836 best known are those cases in which the accident has rapidly proved fatal and so do not come under the category Comments, and of those who have described the disease from personal Notes, Short Answers experience. But of these martyrs to medical research the names of a few may be mentioned :-enteric fever: Allen to Correspondents. MacFadyen, H. J. Tylden, L. Jenner ; yellow fever: W. Myers; Rocky Mountain fever : T. B. McClintie ; plague: DISEASES DESCRIBED BY MEDICAL MEN Miiller ; spirillum fever : J. E. Dutton ; glanders : J. H. Wells WHO SUFFERED FROM THEM.1 (1909). Another group contains those who have deliberately inoculated themselves with infective or probably infective BY SIR HUMPHRY ROLLESTON, K.C.B., M.D CAMB., material; thus J. W. Lazear allowed mosquitoes to bite him F.R.C.P. LOND. and by his fatal illness proved the transmission of yellow the late Dr. P. T. Manson allowed infected ST. GEORGE’S HOSPITAL SENIOR fever ; mosquitoes EMERITUS PHYSICIAN, and thus malaria PHYSICIAN, VICTORIA HOSPITAL FOR CHILDREN. to bite him, by contracting proved that they transmitted the disease; his death, however, was due to an the late Dr. R. of IN the selection of a subject in response to your com- independent accident; Cory, St. Thomas’s vaccinated himself with invitation it was obviously unwise to encroach Hospital, frequently plimentary vaccine from infants and on those aspects of medicine that your teachers deal with so lymph syphilitic eventually became and John Hunter inoculated himself much more advantageously, and I have accordingly chosen infected; with from a case of but one on which it is to be hoped that none of them-though pus gonorrhoea developed syphilis, and was in here I am not on safe ground-are personally competent to thus led to believe the unity of venereal speak with real authority-namely, diseases described by disease; it is, indeed, probable that his dramatic death from medical men suffering from them. Stephen Paget, in his angina pectoris was due to syphilitic aortitis. delightful Confessio Medici, says : 11 You cannot be a perfect Great Names Connected zrith Special Diseases. doctor till you have been a patient: you cannot be a perfect surgeon till you have enjoyed " (and he goes on to emphasise Bright, Addison, and Hodgkin-the great triumvirate of his choice of this verb) " in your own person some surgical Guy’s Hospital-did not suffer or die from the diseases so experience." According to this line of reasoning the perfect inseparablv connected with their names. Bright died at the author should be a man of many joys (or sorrows?) ; and age of 69 after four days’ illness attended with haematemesis, though I wish them well it is not this kind of joy that your and the-necropsy revealed pure aortic stenosis with healthy teachers deserve. kidneys. He was known to have some cardiac affection, but Victims to Tlaeir Specialty. it is said that inquisitive attempts to find out its exact nature Although the title, " Diseases Described by Medical Men were always frustrated by him ; at consultations between who have Suffered from Them," excludes the examples of several eminent physicians, including Bright, the problem was sometimes attacked to the medical men who have paid particular attention to a disease by proposing compare patient’s with that of a man but and fallen a victim to their a brief pulse presumably healthy (Bright); eventually specialty, the erudite touch of the was reference to this subject may perhaps be made. It has been inquiring colleague always said, the attractive that skilfully evaded. About Addison’s end kindly reticence possibly inspired by speculation drew a veil at the time of his but it that he is at work, that this sequence is common, death, appears auto-suggestion became insane and out of a window at and Sir William tells me that Sir Samuel jumped Brighton Hale-White Wilks, who was but never who was a doctors’ doctor, was convinced of this when 67 years old. Hodgkin, pathologist, firmly on the medical staff of died of at association. On the other hand, this coincidence is so Guy’s Hospital, dysentery Jaffa at the age of 68. Dr. Guillotin striking that there is a risk of exaggerating its frequency. Joseph Ignatius Writers of text-books would of swell this (1738-1814), who was a zealous advocate of vaccination and complete necessity a de Medecine in and must therefore be For the founder of short-lived Académie Paris, category disqualified. example, as well his Nothnagel died of what has from the toll it levies did not, poetic justice might demand, have been called the doctors’ head removed by the instrument to which his name is disease-namely, angina pectoris- attached. on which he was a but he recognised authority ; When of diseases from which was also