G. T. Bettany

“ ADDISON, BRIGHT, AND THE DISEASES WHICH BEAR THEIR NAMES. Operative dexterity, as was natural, arrived more quickly at perfection than did medical treatment. In fact, no one will pretend that medicine has yet travelled far, in comparison with its future achievements, when physiology, pathology, and therapeutics shall have become more complete. Thomas Addison is a specimen of the physicians of genius who have adorned this century. He is known as the discoverer of a disease which bears his name; but his true fame rests upon his practical talent in diagnosing disease. ”

“ There is not a day that I do not in my practice employ some of the modes of treatment which Graves excels in describing with the minuteness of the true practitioner, and not a day that I do not, from the bottom of my heart, thank the Dublin physician for the information he has given me.”
“Graves is in my acceptation of the term a perfect clinical teacher. An attentive observer, a profound philosopher, an ingenious artist, an able therapeutist, he commends to our admiration the art whose domain he enlarges, and the practice of which he renders more useful and more fertile.” ”

“ Again, he characterises the profession of medicine in noble terms. “The profession of medicine having for its end the common good of mankind, knows nothing of national enmities, of political strife, of sectarian divisions. Disease and pain the sole conditions of its ministry, it is disquieted by no misgivings about the justice or the honesty of its client’s cause; but dispenses its peculiar benefits, without stint or scruple, to men of every country or party, and rank and religion, and to men of no religion at all. ”

“ Maudsley, “is, that I have been engaged all my life in dealing with mind in its concrete human embodiments, and that in order to find out why individuals feel, think, and do differently, and in what way best to deal with them so as to do one’s duty to oneself and to them, I have had no choice but to leave the barren heights of speculation for the plains on which men live and move and have their being. It is not enough to think and talk about abstract minds and their qualities when you have to do with concrete minds that must be observed, and studied, and managed.” ”

“ I can imagine no boldness greater than his would be, who would neglect the study of his profession, and yet venture on the charge of interests like these; and I can imagine no ambition more honourable, no envy so praiseworthy, as that which strives to emulate the acquirements of those who are daily occupied in giving safe guidance through the perilous passages of disease, and who, in all these various difficulties and dangers, can act with the energy and calmness that are the just property of knowledge. ”

“ SIR JAMES SIMPSON AND ANÆSTHETICS. Future ages will perceive in the history of medicine and surgery in the nineteenth century no more remarkable event than the discovery and the introduction of means for relieving and temporarily abolishing pain. And although the name of Simpson is by no means the only one honourably associated with this discovery, his achievement in the introduction of chloroform places him on an enviable pinnacle of greatness. ”

“ PARKES, GUY, SIMON, AND PUBLIC HEALTH. “Prevention is better than cure” is the homely proverb which marks out a large proportion of the work of sanitary science. The prevention of disease and of its spread, and the promotion of the general healthiness of the people—these are objects which modern progress has brought into view. When they are completely attained we shall all die of old age unless cut off by accidents or violence; and this is a goal which many sanitarians of the present day have vividly before their mind. ”

“ SIR THOMAS WATSON, SIR DOMINIC CORRIGAN, SIR WILLIAM GULL, AND CLINICAL MEDICINE. The Nestor of the medical profession, Sir Thomas Watson, died in 1882, at the great age of ninety, universally beloved and honoured. Yet he had written but one extended work, the “Lectures on the Principles and Practice of Physic,” and had made no striking discovery. But to have written a book which every cultivated practitioner reads, and reads with delight and satisfaction, is an achievement given to few, many though there be who aim at it. ”

“ In 1864 was published the first edition of Parkes’s “Manual of Practical Hygiene,” a masterly book, accurate, learned, clear, full, and of the highest interest to the thoughtful mind. The introduction to this work opens with a clear definition of the subject. “Hygiene is the art of preserving health; that is, of obtaining the most perfect action of body and mind during as long a period as is consistent with the laws of life. In other words, it aims at rendering growth more perfect, decay less rapid, life more vigorous, death more remote.” ”

