Graves Lecture 1972

12/09/1972 in Royal College of Physicians of Ireland, 6, Kildare Street, Dublin 2

Dr. John Ashton Dodge, M.D., Welsh National School of Medicine, Cardiff.

Infantile Pyloric Stenosis : Inheritance Psyche and Soma

Introduction:

I believe that I am the first paediatrician to be honoured by giving this lecture. We shall never know whether Graves himself would have approved of your choice but there is no doubt that he would have approved of the principle. His writings show clearly that he was concerned with children’s diseases, and he wrote authoritatively about a number of childhood symptoms. He indicated that disorders of children were not to be equated either aetiologically or therapeutically with similar disorders in adults. A section of Graves’ Clinical Lectures on the Practice of Medicine was devoted to a consideration of infantile convulsions in which he discussed, inter alia, the vomiting infant. Graves’ view that the vomiting of curdled milk immediately after a feed is a sign of health in infants is not one to which I can subscribe in the light of this lecture, but even in the same paragraph he wrote so sensitively and so clearly about neonatal physiology, with careful observations from his own experience, that one feels he was in truth a paediatrician before his time. (Graves, 1848).

One particular, identifiable disorder which produces vomiting in infancy is infantile hypertrophic pyloric stenosis (IHPS). A very few early descriptions had been published but the works of Graves suggest that he was unaware of the condition, and indeed it was not until 1888 that Hirschsprung’s account established it in the medical literature. Hirschsprung was then Professor of Children’s Diseases in Copenhagen, and a very influential figure in European medicine.

Irish Journal of Medical Science , 142:6

 This being the twelfth Graves Lecture since its beginnings in 1961.