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25 - Evolution of Modern Medicine by Sir William Osler · Evolution of Modern Medicine

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  Speaker 1: Section twenty four of the Evolution of Modern Medicine. This
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  Speaker 1: is a LibriVox recording. All LibriVox recordings are in the
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  Speaker 1: public domain. For more information or to volunteer, please visit
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  Speaker 1: LibriVox dot org. The Evolution of Modern Medicine by Sir
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  Speaker 1: William Osler, Section twenty four, Chapter five, The Rise and
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  Speaker 1: Development of modern Medicine, Part three, Internal Secretions. One of
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  Speaker 1: the greatest contributions of the nineteenth century to scientific medicine
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  Speaker 1: was the discovery of the internal secretions of organs. The
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  Speaker 1: basic work on the subject was done by Claude Bernard,
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  Speaker 1: a pupil of the great Magendie, who's saying it is
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  Speaker 1: well to remember when entering a laboratory one should leave
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  Speaker 1: theories in the cloakroom. More than any other man of
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  Speaker 1: his generation, Claude Bernard appreciated the importance of experiment and
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  Speaker 1: practical medicine. For him, the experimental physician was the physician
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  Speaker 1: of the future of view, well borne out by the
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  Speaker 1: influence his epoch making work has had on the treatment
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  Speaker 1: of disease. His studies on the glycogenic functions of the
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  Speaker 1: liver opened the way for the modern fruitful researches on
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  Speaker 1: the internal secretions of the various clans. About the same
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  Speaker 1: time that Bernard was developing the laboratory side of the problem. Addison,
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  Speaker 1: a physician to Guy's Hospital in eighteen fifty five, pointed
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  Speaker 1: out the relation of a remarkable group of symptoms to
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  Speaker 1: disease of the super renal glands, small bodies situated above
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  Speaker 1: the kidneys, the importance of which had not been previously reckonedgized.
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  Speaker 1: With the loss of the function of these glands by disease,
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  Speaker 1: the body was deprived of something formed by them which
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  Speaker 1: was essential to its proper working. Then, in the last
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  Speaker 1: third of the century, came in rapid succession the demonstration
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  Speaker 1: of the relations of the pancreas to diabetes, of the
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  Speaker 1: vital importance of the thyroid gland and of the pituitary body.
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  Speaker 1: Perhaps no more striking illustration of the value of experimental
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  Speaker 1: medicine has ever been given than that afforded by the
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  Speaker 1: studies upon those glands. The thyroid body, situated in the neck,
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  Speaker 1: and the enlargement of which is called goiter, secretes substances
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  Speaker 1: which pass into the blood and which are necessary for
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  Speaker 1: the growth of the body in childhood, for the development
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  Speaker 1: of the mind. And for the nutrition of the tissues
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  Speaker 1: of the skin. If following an infection disease, a child
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  Speaker 1: has wasting of this gland, or if living in a
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  Speaker 1: certain district it has a large gorder, normal development does
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  Speaker 1: not take place, as the child does not grow in
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  Speaker 1: mind or body and becomes what is called a cretan
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  Speaker 1: More than this, if in adult life the gland is
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  Speaker 1: completely removed, or if it wastes, a somewhat similar condition
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  Speaker 1: is produced and the patient in time loses his mental
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  Speaker 1: powers and becomes fat and flabby mixedemaitis. It has been
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  Speaker 1: shown experimentally in various ways that the necessary elements of
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  Speaker 1: the secretion can be furnished by feeding with the gland
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  Speaker 1: or its extracts, and that the cretanoid or mixedemaitis conditions
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  Speaker 1: could thus be cured or prevented. Experimental work has also
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  Speaker 1: demonstrated the functions of the super renal glands and explained
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  Speaker 1: the symptoms of Addison's disease, and chemists have even succeeded
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  Speaker 1: in making synthetically the act of principal adrenaline. There is
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  Speaker 1: perhaps no more fascinating story in the history of science
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  Speaker 1: than that of the discovery of these so called ductless glands.
