PHYSIOLOGY AND ITS RELATION TO MEDICINE 399 



the thyroid gland for goitre revealed the physiological importance of 

 that ductless gland for which physiologists, with one single exception, 

 had no interest. This discovery helped at the same time to establish 

 and to introduce into physiology the far-reaching conception of in- 

 ternal secretion. Furthermore, the observation of Bouchard, Lancer- 

 eaux, and other medical men of the occurrence of a degeneration of 

 the pancreas in cases of diabetes mellitus, led to the discovery, by 

 two medical men, of the remarkable fact that the complete removal 

 of the pancreas in dogs leads to diabetes. This discovery demonstrated 

 at the same time the further principle that even glands with a distinct 

 external secretion have besides a physiological importance for the 

 body by virtue of their internal secretion. In the long list of workers 

 on this subject we hardly find a single physiologist. 



I could quote a good many more instances in which medical studies 

 brought out important physiological facts and how physiology is 

 slow to avail itself of such golden opportunities. 



The physicists are only too glad to meet with exceptions; the 

 physiologists run away from them. Is there any well-founded justifi- 

 cation for such a course in physiology? I believe none. I believe it 

 is simply an erroneous position. It would lead me too far to attempt 

 here a discussion of the causes which led to this position in physiology. 

 But I say without hesitation that this position is deplorable, is harmful 

 to physiology as well as to medicine. Animal experimentation is the 

 essential method of developing physiology. Now, then, nature makes 

 daily thousands of experiments upon man and beast, and physiology 

 refuses to utilize them for its own elucidation. I feel quite sure that a 

 study of the functional processes in pathology, or at least the system- 

 atical taking up of physiological problems indicated by pathological 

 processes, by minds naturally endowed and properly trained for 

 physiological studies, would greatly elucidate the proper sphere of 

 physiology itself, and would at the same time be of incalculable 

 value to pathology and medicine. 



And medicine is greatly in need of such a physiology. 1 am afraid 

 that the actual situation in medicine is not fully grasped, even by a 

 great many of its enlightened disciples. To state the critical point in a 

 few words : The actual disturbance in most of the diseases is primarily 

 of a functional nature, but the essential part of the present know- 

 ledge in medicine is morphological in its character! This discrepancy 

 is due to the uneven development of the sciences of -medicine. When 

 the empirical art of medicine awoke to the necessity of acquiring a 

 scientific basis, it found ready for its disposal an already well-defined, 

 precise anatomy, but only a vague, incoherent physiology. It set out 

 and continued to work in the precise lines of anatomy, in which it 

 attained a marvelous completeness. By this step, however, mor- 

 phology became the dominant factor in medicine, and the definition 



