The Study of the History of Medicine.

NZMJ, 1926

By James Young, M.D.

Times change, and we are said to change with them. Whether the changes make for better or for worse each at the moment seems to be an improvement and a step towards a still higher future. At least that is the modern belief or assertion. But it was not always held with faith. Every man now describes the changes as progress, and asserts that never in the world was there such a hopeful time as the present. Somehow the experiences of the past ten years have somewhat disturbed this comfortable notion, although it cannot be said to be unfixed. Indeed, I should be unwilling to unfix it were the task within my power. This hopeful idea or condition of mind has its use, so let it pass.

One often hears the question put, in all departments of human activity—what is the use of recalling the past? of bringing out the assumedly absurd views and practices of a dead past when there are such wonderful things going on now that concern us immediately? This is a puzzler for your sheer utilitarian, who usually closes his eyes to all but the immediately obvious. Somebody has retorted—“What is the use of a baby?” and the answer is just as difficult.

Yet a very superficial knowledge of the history of notions pertaining to our own work might suggest humbly a kind of utility for the study of the past, even to the severest critic of the purely practical school. For one instance, take the case of Phillipe Ricord (1799-1889), whose name was very great as an authority on venereal diseases when I was a medical student. He has corrected John Hunter’s error about the identity of gonorrhœa and syphilis and had written much about these subjects, saying many wise and witty things, not only about these diseases, but also about who acquired and who treated them. Oliver Wendell Holmes called him “the Voltaire of pelvic literature—a sceptic as to the morality of the race in general, who would have submitted Diana to treatment with his mineral specifics, and ordered a course of blue pills for the vestal virgins.” Well, this mighty authority, Ricord, in 1838 published a large volume— his ‘Traite Pratique des Maladies Veneriennes’—in which he makes the statement, apparently supported by thousands of experiments, that secretions for secondary syphilitic affections do not bring syphilis to those who are uninfected previously. Now, such, even in the last century, was the influence of mere authority, that it took (according to my sources) the experiments of 19 physicians of many lands to prove that the blood and pathological secretions of secondary syphilitics do carry the infection—which was done in 77 cases. Now this was a terrible sacrifice to correct an error which a little knowledge of past experience would have prevented. The matter had been determined in the earliest century of the recognition of syphilis as a distinct disease. The literature of the subject is full of accounts of infection of the mouth from secondary syphilis cases, conveyed by drinking vessels, kissing, biting, etc. Bath-keepers in Moravia, as early as 1496, were literally forbidden, under penalty of ten gulden, to use upon non-syphilitic patients any surgical instrument that had been used with syphilitics on any account. This indicates that much mischief was known to have arisen from this malpractice before such a regulation was made. Notwithstanding this regulation there arose in Brünn in the year 1577 an epidemic of the disease due to dirty cupping instruments in one “badestube.” This was described repeatedly by several physicians. Other similar epidemics were reported in several parts of Germany due to similar causes.

Not only in these instances of long past times, but also during Ricord’s own lifetime, there was an epidemic which drew much attention but apparently failed to meet Ricord’s. In 1811 Johann Nepomuk Rust published an account of a considerable epidemic of syphilis in the Jewish population of Cracow in 1805, among children there who had been circumcised by an operator who was suffering from syphilitic ulcers of the mouth and throat. Newspapers of the day paid much attention to this. Thus a moderate acquaintance with the medical history of his own time should have saved hundreds at least from the consequences of Ricord’s error. Before 1838, when Ricord made this astonishing statement, there had been (according to my patient source) more than fifty monographs published, in which syphilis had most clearly been proved conveyable by secondary secretions and blood to non-syphilitics.