Lapas attēli
PDF
ePub

have earned retirement. The society especially fosters and encourages younger members to read essays and to present unusual cases, and they are always certain of an appreciative audience. This is a keen incentive to study and research work.

Since it is true that history repeats itself, is it not well to pause now and then to take a glance at the achievements of the past in order to gain new encouragement for the accomplishment of the future?

A survey of its history shows that medicine has had a far greater development in the past century than in all previous time. The changes that have taken place have been truly stupendous. The current of medical progress is still in rapid and vigorous flow, with no sign of slowing. A multitude of keen investigators are eagerly and industriously hunting out and developing new knowledge and new methods. Every year or two yields new facts of fundamental value. These discoveries are rapidly assimilated into the body of diagnostic and therapeutic methods and practise; the novelty of one year becomes the routine of the next.

Of the great body of science, medicine is an integral part. In no department of knowledge is scientific method more rigorously pursued, or with more productive results than in medicine. It is the use of the scientific method alone that has brought about the vast development of medicine within the past century, with all the resultant benefit to mankind. In no field of human activity is there a greater exercise of humanitarian spirit than in medicine. In the difficulties that confront mankind to-day, the course and the duty of the medical profession are clear-to continue the vigorous employment of those scientific principles and the exercise of the altruistic spirit that elevated medicine out of the empirical and stagnant inefficiency that characterized it for a thousand years. Furthermore, medicine is in a position to offer the application of those same principles and spirit to the solution of the grave difficulties that confront mankind to-day. Medicine can proudly present its record before the world as a con

spicuous example of the stantial efficiency and S methods and the spirit tha cess to medicine ought to equal efficiency and achieve economic and civic institu

The great achievement of affords us inspiration and upon us serious responsib tions. It is our duty, ind lectively, to keep ourselv great profession, assiduous art, to maintain unimpair tage of the past, and, as to add to the store of medic should cherish the princip that have brought us to o We should keep aglow the pelled so much of the dark of the peculiar problems tha let that light shine into th ordered world. In the con great achievements and use been attained, and in ou efforts to live up to the sp profession, rest the greatest the greatest rewards that can

Will you not turn with glance at some of the devel cine during the last half short time which I have a will be possible to touch on of this subject.

Fifty years ago the use was in the hands of a few their lives exclusively to whereas to-day, it is one of t the right hand of every 1 who would feel as much at without his stethescope or t

[ocr errors]

Among the broader develo half century when medical out and its progress deper specialized study and resear medicine evolved the specia increased to enormous nun for the most part are justif be confessed that some are mature. It will require a d

ment of subservice; the brought suein bringing in industrial,

cine not only
but impose
and obliga-
lly and col-
thy of our
ultivate our
great heri-
unity offers,
ledge. We
! the spirit
d position.
at has dis-

1 obscurity

ont us, and
of a dis-
ess of the
that have
assiduous

our great
tions and

[blocks in formation]

drop to the mean level in this regard. There can be little doubt but that the pendulum is swinging from the extreme degree in specialized medicine so that in a few years the normal balance between the specialist and the general practitioner will be established.

Along with the growth of specialized medicine has come the laboratory, which at the present time is the brain of practical scientific medicine. It is to the laboratory that we are chiefly indebted for all of the great discoveries in medicine and the allied sciences. The beginning of this era of laboratory work was the establishing of Von Ziemssen's laboratory in Munich in 1885.

Among the great discoveries which we owe to the laboratory are Pasteur's work on pathogenic microbes, in which he brought out the theory of protective inoculation against certain infectious diseases. Later on he gave to the medical world the results of his studies on rabies and anthrax, which have been of immeasurable service to mankind throughout the civilized world.

About the same time Koch introduced a new method for the isolation and pure culture of bacteria which is essentially the same as is now in use. In 1874 Ehrlich improved the method of staining smears which had been worked out by Weigert three or four years previously. This opened the door to the study of a great number of microorganisms and has proven one of the most important diagnostic criteria in the practise of medicine. As a result of Weigert's and Ehrlich's laboratory technique the spirillum of relapsing fever was discovered in 1873 by Obermeier and the parasitic amoeba in dysenteric stools by Loesch in 1875. Koch was able to grow anthrax bacilli for the first time in artificial media in 1875. In 1879 Neisser announced the discovery of the gonococcus. In 1880 Pasteur presented his monograph on the study of the streptococcus and the staphylococcus which had been isolated for the first time by him two years previously. About the same time Eberth described the typhoid bacillus as the cause of the continued fever known as typhoid. Laveran discovered and described

the plasmodium of malarial fever, N 6, 1880.

