Author: Dr. A. Gotlieb
The field of pathology and laboratory medicine has had a very distinguished past.
Many important medical discoveries arose from careful observations and innovative experimentation carried out by pathologists. The clinical material became the source of inspiration to study the pathogenesis of human disease. Major advances in oncologic research, cardiac and vascular pathobiology, neuropathology, and bone and connective tissue pathobiology were made by investigative pathologists working in academic pathology and laboratory medicine departments in Toronto and across the world.
Pathologists have also distinguished themselves as medical educators; Sir William Osler and Maud Abbot utilized pathology to train generations of physicians; Sir William Boyd’s text books were legendary and their influence reached around the globe; Robbins’ Pathologic Basis of Disease edited later by Ramzi Cotran and currently by Vinay Kumar, Nelson Fausto, and Abul Abbas continues to have an enormous influence on undergraduate medical education in over 70 countries worldwide.
William Boyd, the famous Canadian Pathologist [1885-1979], was an important influence on the practice of medicine. He wrote several textbooks that were very well received and his lectures to medical students were legendary. Boyd understood the noble role that the field of pathology played in the grand scheme of medical practice and he did his best to inform the medical professions about pathology.
Boyd wrote in the preface to the 8th edition of Pathology for the Physician that “the purpose of pathology is not merely to learn a set of facts about things, but to study the causes of things, and why things happen. Truth lies not in facts, but in the relation between facts.”
He wrote that “thirty-five years have elapsed since the publication of the first edition. In the intervening years the headlong rush of medicine, and in particular of the basic sciences which have come to form such an integral part of medicine, has left us all a little breathless, a fact of which the author of such a book as this is painfully aware. The growth of medical information has been compared to that of bacteria, which show a lag at the beginning of growth and then multiply at a logarithmic rate. Modern medicine seems to have reached the logarithmic phase. In medicine, as with Alice Through the Looking Glass, “it takes all the running you can do to keep in the same place. If you want to get somewhere else, you must run twice as fast as that.”
He also sent an important message to physicians in his writings from 1958 that still remains true today: “our concept of pathology has changed almost beyond recognition since I was an undergraduate, and very materially since the first edition of this book was published. It has long been recognized that the description of a dead body is of no value as an isolated piece of information, a fact indeed which was fully realized by the great masters of the past, including Virchow and Cohnheim. The purpose of pathology is not merely to learn a set of facts about things, but to study the causes of things, and why things happen. Truth lies not in facts, but in the relation between facts. Collected facts do not constitute knowledge. Some physicians know so much that they are suffocated beneath a dead weight of erudition. The difficulty lies not so much in the new ideas, which are readily accepted, but in escaping from the old ones. The science and the art of medicine are not mutually antagonistic, and in ways the art of medicine list in knowing when and how to apply the science of medicine at the bedside, a task of ever increasing difficulty. But it is well to remember that science is not substitute for wisdom.”