Volume 1

A system of medicine / by many writers ; edited by Thomas Clifford Allbutt.

Date:
1896-1899
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / by many writers ; edited by Thomas Clifford Allbutt. Source: Wellcome Collection.

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    are matters of no essential difference. To kill Laveran's microbe ^ within the body by eating quinine is not to cure an ague, but to prevent the cause of a future ague : the ague itself is a perturbation of the systemic balance which will usually yield to the vis. medkatrix naturce; that is to say, to the tendency of all stable equilibriums to maintain them- selves—the vis medkatrix naturce being an aspect of inertia. If we keep clearly before us this distinction between the causes of disease and disease itself, we shall use our remedies more intelligently ; we shall see how dominant is the sphere of preventive medicine, and that curative medicine is often but the ancillary mouse which liberates the body for its own work of recovery. To know disease, then, we must first know the latitudes of health; we must study the balance of forces in their normal play before we can comprehend and neutralise the disturbances to which this balance is subject. The corporeal system of man is one of vast multiplication and differentia- tion of members; in him, therefore, comprehension of the system is most difficult. As we descend the scale of life, and study simpler systems and simpler functions, description becomes easier; and physiologists, building up our knowledge of the normal by the comparative method, take pathologists with them, who, in their turn, working upwards from the lowest forms of life, or the embryos of the higher or the embryonic tissues of the higher, are revealing to us day by day the secret ways of the earliest and simplest deviations from the normal—that is to say, the elements of disease \vide arts, on Inflammation, Fever, and Pathology of Infection in this volume]. Again, as the buildiiig up of an organism is not by permanent accretion like the building of a house, but by an incessant repair of decay, the student of the normal, that is the physiologist, is constantly in the presence of pathological features. As the healthy, so the normal is but a relative term; that which is normal in one series may be abnormal in another, and thus the physio- logist and the pathologist are intimately one : physiology as well as pathology is concerned with decay. The comparative method necessarily embraces the work of both, pathology being one aspect of physiology; to speak metaphorically, it is the reverse view of physiology, the study of accelerated or irregular rates of decay. Disease is a matter of time relations. What, then, is the nosologist 1 The nosologist bears the relation to the pathologist that the naturalist or morphologist does to the physio- logist ; as the pathologist classifies the morbid variations of plants and animals, so the nosologist describes the natural history of diseases : the nosologist, as such, has no concern with curative means ; he has his views of the balance of forces, but has no concern in the promotion of them. Cure is an art; it is the application of these sciences, and ig the concern of the physician : a physician is an engineer who cannot construct, bub is skilled in conservation and repair. Classification.—The nosologist or clinician, describing and comparing ^ The use of the word microbe is not to Le limited to bacteria. A general term for minute living things is required, and micro-organism is too cumbrous.