“ His practice was always to treat a hospital patient with exactly the same consideration as one in private. Mr. Henry Smith records the profound impression made upon him as a young student by his remarkable kindness and gentleness towards a little lame boy. It is not to be wondered at that he inspired his patients with the utmost confidence, an art that many equally clever have lacked. A gentleman who came to London to have an enormous tumour of the lower jaw removed, saw several eminent surgeons, but chose Fergusson as the operator without hesitation. ”

“ Could any one be surprised at the outbreak of some devastating pestilence a hundredfold more destructive than the plague or black death of the Middle Ages? And ought not every sanitary reformer to aid the revival of the ancient practice which would convert the existing cemeteries, so rapidly becoming sources of danger to the public health, into permanently beautiful gardens, receptacles for vases and cinerary urns, which would encourage sculpture, mural decoration, and coloured glass-work ”

“ We have to dissect nature; which, for practice, is better than to abstract it.” “To clinical medicine the body becomes a pathological museum. In every part we recognise certain proclivities to morbid action; and the purpose of our study is to trace these tendencies to their source on the one hand, and to their effects on the other.” “The effects of disease may be for a third or fourth generation, but the laws of health are for a thousand.” “Happily, at this day, hygiene has gained strength enough to maintain an independent position in science. ”

“ He unfortunately pursued his experiments while alone, and was found dead on July 7, 1866, in his consulting room at Savile Row, with a pad of cotton wool over his face, and chloroform and prussic acid bottles, his open watch, and various memoranda of experiments near him. His death excited universal sympathy for Mr. Toynbee’s widow and nine children, with whom he had lived most happily.
If one great aural surgeon became a martyr of science, another was no less a martyr of philanthropy. ”

“ SIR HENRY THOMPSON AND CREMATION. The mode of disposing of the remains of the dead is naturally one upon which doctors may be expected to have a good deal to say. As guardians of the health of the living, the dangers and diseases which the material remnants of our deceased friends may occasion the living must concern the medical profession. The increasingly dense aggregation of human beings in great towns has impressed the last two generations with the necessity of doing something to prevent disease from spreading through delay in burial, and the use of unsuitable burial-places. ”

“ At this period of his career, when practice as yet was but scanty, he was much encouraged by reading “The Lives of British Physicians, from Linacre to Gooch,” published in 1830, and he referred to it afterwards as showing that “there is but one road to excellence and success in our profession, and that is by steady study and hard labour; and you will at least always have this consolation in your dreariest hour of labour, that no proud man’s contumely, no insolence of office, nor ‘spurns that patient merit of the unworthy takes,’ can bar your way.” ”

“ There is no method so good for maintaining a constant habit of inquiry, with accuracy and perseverance in research, the power of weighing evidence, of calmly judging, and of accurately speaking; none better for cultivating the love of truth, the contempt for fallacies, whether others’ or our own, the gentleness and courtesy which are appropriate to the consciousness of the imperfection of our knowledge. ”

“ As you visit the wards of this hospital, mark some of the hardly less portentous questions which, before a few years are past, you may be permitted to determine. In one, you will find it a doubt whether the remainder of the patient’s life is to be spent in misery, or in ease and comfort; in another, whether he and those who depend upon his labours are to live in hopeless destitution, or in comparative abundance. One who used to help his fellow-men finds ground to fear that he may be a heavy burthen on their charity. ”

“ To know and counteract the causes of disease before they become effective is evidently the triumph of our art; but it will be long before mankind will be wise enough to accept the aid we could give them in this direction. Ignorance of the laws of health, and intemperance of all kinds, are too powerful for us. ”

“ How long will it be before men perceive and acknowledge the eternity of action, good or ill, and feel the keen sense of responsibility, and the strong sentiment of duty which so awful a reflection is fitted to engender? How long before they realise vividly that under the reign of law on earth sin or error is inexorably avenged, as virtue is indicated, in its consequences, and take to heart the lesson that they are determining [Pg 237] in their generation what shall be predetermined in the constitution of the generation after them? ”

