August 8, 1S95] 



jVA rURE 



^^a 



which they may he exposed —So in the great econoniy of Nature 

 'certain groups of animals have been shown to exhibit no capacity 

 for ' taking.' or for even being ' inoculated' with the poisons to 

 which others are exposed, and from which they sufl'cr, and that 

 severely. It would seem, therefore, that use may be made of 

 these animals, more or less naturally immune from certain 

 maladies, and that their immunity may be partially conferred on 

 man. 



'• (Juite recently a communication of the greatest im])ortance 

 lias been made on the rendering of animals immune against 

 the venom of the cobra and other snakes, and on the antidotal 

 properties of blood serum of immunised animals. This subject 

 has occupied attention during the last six years, and we must 

 all look forward with expectancy and hope to the possible 

 and probable diminution of a great national and im]ieri3l 

 calamity. 



"The outcome of what I have Ijeen saying is this: that 

 the scattered fragments of knowledge and ' guesses at truth ' of 

 many years have been gathered into a focus during the jiast 

 Iwenty-live years; that the vegetable life, extracting from the 

 mineral world the materials it needs for growth and production 

 of jiowerful agencies for good in the form of foo<l and medicines, 

 and for evil in the form of poisons, has given itself up to the 

 growth of animal life, with its much more com])lex organs, and 

 for cure of ills once thought beyond the reach of human aid ; 

 but that, thanks to man's scientific ardour and industry, it has 

 again shown itself to be our servant, our helper, and our 

 jirotector. 



"These are not dreams of the study, they are facts of the 

 laboratory and of daily life; and in using that word 'life' 

 again, I must endeavour to emphasise still more forcibly upon 

 you my urgent belief that it is to living ;igencies and their 

 cmplov'ment that we must look for help in the care of infancy, 

 the coniluct of education —moral, mental, and physical — the 

 training up of character as well as of limbs ; that it is the 

 guidance of living functions, in the choice of living occupations, 

 be they either of hard work or of amusement. It is to these we 

 must api)eal if we would see the mens saita in iorpore saiw : 

 and then it will be to these that we may confidently look for 

 help when the inroads of age or of disease are at hand, often 

 to cure us of our trouble ; or, if not, to give us rest and peace. 



" It wtmid be absurd in me, now and here, to attempt to say 

 in what this potency of life exists. It is enough for us to 

 ieci»gnise its existence, rejoice in its marvellous energy, and 

 ;inticipate still more from our investigations of its modes of 

 action, but I cannot help feeling that, however far we go in our 

 research into the arcana of nature, one of our ablest tieuro- 

 logisls, who has gone very far, is right when he .says : ' .Search 

 while you may with eyes, however aided and however ea.'nest, 

 that which we call " life,"' eludes our search and resists our 

 ertbrts. We must be content with what knowledge we can 

 gain, secure or insecure, and while using it as best we may, 

 should realise in all humility how much there is we cannot 

 know, an.l yet we cannot doubt.'"' 



An a<ldress in medicine was delivered l)y .Sir William Broad- 

 bent, who traced the growth of the art and science of medicine. 

 He pointed out that of the infancy of medicine properly speaking 

 nothing is know n. 



Indiviilual acts of healing are related in the (JId Testament, 

 and the treatment of wounds is described by Homer; the 

 Chinese from remote antiquity had a system of medicine, and 

 medicine has a place in the Vedas : but in the works of 

 Hippocrates, who was Ijorn about 46on.c-.,the earliest medical 

 literature which has been handed dr)wn, the theory antl i)ractice 

 of the art of healing is shown in a considerably advancetl stage 

 of development. The development of medicine fnini that time 

 was sketched by Sir W. Broadbent in an admirable a<ldress, and 

 the great advances made <hiring the present century in the many 

 <lepartmeiits of his subject were touched upon. In one of the 

 sections, the excellence .and defects of modern therapeutics 

 were passeil in review as follows : — 



" We have still to ask. What is the bearing of all these ad- 

 vances of knowledge on therapeutics, which, after all, is the 

 object of our lives ? 



" Until the last few years it has not been easy to answer this 

 <luestion by instances of any very extensive ajiplications of 

 jihysiology III the treatment of disease, and morbid anatomy vias 

 at one time a slvmd)ling block in the way of therapeutic eftort. 

