348 



NATURE 



S^August II, 1 88 1 



spread among physicians. The multiplication of the powers 

 of labour, the constantly increasing emulation in researches, the 

 unmistakable increase in the depth of the questions proposed — 

 all these are phenomena of the most gratifying nature ; and one 

 would be very ungrateful if he would not acknowledge that the-e 

 were in a considerable measure to be ascribed to the improve- 

 ments in the means of instraction and to the multiplication of 

 laboratories. 



No one can be more disposed to concede the high value of 

 anatomical studies to the development of medicine, than one 

 who has made it a part of the task of his life to place anatomy 

 and histology in that commanding position in the recognition of 

 his contemporaries which they deserve. Nothing lies further 

 from me than to discourage those who still expect the greatest 

 benefit to the practice of medicine to arise from following out 

 these studies. May indeed the grow ing youth, who will have to 

 follow us in a snring the progress of medicine, learn from our 

 example how useful it is to lay the true foundation of our science 

 in anatomy. Assuredly much of that which remains dark to us 

 will then be rendered clear. 



But we must not allow ourselves to be forced back on this 

 way as the only jjermissihle one. Were the attempt to hinder 

 totally or in great part researches on living animals to become 

 successful, the same procedure w hich has been now entered on 

 against vivisection uould also be commenced against mortisec- 

 tion. There would no lon.fjer be societies for the protection of 

 animals, which we see opposed to us, but societies for the pro- 

 tection of human bodies. There would no longer be thunder- 

 ings against the tormentings of animals, but against the desecra- 

 tion of corpses. Under the standard of huminity, which is 

 just now unfurled even for animals, there w-ould be preached in 

 a still more impressive manner the campaign against the bar- 

 barity of medical men. PeojJe w^ouUl appeal to the feeling of 

 the masses — to the mother on behalf of the body of her child, 

 the son on behalf of the dear remains of his parents. It would 

 be proved that the dismembering of human bodies is injurious 

 to morals and opposed to Lhristianity. It would be shown that 

 the anatomy of man is useless for the treatment of disease ; 

 and perhaps there would be found ignorant or timid or egotisti- 

 cal medical men who would come forth as witnesses against 

 science. The mildest of our opponents would perhaps propose 

 to us the compromise that we should again make the dissection 

 of animals the foundation of instruction. In short, we should 

 be thrown back to the time before Mondini, before Erasistratus. 



Such thoughts are hy no means the productions of an alarmed 

 fancy. The study of history teaches us sufliciently that victorious 

 fanaticism knows no limits. It desires to heap to the full the 

 measure of its victories; and, even when the traders are con- 

 tented, the irritated ma-ses pre-s on to obtain the whole results. 

 It is indeed not at all necessary for us to go back to antiquity in 

 order to bring before our eyes the condition of such minds. In 

 no country of modern time are there wanting examples which 

 are recognisable by tlie eye ; for, along nith the societies against 

 "scientific tormentors of animals," there exi-t everywhere, but 

 mostly in a more unassuming form, brotherhoods and associa- 

 tions of all kinds which labour most zealously against the scien- 

 tific examination of dead bodies. It needs only an impassioned 

 and exciting agitation, such as is now going on against the 

 "torture chambers of science," to denounce to popular indigna- 

 tion the dissecting-rooms as places where the youths under 

 instruction are made barbarous. Whoever undertakes, with the 

 same extravagant fancy as is now u ed in delineating the physio 

 logical laboratory, to de cribe the post-mortem examinaiion of a 

 man, or an anatomical theatre, will not fail to have readers who 

 will turn away with horror and amazement at the misdeeds of 

 anatomists. 



In vain will an appeal be made to the fact that not one single 

 school of medicine has existed which has, without a fundamental 

 knowledge of anatomy, establi-hed lasting advances in the 

 science or the art of healing. The homceopaths and the so- 

 called nature-doctors {A'afurdi-zte), who indeed are already on 

 the scene to strengthen the ranks of the anti vivisectors, will step 

 forth and ].raise their results. Sce|iticisin, which, from time to 

 time grasps about even in medical circles, and which only too 

 easily finds there followers who have in vain called on medical 

 aid for themselves or their belongings — it will scornfully point 

 out how often the physician is powerless against disease. Thera- 

 peutics will be thrown aside as u eless luaiber; and it will be 

 pointed out to us, as is now already done in the petitions of the 

 societies for the protection of animals, that therapy is to be 



replaced by hygiene, the treatment of individual patients by 

 general measures of pul.lic sanitation. And the attempt will 

 then be made to excite the beliefih.it prophylaxis can exist with- 

 out anatomy or experiments on animals. 



