36 DISEASE. 



We must study diseases from their causes, known and 

 appreciable ; from their symptoms ; from pathological phy- 

 siology ; and from the morbid alterations discoverable after 

 death. 



The PRACTICAL Study of Disease is to be conducted 

 in the stable : there alone can the " book of nature^^ be 

 consulted. We must bear in mind that our patients cannot 

 speak to us about their sufferings, or inform us of anything 

 that may have happened during our absence : for all that 

 can be learned we have to rely upon a man who may be 

 veracious, or who may have some interest in distortion : 

 consequently it becomes imperative, if we would know facts, 

 to spend much time in the stable, and, while there, to insti- 

 tute every inquiry calculated to throw light upon the case. 

 The late Mr. Abernethy told us, that ^' the best mode of 

 obtaining and extending medical and surgical knowledge is, 

 in my (his) opinion, to pay strict attention to diseases; 

 which qualifies us to note even the slightest shades of dif- 

 ference that distinguish them from each other. Such dis- 

 crimination leads us to form some regular arrangement of 

 them, which, even if it be not correct, may ultimately enable 

 us to discover their natural series and order. 



Clinical Observation, as tkis practical study is called, 

 cannot be too much insisted on. Through it we learn the 

 changes that take place during life; and the account, thus 

 began, is after death completed by an examination into 

 internal alterations. In this manner we obtain a know- 

 ledge, 1st, of the signs by which the presence of the disease 

 is indicated ; 2dly, into its history ; 3dly, into its causes ; 

 4thly, we watch its course ; and, 5thly, we note its termi- 

 nation. 



Touching the essence or intimate nature of disease — that 

 morbid action which is going on between the cause and the 

 effect, or appearance of the disease — let us cease to look 

 after it. Content ourselves with studying the sensible 

 effects, such as are palpable, material ; for the ultimate 

 essence, distinct from the organic lesion, is a point which 

 Nature has covered with an impenetrable veil, which the 



