Address in Medicine

T. R. Fraser
1898 BMJ (Clinical Research Edition)  
was delivered by the accomplished and universally -beloved physician, Dr. Warburton Begbie, and notwithstanding the lapse of time, I can still recall-and there are others here also able to recall-the thesis which formed the subject of the address, expressed in the iniquiry, Has the practice of medicine made a single step since the time of Hippocrates? In dealing with this thesis, Dr. Begbie described the hiistory of medicine from its beginnings, as only could be done by one who had not only
more » ... ho had not only carefully studied the writings of the Fathers of medicine, but had also made himself familar with the work of their successors. The doctrines regarding the nature of disease, which successively replaced eaclh other during the twenty-three centuries dealt with, were clearly described, and, as was to be expected from the practical physician, he fully discussed the bearings of these doctrines upon treatment, and pointed to the more conspicuous acquisitions in the healing art which had enriched practical medicine. He had the opportunity of showing how greatly medical doctrine had been transformed by Harvey's discovery of the circulation of the blood; how the diagnosis of pulmonary and cardiac disease had received an extension and previously unknown definition from Laennec's discovery of auscultation; how the memorable discoveries and courageous applications of nitrous oxide, ether, and chloroform, by Horace Wells, Morton, and Simpson, had deprived the knife of the surgeon and the reproduction of animal life of much of their former terrors and anxieties; and how by that vaccination, which will ever be associated with the name of Jenner-the first and still unsurpassed means of restricting the ravages of a fatal infectious disease-an almost incalculable benefit had been conferred upon the human race. From his elaborate survey of the hlistory of medicine, he -concluded that no general doctrine-chemical, physical, -humoral or physiological had been propounded which satis-'factorily explained the nature and production of disease; that therapeutic advancement had been obtained, chiefly by the observation of patients, by adhesion to the classic method of rational empiricism; and that by this method such valuable accessions to the means of treating disease had been gained as the administration of turpentine in pulmonary gangrene and bronchitic affections; of quinine in intermittent fever; of iodide of potassium in syphilitic periostitis and thoracic aneurysm; of bromide of potassium in epilepsy; and of codliver oil in pulmonary tubercle. It may not be without interest to consider to-day how far, and in what directions, this great and wide subject of medicine has chiefly-advanced since Dr. Begbie delivered his 'address. The intervening period is the relatively brief one of scarcely a quarter of a century. It has, however, been 'signalised by a great increase of knowledge regarding the fundamental sciences of chemistry, physiology, and morbidanatomy; by the creation of pharmacology as a science of the action of remedies; by steady advance in symptomatology and diagnosis, and above all by so remarkable a development 'in our conceptions of the nature and production of many diseases, that we appear aimost to lhave attained a position, vainly sought for during centuries by our predecessors, of 'being able to formulate a doctrine of disease, founded upon
doi:10.1136/bmj.2.1961.287 fatcat:7afu7nyconh4xpu2j7hzmqnu5q