On some rare and new diseases : suggestions for the study of part of the natural history of disease : the Bradshawe lecture delivered at the Royal College of Surgeons of England in 1882 / by Sir James Paget.

Date:
1883
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Licence: Public Domain Mark

Credit: On some rare and new diseases : suggestions for the study of part of the natural history of disease : the Bradshawe lecture delivered at the Royal College of Surgeons of England in 1882 / by Sir James Paget. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    little studied—that part, namely, which relates to the variations and the combinations of diseases in hereditary transmission. Besides, both in the choice of its subject and in the whole enterprise of giving this lecture, I have looked for an opportunity of promoting pathology by pro- moting pathological museums ; a motive which, I am sure, will be pardoned, though I am conscious of its being in some measure personal, for I have spent so much time and thought in museums that I feel as if in their greater utility I should myself become more useful. Now, first, respecting rare diseases, there may seem no want of opportunity of studying them. Our journals and the proceedings of our societies are full of the records of rare cases; many collections of such cases have been published,1 and there are many rare specimens in every museum. All these have that kind of attraction which belongs to everything that excites our wonder; but we too seldom let the wonder have its proper consequences; we too seldom let it provoke our curiosity so far as to make us search for the meaning and reason of the rarity. There is a question which we should often ask ourselves : Why is any disease rare ? at least, why is any rare which does not depend on some accident or some rarely con- curring external causes ? I shall try to suggest answers which may be, in some instances, sufficient; but I fear that, in more instances, if 1 can be useful at all, it can only be by suggesting how answers may be found. First, there is a difference, though it may often seem 1 Two of the best are Fournier, art. ‘ Cas rares ’ in the Diet, dcs Sciences Medicates (t. iv. 1813), and Eve, Remarkable Cases in Surgery (8vo, Phila- delphia, 1857). Fournier says that professorships for Lectures on rare cases had lately been established, and Dr. Norman Moore has shown me that Mr. Cross, in his Sketches of the Medical Schools of Paris (8vo, 1815, p. 4), enumerates among the regular courses of winter-lectures at the Ecole de Sant6 those on the Doctrine of Hipocrates and History of Rare Cases.