A manual of general pathology : for the use of students and practitioners of medicine / by Ernst Wagner ... Tr. from the 6th German ed. by John Van Duyn ... and E.C. Seguin.

Date:
1876
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Licence: Public Domain Mark

Credit: A manual of general pathology : for the use of students and practitioners of medicine / by Ernst Wagner ... Tr. from the 6th German ed. by John Van Duyn ... and E.C. Seguin. 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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    fiioians have distinguished themselves as HUMORAi.rSTS or solidists. Among solhl- ists the NEURO-PATHOLOGISTS and cellular PATHOLOGISTS must be separately- designated. It is the aim of cellular pathology to place our anatomical notions of disease upon an histological foundation, i. e., to connect them with the smallest integral parts which the microscope can discover. It is important enough that onr general notions should be sensorial in so far as is possible; but it was an error to suppose that cellular pathology embraced the whole of pathology. For the latter the blood and nerves are quite as important as the cells of organs. In earlier times disease was looked upon as something foreign to the organism, as something forced upon it. as something separate from the lite of the body. This conception, according to which disease was a particular entity (ox. ckx, I which lodged in the body, was called ontological. Many went so far as to speak of disease as em- bodied. Many expressions still in common use. as the disease attacks the body,’’ “ the body struggles with the disease,” “ the physician combats the disease,” *• na- ture has overcome the disease,” etc., serve to remind us of the older notions. Again, medical men have been designated as EMPIRICISTS and rationalists in matters of pathology, but more in regard to therapeutics. lie is an empiricist who reasons as little as possible, does not concern himself about the explanations of separate symptoms, or of the mode oi action of medicaments, but who relies on ex- perience. If he l>e old in years, and iij>e in so-called practical experience, he will attach especial importance to his own observations. On the contrary, those physi- cians arc called rationalists who do not value the facts themselves so highly as their explanation, and wnoseek the advance of pathoh gy in the connecting of every morbid manifeetatation immediately with physiological data. From this, however, nothing can issue but a pathology -whose facts are taken from the sick, together with certain associated physiological hypotheses. Lastly, much is said of anatomical and physiological medicine. The anatom- ical school busies itself with the investigation of anatomical changes in the diseased organs and the r relation with the symptoms exhibited during life. All important progress in medicine has been dependent upon anatomico-pathological discoveries. Up to the present time no method of study has penetrated so far towards the seat and causes of disease as pathological anatomy. The anatomical study of disease, as well u.s it.s histological or cellular study, is provisionally the most solid basis for our reasoning. And yet pathological anatomy cannot by itself explain the relations of phenomena in the sick; this is best done by a knowledge of similar processes in the healthy body, and the study of morbid processes by all the meth »ds which are used in physiology for tlm investigation of the functions of the normal body. This is physiological medicine. The correctness and importance of the pretension to build np pathology upon a physiological basis rest upon these two considerations. First, it is nect-sary to maintain the elementary notion that morbid processes do not essentially differ from normal ones: each morbid manifestation finds its analogue in physiological condi- tions and processes. There are no specific chemico pathological bodies. Leucin and tyrosin, which were looked upon by their discoverer as the cause of the nervous symptoms in atrophy of the liver, were soon proven to be usual constituents of the healthy body. There are no specific pathological forms. It was believed, a while ago, that peculiarly formed cells could be said to exist in tubercle, sarcoma, cancer ; a statement which has been shown to be false. There are no spe.eilie pathological symptoms ; even the venous pulse, which is ouly met with in morbid states, has its analogue in the arterial pulse. We may, as has been done by Virchow, designate the general morbid processes as IIETEROCHKONIC and Heterotopic : that is to aay, as processes whiua would be called normal, did they take place at a different time or in a different spot. For example, an effusion of blood in the ovary at the time of menstruation is normal; an effusion of blood into the brain is always abnormal, arid is flic cause of other mor- bid phenomena ; we have here heterotopia. Hemorrhage from the mucous mem- brane of the uterus at a certain time (menstruation) is normal; at other times abnormal, akteihmjiironia. I here is no radical difference between the forces and the substances by means of which normal and morbid life is kept up; no important difference between phy- siological and pathological laws. The difference lies in the conditions under which the forces and substance* of the body operate. lhe second important factor which is fundamental in the conception of physiolog- ical medicine, is the manner in which the altered, that is to say, pathological phe- nomena of life are investigated. This is the so-highly praised physiological method. However, physiology knows no methods save those of chemistry, and chemistry none