In so large an as-embly of medical men as this is, a glance at 

 these present teaches in how many spei ial directions the medicine 

 of to day has gone. Not every one of these directions is in like 

 measure and as constantly in want of all the means r'f inquiry 

 and scientific preparation, which are ind spensable to cure disease 

 as a whole. Hence, from time to time, a perceptible one- 

 sidedness becomes manifest in certain of these special arrange- 

 ments. C)ne believes in his own sufficiency, and looks with 

 indifference, sometimes with a kind of polite contempt, on the 

 rest of medicine. Even the truly scientific studies are not exempt 

 from such one-sidedness ; on the contrary, human pride, the 

 tendency to over-estimation of one.self, prevail more readily in 

 these than in partial disciplines. We our elves have seen that 

 organic chemi-try, by a most partial use of a very moderate store 

 of knowledge, has made the attempt — and indeed not without 

 some temporary re-ult - to pre-cribe its laws to merlicine: and 

 that numerous practical physicians, unmindful of the history of 

 our science, have in fact .sought safety in a new kind of iatro- 

 chemistry. Yes, I have a very lively remembrance of the fact 

 that, when I myself was entering on the scientific career, the 

 hope of giving a purely physical aspect to biology was so power- 

 ful, that every attempt at morphological .study was treated as 

 something antiquated. 



We have not allowed ourselves to be prevented by this from 

 carrying on anatomical research » ith every exertion ; and we arc- 

 now in the hai py position of seeing it everywhere acknondedged, 

 that every advance in minute anatomy sees behind it an advance 

 in physioloL'ical knowledge. Fhy.siologists themselves are more 

 and more becoming al-o histologists. No one however must say 

 that physi-ilogy is becoming totally dissolved in histology. No 

 attempt must be made to replace one special subject by another. 

 What is necessary to all branches of medical science in general 

 is the knowletlge of life. But this cnn as little be attained by a 

 simple external examination of the livin - as by a partial investi- 

 gation of the dead. It can be reached by no single study or 

 specialty ; it is much rather the collective result of the cultiva- 

 tion r>f all individual branches of science. 



What is to be attained by a mere external examination of the 

 living body has been thor ughly taught by the older medicine. 

 For centuries sick and healthy have i een observed with assiduous 

 diligence, and in fact most valuable material has been collected 

 in the most ingenious n anner ; but, on the whole, no advance has 

 been made beyond "symptoms." What wns perceived were 

 the signs of something internal which was not perceived— indeed 

 the possible perception of which was hitherto doubted. Life 

 it.self stood as it were outside oliservation ; it was only a subject 

 of speculation. Intellectual formulae were laid down, spiritual- 

 istic or miterialistic, according to the general tendency of the 

 mind of the individual or of the time ; but all agreed in the con- 

 viction, that life it'elf is a transcendental and metaphy.sical 

 problem. For the practical physician, knowledge that was 

 franded in fact began with symptomatology ; for disease as such 

 was apparently not less transcendental than life itse f, whose 

 antitype it constituted. 



Ilo.v has it now come lo pass, that symptomatology has 

 entirely lost the high position in which it still stood little less than a 

 generation ago, to such an extent that in most universities it is 

 no more taught as a specialty ? Have symptoms no more any 

 importance for the physician ? Can a diagnosis be made with- 

 out a knowledge of symptoms? Certainly not. But, for the 

 scientific physician, the symptoms are no more the expre-sion of 

 a hidden power, recgiiisable only in its outer workings :_ he 

 searches for this power itself, and endeavours to find where it is 

 seated, in the hope of expl-iring even the nature of its seat. 

 Hence, the first question of the pathologist and of the biologist 

 in general is. Where? That is -the anatomical question. No 

 matter whether we endeavour to ascertain the place of the 

 disease or of life with the anatomical knife, or only with the eye 

 or the hand ; whether we dissect m- only observe, the method of 

 investigation is always anatomical. For this reason, the tho- 

 roughly logical founder of pathcilogical anatomy named his 

 fundamental b ok " De Sedibus Morborum"; and hence this 

 book became the starting-p .int of a movement which, in a few- 

 decades, has changed the entire aspect of science. 



This change has been carried out to the greatest extent m 

 ophthalmic surgery. Who could limit himself to perceivmg 



