The sun., 1919-08-17
Doctors Sixty Years Ago and Now.


The nature Of the progress made by
medicine in the last sixty years is in
dicated by a comparison between the
methods of the older physicians and
those Of to-day which Is contained in
IN address delivered by DR.. ALExAN-
DER LAMBEKT at the sixtieth annual
commencement OF the Long Island Col
lege Hospital in Brooklyn and printed
In the Medical Record.
Sixty years ago physicians were
handicapped by lack Of knowledge Of
things now deemed elementary. 1t
was in 1859 that DARWIN upset &C
cepted scientific theories with his
"Origin Of Species" The instruction
given in medical colleges omitted all
conception Of antiseptic or aseptic
surgery, all conception Of antitoxins,
all conception Of bacteriology and Of
sanitation based on 1t. Only the year
before WICKLOW had published his book
showing that the body is a cell state
In which every cell is a citizen, that
the health of every cell is a matter OF
| concern to the whole state, and that
disease Is merely conflict of citizens
In this state brought about by the ac-
ton of external forces-a contribution
to medical science comparable In i'm
portance with HARvEY's discovery OF
the circulation Of the blood. Another
generation was to pass before an &C.
curate knowledge of the blood and the
meaning OF its intricate changes Of
| the cells In various diseases was to
be acquired.
Looking backward these handicaps
seem very great In a science so beset
| with difficulties as medicine, and yet
| the physicians of those days were
ablo to do things which still awaken
admiration in their successors to-day.
DR.. LAMBERT says:
THE diagnosis rested on the ex-
| periences of the man examining and
| interpreting. from accurate and NIL
mute observations. the various
| changes. according to what he knew
the body should show In health. A
| careful physical examination. .
shrewd look with unconscious rea-
soning. and the diagnosis would be
| given. based on minute changes that
| those Of lesser experience could not
understand nor see.
ITO see FLINT or the elder JANE
WAY, thirty-fve or forty years ago.
come in TO a patient. go carefully
/ over him. listen to what could be
obtained Of a history. and give a d.
| agnosis with a marvellous accuracy.
with no aid OF clinical pathology as
developed to-day. would seem little
less than uncanny to the modern
student"
| To-day the pendulum has swung
clear to the other edge Of its arc. Dr.
LAMBERT observes Indications of an in
ability to realize that diseases are not
entities, that they are but morbid
processes varying In intensity. but the
combinations and permutations Of the
| DCL Wi olOAS VI SCoc1tAOh
functions. 1t Is possible for a patient
to be suffering from typhoid fever,
for instance, and yet not show every
possible blood reaction that chemistry
and bacteriology can produce in that
fever. But the tendency of the hu-
man mind Is to shift responsibility of
a decision, and the student of to-day
In making a diagnosis Is In danger of
relying more on the laboratory tests
than on the signs and symptoms shown
by the patient
] DR.. LAhBEBr, looks for more Ell
cient cooperation between the clint
clan and the laboratory expert In the
future-indeed for more efficient CO.
operation among experts In all
branches Of medicine. The growth Of
scientific medicine and scientific
knowledge has been so great that it
is no longer possible for one man to
confine himself to the whole subject.
The future development of the prac-
tice of medicine must come through
a greater sense Of cooperation and 4