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

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  Speaker 1: Section twenty five 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. Recording by Larry Wilson. The Evolution of
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  Speaker 1: Modern Medicine by Sir William Osler, Chapter six, The Rise
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  Speaker 1: of preventive Medicine. Introduction. The story so far has been
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  Speaker 1: of men and of movements, of men who have consciously
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  Speaker 1: or unconsciously initiated great movements, and of movements by which
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  Speaker 1: Nolan's Vollan's the Men of Time were molded and controlled. Hippocrates,
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  Speaker 1: in the Tractate on Ancient Medicine, has a splendid paragraph
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  Speaker 1: on the attitude of mind towards the men of the past.
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  Speaker 1: My attention was called to it one day in the
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  Speaker 1: Roman form by Commendatory Bony, who quoted it as one
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  Speaker 1: of the great sayings of antiquity. Here it is it
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  Speaker 1: is quote. But on that account I say, we ought
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  Speaker 1: not to reject the agent art as if it were
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  Speaker 1: not and had not been properly founded, because it did
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  Speaker 1: not attain accuracy in all things, but rather, since it
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  Speaker 1: is capable of reaching to the greatest exactitude by reasoning
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  Speaker 1: to receive it and admire its discoveries made from a
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  Speaker 1: state of great ignorance, and as having been well and
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  Speaker 1: properly made, and not from chance unquote. I have tried
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  Speaker 1: to tell you of what the best of these men
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  Speaker 1: in successive ages knew, to show you their point of
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  Speaker 1: outlook on the things that interest us. To understand the
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  Speaker 1: old writers, one must see as they saw, feel as
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  Speaker 1: they felt, believe as they believed. And this is hard,
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  Speaker 1: indeed impossible. We may get near them by asking the
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  Speaker 1: spirit of the age in which they lived to enter
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  Speaker 1: in and dwell with us, but it does not always come.
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  Speaker 1: Literary criticism is not literary history. We have no use
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  Speaker 1: here for the former. But to analyze his writings is
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  Speaker 1: to get as far as we can behind the doors
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  Speaker 1: of a man's mind, to know and appraise his knowledge,
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  Speaker 1: not from our standpoint, but from that of his contemporaries,
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  Speaker 1: his predecessors, and his immediate successors. Each generation has its
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  Speaker 1: own problems to face, looks at truth from a special focus,
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  Speaker 1: and does not quite see the same outlines as any other.
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  Speaker 1: For example, men of the present generation grow up under
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  Speaker 1: influences very different from those which surrounded my generation in
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  Speaker 1: the seventies of the last century, when Verkou and his
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  Speaker 1: great contemporaries laid the sure and deep foundations of modern pathology.
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  Speaker 1: Which of you now knows the cellular pathology as we
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  Speaker 1: did to many of you, It is a closed book
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  Speaker 1: to many more. Vichau may be thought a spent force,
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  Speaker 1: But no, he has only taken his place in a
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  Speaker 1: great galaxy. We do not forget the magnitude of his labors,
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  Speaker 1: but a new gene generation has new problems. His message
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  Speaker 1: was not for you, but that medicine to day runs
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  Speaker 1: in larger molds and turns out finer castings is due
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  Speaker 1: to his life and work. It is one of the
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  Speaker 1: values of lectures on the history of medicine to keep
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  Speaker 1: alive the good influences of great men, even after their
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  Speaker 1: positive teaching is antiquated. Let no man be so foolish
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  Speaker 1: as to think that he has exhausted any subject for
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  Speaker 1: his generation. Virgiw was not happy when he saw the
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  Speaker 1: young men pour into the old bottle of cellular pathology
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  Speaker 1: the new wine of bacteriology. Lister could never understand how
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  Speaker 1: a septic surgery arose out of his work. Erlich would
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  Speaker 1: not recognize his epoch making views on immunity when this
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  Speaker 1: generation has finished with them. I believe it was Hegel
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  Speaker 1: who said that progress is a series of negations, the
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  Speaker 1: denial today of what was accepted yesterday, the contradiction by
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  Speaker 1: each generation of some part at least of the faulhilosophy
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  Speaker 1: of the last. But all is not lost. The germ
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  Speaker 1: plasm remains a nucleus of truth to be fertilized by men,
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  Speaker 1: often ignorant even of the body from which it has come.
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  Speaker 1: Knowledge evolves, but in such a way that its possessors
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  Speaker 1: are never in sure possession. Quote. It is because science
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  Speaker 1: is sure of nothing that it is always advancing. Unquote.
