RESEARCH IN MEDICINE 215 



Yale, and Macallum, of Toronto; Delafield, Welch and Prudden in 

 New York and Fitz in Boston appear to have been among the first to 

 control university laboratories of pathology in which at least a few 

 men gave much of their time to teaching or investigation, but the 

 great impetus to research in pathology and bacteriology coincides with 

 Welch's affiliation with the Johns Hopkins Hospital, and experimental 

 pathology as a sustained effort was first broadly cultivated by Flexner. 

 Investigation in pharmacology by modern exact methods, in laboratories 

 devoted to that subject, is the result of the labors of Wood at Pennsyl- 

 vania, of Cushny at Ann Arbor, of Abel at Baltimore, of Herter in New 

 York and of Sollman in Cleveland. The first university institute of 

 hygiene was that established at Pennsylvania in 1892. These are the 

 names which the compiler of American medical history one hundred 

 years from now will compare, in discussing the development of our 

 laboratories, with those of the period of 1820 to 1860 in Germany. 

 Why ? Because these men established not merely teaching laboratories, 

 but stimulated investigation, inculcated exact methods and trained men, 

 and thus made an impression upon the medicine of their time. This is 

 true not merely of their influence in furthering research, but of their 

 influence in advancing the fundamental principles of proper medical 

 education. As soon as it was demonstrated that laboratories were 

 indispensable to proper medical education, the day of the medical school 

 worthy of university rank arrived and the proprietary medical school 

 as an important factor in medical education became a thing of the past. 

 Moreover, as I have intimated, the principle of laboratory instruction 

 and laboratory research which gave to laboratory effort the strongest 

 place in the curriculum has had a distinct effect on the clinical teaching 

 of medicine and surgery, so that in some of our better schools the indi- 

 vidual student now has that opportunity for immediate contact with 

 the patient which allows the direct exercise of his powers of observation, 

 of the use of instruments of precision and of exact procedures which 

 assure the acquirement not only of knowledge, but power to obtain 

 knowledge. The result is the recognition of the clinic as a place for the 

 exercise of exact methods in the teaching of the clinical branches and 

 in the investigation of disease. Both fields of activity, the hospital and 

 the laboratory, now have the " common purpose to advance medical 

 knowledge and thereby bring healing to the nations." 



With this conception of a common purpose guiding medical educa- 

 tion and medical research and with the present unanimity of opinion 

 concerning the absolute necessity of control of a hospital by the univer- 

 sity, the duty of the latter to research is clear. If the purpose of the 

 machinery of medical education is to " bring healing to the nations " ; 

 if " the business of medicine is to get people out of difficulties through 

 the application of science and dexterity manual and psychical" (Cabot), 



