H September 17, 19 14] 



MATURE 



75 



imagination of the man of science, call forth new 

 ideas to his mind, and suggest fresh experiments to 

 test those ideas ; or, a chance empirical observation of 

 an experimental nature, which without theory and 

 scientific imagination would remain isolated and 

 sterile, placed in relationship to the rest of the scheme 

 of science, awakens thought, and may lead to a fresh 

 departure and a long train of important discoveries. 



It was this correlation of the imagination with 

 experimentation and the tracing out of relationship 

 from point to point so as to develop the evolution 

 of phenomena that characterised the science of 

 medicine when new-born about seventy years ago, 

 and differentiated it from the older nosological medi- 

 cine in which imagination and experimentation, while 

 both existing, seemed to possess independent exist- 

 ences and pay little regard the one to the other. 



It seems well-nigh forgotten nowadays by the 

 majority of people that science and religion originally 

 began together from a common thirst for knowledge, 

 and usually in the same type of mind endowed with 

 a divine curiosity to know more of the origin and 

 nature of things. 



Every great religion worthy of the name contains 

 some account of the natural history and creation of 

 the world, in addition to its metaphysical aspects, 

 and reflects the degree of knowledge of natural 

 science possessed by the nation in which it arose at 

 the time of its birth. 



The fundamental error throughout the ages of 

 human conceptions both in science and religion was 

 that of a non-progressive world to which a stereotyped 

 religion, or science, could be adapted for all time. 

 Perfection was imaged where perfection, we are now 

 happy to realise, was impossible, and, believing in 

 this imaginary perfection and that all things new 

 deviating from it were damnable, men were prepared 

 to burn one another at the stake rather than allow 

 error to creep into T:he world in either science or 

 religion. Thus there have been martyrs for the scien- 

 tific conscience just as for religious belief, and at this 

 distance in time we can perhaps better understand both 

 inquisitor and martyr and realise that both were fight- 

 ing for great ideals. 



Evolution has taught us that as knowledge broadens 

 we must be prepared to have wider vision and 

 abandon old theories and beliefs in the new-born light 

 that makes the world better to-day than it was yester- 

 day, and that also will show things up to our mental 

 vision more clearly to-morrow than they stand out 

 to-day. To the members of any great craft, or pro- 

 fession, or religious order, this scientific outlook which 

 accepts as fundamental a progressive world, and insists 

 that its votaries should adapt their lives to such a 

 doctrine, is peculiarly difficult of assimilation. Routine 

 fixes all men, and so when any new discovery appears 

 to demand change from that order to which the mind 

 has become accustomed, it is immediately looked upon 

 with suspicion, and there being little plasticity of mind 

 remaining, it is rejected as heretical or revolutionary 

 after but scant critical examination. The cry of the 

 craft in danger has been used efficaciously on many 

 occasions since the days of the Ephesian silversmiths, 

 nor is such a cry at once to be set down to pure selfish- 

 ness. A craft is often worth preserving long after the 

 forces which have called it into being have commenced 

 to slumber, and conservatism of this t\'pe is at times 

 an important factor in social progress. However, 

 there are certain limits which must not be surpassed, 

 room must be rhade by adaptation for the new know- 

 ledge, or it will establish a craft of its own iconoclastic 

 to much worth preserving in the older system. 



It is important to insist upon these limitations, 

 because a too reactionary spirit abroad in medicine 



NO. 2342, VOL. 94] 



between i860 and 1880 prevented the world from 

 benefiting from those remarkable discoveries by Pas- 

 teur and their proposed applications by Lister, which 

 laid the foundations of modern medicine and modern 

 surgery. These pioneers of the new age in medical 

 science had to wage for many years a stern and bitter 

 fight against the strong forces of ignorance and pre- 

 judice. But for this illogical resistance "by men who 

 would not even test the new discoveries, and instead 

 spent their time in sneering at the new geniuses who 

 had leadership to give the world, France and Germany 

 would have been saved many thousands of brave lives 

 in the great war of 1870-71. Even thereafter, the 

 slow struggle continued of the few who knew against 

 the many who refused to be taught, and a perusal of 

 any orthodox text-book of medicine published between 

 1875-80 — that is, more than a decade after Pasteur's 

 great discovery- — will show that the etiology of scarcely 

 a single infectious disease had become known, and 

 that medical science was, for example, as ignorant of 

 the nature of tuberculosis as we are to-day of the 

 nature of carcinoma. Take, as an example, the fol- 

 lowing quotation from a well-known text-book of 

 the theory and practice of medicine published in 1876 : 

 "It is now, however, generally admitted that tubercle 

 is no mere deposit, but, on the contrary-, a living 

 growth as much as sarcoma and carcinoma are living 

 growths." The tubercles were the only initial lesion 

 observed, the infecting organism was entirely un- 

 known, and the pathologists of this comparatively 

 recent date argued at length as to whether tubercles 

 were to be classed as " adenomata " or were something 

 sui generis. 



There is a gleam of sunlight for the future in this 

 retrospect at the ignorance of the past, for, if men 

 were as ignorant regarding tuberculosis thirtj'-eight 

 years ago as to-day they are about cancer, then it 

 may be argued that a generation hence as much may 

 be known about cancer as is knoNvn now about 

 tuberculosis. 



It is particularly important at the present moment, 

 when so much interest is being taken in national 

 health, to point out the urgent necessity of allowing 

 as little lagging behind as possible to ensue between 

 the making of discoveries and the practical applica- 

 tion of the results by organised national effort for 

 the well-being of the whole community. 



It must sadly be admitted that it is craftsmanship 

 in imaginary danger fighting hard for the old methods 

 unchanged which were in vogue fifty years ago that 

 stands most prominently in the way of advance. As 

 great a harvest as that which followed the application 

 of the principle of antisepsis in surgery awaits the 

 application of the self-same principle in national sani- 

 tation to-day, but the very profession which ought 

 to be urging forward the new era apparently stands in 

 dread of it, and seems to prefer to reap its harvest 

 from disease rather than to seize the noble heritage 

 won for it by the research of pioneers and so stand 

 forth to the world as the ministry of health. For- 

 tunately it cannot be, the bourne has been passed, 

 and there is no going backward. The advances that 

 have already been made have awakened statesmen and 

 people alike to the needs of the situation, and all have 

 resolved to be disease-ridden no longer. The laws of 

 health must be made known to the people at large, 

 and schemes laid before them for a national organisa- 

 tion for the elimination of disease. Disease is no 

 longer an affair of the medical profession, it is a 

 national concern of vital importance. The problem is 

 not a class question, all humanity stands face to face 

 with it now in the light of modern research as it never 

 has faced it before. It has been realised that disease 

 never can be conquered by private bargains for fees 