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  Speaker 1: Do close. History is the biography of the mind of man,
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  Speaker 1: and its educational value is in direct proportion to the
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  Speaker 1: completeness of our study of the individuals through whom this
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  Speaker 1: mind has been manifested. I have tried to take you
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  Speaker 1: back to the beginnings of science and to trace its
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  Speaker 1: gradual development, which is conditioned by three laws. In the
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  Speaker 1: first place, like a living organism, truth grows, and its
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  Speaker 1: gradual evolution may be traced from the tiny germ to
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  Speaker 1: the mature product, never springing maneval like to full stature
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  Speaker 1: at once. Truth may suffer all the hazards incident to
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  Speaker 1: generation and gestation. Much of history as a record of
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  Speaker 1: the mishaps of truths which have struggled to birth, only
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  Speaker 1: to die, or else to wither in premature decay, or
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  Speaker 1: the germ may be dormant for centuries, awaiting the fullness
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  Speaker 1: of time. Secondly, all scientific truth is conditioned by the
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  Speaker 1: state of knowledge at the time of its announcement. Thus,
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  Speaker 1: at the beginning of the seventeenth century, the science of
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  Speaker 1: optics and mechanical appliances had not made possible so far
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  Speaker 1: as the human mind was concerned the existence of blood
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  Speaker 1: capillaries and blood corpuscles. Jenner could not have added to
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  Speaker 1: his inquiry a study on immunity. Sir William Perkin and
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  Speaker 1: the chemists may cook technique possible. Pasture gave the conditions
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  Speaker 1: that produced Lister Davy and others furnish the preliminaries necessary
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  Speaker 1: for anesthesia. Everywhere we find this filiation, one event following
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  Speaker 1: the other in orderly sequts mind begins mind. As Harvey
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  Speaker 1: de Generacione says, quote, opinion is the source of opinion
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  Speaker 1: Democratis with his atoms, and Eudoxus with his chief good,
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  Speaker 1: which he placed in pleasure, impregnated Epicurus, the four elements
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  Speaker 1: of Empedocles, Aristotle, the doctrines of the Ancient, Thebans, Pythagoras,
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  Speaker 1: and plato Geometry euclid unquote. And thirdly, to scientific truth
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  Speaker 1: alone may the homeo mensura principle be applied, since of
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  Speaker 1: all mental treasures of the race, it alone compels general acquiescence.
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  Speaker 1: That this general acquiescence, this aspect of certainty, is not
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  Speaker 1: reached per Sultham, but is of slow, often difficult growth,
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  Speaker 1: marked by failures and frailties, but crowned at last with
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  Speaker 1: an acceptance accorded to no other project. Of mental activity
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  Speaker 1: is illustrated by every important discovery, from Compernicus to Darwin.
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  Speaker 1: The difficulty is to get men to the thinking level
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  Speaker 1: which compels the apple cation of scientific truths. Protagoras, that
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  Speaker 1: mighty wise man, as Socrates called him, who was responsible
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  Speaker 1: for the aphorism that man is the measure of all things,
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  Speaker 1: would have been the first to recognize the folly of
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  Speaker 1: this standard for the people at large. But we have
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  Speaker 1: gradually reached a stage in which knowledge is translated into
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  Speaker 1: action made helpful for suffering humanity, just as the great
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  Speaker 1: discoveries in physics and chemistry have been made useful in
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  Speaker 1: the advance of civilization. We have traced medicine through a
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  Speaker 1: series of upward steps. A primitive stage in which it
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  Speaker 1: emerged from magic and religion into an empirical art, as
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  Speaker 1: seen among the Egyptians and Babylonians. A stage in which
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  Speaker 1: the natural character of disease was recognized and the importance
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  Speaker 1: of its study as a phenomenon of nature was announced.
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  Speaker 1: A stage in which the structure and functions of the
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  Speaker 1: human body were worked out. A stage in which the
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  Speaker 1: clinical and anatomical features of disease were determined. A stage
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  Speaker 1: in which the causes of disorders were profitably studied. And
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  Speaker 1: a final stage in which we have just entered the
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  Speaker 1: application of the knowledge for their prevention. Science has completely
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  Speaker 1: changed man's attitude towards disease. Take a recent concrete illustration.
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  Speaker 1: A couple of years ago, in Philadelphia and in some
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  Speaker 1: other parts of the United States, a very peculiar disease appeared,
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  Speaker 1: characterized by a rash upon the skin and moderate fever,
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  Speaker 1: and a constitutional disturbance proportionate to the extent and severity
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  Speaker 1: of the eruption. The first malady broke out in the
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  Speaker 1: members of a crew of a private yacht, then in
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  Speaker 1: the crews of other boats, and among persons living in
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  Speaker 1: the boarding houses along the docks. It was the cause
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  Speaker 1: of a great deal of suffering and disability. There were
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  Speaker 1: three courses open. To accept the disease as a visitation
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  Speaker 1: of God, a chastening affliction sent from above, and to
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  Speaker 1: call to aid the spirtual arm of the Church. Except
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  Speaker 1: the peculiar people, few now take this view or adopt
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  Speaker 1: this practice. The Christian scientists would probably deny the existence
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  Speaker 1: of the rash and of the fever, refuse to recognize
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  Speaker 1: the itching, and get himself into harmony with the infinite. Thirdly,
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  Speaker 1: the method of experimental medicine. First, the conditions were studied
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  Speaker 1: under which the individual case occurred. The only common factor
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  Speaker 1: seemed to be certain straw mattresses manufactured by four different firms,
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  Speaker 1: all of which obtained their straw from the same source.
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  Speaker 1: The second point was to determine the relation of the
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  Speaker 1: straw to the rash. One of the investigators exposed a
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  Speaker 1: bare arm and shoulder for an hour between two mattresses.
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  Speaker 1: Three people voluntarily slept on the mattresses for one night.
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  Speaker 1: Siftings from the straw were applied to the arm, under
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  Speaker 1: all of which circumstances the rash quickly developed, showing conclusively
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  Speaker 1: the relation of the straw to the disease. Thirdly, siftings
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  Speaker 1: from the straw mattresses which had been thoroughly disinfected, fell
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  Speaker 1: to produce the rash. And Fourthly, careful inspection of the
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  Speaker 1: siftings of the straw disclosed living parasites, small mites, which
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  Speaker 1: when applied to the skin, quickly produced the characteristic eruption
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  Speaker 1: in the section twenty five