VIVISECTION AND PRACTICAL MEDICINE. 617 



to see which is the right one ; he may, after much trouble, by chance 

 hit upon the correct answer, but he more commonly fails : and most 

 probably the boy who works out his sum in the straightforward way 

 will far sooner arrive at the desired result. Physiology moves onward 

 by means of accumulating and arranging facts which have borne the 

 test of experiment. Empiricism accumulates observations which, 

 without further test, are used to formulate theories that, as likely as 

 not, are unfounded, and are as apt to mislead as to advance medical 

 knowledge. When asked to give an example of the utility of experi- 

 mental physiology in the treatment of disease, I feel inclined to an- 

 swer with another question : Is there one reliable system of diagnosis 

 or one mode of treatment now in use which has not been modified or 

 improved, if not directly suggested, by physiological knowledge ? 

 And I must certainly confess that I know none. Before attempting 

 to bring forward single cases, as instances where certain experiments 

 have been of direct use to medical and sui'gical practice, I shall ex- 

 amine the question from the opposite stand-point, by taking some simple 

 case of every-day occurrence, and glancing at its routine examination 

 and treatment. We can then see to what extent vivisection influences 

 the practitioner in the details of his daily work. We may safely take 

 a case at random ; one not associated very closely in our minds with 

 any brilliant experimentation will, perhaps, be the best. The follow- 

 ing case, which I happen to have seen recently, will do as well as any 

 other : 



Not long since I found a policeman examining a poor woman who 

 was said to have had a " stroke." She lay speechless and motionless 

 on a door-step ; she showed no signs of convulsions, no stertorous 

 breathing, no frothing at the mouth. So the policeman hesitated to 

 make a diagnosis thinking, no doubt, that other causes besides a 

 " stroke " might give rise to such a want of muscular irritability. 

 Gently shaking her had no effect, but on his applying some form of 

 stimulus to the finger she showed signs of returning consciousness, and 

 the left leg and arm moved slightly. The right eye remained partly 

 open, the other was closed ; when the eyelid was raised, so as to ex- 

 pose the pupil to the sunshine, some movement of the muscles of 

 expression was observable, but only on the left half of the face, to 

 which side the mouth was slightly drawn. This became more obvious 

 when some drops of cold water were thrown at her. The pulsation 

 of the temporal artery was visible. Putting my ear to the top of her 

 chest I found the heart beating violently, and heard a prolonged blow- 

 ing noise instead of the sharp, clear tone of the second heart-sound. 

 Without much effort my thoughts had passed from the pulsating tem- 

 poral artery to the heart, and from the imperfect aortic valves to the 

 middle cerebral artery, where I fancied an embolus must be impacted. 

 I told the policeman the woman had better be taken to a hospital, 

 which was done accordingly. 



