44 PHYSIC 



extent of the pathological changes already effected, the 

 ability of the subject to "respond" to the application of 

 the necessary means, medicinal or surgical, and the range 

 of "choice of means" available in each particular case. 

 Thus in stasis, or overcomable obstruction, of alimentary 

 circulation of opposed renal and vesical outflow of 

 hindered pulmonary expectoration and cutaneous excretion 

 the therapeutic means to be chosen are aperients, diuretics, 

 expectorants, and diaphoretics respectively, classes of 

 remedies first determined and set aside for regular use by 

 the progenitors of ^Esculapius and Hippocrates, many 

 of which still continue to afford an almost unimpaired 

 satisfaction to the latest exponents of scientific medicine. 



Stasis of blood, lymph, and neural circulation within 

 definite portions of their individual vasculatures, individu- 

 ally and combined, represents a much more complex 

 problem, or series of problems, in pathologico-biological 

 physics (statics and dynamics), and requires the use 

 of a much larger series of medicinal agencies, as well as (it 

 may be) assistance from whatever mechanical and materio- 

 dynamic means which can be brought to bear in their 

 clinical solution. Massage and other mechanical con- 

 trivances for the breaking down of intra- and extra-vascular 

 inspissated and pseudo-organised arrested, material, the 

 promotion of renewed circulation, proper or direct and 

 collateral, and the maintenance of the regained physio- 

 logical regime by whatever can conduce to its permanency, 

 are all here indicated. But if, unhappily, pathological 

 changes have so affected the original vasculatures as to 

 render their renewed functional activity impossible, then 

 the character of the means to adopt to meet the clinical 

 requirements becomes still more modified and problemati- 

 cal, until a limit is reached, when' the ' ' relief of symp- 

 toms " is all that can be achieved or even attempted by the 

 most heroic treatment. 



All which but proves, pathologically and clinically, the 

 truth of the physiological finding : circulatio circulationum 

 omnia circulatio^ and that, without it, vitality, local as well 

 as general, is impossible, physiologically and pathologically 

 alike. 



Within the apparently almost homogeneous structures 



