An oration on the classification and nomenclature of diseases, with remarks on diseases due to treatment / by H.D. Rolleston, M.D., F.R.C.P., senior physician to St. George's Hospital; physician, Victoria Hospital for Children.

  • Rolleston, Humphry Davy, Sir, 1862-1944
Date:
[1909]
Catalogue details

Licence: In copyright

Credit: An oration on the classification and nomenclature of diseases, with remarks on diseases due to treatment / by H.D. Rolleston, M.D., F.R.C.P., senior physician to St. George's Hospital; physician, Victoria Hospital for Children. Source: Wellcome Collection.

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    Sir Clifford Allbutt in the preface to his address, “On the Historical Relations of Medicine and Surgery,” delivered at St. Louis in 1904, that the existing spheres of influence should be rearranged ; therefore, as a first step the general physician and the general surgeon of hospitals should be merged and reappear as medical officers to departments or wards for special parts of the body. The medical officer in charge of the neurological department should be equally competent to diagnose and treat tuberculous meningitis, a cerebral abscess, a fractured spine, and neurasthenia; the medical officers in charge of the wards for abdominal diseases should be trained to operate when required, and in like manner the medical officers responsible for intrathoracic disease, with which might be combined disorders of the blood and of the ductless glands, should undertake the entire treatment of their cases. There are no doubt many initial difficulties in such a radical alteration in the established order of the profession, and it would necessarily have to come about very gradually. In the first place, it would naturally be objected that present physicians, being unskilled in operative technique, would only slowly be replaced by their competent successors ; this is undeniable, but in the period of transition the active asso¬ ciation of operating assistants would enable the hospital routine to be carried on. Difficulties would also arise in connexion with the allotment of some forms of disease, though in course of time a satisfactory arrangement would, no doubt, be arrived at after due consideration. Possibly surgery of the extremities and removal of superficial tumours, such as carcinoma of the breast, might, together with orthopedics, form a special group ; diseases of the kidneys might be associated with diseases of the male genito-urinary organs and gynecology respectively in the two sexes, and there might well be a department for fevers and for conditions of doubtful diagnosis. The out-patient departments would probably have to be less specialised, so as to insure a general education both for the medical officers and for students. This may seem visionary, but, as has been said, the principle is already in practice in the case of gynaecology and obstetrics. On the Nomenclature of Diseases. The nomenclature of disease is an interesting subject, but in the hurry of the day’s work there is little or no time to consider the meaning or the origin of the names of the diseases we are attempting to treat. The nomenclature exists for practical purposes and is convenient but not con¬ sistent. Our official nomenclature of the Royal College of Physicians of London undertaken in 1857 was first published in 1869 and is therefore of comparatively recent date. The advantages from a statistical point of view of such a standard