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Our Forefathers' Knowledge.

A striking feature of the “History of the Medical Society of the State of New York,” which has been appearing serially in the New York State Journal of Medicine, and is now published in book form, is the fact that a great amount of medical knowledge which we are prone to think of as originating in recent years was possessed by our forbears in medicine of the early part of the nineteenth century. In the chapter on the prize essays of the society attention is called to the fact that of the first seven essays not one is without great interest at the present time. One would be apt to think that medical matters discussed almost a century ago would have very little practical significance for the physician of the present. We are prone to assume that there has been so much development in medicine that we have been set far beyond the thoughts of that earlier time, especially in matters of treatment and knowledge of the cause of disease. This proves not to be the case, however; on the contrary, many of the subjects discussed are now of the most intense interest, and are frequently brought up in medical society meetings of the present day. The first essay was a dissertation on the “Remote and Proximate Causes of Phthisis Pulmonalis.” We might expect that at least in this the notions would be old-fashioned. The author argues, however, that consumption is not due to cold, but is due to dust-laden air of various kinds.... The whole tenor of this article would seem to stamp it as belonging to the beginning of the twentieth and not to the beginning of the nineteenth century. The second essay had for its subject the “Treatment of Typhus Fever.” At that time typhus and typhoid fevers had not been differentiated. In spite of this lack of knowledge, that would seem to promise such a dearth of suggestiveness for present day therapeutics, the essay is very interesting, especially in its references to cold water treatment. The writer quotes with approval Dr. Currie’s experiences (in Edinburgh) with cold water and cold air. Definite rules for the use of cold water in fevers were given... Though it is usually said that the thermometer came into use much later than this time, this essayist discusses the Fahrenheit temperatures of the patients. The third essay was on the “Therapeutic Uses of Iodin.” We have enthusiastic advocates of the wonderful value of iodin to-day, but none of them is any more enthusiastic than was this writer of the first quarter of the nineteenth century. He recommended beginning with small doses, but considered that the dose should be increased up to physiologic tolerance. He distinguished, however, between physiologic and poisonous effects.... The essayist mentions a number of cases in which enormous doses of the tincture of iodin and of the iodid of potassium were taken daily without bad effect. He does not recommend these huge doses, however, and in general, in reading his essay, one would be much more apt to think the writer a rather conservative professor at a postgraduate school of the last decade, and not a simple physician of almost a century ago. Probably the most interesting of the essays is the fifth. Its title is “The Influence of Trades, Professions and Occupations in the United States on the Production of Disease.” The author discusses the question of overcrowding in the tenement house districts of New York City quite in the same terms as they would be discussed by a sanitarian of the present. He asks: “Can we expect men who live thus to be orderly and sober, or women to be cleanly and domestic?...” Perhaps the most striking portion of this article on occupation and disease consists of a review of the manufacture and consumption of quack medicines, and it is interesting to note that the writer was evidently persuaded, as we are now, that the newspaper press of the country was responsible for the conditions. His expressions are worth recalling because they so completely anticipate the most modern views in this matter. He says: “There is an evil which has of late years become of excessive magnitude, and which is daily increasing—the consumption of quack medicines....” This was written in 1836! Those who are inclined to think that it is only in recent times that American medical men have made thoughtful advances in science, or have endeavored to correct professional and other medical abuses do not know that the early history of medicine in this country is full of the efforts of earnest men to bring about progress in medicine and the uplift of professional dignity. Nothing is so chastening to the self-sufficient complacency of the present generation with regard to its medical progress as to learn how much was done and known in the past, and how little of real advance there is in certain phases of medicine. It is a good thing to hark back occasionally, for to do so will make us more conservative and less ready to jump to hasty conclusions regarding the knowledge of the past and the present.