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  Speaker 1: Part of its special interest is due to the fact
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  Speaker 1: that clinicians, surgeons, experimental physiologists, pathologists, and chemists have all
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  Speaker 1: combined in splendid teamwork to win the victory. No such
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  Speaker 1: miracles have ever before been wrought by physicians as those
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  Speaker 1: which we see in connection with the internal secretion of
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  Speaker 1: the thyroid gland. The myth of bringing the dead back
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  Speaker 1: to life has been associated with the names of many
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  Speaker 1: great healers since the incident of Empedocles and Penthea. But
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  Speaker 1: nowadays the dead in mind and the deformed in body
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  Speaker 1: may be restored by the touch of the magic wand
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  Speaker 1: of science. The study of the interaction of these internal secretions,
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  Speaker 1: their influence upon development, upon mental process, and upon disorders
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  Speaker 1: of metabolism, is likely to prove in the future of
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  Speaker 1: a benefit scarcely less remarkable than that which we have
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  Speaker 1: traced in the infectious diseases. Chemistry. It is not making
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  Speaker 1: too strong a statement to say that the chemistry and
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  Speaker 1: chemical physics of the nineteenth century have revolutionized the world.
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  Speaker 1: It is difficult to realize that Leibig's famous geese in laboratory,
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  Speaker 1: the first to be opened to Students for Practical Study
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  Speaker 1: was founded in the year eighteen twenty five. Boyle, Cavendish, Priestly, Lavoisier, Black,
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  Speaker 1: Dalton and others had laid a broad foundation, and Young Freuenhoffer, Rumford, Davy, Jewel, Faraday, Clerk, Maxwell,
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  Speaker 1: Helmholtz and others built upon that and gave us new
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  Speaker 1: physics and made possible our age of electricity. New technique
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  Speaker 1: and new methods have given a powerful stimulus to the
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  Speaker 1: study of the chemical changes that take place in the body,
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  Speaker 1: which only a few years ago were matters largely of speculation. Now,
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  Speaker 1: in the words of Professor Lee, we recognize that, with
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  Speaker 1: its living and its non living substances inextricably intermingled, the
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  Speaker 1: body constitutes an intensive chemical laboratory in which there is
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  Speaker 1: ever occurring of vast congarees of chemical reactions. Both constructive
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  Speaker 1: and destructive processes go on. New protoplasm takes the place
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  Speaker 1: of old We can analyze the income of the body,
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  Speaker 1: and we can analyze its outcome, and from these data
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  Speaker 1: we can learn much concerning the body's chemistry. A great
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  Speaker 1: improvement in the method of such work has recently been
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  Speaker 1: secured by the device of inclosing the person who is
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  Speaker 1: the subject of the experiment in a respiration calorie meter.
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  Speaker 1: This is an air tight chamber artificially supplied with a
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  Speaker 1: constant stream of pure air, and from which the expired air,
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  Speaker 1: laden with the products of respiration, is withdrawn for purposes
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  Speaker 1: of analysis. The subject may remain in the chamber for days,
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  Speaker 1: the composition of all food and all excrete being determined,
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  Speaker 1: and all heat that is given off being measured. Favorable
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  Speaker 1: conditions are thus established for an exact study of many
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  Speaker 1: problems of nutrition. The difficulties increase when we attempt to
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  Speaker 1: trace the successive steps in the corporeal pathway of molecule
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  Speaker 1: and atom. Yet these secrets of the vital process are
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  Speaker 1: also gradually being revealed. When we remember that it is
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  Speaker 1: in this very field of nutrition that there exist great
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  Speaker 1: popular ignorance and a special proneness to fad and prejudice,
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  Speaker 1: we realize how practically helpful are such exact studies of metabolism.
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  Speaker 1: End of section twenty four.