Perhaps the most important of th coveries and the one which attracted i the most wide-spread attention amo laity as well as the medical professi that of the tubercle bacillus by Koch Tuberculosis had been known and d for centuries, but the microorganism produced it had eluded all of the keer servers up to that time. Another equally important discovery made by I 1883 was the diphtheria bacillus; its relation to diphtheria was demonstra Loeffler in the same year. Along ab time came the discovery of the tetanu lus, the colon bacillus, the meningococ bacillus of Malta fever and a nun others. Still another contribution alo line was that of Smith and Kilbour discovered that Texas fever was tran by the cattle tick. However, some antedating the announcement of Sm Kilbourne, Dr. A. F. A. King, of th read a paper before this society in w expressed the belief that malaria was mitted by the mosquito. This may, an ably did, give a hint as to the transmi certain infectious diseases, which led able discoveries, chief of which was Reed and Carroll of this city, who strated that yellow fever was transmitt certain species of mosquito; thus cor ing Dr. King's theory. As a result discovery Cuba was made safe to the and the completion of the Panama Ca made possible.

Another notable contribution to p bacteriology was the discovery in 1 Widal of the agglutination test for fever, upon which the present-day diff diagnosis between typhoid and oth tinued fevers rests.

With the mention of one addition portant discovery I will pass on to ments in other fields. Perhaps none mentioned heretofore have arrived at prominent place in the history of y discoveries than Wassermann's serod

of syphilis in 1907 and Schaudinn's discovery of the Treponema pallidum, two years earlier, in 1905.

Medical science is indebted to the pathologists for many important and valuable contributions during the past fifty years. As a result of their investigations the pathology of many of the diseases to which human flesh is heir has come to be more or less understood. The progress of physiology has kept pace with pathology along allied lines, but its scope is much more comprehensive than the latter, as it invades the domain of chemistry to some extent. This field of medical research has contributed more of practical value than any other, with the exception of bacteriology, with which it is also closely linked. In this field has been developed the knowledge of the ductless glands which at the present time is attracting so much attention. It was BrownSequard who, in 1891, called attention to this domain of the body.

Charcot laid the foundation for the later developments in psychoanalysis by his studies on hysteria a half a century ago. Freud in the present generation has carried this branch of medicine to the point of practical application. To Golgi's method of staining, which was given to the medical profession in 1873, the knowledge of the histology of the nervous system is attributable.

The place which Lister occupies in relation to the developments of surgery is recognized by the entire scientific world. Not infrequently he is alluded to as the father of modern surgery. As he antedates the period covered by this paper I will not dwell further upon his achievements, although to him may be attributed the foundation of aseptic surgery.

The advancements in this branch of medicine are so many and spectacular as to well nigh overwhelm the chronicler of a brief history of medical progress.

One of the earliest important steps in the progress of surgery was the introduction of steam sterilization of dressings and instruments in 1886 by von Bergmann. This super

[ocr errors]

seded corrosive sublimate

use.

Esmarch, in the early seve tion to his method of cont at operations by bandaging site of operation, thereby g an almost bloodless field ar for exact work, and at the the patient from unnecessa

Sir Spencer Wells went devised the clip or hemosta up the individual bleeding of operation, this doing awa method.

Local anesthesia by ether duced by Richardson in 188 Anrep and Kohler about th Corning, in 1885, described experiments in spinal anesth claim for this new and im has been made in Germany in the same year. called attention to the impo of cerebro-spinal fluid in system diseases.

[ocr errors]
[ocr errors]

1

[ocr errors]

Six yea

As a result of the work later Quincke, Crile develop anocia-association, which for widely used.

The strides in abdominal s past twenty-five years have varied and extensive as to n to select any high points f they all come well within th

It may not be inappropriat in passing to the fact that m progress in field surgery has great surgical clinics whic veloped during the past tw here and abroad.

The care of the mother at oldest branch of the practise without doubt, the most imp ture of the world. Whereas no startling developments i medicine yet the obstetricia with the surgeon in mode asepsis.

The progress in the field

[blocks in formation]
[ocr errors]
[ocr errors]
[blocks in formation]

upon the developments in bacteriology, physiology, histology and chemistry. A history of any one of these necessarily describes diagnostic progress.

In therapeutics the most noteworthy advance was the gradual transition from the oldtime so-called gunshot prescription to the simple single drug prescription devoted to the specific need for which it is to be used. Some of the more beneficial additions to modern therapeutics are chloral as a hypnotic and the salicylates for the relief of so-called rheumatic affections.

The discovery of the hemostatic effects of certain drugs by means of which hemorrhage beyond the reach of the hemostatic instruments may be controlled has been a great boon to the physician and to the surgeon.

In the eighties the antipyretic drugs were given to the profession and were soon eagerly appropriated by the laity for the relief of vague and distressing pains in one part of the body or another.

