Page:Popular Science Monthly Volume 80.djvu/560

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rational therapy and for this reason the science of most interest in medicine. Pathology owes its position as a recognized science to the genius of Virchow, but, in its development, it also owes much to the period I have just discussed, as I will show in due time. To present this development properly it is necessary to turn back to 1761 and Morgagni. I must again remind you that in Morgagni's time medical science can hardly be said to have existed. It was the period of a vague philosophy which attempted to systematize diseases according to symptoms, with no reference to the anatomical conditions causing the symptoms. It was Morgagni who first insisted that the clinical history should be set side by side with the results of the autopsy and who by his publication "De Sedibus et Causis Morborum" threw the first gleam of light on the causes and nature of diseased processes, and thus gave a stimulus to the study of pathological anatomy. Before Morgagni's time, and for some time after, pathological anatomy was mainly concerned with the recording of the rare and curious, with malformations and obvious departures from the normal type; observations oftentimes interesting, but not systematized or harmonized. Morgagni is responsible for the maxim that observations should be "weighed not counted," and it was undoubtedly this point of view which influenced his observations and led eventually to the doctrine that most diseases were to be explained by changes in the organs of the body.

Another step in advance was taken when Bichat, about a quarter of a century later, referred disease to the tissues of the organs. In the meantime John Hunter (1738-1793) had applied to the problems of clinical medicine methods which we now recognize as those of experimental pathology. Still pathology was not a science; it was not systematized and it had no underlying principle. The systematization of pathological anatomy came through Rokitansky[1] (1804-1878) and the underlying principle of pathology from Virchow in 1858.

Rokitansky, the father of pathological anatomy, was an assistant to Johann Wagner, later succeeding him in 1834 as prosector and finally in 1844 as professor of pathological anatomy at Vienna. Wagner had encouraged the application to pathology of the methods of anatomy, and the publication of Rokitansky's "Handbuch der pathologischen Anatomie," completed in 1846 (one year before Virchow's "Archiv" was founded), presented to the profession the results of a most thorough study of the details of pathological anatomy. It is said that Rokitansky performed, as the basis for his classifications, more than thirty thousand autopsies. His position in pathology has been likened to that of Linnæus in botany. "Even to-day nothing can equal the accuracy of Rokitansky's observations. There are few things he did not see. When some lesion or combination of lesions seems entirely

  1. A worthy predecessor of Rokitansky was Johann Fr. Meckel, whose "Handbuch d. patholog. Anatomie" was published at Halle in 1804, the year of Rokitansky's birth.