36 MEDICINE 



in medical literature there has come specialization in this, and 

 certain journals are devoted to special subjects and are only read 

 by those working in the field covered. The first differentiation came 

 in the separation of anatomy, physiology, and pathology from prac- 

 tical medicine, that is, the medicine concerned with the exercise 

 of the art. The separation was a natural one, for not only could 

 progress be more rapid, but the subjects could be better taught 

 by one who had the knowledge which came from his own investi- 

 gations. It is no longer possible for a single individual to control 

 the knowledge in any of these primary subdivisions. The most 

 obvious disadvantage in specialization is the loss of the more gen- 

 eral aspects of questions. The large questions become broken up 

 into smaller, and the smaller questions become leading questions 

 to be again broken up. It is also felt that the knowledge gained 

 in such special investigations may not be of a character which can 

 be utilized in the treatment of disease. But few of the questions 

 which arise and form the basis for investigation come from the clinic, 

 and they apparently have only the most remote relation to the 

 problems of disease. The investigator very properly feels that his 

 investigations are justified, in that they form contributions to general 

 knowledge, and whether or not the results are directly applicable 

 to the treatment of disease does not disturb him. 



There was an error perpetrated in not giving to those devoted to 

 the study of the clinical aspect of disease the same opportunity 

 to devote themselves to research, to answer the question which came 

 from the phenomena of disease, which was given to anatomy, 

 physiology, and pathology. Clinical medicine, the study of the 

 problems of disease coming from the bedside, must have the same 

 opportunity and must advance by the use of the same methods as 

 physiology and anatomy. Clinical medicine is behind the special 

 departments in the contributions it has made to knowledge, in the 

 methods by which it seeks to advance, and in the efficiency of 

 teaching. Provision must be made in the universities which will 

 enable men in the clinical departments to devote themselves to 

 research and teaching, and laboratories must be provided for such 

 research. Only one who is himself an investigator can direct in- 

 vestigation by recognizing and properly stating the questions. There 

 need be no fear that the knowledge which comes from investigation 

 will not be utilized. In what way may not be apparent at the time. 

 Often knowledge which seemed furthest removed from utility has 

 become the most important. That knowledge is poAver, and that it 

 is the only power is an accepted axiom. 



Anatomy and physiology, originally arising from human medi- 

 cine for the furtherance of knowledge which could be applied to 

 the treatment of disease in man, have long outgrown such limita- 



