negligent. In another volume are records of all the post-mortem examinations that I made while I was demonstrator of morbid anatomy at St. Bartholomew's. These, too, are useless, for they were before the time of exact microscopic work, and of fine adjustments and thin sections, and various stainings and cultivations. They tell, indeed, of strange oversights; of typhoid ulcers of the intestines carefully described, but regarded as a sort of accident in cases of typhus fever-for Sir William Jenner had not yet made their meaning clear; and there are full accounts of the naked-eye appearances in cases of capillary embolism, which before the time of Kirkes and Virchow were passed by as unintelligible. And when one looks for facts that might help to the discovery of any of the things we now most want to know, none can be found, for such facts were not looked for fifty years ago, or were not seen, though they may have been within the easy range of sight. Thus, as one looks through volume after volume, they seem to prove nothing but a waste of time, till one reflects that the present use of old Case-books is no just estimate of their value in past years. For, to say nothing of the materials they may have supplied for work already done in lectures or in books and papers published at various times, they were among the very best means of self-education. The habit of recording facts is nearly essential to the habit of accurately observing and remembering them. That which we intend to record we are bound and may be induced to observe carefully, and the very act of carefully recording is nearly equivalent to a renewed observation. Thinking of this, and of their personal interest to myself, I ought, perhaps, to have been content with the good service that my Casebooks have rendered to me and with the hope that they have been, in some measure, indirectly useful to others. But I hope that what is here gleaned from them may serve some good purpose, whether in the description of a few diseases or injuries not sufficiently well known, or in the suggestions of probably useful lines of enquiry, or of some general principles which it may be well for younger men to bear in mind and test as to their probability. Perhaps, even, they may have an admirable result, if they provoke some of my contemporaries to do similar but better work with their old Case-books. The several studies, if they may be so called, have been written at various times during the last six or seven years, and some of them have been made even less useful than they might have been by the publication during the same time, but after they were written, of excellent papers on the same subjects; for example, of that by Mr. Teale on subcutaneous ulceration. Various as are the subjects of the studies, an orderly arrangement of them was not possible even if it would have been useful. I hope, therefore, that I need not apologise for what may seem too great disorder, or for the almost complete omission of references to other works on the same subjects. I could not have added these without reading very much more than in the last few years has been possible, and a multitude of references would have looked like a pretence of completeness of study, such as, for sketches like these, would have seemed absurd. a |