RELATION OF PHYSIOLOGY TO MEDICINE. 87 



when infection is got rid of. By the use of anaesthetics 

 another potential vicious circle is broken ; and similarly 

 by the use of splints, of operative interference, or 

 simple rest. It is exactly the same with regard to the 

 use of all varieties of drugs. With digitalis or stroph- 

 anthus, combined with rest, we can often break a vicious 

 circle in heart disease ; with drastic measures for 

 reducing body temperature we break a direct vicious 

 circle in heat-stroke. When the vicious circle is broken, 

 Nature is enabled to re-assert herself. Normal regu- 

 lation of the circulation returns in valvular disease ; 

 and the normal physiological control of body tempera- 

 ture is recovered in heat-stroke. But at the back of 

 all medicine and surgery is the old-fashioned vis 

 medicatrix naturce. Without this there would be no 

 such thing as medicine and surgery. We cannot repair 

 the living body as we repair a table or a clock. The 

 surgeon is not a carpenter, nor the physician a mechani- 

 cian or chemist. 



Medicine and surgery are always counting on, and 

 trying to understand and aid, the vis medicatrix : they 

 evidently cannot get on 'without it. Here I think we 

 touch the subtle barrier which causes the estrangement 

 between practical medicine and the teaching of the 

 preliminary sciences ; for these sciences, as ordinarily 

 taught, pay little or no attention to anything corre- 

 sponding to the vis medicatrix. 



Now let us try to analyse a little more closely what is 

 wrong in the gas-poisoning case. The patient is in 

 urgent danger from want of oxygen. But if we measure 

 his actual intake of oxygen we shall probably find that, 

 owing to his restless condition, it is above, rather than 