“ The body lies there, pale and motionless, except only that the jaw sinks slowly but perceptibly. The pallor visibly increases, becomes more leaden in hue, and the profound tranquil sleep of death reigns where just now were life and movement. ”

“ Already a thousand changes have commenced. Forces innumerable have attacked the dead. The rapidity of the vulture, with its keen scent for animal decay, is nothing to that of nature’s ceaseless agents now at full work before us. ”

“ The early love of Nature, especially as manifested by the Habits and Instincts of Animals to which you refer, in your own case, is so common to a healthy boy’s nature, that the Parlour Menagerie, a work so singularly full of interesting examples culled from so wide a range of Zoology, and so fully and beautifully illustrated cannot fail to be a favourite with the rising generation—and many succeeding ones—of Juvenile Naturalists. ”

“ The duty which lies nearest to us must ever have the first claim; and it cannot but be admitted that the nearest duty each man has to his fellow is to save him as far as possible from all injury, even though that injury may arise as the consequence of his own fault. Nor will it be questioned that the cause of morality is more advanced by beneficent interference than by permitting ourselves to stand passively by whilst intemperance and vice work ruin and infect the very fountains of life. ”

“ Again, with hawk eye the people who want to be cured of disease mark and then swoop down upon men who appear to them specially capable in one department of medical practice, and no denunciation of specialism, no drawing back on the part of the physician, will avail against this natural selection. The man to whom crowds of patients of one kind flock naturally becomes specially skilled in dealing with them: and it is impossible to stem the tide by saying that such ought not to be the case. ”

“ The methods in vogue in Edinburgh had not impressed Graves favourably. Students were not then regularly called upon to investigate cases for themselves, nor trained in so doing: they might obtain their degree without having ever practised diagnosis or co-operated in curing disease even to the extent of writing a prescription. “Often have I regretted,” said Graves in his introductory lecture at the Meath Hospital in 1821, “that, under the present system, experience is only to be acquired at a considerable expense of human life. ”

“ One of the inevitable consequences of such a system is frequent disappointment in foretelling the issue of the malady, that most important of all points to the reputation of a physician, and though such a mode of investigation might not prove unsuccessful in the skilful hands of Dr. Baillie, it must be allowed to be an example of dangerous tendency to those who have not had his means of acquiring knowledge, nor enjoyed the advantages of his great experience, nor have learned by the previous steps of education and good discipline to reason and judge correctly. ”

“ Finally we may quote some sentences from Sir James Paget’s lecture on “Elemental Pathology,” delivered before the British Medical Association in 1880, as expressing his philosophy of life. “I hold it to be very desirable that every one of us should, all his life long, study some science in a scientific manner. There seems to be no equally good method for maintaining the temper and the habits, which by making us always good students, will make us as good practitioners as we can be. ”

“ On more than one occasion he spoke and wrote strongly regarding the exertions and the mortality of Irish doctors in combating fevers and cholera, while receiving the merest pittance from Government for their services. His feelings as to everything relating to the welfare of the profession and the general culture of the student were actively displayed. “Let us emancipate the student,” he said, “and give him time and opportunity for the cultivation of his mind, so that in his pupilage he shall not be a puppet in the hands of others, but rather a self-relying and reflecting being. ”

“ He further powerfully indicates the basis of state medicine, to secure for all individuals the conditions of health which they often cannot secure for themselves. He shows too that self-interest, state-benefit, and pecuniary profit are at one in these matters when rightly understood. “It is but too commonly forgotten,” he says, “that the whole nation is interested in the proper treatment of every one of its members, and in its own interest has a right to see that the relations between individuals are not such as in any way to injure the well-being of the community at large.” ”

“ Gentlemen, if you require an apology for detaining you so long, I find ample material for that apology in the lively interest in which we must all feel in the comfort and happiness of the other sex, doomed as they are, both by the decrees of Providence and by human institutions, to drink deep of the bitter cup of suffering. ”