The modern advancement of practical medicine and surgery : an inaugural address to the Medico-Chirurgical Society of Edinburgh / by James Y. Simpson.

  • James Young Simpson
Date:
[1853]
Catalogue details

Licence: Public Domain Mark

Credit: The modern advancement of practical medicine and surgery : an inaugural address to the Medico-Chirurgical Society of Edinburgh / by James Y. Simpson. Source: Wellcome Collection.

    7/20 page 7
    logical chemistry. The fluids of the body are reckoned by physiologists, to be in relation to the solids, as ten to one ; and in the eclecticism which marks the present era in medicine, physicians are evidently looking every year more and more to an extension in the knowledge of the nature and treatment of diseases, by new and important advances in humorism, rather than by any prospective advances in solidism. And there seems every reason to believe, that if we knew the patho¬ logical chemistry of the blood and fluids, as well as we know the pathological anatomy of the solids of the body—a knowledge I repeat that is to be longed for and worked for, but which has been only yet most slightly acquired—then medi¬ cine, both as a science and as an art, would probably make a forward march of the greatest moment. But even within the last quarter of a century, it has already progressed in no small degree by a cultivation of this department of study. Perhaps the greatest individual discovery hitherto made in pathological che¬ mistry and pathological anatomy, taken together, during the period of which I am speaking, has been the discovery, by Dr Bright, of the great frequency and great importance of albumen in the urine, as connected often, though certainly not always, with organic changes in the kidney, but indicating always to us some important change in the pathological chemistry of the blood itself. For this discovery, however, a very rude chemistry only was required—the testing, namely of the urine with heat or nitric acid. A higher and more refined organic che¬ mistry may yet enable the physician to trace other special changes of perhaps equal importance in the urine, or in the remaining fluids of the body in other diseased states. Reasoning, indeed, from circumstances apart from the evi¬ dence of any actual chemical proof, many physicians at the present time have little doubt that the origin and essence of most specific forms of febrile affections will yet be found lurking in specific morbid states of the fluids of the body, rather than in any morbid states of the solids; that they are, in other words, referable to a pathological toxicology, rather than to a patho¬ logical anatomy. And let me add, that probably most local inflammations will yet also be traced back a step further, viz. to blood-poisoning—varying in its nature, in different types and species of these inflammations. It is most prob¬ ably a special form of toxaemia or blood-poisoning for example, which produces the characteristic inflammations of the skin, and different parts of the mucous membrane seen in small-pox, in scarlatina, and in measles ; and in each of these diseases there is doubtlessly a specific poison present. It is a form of blood- poison which, in all probability, gives rise to the numerous serous and other in¬ flammations which are apt to spring up in patients suffering under albuminuria. It is, in all likelihood, some specific form of blood-poisoning that originates the specific inflammations of gout and rheumatism. Blood-poisoning of another variety, seems also to originate and beget the internal inflammatory complications seen so constantly in puerperal and in surgical fevers. A higher chemistry may, I repeat, enable us to detect the presence of special poisonous or morbid states of the blood, as the causes of these and of other varieties of diseases; and a higher chemistry also may yet perhaps enable us to neutralise these pathological poisons in the system ; or to eject them from it, by the purgative or depurating action of the lungs, kid¬ neys, intestinal canal, or other excretory organs or surfaces.
    digitised image 1
    digitised image 2
    digitised image 3