RELATIONS TO OTHER SCIENCES 451 



longer suffices to carry on investigation and practice within their 

 formerly strictly defined limits. Gradually one recognized specialty 

 has developed after another, partly owing to the necessities of special 

 training in a certain technique, partly because only men trained in 

 that technique could promote further investigations. 



The International Medical Congresses bear testimony to this 

 unavoidable development of contemporaneous medicine. Their 

 organizers desire nothing more than to limit the number of the 

 Sections of the Congress, yet time after time is it found indispensable 

 to create new sections. Thus, whereas at the International Medical 

 Congress of Brussels in 1875 eight sections sufficed to carry on the 

 work, which was truly representative of the state of scientific medi- 

 cine at that time, that number had been more than doubled twenty- 

 five years later, when no less than seventeen sections had to be 

 formed at the International Medical Congress of Paris of 1900. Seeing 

 the unexpected rise of so many branches formerly undreamed of within 

 the memory of our own generation, he would be a bold man indeed 

 who would dare to assert that the limit had been reached of further 

 specialization of our science. 



This progressive division of labor --the outcome, not of individ- 

 ual caprice, but of stern necessity - - has certainly resulted, within 

 the last fifty years, in greater progress of medical knowledge and 

 power than has taken place at probably any corresponding period in 

 the history of medicine. If we middle-aged men remember what 

 medicine was when we entered upon our studies and see what it is 

 to-day, and if we further reflect how much of all the progress achieved 

 meanwhile is due to the labors of specialists, we have every reason 

 I think to be grateful to the division of labor which has brought 

 forth such splendid fruit. 



But while this must be readily and ungrudgingly acknowledged, 

 it cannot be denied that, as in almost every movement of a similar 

 character, thus in this development of modern medicine there is one 

 great and real danger, namely, the peril of over-specialization. Well 

 do I remember, when I first selected a specialist's career, how incensed 

 I was at the reproach then currently leveled at specialism, namely, 

 that it engendered narrow-mindedness, and how ill-founded and 

 unjust that reproach seemed to be to me. With longer experience 

 and riper judgment I have learned that the danger of narrow-minded- 

 ness, accruing from too exclusive a devotion to specialism, is more 

 than a mere phantom. Whether by natural turn of mind, or by 

 want of steady connection with broader aspects of pathology, there 

 is no gainsaying that the enthusiastic specialist is apt to see a local 

 trouble everywhere, and to overlook disturbances of general health 

 and other organs which in reality require the chief attention. The 

 tendency which has become particularly marked during the last 



