644 



SCIENCE. 



[N. S. Vol. II. No. 46. 



THE FOUNDATIONS OF MEDICAL SCIENCE.* 



The extraordinary advance which has 

 characterized nearly every department of 

 science during the past fifty years can 

 hardly be said to have helped the solution 

 of that most important of all problems, the 

 very foundation of natural science— the na- 

 ture of life. To us engaged in the study of 

 disease and the relief of suffering it is — 

 and from more than one point of view — a 

 fundamental question, one which from the 

 eai'liest times has been regarded by the 

 medical profession with the keenest in- 

 terest. Time after time scientific enthusi- 

 asts have announced in the most confident 

 terms, and for more than forty years the 

 public have been assured again and again, 

 that at last the mystery had been solved or 

 was so near solution that it might be con- 

 sidered as practically settled. Among sci- 

 entific workers and thinkers, however, the 

 divergence of opinion as to the real nature 

 of life has been, and is, so great that we 

 are still uncertain how any living thing is 

 formed, how it grows, what is the exact na- 

 ture of many diseases, and in what manner 

 the action of many of our medicines is to be 

 correctly explained; while, notwithstand- 

 ing great progress in investigation, many 

 morbid changes and phenomena connected 

 with the healing of wounds and the repair 

 of injuries have yet to be cleared up before 

 we shall be able to say that the nature of 

 vital processes is understood. The very 

 foundations — the first principles of all liv- 

 ing nature, the exact differences between 

 the living and the non-living state — have 

 still to be established. Even the broad dif- 

 ferences between a particle of matter which 

 is actually living and one that has just 



* An introductory lecture delivered at King's Col- 

 lege Medical School on October 4th, 1895, by Lionel S. 

 Beale, M. B., F. R. C. P. Lond., F. R. S., Joint Pro- 

 fessor of the Principles and Practice of Medicine in 

 King's College, London, and Physician to the Hospi- 

 tal. — Abridged from the report in The Lancet. 



ceased to live have not been ascertained, 

 and our physiology, pathology and medical 

 science rest upon no certain basis. Mental 

 operations have received various explana- 

 tions, but not one that has been offered 

 adequately accounts for the facts, while 

 vague and uncertain data and conflicting 

 interpretations of facts form the founda- 

 tions upon which uncertain and perpetu- 

 ally changing philosophy has been con- 

 structed. So strong, however, is the con- 

 viction of some with regard to the truth of 

 the physical doctrine of life, and the general- 

 ization that the living and non-living are 

 one, that not a few would modify our sys- 

 tems of government and education in order 

 to bring them into accordance with certain 

 fanciful speculations upon the religion, 

 morality and civilization of the future 

 when phj'sical doctrines shall be univers- 

 ally accepted and taught. 



So determined has been and is the set of 

 opinion against the idea of the operation in 

 living beings of anything in its nature dis- 

 tinct from physical or chemical change that 

 I have long hesitated to press a contrary 

 view, notwithstanding that facts and argu- 

 ments in all departments of living nature 

 give to it very strong support; while, on the 

 other hand, the favorite doctrines still 

 taught are contrary to all living nature, 

 and to make them popular it has been 

 necessary to invent a new nature — a nature 

 which from the first has been shown to be 

 impossible. Latelj^ however, a change has 

 come over men's views. IS'ot a few have 

 begun to doubt whether the purely phj'sical 

 doctrine of life is supported bj^ facts, and 

 at last the distinguished President of the 

 Chemical Section at the Ipswich meeting of 

 the British Association has dared, not only 

 to express his doubts concerning the purely 

 physical doctrine of life, but has gone so far 

 as to plead ' for a little more vitalitJ^' I 

 heartily join in his plea, and have for many 

 years hoped that ere long we should be per- 



