I.— PHYSIOLOGY. 165 



the Vieana School held a prominent position in scientific medicine and 

 the new doctrine rapidly spread. The physician studied disease in the 

 patient : its beginnings, its progress, its effects, and the scars it left, 

 as shown at autopsy. Scientific medicine looked askance at treatment ; 

 textbooks spent many pages in describing the symptoms, diagnosis, and 

 pathology of disease, but two 'or three lines dismissed the treatment : 

 and even in our times the ' scientific ' physician is apt to be a diagnos- 

 tician rather than a healer. The study of disease as an entity was the 

 object aimed at, and a complete case was one which went to autopsy. 

 That most admirable and popular textbook of medicine by the late 

 Sir William Osier was typical of the textbooks of the time. Dr. Simon 

 Flexner once told me that Osier's book, characterised by its almost 

 complete lack of indications for treatment, was largely responsible for the 

 Rockefeller millions given to medicine. The textbooks of the period 

 told with considerable precision what was happening in the body during 

 disease and what was likely to happen, but little or nothing on prevention. 

 This state of affairs was unavoidable ; there was no specific treatment, 

 there was no science of treatment, for such a science could only come into 

 existence when physiology and pathology had reached some degree of 

 precision. Diagnosis was then and is now far ahead of treatment ; 

 diagnosis is often accurate where there is no satisfactory treatment and 

 yet diagnosis is only a means to the end. 



The science of treatment or pharmacology is therefore relatively new ; 

 it includes knowledge of all kinds dealing with the treatment of disease 

 or alleviation of suffering. It is the climax of physiology and pathology, 

 devised to subserve a practical end, and forms an important part of the 

 great biological topic of the influence of conditions on the living organism. 

 Few drugs now exist the mode of action of which is not understood, and 

 the goal is not so far distant when it will be possible to introduce into 

 the animal economy a factor which will exaggerate or retard the function 

 of any tissue or collection of cells in the body, leaving the others unaffected ; 

 and most of these results have been obtained by the methods used in 

 experimental physiology. 



The first object of science is to ascertain facts : certain facts in 

 physiology are relatively easily ascertained, those, for example, which 

 involve the behaviour of ferments of isolated cells or of tissues and which 

 require well-known chemical or physical methods. Other facts involving 

 the physiology of the whole organism are more difficult to interpret, 

 though they are the basis of the therapeutic side of medicine. More and 

 more is physiology being regarded as the application of physics and 

 chemistry to the phenomena of life. It may, of course, be argued, as 

 I believe Descartes did first, that the body of a living man is a machine, 

 the actions of which are explicable by the known laws of physics and 

 chemistry : and that, therefore, the correct way to study physiology is by 

 applying these sciences to the cell. I am by no means averse to the vast 

 amount of academic research on these lines which is published annually, 

 often by workers with little biological knowledge or training, but it surely 

 should not precede the more immediate practical aspects of the subject. 

 The modern attitude is expressed by a distinguished young biochemist 

 who, in reviewing a well-known book on chemo-therapy in 1928, asks 