A very important contribution to therapeutics was the introduction of von Behring's anti-diphtheritic serum in 1893. Another was the introduction of anti-typhoid inoculation. The modern synthetic sleep-producing drugs, of which trional and sulphonal are examples, were introduced in 1893. Novocain, which is widely used, was discovered by Einhorn in 1905. No more important remedial agent has been given to the medical profession than Ehrlich's salvarsan in 1909, which has done much to rob syphilis of its terrors both to the community and to the individual.

The multiplicity of pharmaceutical and biological products is bewildering and a large percentage of them are useless and serve merely to enrich the manufacturers and to deceive for a time the credulous public.

The most spectacular of all the discoveries in modern medicine is that of the X-ray, which Roentgen announced in 1895. Not only has it proven a useful therapeutic agent but it holds a commanding position among diagnostic methods. Another therapeutic agent which aroused a great deal of attention was the introduction of radium for

the treatment of cancer and indolent the exact value of which has not, as ye definitely determined. The trend of to therapeutics is to limit the amou number of drugs used, and to employ h and dietetic measures in the treatment ease, and to reach out after propl methods.

In passing from a consideration of peutics I may be pardoned for calling tion to the fact that the medical pro differs from all others in being the or which, in its practise, is self-destruct teaching the public laws of social 1 and of preventive measures.

A necessary development in the sc care of the sick was the advent of the nurse, who came to be recognized as essity in the latter part of the nin century. Nursing as a profession wa gested by Dr. Samuel Gross about fift ago, and shortly thereafter, on Aug 1875, the first training school for nurs formally opened at Bellevue Hospital, Soon, other training schools were estal until at the present time training scho are to be found in great n throughout the civilized world.

nurses

It would be difficult to conceive the bility of carrying out the modern met caring for the sick without the invalua of that great body of earnest and int women who go to make up the nursin fession. One has only to mention th Cross to realize the deep root the nursi fession has taken in the social fabric world.

Of necessity the scheme of medical tion and the development of medical li have grown with the needs arising out progress of the profession during the pa century.

Having considered briefly a few of th important epoch-making discoveries have marked the progress of the 1 profession during the past half centur we not draw therefrom encouragem look at the future, rich in the pron developments which will progressively

250

disease, wretchedness, poverty and despair. This, ladies and gentlemen, is truly the highest mission of the medical man.

There remain many problems which in our day are yet unsolved and in each decade new questions will arise.

Among some of the more pressing problems which face the medical profession of to-day is the discovery of the cause of cancer; a more perfect control of tuberculosis, leading to its ultimate eradication; the ultimate elimination of venereal diseases through compulsory registration, and a wider dissemination of the knowledge of these diseases among the laity, a more accurate knowledge of the etiology, pathology and care of epilepsy, the sufferers from which are the most pathetic and dependent members of society; the relief of and the ultimate prevention of nutritional diseases through a more perfect knowledge of dietetics and hygiene on the part of physicians and the public; a crusade against the ever-increasing number of those, especially the young, who are afflicted with defective eyesight, due chiefly to improper lighting of homes and school rooms; and too frequent attendance at motion picture entertainments.

In closing I can not do better than to leave with you the thoughts embodied in an address by that great medical teacher, Dr. Keen, who says:

In all humility, but with earnestness, medical men tender you their labor and practise, in the hospitals, on teacher's platform, and in the laboratory. What they expect and look forward to is appreciation, not of the individual, but of the aggregate work, and cooperation on the part of the public, for the immediate results of our work are at the same time humane and practical. The reduction in your death rate of one in a thousand means, beyond the saving of one life, a lowering of more than thirty in the total number of cases of sickness, and therewith prevention of much anxiety, wretchedness, and financial loss or ruin in as many families. Results like these are liable to be acIt should not be forgotten, cepted as natural. however, that they are obtained only by the work of medical men who labor for the good they can do, often as hermits, unknown, unappreciated, always

bent upon the diminution of lems which hitherto were deem WILLIAM

WASHINGTON, D. C.

THE SCIENTIFIC BASI
TEACHIN

[ocr errors]

THE article on The Sci Science" in the issue of O both suggestive and disappo gestive because it is the re ment in the methodology of it is disappointing because to hope that some one has a the necessary fact basis for t ing of science, yet the artic facts.

a

The author says that " more rapidly develop the rig by discovering facts for hir they were known before, th a multitude of facts discov ple." If this statement D would be quite impossible i of our knowledge for the tiate his point of view wit the statement is true but t ence is to provide a fact ba edge and establish princi Furthermore it must not these two alternatives exhau procedure. It is conceivab might develop the right me quickly by imitation, follo steps of discovery taken by vestigator than by blunder problem of his own. Whet must be determined by ca record of results, and this student, but with many.

There can be no question very important thing both and in the earlier schools student the power of creat author of the article records progress for three years in partment of a university i tomary laboratory-lecture-qu

« iepriekšējāTurpināt »