UTILITARIAN SCIENCE 15 



Medicine 



In the vast field of medicine I can only indicate in a few words 

 certain salient features of medical research, of medical practice, 

 and of medical instruction in America. 



In matters of research, the most fruitful line of investigation 

 has been along the line of the mechanism of immunity from con- 

 tagious diseases. To know the nature of microorganisms and their 

 effect on the tissues is to furnish the means of fighting them. " The 

 first place in experimental medicine to-day, "says Dr. W. H. Welch, 

 "is occupied by the problem of immunity." That medicine is be- 

 coming a scientific profession and not a trade is the basis of the 

 growing interest of our physicians in scientific problems, and this 

 again leads to increased success in dealing with matters of health 

 and disease. The discovery of the part played by mosquitoes in 

 the dissemination of malaria, yellow fever, dengue, elephantiasis, 

 and other diseases caused by microorganisms marks an epoch in 

 the study of these diseases. The conquest of diphtheria is another 

 of the features of advance in modern medicine, and another is 

 shown in the great development of surgical skill characteristic 

 of American medical science. But the discoveries of the last decades 

 have been rarely startling or epoch-making. They have rather 

 tended to fill the gaps in our knowledge, and there remain many 

 more gaps to fill, before medical practice can reach the highest 

 point of adequacy. The great need of the profession is still in the 

 direction of research, and research of the character which takes 

 the whole life and energy of the ablest men demands money for 

 its maintenance. We need no more medical colleges for the teach- 

 ing of the elements. We need schools or laboratories of research 

 for the training of the masters. 



In the development of medicine there has been a steady move- 

 ment away from universal systems and a priori principles, on the 

 one hand, and, on the other hand, from blind empiricism, with 

 the giving of drugs with sole reference to their apparent results. 

 The applications of sciences all sciences which deal with life, 

 with force, and with chemical composition must enter into the 

 basis of medicine. Hence the insistent demand for better prelim- 

 inary training before entering on the study of medicine. "Only 

 the genius of the first order," says a correspondent, "can get on 

 without proper schooling in his youth. What our medical inves- 

 tigators in this country most need is a thorough grounding in the 

 sciences, especially physics and chemistry." 



The instruction in medicine, a few years ago almost a farce in 

 America, has steadily grown more serious. Laboratory work and 

 clinical experience have taken the place of lectures, the courses 



