450 PHYSIOLOGICAL REGULATIONS 



of components. Some procedures frequently used to characterize 

 men are listed in table 46. One estimate of the utility of these 

 signs and tests would be to compare the numbers of determinations 

 of each made in a hospital per bed per year. A large experience, 

 and multifarious beliefs, are epitomized in the mass employment 

 of each of them. 



A physiological abnormality or a disease may be viewed as a 

 simultaneous array of continued loads in many components. The 

 displacements from balances are multiple. It is even possible that 

 with respect to each single component the state might be regarded 

 as within the physiological range, whence the simultaneous com- 

 bination constitutes the disease. The "underlying" states so 

 often mentioned are in my opinion the interrelations themselves. 

 Of course, any one component appears loaded in numerous dis- 

 eases. Differential diagnosis applies a dichotomous key to the 

 combinations among the various components commonly measured 

 or tested. 



The practice of observing each component probably developed 

 independently of every other, and in parallel with the development 

 of instruments and human needs. Now that the quantitative 

 characteristics common to many components are partially known, 

 shall each load be described in a diverse and traditional way, or 

 shall it be acknowledged, for instance, that all tests are tolerance 

 curves? Shall it further be recognized that common scales, such 

 as percentage of Co, can be used for most components'? I am not 

 concerned with reform or advocacy; my present obligation is to 

 point out that the means of schematizing (perhaps simplifying) 

 these matters of everyday physiology and nosology are available, 

 and that some of their uniformities have been quantitatively 

 ascertained. 



Knowledge of the multiple interrelations among loads and com- 

 ponents is some indication of the complexities inherent in thera- 

 peutics. Therapy can be regarded as the removal of loads. But 

 removal of one load may enhance others ; this is the limitation of 

 "rational" therapy, for no physiologist or clinician comprehends 

 how many components and what loads of each are concerned. 

 Every sign suggests a treatment, but no assurance of recovery in 

 all respects is obtained except by trial. It is widely understood 

 that what seems most "indirect" is sometimes the shortest way to 



