4 I 4 DEFICIENCY OF ACTION. 



day to day, still pathologists continue to talk of "defi- 

 ciency of action? " defective vital power" "diminished 

 vitality? as if it was certain that by these phrases the 

 phenomena of disease were to be explained. The 

 surgeon " stimulates? the wound with caustics, and 

 fancies that he "increases" the "vitality" of the 

 surface just below ; the physician pours in brandy, 

 and supposes that he " increases the vitality " of the 

 affected tissues. But it is easy to prove that by these 

 measures, many cells that were, alive are killed, and 

 that those that escape death live and grow more slowly 

 than before. This diminished rate of growth and life 

 is really what is required. It is indeed the very 

 condition which approaches to the healthy state. But 

 then it is, as compared with the morbid state, the 

 very reverse of " increased vitality? 



Probably even now most physicians would affirm 

 that there was deficiency of vital power in a case of 

 low pneumonia ; and yet what evidence is there of 

 such deficiency ? It is true, the patient is weak and 

 cannot move ; he may be delirious ; all his muscles 

 may be relaxed ; his heart's action may be weak ; 

 and he may be dying of exhaustion ; but has it 

 been shown that weakness, or inability to move, or 

 delirium, or relaxed muscles, or weak heart's action 

 or what we call " exhaustion," are due to diminished 

 vitality, to depression of vital power ? It is very well 

 to say that in this particular morbid change there is 

 "excess of action," and in that one there is "deficiency," 



