52 



SCIENCE 



[N. S. Vol. XXXIX. No. 993 



can be made to explain the functioning of 

 the parts. Physiology, in short, must con- 

 cern itself with an application of the known 

 laws of physical and chemical science to the 

 process of living in both plants and ani- 

 mals. It must, for example, endeavor to 

 show whether the facts known to the chem- 

 ist can be made available to explain the 

 synthesis of the various constituents of 

 plants, and the liberation of energy which 

 follows the ingestion of these f oodstuifs in 

 animals; it must ascertain whether the 

 movements of a muscle, the secretion of a 

 gland, the transmission of a nerve impulse, 

 are adequately accounted for by the known 

 laws of physics, or whether there exists in 

 living things some force that entirely alters 

 or entirely obscures the physical process. 



As thus defined, the science of physiology 

 is obviously too wide in scope, and its rami- 

 fications too diversified, to make possible its 

 inclusion as a subject in the medical cur- 

 riculum. It must be delimited. For this 

 purpose, the object aimed at is of course 

 a knowledge of the functioning of the 

 human animal, although in gaining this 

 we must constantly endeavor to show, 

 by observations on the lower animals, 

 how the same general laws of function ap- 

 ply throughout the animal world. We 

 must, above all things, treat the subject 

 from a broad scientific point of view, not 

 narrowing it down to a mere study of the 

 complicated mechanism of the higher mam- 

 malia, but making it a general study of the 

 essential nature of the life processes. Just 

 in so far as the knowledge of physiology is 

 sound will the practise of the physician be 

 likely to be proficient. 



For the medical student, therefore, phys- 

 iology must serve as the connecting link 

 between his pre-medical scientific studies 

 and the clinical work which is to follow. 

 It must be considered as the center to which 

 the basic sciences converge, and from which 



diverge the various subjects that are related 

 to the study of disease. 



A knowledge of physics, chemistry and 

 morphological biology constitutes the bed- 

 rock upon which the foundation of medical 

 knowledge, represented by physiology, must 

 be built, and it is only after the founda- 

 tion is completed that it becomes possible 

 to add the superstructure which is repre- 

 sented by pharmacology, experimental 

 pathology, hygiene and medicine. Physi- 

 ology bears to medicine much the same rela- 

 tionship that anatomy bears to surgery, for 

 the physiologist of to-day is the physician 

 of to-morrow, just as the anatomist of to- 

 day is the surgeon of to-morrow. 



The objects which must be kept in view 

 in framing the course in physiology for 

 medical students may therefore be stated 

 as being: (1) a knowledge of the applica- 

 tion of the known laws of physics and chem- 

 istry in living things; (2) a knowledge of 

 the behavior of those life processes which 

 can not at present be explained on a phys- 

 ico-chemical basis. To impart such knowl- 

 edge, we must, in the first place, offer the 

 student ample opportunity for the direct 

 observation of the behavior of living things, 

 so that his knowledge of physiology may 

 rest upon a basis of personal observation 

 rather than upon one of authority. The 

 student must, above all things, be trained 

 to be an investigator of the behavior of 

 living things, and he must be constantly 

 reminded that the observations which he 

 makes on the normal animal are later to 

 serve him as a standard with which to 

 compare the behavior of the disturbed func- 

 tions in disease. But practical courses 

 alone will not sufBce. They must be sup- 

 plemented by didactic instruction of such 

 a nature as to show the student how the 

 facts which he himself gathers from direct 

 observation can be linked together with one 

 another and with those of other investiga- 



