THE STUDY OF NEUROLOGY 227 



The argument is not that the anatomical principle is faulty be- 

 cause it has failed to accomplish all that had been hoped of it as 

 regards the discovery of the essential nature of disease, but that, 

 under it, certain local aspects of the disease-process are made the 

 exclusive subjects of research, and that the mind is thus turned 

 aside from a recognition of the fact that an equally important 

 object of study is the modification of functional activity, local or 

 general, which marks the efforts of readjustment on the part of 

 the organism to the effects of the primary disturbance. Such a 

 study as this cannot be adequately made without a thorough use 

 of physiological methods, or of clinical methods inspired and guided 

 by physiological conceptions, the term physiological being under- 

 stood as including all means of research which throw light upon 

 the mechanism of the processes of life. Psychological and chem- 

 ical investigations belong preeminently in this category. The faint- 

 heartedness which most of us have felt in searching for an ana- 

 tomical explanation of the great neuroses and psychoses has not 

 been simply a quailing at difficulties which were theoretically sur- 

 mountable, but has been due in part to a justifiable suspicion that 

 we were not altogether on the right track. We have striven to 

 ticket each one of the histories in our case-books with an anatom- 

 ical designation indicative of some localized pathological process, 

 but we have realized when we did so that our designations usually 

 fell far short of expressing the whole state of the sick man whom 

 we had before us when the history was made. 



The widespread feeling that no investigation of symptoms, how- 

 ever thorough, could give us the sort of insight which we needed 

 has led us to underestimate the real value of such inquiries. If the 

 study of symptoms does not carry us to the heart of the disease, 

 neither does the anatomical study of the disease carry us to the 

 heart of the symptoms. In fact, a thorough inventory of symp- 

 toms, that is, an inventory of the signs of disordered functions of 

 the body as a whole, can often tell us more of what we wish to 

 know than an inventory of anatomical signs of altered structure. 

 No anatomical research can pierce to the secret of broken coordin- 

 ations, and yet it is in these that a great part of disease begins, 

 or comes eventually to consist. No anatomical research can help 

 us to estimate the margin of resistance against strain, and yet on 

 the estimation of this margin, for each individual patient, issues 

 depend which are of scientific and practical importance. One man's 

 health is very different in quality and quantity from another man's 

 health, though the two men, untested, may appear alike, and the 

 investigation into their respective powers of effectiveness and of 

 resistance is often a valuable part of the study of their diseases. 1 



1 Physiologists recognize that organs, such as the heart (cf. the address by 



