EDITORIAL OBSERVATIONS. 
161 
become perfected, every division supporting and strengthening 
the other. The like objection has been taken to the promi¬ 
nence given to morbid anatomy. The study of this, how¬ 
ever, seems to be of even greater moment, but of course 
diseased structure, or an altered condition of a part, cannot 
be understood without a previous acquaintance with healthy 
structures, and the normal state of the organs. 
“ A knowledge of structural changes is of very high importance, but it 
is not of exclusive value. Acquaintance with the nature of organic lesions, 
their causes, natural history, sequence, and results, is of real assistance in 
practical medicine only when combined with etiology from the other side, a 
knowledge of symptoms and of general dynamic changes. But now we 
often see men who can discuss the quality of myeloid tumours, and talk 
very learnedly upon cells, nuclei, and degenerations, upon what is carci¬ 
noma, and upon what is not; and yet whose opinion of a case during life 
would be of value in inverse proportion to the accuracy of their micro¬ 
scopical delineations. In practical medicine what errors have we not seen 
from an exclusive attention to bruits, rhonchi, percussion notes, and the 
like, when these have been set up in value above the general, vital phe¬ 
nomena, whose perception and valuation is not quite so readily attained.” 
So with therapeutics, or that division which treats of the 
application of medicines to disease, how much there is still 
to be ascertained under this head ! Science has unques¬ 
tionably of late years done much to explain the modus 
operandi of medicinal substances, yet here we find the 
opposite extremes to be advocated. Some practitioners 
direct the employment of large quantities of certain drugs, 
while others recommend infinitesimal doses; and again 
there are some who have the temerity to assert that none 
is called for; all we have to do is to leave nature to her own 
resources, a placebo being all that is required. Such 
verify Ben Jonson^s definition of physic :—the art of amusing 
the patient while nature cures the disease. But this is not 
enough. From causes brought into operation, the harp of 
many strings becomes untuned, and functional derangement 
is set up, which if not restored leads to organic change. To 
prevent this the judicious employment of remedies, the action 
of which is known, is called for. All this doubtlesslv 
arises from the operation of medicines not having being 
correctly ascertained; no rigid examination as to their effects 
on the organism being entered upon; hence the discre¬ 
pancies. Bat surely no one will be bold enough to gainsay 
the importance of the inquiry, for however skilful a practi- 
xxxv. 11 
