Introductory lecture to a course on the theory and practice of medicine : delivered at the Medical School Park Street Dublin / by William Stokes.

  • Stokes, William, 1804-1878.
Date:
[between 1830 and 1839?]
Catalogue details

Licence: Public Domain Mark

Credit: Introductory lecture to a course on the theory and practice of medicine : delivered at the Medical School Park Street Dublin / by William Stokes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    vantage is to be derived from 1 ho careful study of symptoms, even in cases whose pathological nature is not revealed by the knife. They believe that there are many diseases whose local origin cannot be demonstrated; for in- stance, fever. They deny that pathological anatomy is always to be our guide; but ad- mit a rational empiricism, and the use of remedies which may be called specifics; and, lastly, they hold that nature in many cases makes an attempt to cure; and that the phy- sician, in the words of Hippocrates, is to be the minister and interpreter of Nature, rather than her master. Let us then combine the precepts of the founder of medicine with the lights of modern science. Let us take observation, and that ob- servation rendered fruitful by study, for our guide; and-let the observation equally em- brace the phenomena of the living as well as the dead. Let us be Hippocratists in the dissecting room as well as at the bed-side. By comparing the practice of these two schools we get more accurate ideas as to their doctrine. The anatomists, holding that all diseases are local, direct their whole attention to the discovery of the lesion and its con- nexion with symptoms. This, with their doc- trine that almost all diseases are inflammatory, leads them to a strict general and local anti- phlogistic treatment. Fever is. to them symp- tomatic, and the supposed source is to be vigourously attacked in the commencement. Diathesis, the nature of the epidemic, and the powers of nature, to effect a cure, are comparatively neglected. They inhibit pur- gatives for fear of increasing the local inflam- mation, and lose many patients for want of a timely support of the powers of life. They deny specificism in disease as well as in medicine, and are sorely puzzled to explain the extraordinary powers of bark, and mer- cury, and sulphur, and iodine. They despise the experience of the past. The true Hippocratist, on the other hand, believing that we have not yet arrived at the knowledge of the local origin of all diseases, and particularly fevers, grounds his practice accordingly. He draws his experience from the recorded knowledge of the past, and his own unbiassed observation. When he recog- nises a local inflammation ho meets it with judgment, taking into account the habit, dia- thesis, epidemic, constitution, and tendency to crisis. He trusts much to nature, and watches her operations, particularly in fever. He is not afraid of moderate evacuations; the phan- tom of a local inflammation does not always haunt him; and even where he recognises its existence, that does not prevent him from using a stimulating and supporting treatment, if the general state of the patient requires it. He treats particular diseases by particular reme- dies, the utility of which has been proved by experience — such as syphilis, scrofula, inter- mittent fever, and so on. He uses the expect- ant medicine, which is not inactive treatment, but founded on the observations of the powers of nature:—“ Natura morborum medicatrix but he never loses the opportunity of doing good when such presents itself, remembering the first aphorism of his great master : “ Occasio prseceps.” I have great hopes for medicine, for I see men’s minds turning to the true path; and I trust that all whom I now address will deem themselves as labourers in the great work. Think what a noble science you profess! — the only one relating to earth-born things, which, while it ennobles the mind of man, yet softens and expands his heart; whose source is all science, whose end is good to man. Above all things follow truth ; Nature can never deceive,—see that you be her faithful interpreter. The great evil is, that there has as yet been adopted no means by which the experience of the past can be brought fully to bear on the actual teaching and practice of medicine. Too often has the physician to create his own instruments. But when all the scattered facts of medicine are collected, whether they be the observations on the living or the dead body, as old as history or as young as to-day; when these votive tablets are hung up in the temple of truth, and their facts verified, compared, and classified, then, and not till then, will you see medicine in all her glory.