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CUHSLROG M126.Pdf (9.901Mb) Guy's Hospital ca. 1825 Guy's Hospital, erected through the beneficence of Mr Thomas Guy, a prominent London bookseller and publisher, opened in 1725. From 1770 to 1815, medicine and the sciences on which it rests were being taught (in London) were . only at Guy's, although there.courses in anatomy and surgery being offered elsewhere. From the second half of the 18~ century, the Society of Apothecaries had become to all intents and purposes what we today would call a College of General Practitioners. When in 1815 the first Medical Act was passed, it was the Society of Apothecaries, not the College of Physicians, that the Government appointed to implement the provisions of the Act. (This continued through 1848, when a new General Medical Council was established.) The apothecary ordinarily pursued a course of apprenticeship for five years, then attended courses of instruction in medicine at the bedside and in the outpatient departments of hospitals approved for the purpose, for a period of two years. He was then eligible to take a qualifying examination, held by the Court of Examiners of the Society. (The physician, on the other hand, was an erudite scholar, who took his degree at Oxford or Cambridge, or at a foreign university. The surgeon was a member of a separate caste, with qualifications established by the Company of Surgeons. In actual practice, the functions of the three groups showed wide overlapping.) In 1825, Guy's distinguished staff included Astley Cooper as surgeon, Richard Bright and Thomas Addison as physicians, and Thomas Hodgkin as pathologist (Curator of the Museum). At that time, Guy's Hospital had 500 beds. There wa~serious overcrowding on the wards, and nursing was in the hands of a little body of elderly women, who also scrubbed the floors and cooked the meals. Until 1848 there was no separation of medical and surgical patients; cases were mixed indiscriminately on any ward that had a free bed. Disorderly crowds of patients were free to roam the hospital, or to visit the gin-shops in the neighborhood. -- adapted from H C Cameron: Richard Bright at Guy's. Guy's Hospital ~eports 107: 263-93 (1958) I' .. I J ; f r/ r t ,- I • , ;, .. ,. .,.. i •.D II-,~ ( - -t r/f ~ 1k fA vl I~ c1 t I I T L - _. /'tl-4. ~ - ~. ~7 ~1'--~- C ,~ I ~ -1~. l ( t, -, -I t, l~ ~( \ i~ ._ l;J~~ t ~"T J) ,· , '/ .J ~- f y)wJ 144152-4 KLAUSEN K, RASMUSSEN B, GJELLEROO H, ET AL CIRCULATION, METABOLISM ANO VENTILATION DURING PROLONGED EXPOSURE TO CARBON MONOXIDE ANO TO HIGH ALTITUDE. SCANO J CLIN LAB INVEST, 22,SUPPL 103-26+, 1968 •ADAPTATION, PHYSIOLOGICAL, ADULT, ALTITUDE, •ANOXIA/PHYSIOPATHOLOGY, •BLOOD CIRCULATION, BLOOD PRESSURE, CARBON MONOXIDE/TOXICITY, •CARBON MONOXIDE POISONING/PHYSIOPATHOLOGY, (CONTINUED) this volume Whewell's History of the Inductive Sciences was originally part of the library of Richard Bright, and contains his signature (above) 144152-4 UEDA G, MOTOYAHA T, SAKAI A, ET AL ON THE ADAPTATION OF BLOOD ANO CIRCULATORY ORGANS CAUSED BY INTERMITTENT LOW-PRESSURE STIMULI. J PHYSIOL SOC JAP, 31,553-64, 1969 •ADAPTATION, PHYSIOLOGICAL, ALTITUDE, ANIMAL EXPERIMENTS, •ATMOSPHERIC PRESSURE, •BLOOD CIRCULATION, BODY WEIGHT, ELECTROCARDIOGRAPHY, ENGLISH ABSTRACT, GROWTH, •HEART/PHYSIOLOGY, HEART VENTRICLE, HEMATOCRIT, HEMOGLOBINOMETRY, MALE, ORGAN WEIGHT, OXYGEN CONSUMPTION, (CONTINUED) photocopied excerpts are from Ralph Major, Classic Descriptions of Disease ON SOME MORBID APPEARANCES o~• THE ABSORBENT GLANDS · AND SPLEEN. RY DR. HODGKIN. Thomas Hodgkin_ Thomas Hodgkin was born at Tottenham in 1798 and took his medical degree at Ed~nburgh in 1823. He became a member of the College of Physicians in London in 1825 and soon afterwards proceeded to the Continent, spending much time in France and Italy. Upon his return to England, he joined the group at Guy's Hospital, becoming curator of the pathological .museum and demonstrator in pathology. He did an enormous amount of work at Gu):'S Hos­ pital in collecting specimens· and labelling them, this work forming the basis of his Lectures on t!ze Morbid Anatomy of the Serous a1id :Mucous .Membranes. Hodgkin was lecturer on pathology at Guy's Hospital for ten years, bU:t . resigned his chair after an unsuccessful candidature for the position of assistant . physician. He continued to practice medicine in London, but being very generous by nature and careless in collecting fees, g·radually dropped ·out of practice and devoted the latter years of his ' life to philanthropk work. He · formed a·deep and lasting friendship with Sir Moses Montefiore,, the Jewish philanthropist, and while traveling with him in the Orient d_ied at Joffa of rly.sentery in 1866, at the age of sixty-eig!it. He was buried at Joffa, his tomb bearing over it an ohelisk of granite with an inscription setting focth his splendid character .and attainments and also the note, "This . tomb is erected · by Sir Moses Montefiore, Bart., in commemoration of a friendship of ·more . than forty years and cif many journeys taken together in Europe, Asia1 and . Africa.