CONSERVATIVE DESIGN OF ORGANIC DISEASE. 165 



character, whose deviation from physiological and approach to patho- 

 logical development have been less decided, or extremely slight, it is 

 evident there exists between the two kinds of growths no well-defined 

 line of demarkation ; physiology and pathology run gradually into 

 each other. It is not possible to say where one ends and the other 

 becrins. That this must be the true state of the case is unmistakable 

 when we consider that the change of external conditions from natural to 

 unnatural may be in any the slightest or the most extreme degree. 

 Thus we frequently observe modifications of structure induced by 

 exceptional conditions that have been brought to act upon the body, 

 of so trivial a character that they can hardly be called diseases, while 

 at the same time they are in some measure anomalous deviations from 

 the typical standard of the species ; but in these, as in the higher 

 grades of structural modification, it will be seen that the conservative 

 purpose of adaptation is carried out. For example, the muscles in the 

 right arm of the blacksmith, those of the leg-calf in the limbs of the 

 dancer, and the crural adductors of the jockey, undergo a process of 

 increased growth (a physiological hypertrophy) by which they become 

 adapted to the increase of function imposed on them. So the thick- 

 ened epidermis of a laborer's palm adapts the hand by protecting 

 the softer tissues underneath from being bruised to the rough han- 

 dling of manual instruments ; an adaptation altogether wanting in one 

 unaccustomed to labor, as evidenced by the inflamed and blistered 

 condition of his hands when first beginning to practise such exercises.* 

 By the same kind of thickening and induration the finger-ends of the 

 violinist become adapted to sustain without inconvenience prolonged 

 pressure upon the strings of his instrument. When the main artery 

 of a limb has been obstructed, or tied by the surgeon's ligature, we 

 find the nutrition of the tissixes beyond is supported by the blood find- 

 ing its way through the smaller anastomosing arteries, and in time we 

 observe these smaller arterial branches to become considerably en- 

 larged, thus adapting themselves to the increased amount of blood 

 they have been called upon to transmit. In cases where obstruction 

 to the arterial circulation is more general, so that it requires an in- 

 creased heart-force to pump the blood through its channels, we obsei've 

 the heart itself to become larger, and thus its increase of structure 

 (like the blacksmith's arm) is adapted to the required increase of func- 

 tion. The head of the thigh-bone, when irreducibly dislocated, be- 

 comes surrounded in its new position with fibro-ligamentous and mus- 

 cular structures, which so far resemble an articulation as to permit 

 the patient to walk about. Similarly in ununited fractures, we find 

 the ends of the broken bone, when the muscles attached to them cause 



' If it should here be alleged that the " inflammation " is the real disease, and that it 

 accomplishes no good, we answer : Inflammation is the process by which the mechanical 

 injury of contusion is to be repaired. It restores the part, just as the "adhesive inflam- 

 mation " of surgeons heals up the cut of an incised wound. 



