Page:Popular Science Monthly Volume 22.djvu/634

616, but rather to attain to a more complete and sound understanding of those general laws which govern the actions of the living body in health—laws which must ever form the only firm basis of the knowledge of disease, and the only sure guide to judicious modes of treatment.

The rational practice of physic, as it is carried on in the present day, is in a great measure the outgrowth of a slowly growing physiological science, upon which it depends, and from which it can not be separated. There is hardly a thought that can strike a practitioner that does not in some way depend upon physiological facts which have been elicited by experimental research. I do not mean to state that the accurate and painstaking observation of clinical facts and postmortem appearances has not done much—probably more than anything else—to bring our medical knowledge to its present stand-point; but I contend that clinical observation and post-mortem experience without physiological research would never have been able to advance medicine to the position it holds in modern times; and, on the other hand, I believe that physiological study, even unaided, could arrive at a rational system of treatment. No doubt both clinical study and pathological observation have not only helped practical medicine onward, but they have also greatly contributed to the progress of physiology itself. In fact, I find it impossible to separate exact clinical and pathological work from scientific research of a purely physiological nature. Is not all treatment more or less experiment? And is not this particularly true of purely empirical treatment? Nowadays, where is the pathological laboratory in which a mere record of post-mortem changes in the human subject is not aided by experimental inquiry into pathological changes in the lower animals?

In assigning to each department of medical study its due meed of credit, their relative ages must be borne in mind. It has been asserted that all the improvements brought about by experimental research would have been introduced with equal certainty had experiment on living animals never been attempted. Observation, experience, and thought would have attained all the results we now enjoy. Possibly so; but when? Clinical observation can be traced back some three or four thousand years, and even then it started with a rich legacy of traditional knowledge. Experimental physiology as a science was only born about a hundred years ago. If we compare the progress made by medicine during the last hundred years with that of the previous thousand years, we shall be able to judge of the relative rates of progress of the two systems of working. The difference seems to me to lie in the fact that unaided clinical observation—that is, practically the empiric method—goes the wrong way about arriving at a conclusion. It says, Try this or that or the other remedy, and note which is successful. This is like a boy who will not systematically work out his sum in long division, but prefers to arrive at the quotient by guessing probable numbers one after the other, and multiplies them