born the Hunters, early of the John in 1728, part eighteenth very century, steady has been made in the and treat- progress etiology, pathology, ment of disease. It is curious to note that this revival of scientific was first started in investigation Italy by Morgagni, from which the to and country impulse passed England while for after made no advance France, ; Italy, long Morgagni, then the seems to have and the to impulse passed Germany, in names and with great practical experimental pathology which we now are German. conjure A few of these are of such that be importance they may mentioned. of who has made his Cohnheim, specially Leipzig, name known his book on General and the Pathology, by by work done in of he has the the experimental investigation Robert the who has Koch, subject; bacteriologist gained world-wide fame his of the bacillus tuberculosis by discovery and of the of above cholera; and, all, spirillum Rudolph of who has done such work as is Virchow, Berlin, splendid evidenced in his books on and Cellular Die Pathology as well as in for Geschwiilste, Krankhaften editing many years the which is known his Virchoiv's Archives. name, magazine by He is far the in addition to and, by greatest living pathologist, all his labours in this line and as in the of professor University Dr. Workman?The History of Pathology. he is a and orator on the Berlin, side of free politician thought and liberalism in the German Reichstag. Another name is one much less known in this country, Bernard von who was a to his Gudden, in martyr profession when on the late of Bavaria he that, attending King Ludwig him was drowned in the Lake. His name is by Stranberg his microtome for brain known, perhaps, mostly by making but he did enormous work in the of sections, the pioneer study nervous and its and was the first to use the diseases, system method of the or want of following up degeneration develop- ment which follows the removal of a limb or and thus organ, out the nervous centres which are connected with the mapping functions of the removed. He at the same was, time, part in most earnest and endeavours for the of philanthropic good the insane under his care in the at Munich. The asylum name and follies of the who drowned him will king probably remembered after his name has faded into the be infinite long the azure of past." I wish to call fellow-students of St. upon you, my Mungo's a teacher I am I fellow- still, (for though hope, your College to take the for not to rest Scotland, student), up gauntlet on the laurels of but to determine that your idly predecessors, in shall be more more the next scientific, generation Glasgow than the more brilliant hopeful, past. done in the of To turn now to the work investigation medical the One of the questions during present century. most is as our view of the causation regards important changes of some forms of and from this to a certain disease, degree a considerable in the method of treat- there has been change ment. few was till a heredity thought comparatively years ago Up in the causation of such diseases to a very important part play and as well as as consumption (phthisis pulmonalis) leprosy, considered if in cancer and which are still sarcoma, by many, the result of to be not most, hereditary greatly pathologists it was believed In the earlier half of this century tendency. transmission of a tend- was not the that this merely heredity but that the actual the diseases or to leprosy, ency phthisis the time was as at cause transmitted, just present exciting to his child transmit it is believed that a father may syphilis Hutchinson infected. Johnathan without the mother being for this is a has stated that way syphilis frequent quite lately This in the case from to child. to be transmitted idea, parent and others before the Cohnheim of was combated phthisis, by Koch and had been demonstrated of the disease by germ Dr. Workman?The History of Pathology, and he came to this conclusion from his Baumgarten, largely on He was so convinced animals. of the experiments purely nature of the disease that he was able to infectious prophesy a would be found to be the cause some time that before germ tuberculosis was Other the bacillus discovered. pathologists came to much the same conclusion as the of regards fallacy view that was the cause of that disease from the heredity very different data. Professor from teacher, Redfern, My argued, his that the disease was produced by experience, unhealthy for if breed rabbits in surroundings, you damp unhealthy hutches numbers are sure to die from this while disease, great are bred in hutches the is if dry they mortality greatly he believed from this and from his and observations reduced, of that where the disease to be transmitted appeared patients husband to or vice this was due to the from wife, versa, damp as is caused well known to by sweating, profuse perspiration a common feature in this disease. We now know that in be the direct transmission of the far such a case is more germ the but the remains cause, argument against heredity probably the same. father of Sir William the an old and MacCormac, Again, educated Belfast held the view that the physician, highly this disease was rebreathed cause of that air, practically it was due to excess of carbonic and he recommended acid, to with the windows of their rooms everyone sleep open and in order that fresh both above below, oxygen might admitted. And I remember well his when be me, telling his attention to the of the I called bacilli in discovery the that these must be as he had accidental, only sputum, the in a number of cases and examined had great sputum a He did not seem to never seen such realise that the thing. he had used was too nor did he understand the low, power of but he had from a wide come, importance proper staining, the cause to see that was from and that without, experience, was not a one. And to crown the disease now, hereditary all, clear evidence that this we have the disease can experimental the inoculation of a cultivation of the be by pure produced so that it is almost believed that bacillus, universally heredity in this disease a can act weakness of the only