RELATION OF PHYSIOLOGY TO MEDICINE. 99 



pharmacology form the future basis of practical medicine. 

 The rest is only subordinate detail, changing from year 

 to year and from place to place, and only surviving 

 through the contributions it is constantlv makino- to 

 these sciences. Practical medicine is one of their active 

 growing points — perhaps I should say their main active 

 growing point — nourished by the mother earth of new 

 experience. The medical art which is not grounded on 

 these sciences is bound to become more and more of an 

 anachronism. Treatment can only be securely founded 

 on a correct and full diagnosis of what is amiss in organic 

 regulation, and how Nature can be aided in restoring 

 the regulation. But diagnosis is far more than the mere 

 giving a name to a morbid condition. The practical 

 problem is always as to how in each particular case 

 there is deviation from health, and how in each particular 

 case Nature can be aided. In solving these problems 

 scientific knowledge is indispensable. It is " with 

 brains, sir," that the physician mixes his prescriptions 

 and the surgeon guides his knife. 



This means that the preliminary sciences must go with 

 the medical man to each bedside and guide him at every 

 step. As regards clinical demonstration and instruction 

 in medicine and surgery, I think it means that we must 

 more effectively install the active prosecution of the 

 preliminary sciences at the bedside, and not merely 

 leave scientific investigation behind in special laboratories. 

 The diagnosis and treatment taught to students cannot 

 possibly be progressive unless the teachers are progres- 

 sive in the personal prosecution of scientific knowledge. 

 At present the majority of medical and surgical teachers 

 are so busily engaged in private practice that they cannot 



