616 THE POPULAR SCIENCE MONTHLY. 



ease, but rather to attain to a more complete and sound understanding 

 of those general laws which govern the actions of the living body in 

 health laws which must ever form the only firm basis of the knowledge 

 of disease, and the only sure guide to judicious modes of treatment. 



The rational practice of physic, as it is carried on in the present 

 day, is in a great measure the outgrowth of a slowly growing physio- 

 logical science, upon which it depends, and from which it can not be 

 separated. There is hardly a thought that can strike a practitioner 

 that does not in some way depend upon physiological facts which have 

 been elicited by experimental research. I do not mean to state that 

 the accurate and painstaking observation of clinical facts and post- 

 mortem appearances has not done much probably more than any- 

 thing else to bring our medical knowledge to its present stand-point ; 

 but I contend that clinical observation and post-mortem experience 

 without physiological research would never have been able to advance 

 medicine to the position it holds in modern times ; and, on the other 

 hand, I believe that physiological study, even unaided, could arrive at 

 a rational system of treatment. No doubt both clinical study and 

 pathological observation have not only helped practical medicine on- 

 ward, but they have also greatly contributed to the progress of physi- 

 ology itself. In fact, I find it impossible to separate exact clinical 

 and pathological work from scientific research of a purely physiological 

 nature. Is not all treatment more or less experiment ? And is not 

 this particularly true of purely empirical treatment? Nowadays, 

 where is the pathological laboratory in which a mere record of post- 

 mortem changes in the human subject is not aided by experimental 

 inquiry into pathological changes in the lower animals ? 



In assigning to each department of medical study its due meed of 

 credit, their relative ages must be borne in mind. It has been asserted 

 that all the improvements brought about by experimental research 

 would have been introduced with equal certainty had experiment on 

 living animals never been attempted. Observation, experience, and 

 thought would have attained all the results we now enjoy. Possibly 

 so ; but when ? Clinical observation can be traced back some three 

 or four thousand years, and even then it started with a rich legacy of 

 traditional knowledge. Experimental physiology as a science was 

 only born about a hundred years ago. If we compare the progress 

 made by medicine during the last hundred years with that of the pre- 

 vious thousand years, we shall be able to judge of the relative rates 

 of progress of the two systems of working. The difference seems to 

 me to lie in the fact that unaided clinical observation that is, prac- 

 tically the empiric method goes the wrong way about arriving at a 

 conclusion. It says, Try this or that or the other remedy, and note 

 which is successful. This is like a boy who will not systematically 

 work out his sum in long division, but prefers to arrive at the quotient 

 by guessing probable numbers one after the other, and multiplies them 