by producing and that a suitable soil is thus in his individual, produced the and of the for lungs growth development germ. the In the same to was time, way, up present heredity to be a factor in the causation of but believed prime leprosy, certain that this disease is a it is almost produced by very and to that of that the reason similar tubercle, organism why Dr. Workman?The History of Pathology. infective nature was its so obscured was the long simply very incubation This incubation has been prolonged stage. stage found to last several years. In one case a soldier who had been in and was India, there, to a or two after infection, probably, exposed year returning was to Ireland attacked the and died disease, by ultimately from it. a friend with whom he had been Afterwards, living, but who had never been out of Ireland, developed leprosy. number of similar cases have been lately published, notably of Father which all that to the infectious Damien, go prove disease and character of the its nature. non-hereditary In the case of the tumours the is a much malignant question more difficult even here the of one, yet importance heredity, even as a is to be for cause, doubted, predisposing coming if as Snow to the of that, argues you inquire family history have as evidence of cancer as healthy persons you great you will find in the histories of those who are cancerous. family the fact is that has some of Practically, everyone history disease if the records be investi- malignant family thoroughly gated. On the am inclined to the view that we whole, strongly cannot blame our forefathers with our infirmities and diseases, but must them down to some of the laws of put breaking either in ourselves or in our so that we health, neighbours, become with disease of some kind. infected In advance has our of diseases knowledge epidemic great their been made within the last half both as century, regards causation and the best means of a to their putting stop spread. In olden time of the treatment any systematic regulation of the or of the bodies of those who had died plague-stricken from the disease was rendered the insane terror by impossible of inhabitants of affected which took the town, any possession as of the Attic be well seen from the plague may description who was himself a the Greek historian, given by Thucydides, when cholera attacked and even a few sufferer; years ago, authorities when the with the Naples, people fought sanitary for better to remove the sick to they attempted hospital in and a similar was treatment; difficulty experienced Bombay the occurrence of this the to hide endeavouring year, people cases of bubonic for fear of the sanitary regulations. plague have come to in civilised countries the Now, people generally such realise that the of a is by only encouraged spread plague is and that their individual demoralisation, enormously danger for such a increased so that it would be it, impossible by was condition of to occur and this us, among advantage things 346 Dr. Workman?The History of Pathology. well seen a or two when the cholera invaded year ago and caused terrible was not looked Hamburg mortality?it as some dreadful from upon incomprehensible scourge coming the Mars or from and from which there elsewhere, planet could be no but in The was escape flight. plague calmly and means taken to it out. investigated, proper stamp Very soon this was and the which seemed accomplished, epidemic about to over all was confined to the narrow spread Europe limits of and Altona. Hamburg In the of the but little was known of early part century the fevers and and were enteric, typhus, relapsing, they very confused with one this be seen from completely another; may our old where I find a case in 1852 pathological reports, put down as on the account of the which, typhus reading post- mortem found in the intestine with the appearances along of the was a case of report life, symptoms during evidently most enteric. In those to pronounced days typhus appears have been common in and all cities of like very Glasgow while that better have been size, now, sanitary arrangements both that disease and fever are rare obtained, relapsing very so much is this the case that indeed; you may probably course as students and obtain pass through your your diploma without ever seen a case of either and disease, having yet even in student in which are not Belfast, my days very long I saw cases of past, many typhus. I am that we cannot of a similar sorry speak improvement with to enteric which is still fever, regard fearfully prevalent in of all our and spite sanitary regulations precautions, especi- when are not carried as has been the case out, ally they just now at Maidstone. And here I should like to call attention to a rather your remarkable fact which or not have some causal may may relation to this difference in the results obtained. In enteric fever a definite has been found?the bacillus germ of Eberth?which has been almost to be the certainly proved cause of that in the other exanthe- while disease, exciting matous and measles? scarlatina, fevers?typhus, small-pox, no has been found which with show of reason can germ any be considered be the cause of the disease. with this to Along does it seems to me remarkable that enteric fever not fact, such a from a second attack as we give immunity pronounced find in these other and it does not seem to rise diseases, give to direct but the disease almost to infection, appears always be means of food or drink. by spread Before from the of the I should fevers, subject passing Dr. Workman?The 347 History of Pathology. out a in as to direct change opinion among point pathologists infection. in his states he that book, Morgagni, always avoided examinations in such cases for making post-mortem fear of and this fear seems to have hindered infection, many other earnest students as well as him from such investigations. on the other such an as Now, hand, experienced physician of who was to Dr. Wilks, London, formerly pathologist Guy's stated that he had never known an disease infectious Hospital, to be transmitted from a dead examina- body by post-mortem and for I should not fear to make