638 SCIENCE PROGRESS 



body in health, and the nature, prevention, cure, or mitigation of injuries 

 and diseases of human beings. 



(2) The invention of new methods or instruments for the improvement 

 of sanitary, medical, and surgical practice, or of scientific and pathological 

 work. 



II. Reasons for Rewarding Medical Discovery 



These are : 



(1) To encourage medical investigation. 



(2) To discharge a moral obligation incurred by the public for its use of 

 private effort. 



III. Various Possible Types of Rewards 



(1) Titles and honours given by the State, by k Universities, and by other 

 Public Bodies. 



(2) Prizes and Medals. 



(3) Patents. 



(4) Promotions and Appointments. 



(5 ) Pecuniary Awards by the State . 



IV. General Principles of Assessment 



It will probably be agreed that in the interests of the public all Medical 

 Discoveries should, if possible, receive some kind of acknowledgment or 

 recompense. But in view of the very variable conditions, nature, and 

 effects of particular investigations, it will often be difficult to assess the 

 kind of recompense most suitable for each. I will therefore now set down 

 my own analysis of the subject for consideration by the Committee. 



In the first place we should distinguish carefully between Compensation 

 and Reward. By Compensation I mean an act of justice done for the purpose 

 of reimbursement of losses ; by Reward an act of grace in appreciation 

 of services rendered. A plea for compensation is of course stronger than 

 one for reward only. 



The following different cases should next be considered : 



(a) Discoveries involving pecuniary or other loss to an investigator, 

 either by direct monetary sacrifice, or by expenditure of time, or by diminu- 

 tion of professional practice, without corresponding pecuniary gains. A 

 great example is that of Edward Jenner, who occupied himself so closely 

 with the investigation of vaccination against smallpox that he lost most 

 of his medical practice, and also considerable sums in expenses. The plea 

 for compensation in such cases is unanswerable ; and in 1802 and 1807 

 Parliament fully acknowledged its obligations under this head by giving 

 Jenner compensation in two sums of ^10,000 and ^20,000. 



(6) Discoveries which have increased the professional emoluments of 

 the investigator by enhanced practice, University or other appointments, 

 or other means. Such are, frequently, improvements in surgical operations 

 or medical treatment, which often lead to large practice. Another case is 

 that of serums, etc., which have been patented and put on the market. Here 

 compensation cannot be demanded, and pecuniary awards will, I think, be 

 generally held to be unnecessary. On the other hand, honours are often, 

 and justly, bestowed upon such work. 



(c) Discoveries which involve neither gain nor loss to the investigator. 

 This class includes most of the good, and sometimes great, clinical, patho- 

 logical, and sanitary discoveries achieved in the world. Here also com- 

 pensation can scarcely be demanded, and honours are already often given ; 

 but pecuniary awards should, I think, be sometimes bestowed as an act of 



