PHYSIOLOGY AND NATIONAL NEEDS.*
ALTHOUGH physiology is the basis of scientific medicine and still in some schools retains its name, the Institutes of Medicine, it has not received the wide recognition its great importance merits. It has been our experience to find this branch of their studies much disliked by medical students, and spoken of with something akin to disrespect by the recently qualified medical men. As Professor Noel Paton, in his lecture on " Physiology in the Study of Disease," points out, two factors have contributed to this result—namely, the tendency of teachers of physiology to omit to lay stress on the bearings of the subject on the work of the physician, in other words to teach it as a subject apart, and the fact that many hospital physicians have forgotten such physiology as they at one time knew. A third factor not men- tioned by the Professor is the necessarily unscientific basis of much practical medicine, which nevertheless is frequently very beneficial to the sufferer. In a sense, .of course, it is wrong to speak of such medicine as unscientific. It is empirical to-day ; to-morrow, when the physiologist by painstaking research has explained its beneficial action, it will be scientific. This point is, apparently quite unintentionally, brought out in the course of this interesting series of lectures. Thus scurvy was efficiently treated long before vitamines and many other things had been studied by the physiologist, but on the other hand the dangers of empiricism are exhibited in the substitution of limes for lemons in the Navy. The benefits of an addition of lemons to the dietary in the prevention and cure of scurvy were ascribed to their acidity and, as limes are more acid than lemons, they were substituted for the latter. Physiologists have recently proved that the acid has no anti-scorbutic properties, and that it is a vitamine which can be obtained free from acid which is essential. Now limes contain only a small amount of the vitamine, whereas lemons are rich in it. Thus empirical medicine can be very beneficial, but its power for good will be greatly strengthened and extended by the scientific work of the physiologist. Throughout medicine it will be found that the patient acute observer has outrun the necessarily more slow-going physiologist, who must avoid the temptation of saying to the physician and surgeon : " What I don't know isn't knowledge."
These six lectures, however, were written primarily not for the purpose of bringing home to medical men the importance of
• Physiology and National Needs. Edited by W. D. Halliburton. M.D.,
LL.D.. F.H.B. London: Oonetable. 13d. net.]
physiology in the furtherance of their life-work, but to demons. trate to the public how much the nation owed to the physiolo• gists in the past years of stress, and how necessary to the nation's well-being in the future may be encouragement of their pains- taking and, sad to say, at the present time, ill-paid investigations. Our food problem was only kept within reasonable limits by the work of such men, andi t is to our credit that, unlike the Germans, we based our food regulations on such expert advice. A diet containing sufficient calories may not appear to the average man or woman very appetizing or satisfying, but a knowledge of the calorific values of foods saved the situation, and perhaps inaugu- rated an era of more wholesome feeding. As Professors Halli- burton, Hopkins, and Harden demonstrate in their lectures, a diet providing a sufficient number of calories, and consisting of proteid, fat, and carbohydrate in proper proportion, may, nevertheless, not support life satisfactorily and, unless it at the same time contains a sufficiency of those elusive substances vitamines, may lead to diseases and death. Such diseases, known as deficiency diseases, are rickets, scurvy, and beri-beri, to mention some of the best known, and their treatment by Dr. Harriette Chick and her co-workers at the present time in Central Europe, where unfortunately as a result of the recent war they are very rife, is adding a fascinating chapter to the pages of physiology. In all probability the reader will find the first three lectures dealing with foods and vitamines the most interesting of the series, but each one is well worth studying. Dr. Noel Paton, in his lecture on "Physiology in the Study of Disease," states :—" Without training in medicine the physiolo- gist can approach the study of disease with some prospect of success ; without a knowledge of physiology the physician is merely groping in the dark." Quite true ; but, as we have at- tempted to show, groping in the dark, if careful clinicale observa- tion may be thus described, has led to some very important progress, which would certainly not have been made if experience had had to wait on physiology.
Important as the subject is, we are, even after reading Professor Dendy's explanation, puzzled to explain the presence of his lecture on " The Conservation of Our Cereal Reserves " in this series. We are at least sure that the student of physiology would resent questions on the subject in any examination paper, but if the bounds of physiology have to be extended to receive it, finding it there, we welcome it on account of its extreme interest and the author's attractive style.
The last lecture on " Physical Training and the Open-Air Life," by Dr. Pembrey, will be read with interest by those who see in our love of games, by which is not meant the love of watching games, the source of our national vigour. The view that drill and exercise in the gymnasium cannot take the place of games and exercise in the open air here finds expression. It is a view that has been emphasized by several of the medical officers attached to camps for convalescent soldiers.
We have already mentioned that in these lectures the sphere of physiology is made to include a very large number of subjects, but few readers would think that physiological needs have any connexion with industrial unrest and strikes, yet in Dr. Pembrey's opinion there is such a connexion. Thus the farm labourer has healthy occupation in the open air, " a good standard of physique has been maintained, and unrest and strikes are not generally associated with work on the land." On the other hand, coal- miners " do not work in the open air, and have strenuous and monotonous labour in constrained positions, but they have compensated for these drawbacks by insisting on shorter hours of labour and higher pay ; their strikes have been the expression of their physiological needs, a high standard of food and recrea- tion in games and sport in the open air." And now we know why our coal costs us more, and should be satisfied, but possibly the interference with our own physiological needs may exhibit itself in quite explicable discontent.
To sum up, Professor Halliburton and his coadjutors have certainly succeeded in this series of lectures in demonstrating the importance to the nation of the study of physiology, and, if the book is read as widely as it deserves to be, should equally succeed in rousing the interest of the public in a department a science hitherto hidden in obscurity.
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