an tion, myself certainly on disease that I ever heard of or saw. any inspection Enormous advance has been made of late in our years nervous as I have indicated in of diseases, knowledge already von This has of old Professor Gudden. teacher, speaking my in various been the of the seat of way localising specially brain and thus interference to be diseases, enabling surgical of use. As I have Gudden was a in this indicated, pioneer but his work was followed and direction, up improved upon Munk in and Ferrier in this until by Germany by country, has so common means of now brain become and, surgery by as be a and so safe almost to considered anaesthetics, aseptics minor operation. in Just a new line of research has been lately opened nervous disease the studies of Charcot and others into by nature of and allied the somnambulism, states, hypnotism, lead to an advance in our of and this knowledge pschy- may which has been almost and mental disease, cology hopelessly I in an address at obscure. remember Belfast, Huxley, as a useless for one of might metaphysics study, speaking himself the band of his trousers as as well to lift try by hope If it is to that one uses a any light by study. pulley get it is to raise oneself the and by bellyband, just possible find a that in and its allied states we hypnotism may possible to raise us from our suitable ignorance. pulley is remarkable that there are remnants of ancient It patho- and ideas still not prevalent only among logical philosophies and but even well-educated the uneducated, among physicians surgeons. us back to often still hear ideas that take We propounded and his four humours. We hear even doctors Galen speaking out evil medicines that or close the thus to let of pores, open how or to hinder the loss of ones. And humours good very the liver we hear both doctors and talk of often do laymen our were some evil demon within us to as if it placed destroy liver or and medicines are to the to given purge happiness, 348 Dr. Workman?The History of Pathology. soothe the and men talk as if the whole function of this liver, was to while tell us that bile, organ produce physiologists the of this secretion is a and production only very slight of its and as to the nature and duties, insignificant part method of its real work we are still in the dark. When sadly men their liver all is of out of that meant order, speak being is that are from one of the forms of they suffering many stomach or intestinal The of the indigestion. plan blaming liver be a nice of and our may very way soothing patients but we should never let it blind us to the them, comforting fact that it is a cloak for our and though merely ignorance, we we should endeavour calm our this means, may patients by if to find out what is relieve it. and, really wrong possible, Another form in which ancient medicine remains with us is in the idea are taken that either sthenic or asthenic, patients from the medical of whose view was that Brown, philosophy disease is caused either the fact that the vital force is in by case to be excess of or below the mean of health?in the first treated and in the other case to be by blood-letting purging; treated food and This view has a stimulants. by probably in in cases of certain amount of truth at least certain it, disease. But it led to when great injury frequent probably was as it used be even a of a to in, bleeding indulged quarter century ago. The medical of the de siecle to be Jin appears philosophy the almost all diseases and their treatment microbic of origin in various kinds of antitoxic serum. Do be not, however, by too a to conclude that when have found a great hurry you in the or a blood tissues of special organism patient suffering in from a and that can cultivate it disease, peculiar you pure or and that inoculation of the further, pure gelatine agar, by of the cultivation can similar to those you produce symptoms in men or animals that have found inoculated, you patient out all that can be known of the disease and its causes; the future show us that when we have found years may germ we have reached the bottom of a ladder. very long only rung The at to stretch before which seems also, prospect, present and then that we must have our children vaccinated us, with anti- antirabic, injected antisyphilitic, antidiphtheritic, one knows what other antitoxic is to and no serums, mallic, to look mind but and comes very my anything reassuring, ideas much as if we were back to the old Galenical trending and humours. of bad good in serum we as this craze, Gentlemen, sometimes, although .are to faster than our or our knowledge experiments apt go Dr. Findlay?Presidential Address. 340 would on the in the course of the I warrant, whole, yet, ages that is and am convinced that made, gradual progress being a freedom from illness we much and from enjoy greater of than did our forefathers two hundred anxiety years ago, in in of the fact that our civilisation has added progress spite new as well as us realise more dangers, making many clearly which surrounded them and still surround us in the dangers for existence. the struggle and of A few words now of welcome to those of warning studies in who are the medical just commencing your you You are on a serious life which work, entering profession. to cause or sore is almost certain you great happiness suffering, I that of would take such a for cannot think any you up the of If for profession simply purpose pecuniary gain. you in the school and in the are well studies equipped by your can will have in the to wards, joy help you give your you if while have idled fellow-creatures; you away suffering will have the sorrow of student great seeing your years, you have aided those should suffering through your ignorance. you Geh ! meinen Winken, gehorche deine Nutze jungen Tage, sein Lerne zeitig kliiger ; Auf des Gliickes Wage grosser Steht die selten ein; zunge Du rausst oder sinken, steigen herrschen und Du musst gewinnen, und Oder dienen Yerlieren, Leiden oder triumphieren, Ambos oder Hammer sein."?Goethe.

Journal

Glasgow Medical Journal – Pubmed Central

Published: Nov 1, 1897

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