• Thomas a:odgkin was a consistent member of the Society of Friends. He aJw.;i,~s wore their . characteristic dress and employed their distinctive forms · of speech, _both in his conversation and his_writings. He ~rot; an ~c.count of insufficiency of the aortic valves three years before Corngan s classic. pll.per, and described first a simultaneous enlargement of the spleen and lymph glands; a morbid en.tit}' later called by Wilks in 1865 "Hodgkin's Disease,'1 by which name it has since been known. In his Lectures on the Morbid Anatonii of the ' Serous a,id Mucous Membranes, published in 1836,. he shows a clear under• · standing of act:te appendicitis and its cor:::;ilications. CLINICAL MEMOIRS OM ABDOl\tIINAL TUMOURS AXD INTUMESCENCE. Dl: Tlll:: L.A.:U: DR. BRIGHT. Rep.rinlt:cl frwn tlw 'Guy's Hos11ital Report,.' • LJJJTED U"f G. HILARO BARLOW, 1\f.D., M.A. CANTAD., Pl1'n1ct.t.:'11 TO Gt"t-S tt()S1'11'.U .. '£HE NEW SYDENHA?II SOCIETY, LONDON. MDCCCLXI, I RICHARD BRIGHT i Richard Bright was born at Briston, England, in 1789, the son of a I wealthy banker. His father gave him an excellent education and enabled him to travel extensively. He graduated in medicine at Edinburgh in 1813. In 1820 he began practice in London and became assistant physician at Guy's Hospital, where he became associated with Addison and Hodgkin. These three great men of Guy's-Bright, Addison, and Hodgkin-each have the distinction of having a disease named after them. Bright's rise to fame was slow and gradual. At Guy's Hospital he was noted for diligent attendance in the wards and postmortem room. His Re- · port of Medical Cases, which appeared in 1827, contained the epochal. ac­ count of renal disease. Bright not only pointed out the association between dropsy, albumitiuria, and hardened kidneys,. but also found that there was an excess of urea in the blood of these patients. Bright was a very favored man, handsome, cheerful, courteous, even­ tempered, highly respected by his colleagues, and deeply loved by his · friends. He had a remarkably keen, analytical mind and made the most _careful and minute notes on his patients, often illustrating tpem by beai.1tif ul drawings, for he was a very skillful draughtsman, He died in 185S from _ arterio-sclerotk aortic disease and at the time of his death was the :most widely known British physician. Bright was little interes_tcd in theories and had no doctrines, but, · as ~ir Samuel Wilks, his colleague wrote, "he could see and we are struck with a:-tonishment at his powers of observation,. as he photog·raphed pictures of di~ease for the study of posterity." Wilks, who was associated with Guy's Hospital all his life, was its loyal historian and his writings "really gave l ht• diseases called after Bright, Addison, and Hodgkin their place in Eng­ ii:-h medicine." (Garrison) >!< Hright, Richarrl, Repol"ls of Medical Cases selcctrd .;.1ith a l'icw of //lmtratii1;; tl1e Symp­ toms and Cure of Disraus by a R(·jerrnce to Jlorl>id A11al1•111y (Lonrlon, 1827), Vol. I. CA.SES !tLt;STJV\.TI\"F.- OF Sn::1u=: o.r THE APPEAIIAXCES OusER\'AJILE ox TH£ Ex'A~1I~ATibx · OF D1sEASEs TER:1t1:-=An:-=c rn DROPSICAL EFFus1os_* The morbid ap_pearances whi,l;h prei'ent themselves on the examination of those who have difd with dro9sical effusion, either into the large cavities of the body _or into the cellular membrane, are exceedingly various: and it often becomes a matter of doubt how far these o_rganic changes are to be regarded as originally causing or subsequently aiding the production of the effusion, and ho,.,.· far they are to be · considered merely as the consequence either of the effusion or of some more general unhealthy state of the system.- If it were .possible to arrive at a .perfect ~olution or the!-e :questions, ,ve might hope to obtain the hi!;best reward which can repay :our · labours1-an increased knowledge of the nature of the dise:::,;e, and improve- ment in the means of its treatment. · One great cause of dropsical efflliion appears to be obstructed circulation; and whatever either generally or locally prevents the return of the blood through the venous system, gives rise to effusion of serum more or less extem~ive. Thus, disea~es . of the heart which delay the passage of the blood in the venous system, give rise to general effusion; both into· the cavities and into the cellular tissue. Obstructions. of the circulation through the.liver, by causing a delay in the passage of the blood through the veins connected with the vena portae, give rise to ascites.
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