January 8, 1920] 



NATURE 



489 



as beinji equal to the difference between the emolu- 

 ments which he has actually received and those which 

 a successful clinician might have received in the same 

 time. 



I his is obviously the principle which was accepted 

 by Parliament in the case of Jenner in 1802 and 1807. 



Additional reasons for insisting upon this principle 

 are : — (1) That few medical discoveries are patentable. 

 (2) That such discoveries seldom give good grounds 

 for promotion or for administrative appointments in 

 the public services. 



V. Particular Assessments. — Whether a particular 

 discovery should receive a large or small assessment 

 will depend not only on the considerations given above, 

 but also on the following ; — 



(i) W'idlh of Application. — For example, the work 

 of many of the older anatomists, physiologists, and 

 parasitologists, of Pasteur, and of investigators of 

 immunity has affected most recent discovery. Dis- 

 coveries on widespread diseases, such as the work of 

 Lister, of Laveran, and of Koch, are 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 

 also more time and cost, and therefore deserves more 

 recompense, than a lucky chance observation. 



(3) Immediate Practical Utility. — .\ 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 recognition is also often not forthcoming 

 for them. 



(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 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 the committee does not purpose to 

 consider them. But the subject of pecuniary awards 

 lies entirely within its province. 



During the last few years the British Government 

 has disbursed an annual grant of about 60,000!., under 

 the Medical Research Committee, 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 pro- 

 ceeds upon the principle of payment for benefits 

 already received, deserves close attention, and has been 

 recognised in other countries. 



We 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 frequently deal with simple 

 and straightforward questions, admitting of immediate 

 experimental reply. But, as a matter of fact, most 

 of the greatest medical discoveries were built upon a 

 much more speculative and uncertain basis, and were 

 achieved by men who neither sought nor received sub- 

 sidies for those investigations — as, for instance, 

 Kiichenmeister, 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 



NO. 2619, VOL. 104] 



of investigation also, partly because it costs the State 

 nothing in so 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 

 only "good business," but also a moral obligation. 

 There are at present hundreds of medical men and 

 others in this country who possess the knowledge, the 

 brains, and the opportunity for private independent 

 discovery without subsidies, but do not attempt it 

 because medical research work does not pay even when 

 brilliantly successful. Let these men also be brought 

 into the fold of research by offering them reward w^hen 

 they succeed. 



We therefore suggest that, in addition to assisting 

 investigations in progress, it is proper for the State to 

 remunerate those of its citizens who have already 

 conferred the benefits of medical discovery upon it, just 

 as it is proper for a patient to pay his doctor. And this 

 policy will be not only an act of justice, but also an 

 act of wisdom. 



Our proposals are in detail : — (i) That Parliament 

 should "follow the precedent of Jenner by paying 

 compensation when due for losses incurred in achieving 

 medical discoveries. (2) That Parliament should pro- 

 vide an annual sum, say of not less than 2o,oooi., for 

 life-pensions to be given as rewards to such of his 

 Majesty's subjects as have made worthy medical dis- 

 coveries, such pensions amounting to between ^ooZ. 

 and loooZ. a year. 



Such pensions would be preferable to donations in 

 capital, and the sums suggested would be sufficient, 

 because men of science seek only such independence as 

 will enable them to employ their talents in the manner 

 they think best. 



The procedure of allotment should be similar to that 

 used for the Nobel prizes, and for the honours and 

 medals of learned societies — that is, full particulars of 

 the work of all applicants should be kept and con- 

 sidered. 



Parliament grants large subsidies to soldiers and 

 sailors, has appointed a Commission to consider 

 awards to inventors, and allows patents. It should 

 not, therefore, complain if, the medical profession, 

 •which has done so much for the nation during the 

 war, now asks for some similar consideration. 



(This committee is concerned only with medical 

 research, but recognises that similar awards should 

 be given to workers in other fields.) 



UNIVERSITY AND EDUCATIONAL 

 INTELLIGENCE. 



Birmingham. — .\t the beginning of the coming term 

 Prof. R. H. Yapp will take up his duties as successor 

 to the late Prof. G. S. West in the Mason chair of 

 botany, and Dr. William Cramp will succeed Prof. 

 Gisbert Kapp in the chair of electrical engineering. 



London. — The following courses of advanced lectures 

 in physiology are now commencing : — "The Regulation 

 of Respiration " (Guy's Hospital, Borough, S.E.), bv 

 Dr. M. S. Pembrey" and Mr. J. H. Ryffel, at 4.3b 

 p.m. on Thursdays, January 8, 15, 22, and 29, and 

 February 5, 12, iq, and 26; "The Reaction of the 

 Blood and Acidosis" (St. Bartholomew's Hospital), 

 by Mr. J. W. Trevan, at 4.30 p.m. on Wednesdays, 

 January 28, February i. 11, 18, and 25. and March 3, 

 10. and 17; and "Physiologically Balanced Solu- 

 tions" (Physiological Laboratory of the L'niversity, 

 South Kensington, S.W.7), by Mr. W. L. Symes, at 

 5 p.m. on Tuesdays, January 27, February 3, 10, 17, 

 and 24, and March 2, 9, and 16. The lectures are 



