436 



NA TURE 



[Oct. J, 1874 



all proving the importance of comparative anatomy in a 

 medical point of view; and it is almost certain that before 

 long that science will have a more prominent position in 

 medical education than it at the present time possesses. 



Tliose who have no other aspirations than to follow the 

 routine practice of their profession immediately their few 

 years of education are completed, will no doubt ignore 

 the value of the extended curriculum we advocate : they 

 imagine that it does not conduce to more accurate 

 diagnosis or more correct treatment. This view is a 

 short-sighted one, to say the least ; for though the most 

 able theorist may, by chance, be a bad practical physician 

 or surgeon, yet the good he does by his higher work is 

 insuperably greater in the long run than the immediate 

 relief of individual cases. It is by the progress that is 

 made by the profession in obtaining the mastery of 

 disease that its position is maintained in society gene- 

 rally, and this progress is due much more to the theo- 

 retical chemist and physiologist than to the successful 

 practitioner who simply follows the ordinary routine of 

 his calling. 



NOMENCLATURE OF DISEASES 



Nomenclature of Diseases, prepared for the use of the 

 Medical Officers of the United States Marine Hospital 

 Service, by the Supervising Surgeon. (Washington : 

 1874). 

 '"P'HE preparation of this volume by Dr. Woodworth, 

 -1- supervising surgeon, has consisted in adopting, with 

 some important omissions and unimportant transposi- 

 tions, a literal transcript of the original " Nomenclature 

 of Diseases" drawn up by a joint committee appointed 

 by the Royal College of Physicians of London, of which 

 Dr. Sibson was the editing secretary. 



The original work received a modified sanction from 

 the British Government, inasmuch as by the remarkalDlc 

 liberality of Mr. Lowe, then Chancellor of the Exchequer, 

 money enough was provided to print off a large edition^ 

 and transmit a copy gratis to every member of the medi- 

 cal profession in Great Britain and Ireland. The further 

 diffusion of the work in the United States by Dr. Wood- 

 worth is a thing for which the profession owes that 

 gentleman hearty thanks. The work, indeed, seems to be 

 more authoritative on that side of the Atlantic than on 

 this ; for the statistics of mortality for the ninth census of 

 the United States were made up in accordance with its 

 arrangement. This extension of a uniform nomenclature 

 is itself, apart from the merits of the worl.;, an evident 

 great gain to science. 



It is proposed to give the book a decennial revision ; 

 but while revision of some kind is periodically necessary, 

 we do not anticipate that, after the work is thoroughly 

 matured, it will be required above once in a generation, — 

 three or four times in a century. 



In the meantime, the book is in a somewhat imperfect 

 state, many inaccuracies having been pointed out in a 

 report upon it by the Edinburgh College of Physicians. 

 The correction of such errors and the bringing of the 

 work to the level of the present state of medical science 

 will make it mature for tlie time being. But we hope 

 that a new geuciation of medical men willliud it necessary 



to revise it ; not to correct common errors, but to adapt 

 it to the then advanced state of medical science. We are 

 doubtful as to the propriety of attempting work of this 

 kind by a mixed committee. The committee should be of 

 the only kind Dr. Chalmers could tolerate — a committee 

 of one ! only the one should have power to call in aid. 

 The work of Linnajus or of Jussieu could not have been 

 done by a committee. 



A good nomenclature of diseases will inevitably repre- 

 sent the science of the day. According as science ad- 

 vances, so will the nomenclature and arrangement be 

 more and more natural. The profession of medicine is 

 to be congratulated on the felt want of a nomenclature 

 temporarily fixed, and on the evidence this work affords of 

 its generous ambition to' rise above a mere nosology, to 

 something like a natural pathological arrangement. 



The wide diffusion of a book like this in the medical 

 profession, besides its own immediate utility, is sure to 

 exercise a very beneficial and much wanted scientific 

 influence. The looseness of much professional writing 

 will be diminished and precision encouraged. If medical 

 terms are well defined, writers will naturally become more 

 careful in their use of them. At present, medical writing 

 is infested not only with ill-defined terms but indefinite 

 description. How often do we see such phrases as "once 

 or twice," when we should have " once" or "twice." We 

 might give many examples of this looseness for which we 

 tolerate no excuse ; but there is a looseness arising from 

 the imperfection of medical science which we must mean- 

 time tolerate. Good and precise definition of terms only 

 becomes possible when we know the properties or pecu- 

 liarities of what is to be defined, and medicine is as 

 yet in too empirical a state for satisfactory definitions. 

 That subdivision of it which is most advanced — patholo- 

 gical anatomy — illustrates well the growth of precision of 

 terminology as advancing knowledge permits and de- 

 mands it, definition and discovery going hand in hand. 



The same branch of medicine affords the best illustra- 

 tion of an admirable struggle after a good nomenclature, 

 but even for this branch there has not as yet arisen a 

 Tournefort to produce, if not temporary unanimity, at least 

 temporary union in regard to nomenclature — a deficiency 

 which, however much to be deplored as a cause of con- 

 fusion and error, implies blame to no one. If in morbid 

 anatomy we have no established nomenclature, how can 

 we expect it in the nosology ? This department of medical 

 nomenclature we regard as being meantime best left in 

 what may be called its popular state, such names as 

 scarlatina, erysipelas, cholera, thrush, being better than 

 any that could be based on our present imperfect know- 

 ledge of these diseases. But although this m.ay be so 

 now, there is good reason to expect the day when good 

 descriptive names will be found for all these diseases — 

 names which will suggest to the instructed an epitome of 

 what is known regarding them. 



Such suggestive names cannot be, however, without a 

 well-matured classification. At present there are several 

 very natural but isolated classes of diseases which form 

 good samples of what is wanted — zymotic diseases, para- 

 sitic diseases, mechanical injuries — but for the most part 

 we have a disjointed catalogue rather than a classifica- 

 tion. The att.unment of a complete classification will be 

 u great step, an index of progress and an aid to it ; but it 



