226 NEUROLOGY 



serted that the search for this process might be made as properly 

 through the clinical examination of the patient by the trained phy- 

 sician, together with a careful study of his history, as through the 

 scalpel and microscope of the anatomist. He admitted that the 

 time was still far distant when we should be able to discover the 

 whole of the anatomical evidence, and urged that the inquiry should 

 be extended from the organs to the tissues, and from the tissues 

 to the cells, and even to the very "vital functions" themselves. 

 But he insisted, nevertheless, that in some sense --a sense not as 

 yet strictly defined or definable every disease was to be thought 

 of as occupying circumscribed areas, in the midst of tissues for the 

 most part or in great part sound. " Ubi est morbus ?" -"Where is 

 the diseased spot to be found?" was proclaimed as the watch- 

 word of the investigator, while at the same time the students of 

 therapeutics were congratulated on having found means, as a result 

 of anatomic discoveries, to carry local treatment to portions of the 

 body hitherto regarded as out of reach. 



It is needless to attempt a recital of the successes which have 

 been won under this banner of anatomical research. The princi- 

 ple which the great master Virchow proclaimed was one that had 

 appealed and still appeals alike to the faithful plodder and to the 

 man of genius; its history is the best part of the history of medi- 

 cine during the past half-century; it has been the best thread of 

 guidance since the history of medicine began. 



The value of the anatomical principle has been quite as evident 

 for the department of neural pathology as for any other, and the 

 devotion to its maintenance quite as strongly marked. At the 

 meetings of neurological societies the pathologic anatomists have 

 always been more certain of an attentive hearing than investiga- 

 tors of any other sort; in the direction of their work has seemed 

 to lie the sure and trusted path of progress toward a better under- 

 standing and a better treatment of disease. 



And yet, in spite of all that has been accomplished, there are 

 abundant reasons for the opinion that the very successes of the 

 anatomical principle have thrown unduly into the shade the claims 

 of another mode of approaching the problem of disease, without 

 the aid of which anatomical research must prove inadequate to 

 the task which has been imposed upon it. For this latter prin- 

 ciple, which emphasizes the importance of recognition, in disease, 

 the signs of more or less widespread modifications of function of 

 the organism as a whole, the designation of "physiological prin- 

 ciple" is appropriate. 1 



1 There has been a growing tendency to recognize the importance of this 

 standpoint, and very recently Professor Wolkow, of St. Petersburg, has devoted 

 an able and thoughtful essay to a series of considerations analogous to those 

 here offered. Die PhysiologiscJie Anschauung in der Klinischen Medicin, Berliner 

 kl. Woch, 1904, nos. 15 and 16. 