the editor of a voluminous of giving descriptions they encyclopaedia to have had some writers medicine, and wrote on a number of other subjects. As may happen personal experience examples of authors unconscious that the future would add record their own sensations under a modest periphrasis such as "a man known to us ...... whose heart stands work a interest to their favourite grim personal professional well in all other but in whom intermittence of the subjects the following may be quoted: Laennec,who died respects from tuberculosis; Sir William Gull, with heart may occur for many days if he remain for an hour or pulmonary who, with smokers. He in a H. G. Sutton, described arterio-capillary fibrosis, from two many dare not sit close smoking cerebral Mikulicz from carcinoma of the room or in a smoking carriage." Or "a case is known to hæmorrhage; the writer in which the suffered from a severe S. 0. the author of a book on Diseases patient stomach ; Habershon, attack 18 from the onset of the disorder of the of ulcer ; G. R. Fowler, an years (bilharziasis), Stomach, simple gastric which had been in for some The late American surgeon, author of a " Treatise on the Appendix," abeyance years." and originator of the Fowler position, of appendicitis; L. G. Guthrie,4 propos of ophthalmic migraine, wrote: "In Corvisart and Lancisi of heart diseased The late Sir one case known to the writer permanent paralysis of the A. B. Garrod, who wrote in 1876 that, unlike Sydenham, ocular sympathetic appears to have been the result of he could not from personal experience describe the repeated migraine." The accurate observations of medical men on their own sensations of gout, became its victim, when 70 years in of the that " he has a fool for his of so his son the of medi- diseases, spite quip age, present Regius professor are human and add to cine at Oxford tells me. Trousseau, whose clinical patient," interesting documents, may lectures covered nearly the whole field of medicine, our knowledge of the earliest indications of disease. Such pointed are of value from the of out that if thrombosis occurred in a case of gastric disease, personal descriptions special point carcinoma might safely be diagnosed; when himself ill he view of the subjective manifestations or symptoms as opposed to The are best observed the was visited on Jan. his former physical signs. physical signs by lst, 1867, by pupil Peter, who, onlooker and the attention of the Thus when thus calling to express good wishes for the New Year, may escape patient. L. P. for some 15 or 20 each when he had the of hearing his teacher say: "It Mark, years, day painful experience looked into the to brush his hair or to shave had a is all up with me, the appearance of a of last glass patch phlebitis him in the as had leaves no for doubt as to the nature of typical acromegalic literally staring face,5 night loophole my been clear to his friends for and when 49 illness." Trousseau was right in applying his diagnostic professional years, was in a crowd Professor Pierre Marie, who deduction to his own case ; he lingered on for six months, spotted by described the disease, while in London for a dying at the age of 66 years on June 23rd, 1867. originally medical entente cordiale. His graphic account of his sensa- Occupational Diseases among Medical 3ren. tions and sufferings, on the other hand, give much fresh Attention may be called to examples of what might be information, especially as regards the occurrence of exacer- called occupational diseases among medical men ; medical bations in the disease, or of periods which he calls the , officers specially interested in infectious diseases, including acromegalic state during which the symptoms, like the tuberculosis, syphilis, and tropical affections, on which they physical signs, are accentuated; these symptoms varied may have written, are naturally liable to contract these from malaise to complete incapacity to do anything and diseases, and radiologists have suffered much in the past, mental depression. especially from carcinoma. Those who have worked at the Julius Thomsen’s6 description (1876) of the disease of the laboratory aspects of infections may fall victims to these diseases, and many examples might be given. Probably the 3 Works of John Hunter with Notes, edited by J. F. Palmer, 1835, vol. ii., pp. 146, 417. 1 A paper read before the St. Mary’s Hospital Medical Society on 4 Guthrie, L. G.: The Diseases of Children (Garrod, Batten and Feb. 23rd, 1921. Thursfield). Vide also Clinical Journal, August 5th, 1896. 2 For an interesting paper on "Diseases of Great Physicians of 5 Mark L.: Acromegaly, a Personal Experience. Baillière, Tindall, the Past" see William Pepper (Tertius), Medical Library and and Cox.