The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913Osler, William, Sir
History
The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913
Osler, William, Sir
Medicine -- History
The pupils and successors of Corvisart--Bayle, Andral, Bouillaud,
Chomel, Piorry, Bretonneau, Rayer, Cruveilhier and Trousseau--brought a
new spirit into the profession. Everywhere the investigation of disease
by clinical-pathological methods widened enormously the diagnostic
powers of the physician. By this method Richard Bright, in 1836, opened
a new chapter on the relation of disease of the kidney to dropsy, and to
albuminous urine. It had already been shown by Blackwell and by Wells,
the celebrated Charleston (S.C.) physician, in 1811, that the urine
contained albumin in many cases of dropsy, but it was not until
Bright began a careful investigation of the bodies of patients who had
presented these symptoms, that he discovered the association of various
forms of disease of the kidney with anasarca and albuminous urine. In no
direction was the harvest of this combined study more abundant than in
the complicated and confused subject of fever. The work of Louis and of
his pupils, W.W. Gerhard and others, revealed the distinction between
typhus and typhoid fever, and so cleared up one of the most obscure
problems in pathology. By Morgagni's method of "anatomical thinking,"
Skoda in Vienna, Schonlein in Berlin, Graves and Stokes in Dublin,
Marshall Hall, C. J. B. Williams and many others introduced the new and
exact 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 seats of disease from the tissues,
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 on the localization of functions in
the brain. 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 end of
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