560 



SCIENCE. 



[N. S. Vol.. XX. No. 513. 



into physiology the far-reaching conception 

 of internal secretion. Furthermore, the 

 observation of Bouchard, Lancereaux and 

 other medical men of the occurrence of a 

 degeneration of the pancreas in cases of 

 diabetes mellitus, led to the discovery, by 

 two medical men, of the remarkable fact 

 that the complete removal of the pancreas 

 in dogs leads to diabetes. This discovery 

 demonstrated at the same time the further 

 principle that even glands with a distinct 

 external secretion have besides a physiolog- 

 ical importance for the body by virtue of 

 their internal secretion. In the long list 

 of workers on this subject we hardly find 

 a single physiologist. 



I could quote a good many more instances 

 in which medical studies brought out im- 

 portant physiological facts and how phys- 

 iology is slow to avail itself of such golden 

 opportunities. 



The physicists are only too glad to meet 

 with exceptions; the physiologists run 

 away from them. Is there any well- 

 founded justification for such a course in 

 physiology? I believe none. I believe it 

 is simply an erroneous position. It would 

 lead me too far to attempt here a discus- 

 sion of the causes which led to this position 

 in physiology. But I say without hesita- 

 tion that this position is deplorable, is 

 harmful to physiology as well as to medi- 

 cine. Animal experimentation is the es- 

 sential method of developing physiology. 

 Now then nature makes daily thousands of 

 experiments upon man and beast and 

 physiology refuses to iitilize them for its 

 own elucidation. I feel quite sure that a 

 study of the functional processes in pathol- 

 ogy, or at least the systematical taking up 

 of physiological problems indicated by 

 pathological processes, by minds naturally 

 endowed and properly trained for physio- 

 logical studies, would greatly elucidate the 

 proper sphere of physiology itself and 



would at the same time be of incalculable 

 value to pathology and medicine. 



And medicine is greatly in need of such 

 a physiology. I am afraid that the actual 

 situation in medicine is not fully grasped 

 even by a great many of its enlightened 

 disciples. To state the critical point in a 

 few words : The actual disturbance in most 

 of the diseases is primarily of a functional 

 natvire, but the essential part of the present 

 knowledge in medicine is morphological in 

 its character! This discrepancy is due to 

 the uneven development of the sciences of 

 medicine. When the empirical art of 

 medicine awoke to the necessity of acquir- 

 ing a scientific basis, it found ready for 

 its disposal an already well-defined precise 

 anatomy, but only a vague, incoherent 

 physiology. It set out and continued to 

 work in the precise lines of anatomy, in 

 which it attained a marvelous completeness. 

 By this step, however, morphology became 

 the dominant factor in medicine and the 

 definition of a disease became inseparably 

 coupled with that which was found in the 

 body after it succumbed to the disease. 

 When at a later period physiology also be- 

 came a precise science, it broke away at the 

 very onset of its regeneration from medi- 

 cine; it wished to be exact, to be a pure 

 science, and thus gained no infiuence upon 

 pathology, which it refused to study. So 

 it came about that medicine is made up of 

 a eomjDlete knowledge of the anatomical 

 conditions after death, of nearly a complete 

 morphology of the symptoms of the disease 

 during life, but of only a vague, makeshift 

 mechanical interpretation of the functional 

 disturbances during the actual- course of 

 the disease. The last decades have seen 

 the birth and marvelous growth of the 

 knowledge of the aetiology of disease. Ani- 

 mal and vegetable invaders were recognized 

 as the essential cause of many diseases. 

 But the study of the functions of the body 

 whose lot it is to grapple with the invaders 



