I.— PHYSIOLOGY. 167 



the profession a lead and shown by the experience of a great number of 

 doctors that there is a best way of treating varicose ulcer in which the 

 patient gets well quicker than by other ways, an advantage both to the 

 patient and to the community who have to keep him whilst he is unfit 

 for work. 



The British physician is a skilled diagnostician and is in the forefront 

 in all that pertains to this subject. The literature is so extensive that it is 

 impossible for the average clinician to do more than this. But how few of 

 them do, or perhaps the more correct word is ' can,' occupy the same time 

 in the study of recent advances in general therapeutics ? The successful 

 physician has, generally speaking, to be content with such references to 

 treatment as are to be found in clinical reading. The general physician 

 must always be a necessity for diagnosis ; but the details of treatment of 

 patients will, I believe, in the future be handed over to those who have 

 made a special study of the treatment of that particular group of diseases 

 from one of which the patient is suffering. This is already the position 

 in tuberculosis. 



But the advent of institutions for experimental therapeutics is upon 

 us, though Britain has taken little part in the movement. In this 

 connection we welcome the magnificent buildings of the University of 

 Capetown, and when the new hospital with its medical school is completed 

 I confidently anticipate that adequate accommodation will be provided 

 for that important branch of applied physiology, pharmacology, and that 

 this will include laboratories of physiology and organic chemistry, which 

 must be in close and direct association with the wards. The enormous 

 importance of one branch of treatment to Africa, chemo-therapy, I will 

 refer to later. 



From what has been said, it is not surprising that British pharmacology 

 should be so much behind that of other countries in the production of 

 new curative remedies ; practically all come from abroad ; I may mention 

 ephedrine for spasmodic asthma, liver extract for pernicious anaemia, 

 insulin, the organic arsenicals, the dyes such as 205, the new anaesthetics 

 local and general, hypnotics, and many others. 



It has been often stated that the action of remedies may be best 

 determined by experimenting with them on healthy men. This is not 

 true ; quinine is used to treat malaria, yet not one of the subjective 

 symptoms induced in man has the remotest connection with its curative 

 properties. The same is true of the use of the iodides in syphilis and 

 salicylates in rheumatism. The experiments of Joig and his pupils in 

 1825 with camphor, digitalis and other drugs on healthy men added 

 nothing of value to pharmacology. Subjective sensations are, it is true, 

 produced, which are erroneously attributed to the drug which has been 

 taken. The late Dr. Eivers and myself were nearly the dupes of such an 

 experiment which I will give in full because it illustrates the imaginary 

 sensations and effects produced by S. Hahnemann and his pupils, by 

 Perkin with his retractors and by more modern physicians with their 

 mystic apparatus. 



Our experiments were made on healthy men under a regular regime 

 as regarded sleep, exercise, and diet. The men were practised with the 

 use of the ergograph during several weeks at the same hour daily, until 



