Page:The Harveian oration 1912.djvu/23

Rh insist that all this work upon the foundations, whether it be anatomical, histological, chemical, physical, has, unconsciously perhaps, but none the less inevitably, been ushering in another point of view than that from which we started, and the latest phase of pathology is this more intricate one that concerns itself with the investigation of function. It is now no longer so much the morbid change as the prejudicial function that is to be our quarry, or rather the passage of the one into the other. It is to this point that the researches on cancer have come. As pathologists we are now trying to identify as it comes and passes that coign of clinical medicine—

where a detrimental method of function commences devolution, and sets towards decay.

And what numberless instances are there where, with no accessible morbid changes, this is the problem. Perhaps it may even be said that there is no disease, however much we think we know about it, in which this is not the problem still. Take this latter case first as exemplified by arterial tension (de motu sanguinis). It came first into more precise recognition in clinical medicine as a symptom of what we have known as a form of Bright’s disease—a disease that is of structural change. But before very long it was noticed that it might be present under conditions when the examination after death showed no alterations in the kidney of any moment. So Bright’s disease has been rechristened, and now we hardly hear of it. That postal address is now “not known,” and you must inquire for