Excerpt from The Early History of Instrumental Precision in Medicine: An Address; Before the Second Congress of American Physicians and Surgeons; September 23rd, 1891
A broad-minded student of the eye once said to me: "We should all be the better for an hour or two a day in a general hospital ward," and added, loyally, "the very great relative perfection of the therapeutics of visual disorders is an intellectual risk." And if Cornelius Agnew could say that, we may well fancy - and you will pardon the jest which holds a truth - that a too exclusive study of the eye may result in mental egotism. If men as old as I are ready to acknowledge this danger, believe me that for the young the pursuit of but one line of practice is only too apt to result in an overestimate of their complete fitness, in hasty papers, mere case reports, wild pursuit of novelties, and the production of numberless minor text-books which can have but a selfish use. Said Romberg once to a friend of mine, who gave him a new American book, "Is the author thirty-five? I will look at it; is he forty? I will read it."
We have all come to admit gratefully the value of specialisation in medicine; but he who is watchful over the general interests of his profession must have seen that this subdivision of labour involves for us perils, which are seen on the one side by the general practitioner, and on the other by those who, in a large-minded way, pursue limited lines of work. Medicine does not grow in an even fashion. When watching a saline solution under the lens, you observe some brilliant crystal shoot out in advance and hold its place until the rest, more slowly but surely, join or pass it, you see an image of that which continually illustrates medical progress. To-day it is surgery which wins; a few years ago it was ophthalmology, which, in newly acquired precision and in predictive accuracy and therapeutic gains, set up for us novel standards of exactness and, enriching our symptomatology, cast light in many directions. The mere physician seemed to be hopelessly left behind, but now again it is pure medicine which has gone to the front.
What the specialist learns, until it is commonplace, is not easily enough assimilated by the mass of practitioners. At last, however, comes a time when it is, and then the whole body of medicine feels the gain in nutrition and repays the debt. The masters of our still most perfect art, medical optics, may wisely remember that it was physicians who most distinctively recognized and diffused the knowledge that headaches and some other brain disorders are due to eye strain, and thus, while lessening our own futile labours, crowded the waiting-room of the ophthalmologist.
I could easily show you, by added proof, what we all lose by not keeping close touch of one another"s gains.
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