6 4 o SCIENCE PROGRESS 



often, though not always, more important than those on more limited 

 maladies. 



(2) Difficulty of the Work Done. — For example, the solution of a difficult 

 problem requires more study, and therefore deserves more recompense, than 

 a lucky chance observation. 



(3) Immediate Practical Utility. — A strong plea for State remuneration 

 can be made on behalf of cases of this kind, unless they come under Class B. 

 It is strange that at present they never receive it — while academical recog- 

 nition is also often not forthcoming for them. (Of this I know many 

 instances.) 



(4) Scientific Importance. — Discoveries which are not of present practical 

 utility may become so at any moment, and should obviously be included in 

 the scheme, if they are sound and of wide application. 



Medical discoveries made by persons who do not themselves belong to 

 the medical profession should, I think, be included in all schemes of reward. 



Of course each case must be judged on its merits, and the assessment will 

 not always be easy. 



VI. State Awards for Medical Discovery 



Honours, prizes, and medals, being bestowed by H.M. the King, or by 

 public bodies and learned societies, are acts of grace which are generally 

 given after much consideration ; and I presume that the Committee does 

 not propose to consider them. But the subject of pecuniary awards lies 

 entirely within its province. 



Considerable pecuniary awards are already sometimes given in foreign 

 countries by various societies as the result of private generosity. The lead- 

 ing example is that of the Swedish Nobel Prizes, amounting to about ^8,000 

 each. Of these, four are or may be bestowed annually — namely, one each 

 for Medicine, Chemistry, Physics, and Literature ; and the Nobel Committee 

 has, I calculate, distributed about half a million pounds in this way through- 

 out the world during the last eighteen years. But one such annual prize 

 does not suffice for the whole of medical discovery. 



These prizes are given upon the principles of payment for benefits already 

 received. But during the last few years the British Government has dis- 

 bursed an annual grant of about ^60,000, under the Medical Research Com- 

 mittee, for subsidising investigations in progress, authorised by the Committee 

 and carried on by workers selected by it. This grant does not remunerate 

 discoveries already made, but proceeds upon another principle, namely that 

 of payment for prospective benefits. 



I think that both principles are sound. But they apply to two different 

 classes of research, and are indeed complementary of each other. Payment 

 for prospective benefits is " good business " only when some return is almost 

 certain ; and for this reason subsidised researches must almost always deal 

 with simple and straightforward questions, admitting of immediate experi- 

 mental reply. But, as a matter of fact, most of the greatest medical dis- 

 coveries were built upon a much more speculative and uncertain basis ; 

 and were achieved by men who were engaged at the time upon their ordinary 

 medical duties in addition to their investigations, and who neither sought 

 nor received subsidies for those investigations — as, for instance, Kuchenmeister, 

 Jenner, Simpson, Lister, Koch, Laveran, Bancroft, Manson, Bruce, Mackenzie, 

 and a score of others who have so greatly improved medical practice. Surely 

 the State should encourage this class of investigation also — partly because 

 it costs the State nothing in the doing, and partly because it seems to achieve 

 the greatest results. And there is only one way to encourage it — by paying 

 for discoveries when made. Payment for benefits received is always not 



