THE LIMITATIONS OF THE HEALING ART. 81 



affect the processes which play in hallucinations their wild pranks 

 in the ganglion-cells and associative paths. 



We can certainly by the application of certain substances 

 cause changes in particular cells which are expressed, albeit in 

 some unknown way, by physiological effects. Thus many alka- 

 loids, alcohol, ether, chloroform, bromine, curare, digitalis, etc., 

 operate directly on particular cell-groups, and bundles of nerves 

 and muscles ; pilocarpine, arsenic, and iodine on certain glands ; 

 phosphorus on growth processes in the bones. When the cases at 

 present known are analyzed, it is found that bromine restrains 

 the paroxysms of epilepsy for a short time, but does not remove 

 the processes in the central nervous system from which they 

 originate. Alcohol in moderate doses temporarily excites the 

 brain and heart to activity, but does not cure a single pathological 

 condition the presence of which made the administration of alco- 

 hol necessary. Morphine alleviates the pains of neuralgia, but 

 does not effect any fundamental change in the disease. Some- 

 times effects appear like those of iodine in certain diseases corre- 

 sponding with a real cure brought about by the means itself ; but 

 it is still the last experience of medical art that the restoration 

 from the diseased condition, in the true sense of the word, must 

 come to pass through the organism itself. Whether an order of 

 thoughts like that which Robert Koch developed in his studies of 

 tuberculin will lead to this end must be learned by clinical ex- 

 periment. It may be that the healing art will make its advance 

 in this way. For the present we must learn, the more impress- 

 ively as medical knowledge becomes more perfect, that the doctor 

 is only the servant of Nature, not its master. 



Although the expectation and the possibility of controlling 

 the fundamentals of pathological processes are so limited, the 

 healing art is nevertheless not doomed to vain contemplation and 

 inactive dallying. While art can not master Nature, it can follow 

 it with diligent observation. The truth of this remark covers a 

 genuine progress, and furnishes the key to the secret of the suc- 

 cess of really great physicians. To investigate the exact origin 

 of pathological changes, to ascertain by what methods and under 

 what conditions disturbances of the organism are most easily 

 overcome or counterbalanced, deliberately to support and imitate 

 these methods if possible, and before everything to do no harm, 

 is the way by which the healing art can accomplish something 

 important and good. History proves incontestably that practical 

 efficiency at the sick-bed goes in an exactly parallel line with the 

 cultivation of scientific methods. Medicine to-day, without yet 

 being able directly to cure the pathological condition, reaches, 

 simply by following the principles here laid down, incomparably 

 more favorable results than formerly. It has learned, first of all, 



VOL. XLI. 8 



