October 13, 1923] 



NA JURE 



545 



the main lines of clinical research, often notoriously 

 injure practice. There is still a feeling that a man 

 will not be " a good doctor " if he takes to flying the 

 scientific kite too often. Thus every one knows that 

 >oth Harvey and Jenner ruined their respective 

 )ractices by their scientific studies. For another 

 Example, it was said of Thomas Young, the father of 

 )hysiological optics and discoverer of many great 

 theorems on light, heat, and energy, that he " was not 

 regarded as a successful practitioner, becaus'e he studied 

 symptoms too closely, although his treatment was 

 idmitted to be effective." In other words, he cured 

 lis cases by studying their symptoms instead of study- 



ig the correct bed-side manner ! Wise or not, this 

 feeling has to be considered by practical men. Then 

 fhere is a third class of effort — perhaps the very highest 

 class of medical work — which is concerned with the 

 )revention of the great epidemic diseases. At present 

 fit receives no payment whatever, either from practice 

 or otherwise. What has been done, for example, for 

 [Mr. W. M. M. Haffkine or for Mr. H. E. Hankin— both 



lymen and private enthusiasts — whose studies have 

 saved untold numbers of lives from cholera and plague 

 India and elsewhere ; or for the almost unknown 

 lectors who discovered that plague — the world- 

 lestroying plague — is carried by the rat-flea ? 



Such drawbacks, and others, are unfortunate, 

 because they tend to impede enlistments in the great 

 Voluntary army of medical science. Our friend the 

 private enthusiast is a rare species ; and the successful 



ithusiast is very rare indeed. You cannot subsidise 

 lim beforehand, because you cannot discover him until 

 le has done his work. You can supply him with 



iboratories, test-tubes, and microscopes — if he wants 

 them, but you cannot pay him for his thoughts, his 



ilculations, or his natural aptitude, nor, above all, 

 lor that passion for discovery — for discovery not 



lerely for investigation — which drives him over every 

 obstacle to his ultimate goal. You cannot subsidise 



im, and you cannot reward him either. It is beyond 

 ^he power of the whole earth to reward him ; his dis- 



)very is his reward. But still you can do something 

 jEor him in a small way. In 1802 and 1807 Parliament 



)mpensated Jenner for the loss of his practice ; in 

 1884 the German government did the same for Robert 

 ^och ; and quite recently, I understand, the Canadian 

 government has, very wisely, shown the same con- 

 ideration to Dr. Banting for his brilliant labours on 



isulin. 



The least that the world can do for the success- 

 ful investigator, whomsoever he may be, is to pay 

 lonourably such of his little out-of-pocket expenses 



id losses as he may have incurred in the world's 

 lervice ; and the most that the world can do for him 

 5 — to keep him at work. This is the way in which 

 money can now be most profitably spent for science. 

 I see that Sir Alfred Yarrow has recently given a 

 fine donation, which is to be devoted partly to this 

 purpose. If I were a millionaire I should follow his 

 example. 



It is often said that there is no such thing as dis- 

 covery, that each advance is built upon previous 

 advances. True ; but what is the interval between 

 these advances ? Many people carry on incomplete 

 investigations, and just miss their triumphant culmina- 



NO. 2815, VOL. 112] 



tion. The culmination is the discovery. I have often 

 wondered how it was that those wonderful people, the 

 ancient Greeks, missed four great discoveries which 

 they seem to have been on the point of achieving — 

 the calculus, evolution, electricity, and vaccination. 

 As it is, the world was obliged to wait for nearly two 

 thousand years before these little " advances " were 

 made. It awaited the proper men. Only the other 

 day an able biochemist told me that probably most of 

 the facts regarding the complicated diseases of meta- 

 bolism are already known, but that another Newton is 

 required to integrate them. Such, I think, may also 

 be the case regarding other grave medical problems, 

 as, for example, that of cancer. Possibly the discovery 

 may already be made, but there is no one to drag it 

 forth into the light. In science, as in art, the man is 

 everything. 



I must make one more remark. What always 

 amazes me is the fact that there are millions upon 

 millions of human beings whose health and whose very 

 existences are constantly threatened by numbers of 

 diseases, and yet who never subscribe one farthing for 

 the medical researches which endeavour to defeat these 

 terrible enemies of theirs, and often succeed in doing 

 so. Yet thousands of these same people pour out their 

 subscriptions and bequests for all kinds of projects, 

 many of which are futile ; while even those good and 

 generous people who maintain our hospitals and 

 universities seem often to forget that behind hospital 

 practice and behind university teaching there is tl" 

 great science which inspires both. 



I have tried to give you a brief review of what may 

 be called the natural history of discovery. "The 

 management of medical research " will lie in the 

 hands of you young people ; but you must study the 

 book of the past in order to direct the advances of the 

 future. I hope that most of you will be " mere practis- 

 ing doctors " ; but, if so, let every afferent and efferent 

 nerve of your thoughts connect the brain of science 

 with every sense, muscle, and faculty of your practice. 

 The practitioner nowadays cannot live apart from 

 science, trying to evolve wisdom from his own medita- 

 tions, like a hermit in the desert : you must not only 

 observe, but also think ; and not only think, but also 

 read. Your first duty will be the cure or prevention of 

 sickness ; but some of you in your leisure may perhaps 

 try to solve problems, may become enthusiasts, may 

 even become wild enthusiasts ! — I cannot imagine a 

 nobler fate. Even, perhaps, one of you — probably 

 not more — may be destined to become the Newton 

 or Einstein of some hitherto undreamed-of synthesis. 

 I hope so. 



Science has indeed measured the stars and the 

 atoms, has knit together the corners of the earth, and 

 has enabled us to fly over oceans and deserts ; but her 

 greatest victory remains to be won. Why should we 

 men, heirs of all the ages, continue to suffer from such 

 mean things as diseases ? Are you going to be defeated 

 any longer by bacilli, rat-fleas, and mosquitoes ? It is 

 for you to conquer them ; and remember that every 

 gift of science is a gift not to one country or to two 

 countries, not only for to-day or for to-morrow, but 

 also to the whole world and for all time, until, as the 

 poet said, 



" The future dares forget the past," 



