28o PHYSIC 



so-called functional disease. From the preparation of the 

 alimentary materials for the process of nutrition until 

 their excretion from the body at all points of their circu- 

 lation, but more especially at the ''linking up" of the 

 various circulatory acts, stasis is liable to take place, and 

 to be followed by, it may be, a merely ephemeral dis- 

 turbance, or a most lasting and destructive pathological 

 entity. The appreciation, therefore, of every stage of 

 the great process of circulation throughout the human 

 body becomes a matter of the first necessity in all diag- 

 nostic and therapeutic work. 



When circulatory stasis has done its mechanical work, 

 and established a larger or a smaller area of arrested 

 circulatory movement, it has then established a basis for 

 the operation of further morbid etiological influences in 

 the form, it may be, of still merely mechanical agency, 

 or of the super-added physical, chemical, and bacterial 

 morbid elements, which are ever ready to seize a chance 

 to follow up a pathogenic opportunity, and to assist the 

 process of involution "in season and out of season" in 

 the young, the adolescent, and the aged alike ; but, from 

 this point of view, involution is as natural as evolution. 

 At the linkages of the various circulations, great and 

 small, wherever a change of lumen of vasculature or inter- 

 spaces takes place, the predisposing causes of circulatory 

 stasis exist in greatest proportion, and when disease pre- 

 sents itself for consideration at its very earliest stages, the 

 truth of this can be observed with much greater ease and 

 certainty than can be the case when pathological changes 

 have ensued, which destroy the traces of the original 

 incidence of the process of disease and the sequence of 

 its various stages. 



Who would at first sight suppose, for instance, that in 

 the evolution of the formidable disease, elephantiasis, we 

 had only to reckon with a simple erysipelas and inflam- 

 mation of lymphatic vessels, which, being repeated, it 

 may be, time after time, have left the whole lymphatics 

 of a limb or limbs absolutely occluded and impervious to 

 the passage of lymph, rendering the affected limb or limbs 

 the receptacles of uncirculatable or derelict lymph and 

 the accumulators of metabolic waste until the limits of 