 The i>athologist, pointing to an excavatcil lung or eirrhoseil 

 iivcr, would ask the |)hysician what he could expect to do with 



NO. 1345, VOL. 52] 



ilrugs against such conditions. But that sLage has pa>sed away, 

 and I will not mock your intelligence by other illustrations be- 

 yond those just given of therapeutic applications of jihysiolc^ical 

 and pathological knowledge, or by arguing that all knowledge of 

 nrjrmal jirocesses aids in the com|)rehension of morbid ]irf)cesses, 

 and that we are in a better p(jsition to combat disease when we 

 thoroughly understand its causation and initiation, and follow 

 mentally its development, course, and tendencies. 



"(liven the faculty of observation, the insight which jwne- 

 tr.ates the meaning of the phenomena, the analytical and syn- 

 thetical jiowers by which a diagnosis is constructed, the ready 

 adaptation of means to a well-defined end, and the firmness of 

 char.acter required to deal with the frailties of human nature, and 

 the best physiologist will make the best pathologist and the best 

 pathologist the best jihysician. 



" .-^s regards the remedies at <jur command, they are only loo 

 numerous. Recourse to a great variety of drugs is fatal to exact 

 knowledge of their efl'ects and to j^recisiijn in their use, Init new 

 ones are added every day for the lienefit chiefly of those who do 

 not know how to empl<.)y the <jld tines. There have, however, 

 been recent accjuisitions of extreme value, heavily discounted, 

 imfortimately, in the case of some by the mischief done through 

 their indiscriminate use : the antiseptic group, the chloral sul- 

 phonal group, the salicylates and salicine, the phenacetins and 

 antipyrin class, coca and cocaine. What makes some of these, 

 moreover, far more important and interesting is the fact thai 

 their physiological action has been inferred from iheir chemical 

 constitution. 



" A fact which brings practical therapeutics into near relation 

 with physiology and jiathology is that the active principles of all 

 drugs are isolated, their chemical composition is ascertained, and 

 their physiological action investigated. Pharmacology, in eft"ect, 

 has become a branch of exjierimental physiology, and the imme- 

 diate efl'ect of remedies is known with a completeness and accu- 

 racy heretofore undreamt of. .\11 this is working towards a 

 more intelligent employment of drugs, and leads towards the 

 goal of all the eftbrts to bring therapeutics within the ciicleof the 

 sciences. This goal is that we should know not only the effects 

 of remedies, but how these effects are produced. This is in the 

 last resort a question of chemistry. .\s I have said before, all 

 vital actions are attended with molecular or chemical changes ; 

 are, from one point of view, chemical action, and come under 

 the laws of the correlation of force and conservation of energy ; 

 so, therefore, are the physiological and thera])eutical action of 

 drugs, and obviously the key to the latter is to be found in the 

 chemistry of vital processes. Therapeutics, to become scientific, 

 is only waiting for answers to the questions which she puts to 

 chemistry. Why are sodium salts so much more abundant than 

 potassium salts in the blood, and whyare the former almost con- 

 fined to the liquor sanguinis, and ihe latter to the corjiuscles ? We 

 must assume that albuminoid proteids have an aftinity for sodiinu, 

 and the globulins for ixjtassium. With the answer to this is 

 bound up the secret of the necessity of sodium, potassium, and 

 calcium salts to anabolic and cat,abolic operations, in which they 

 Lake no traceable part, and of the presence of iron in the blood 

 corpuscles. 



" Why, again, in the case of substances apparently so similar 

 as potassium and sodium salts will the former, if injected into a 

 vein, even in small quantity, p.aralyse the heart and destroy life, 

 while we see i)ints of normal saline solution thrown into the 

 circulation with none but good results ? How does prussic .acid 

 — the simplest in composition and constitution of all organic 

 std)stances — prove fatal with such fearful |)romptitude by its pre- 

 sence in infinitesimal jirojK.irtion in the blood? How again does 

 morphine suspend the .activity of the nerve centres? Chemists 

 must admit that the poisonous efi'ects of jirussic acid and nmr- 

 phine can only be due to some molecular change in these sub- 

 stances ; they know that if the deadly cyanogen is so tied up that 

 its component atoms cannot fly a|>art it is innocuous, and that a 

 very slight change in the chemical constitution of the morphine 

 molecule entirely alters its eftect ; it is an almost irresistible in- 

 ference from the doctrine of conservation of energy that the 

 change in the molecule, say of the morphine, must be equal and 

 o]5posite to the molecular change in the nerve cells which it 

 .arrests. It seems to me. therefore, that we have in the chemical 

 constitution of the morphine molecule a clue to ihe character of 

 the chemical change by which nerve action takes place and to 

 the (juantivalence of nerve energy. 



" What then is our i)o,silion to-day in resi)ect of the three jwints 

 which we have been following — the recognition of disease, the 



