MBER 12, 19 1 8] 



NATURE 



297 



infested and throve among thosi unfori 

 boured the more terri oi typhus and re- 



laps 



show n conclusive: l\ thai d< 



1 \ |>hu~ fever to shed, and thai relapsing 



could be cured b) salvarsan, neithei ol thesi 

 facts could be acted cm. "Ami now arose a situation 

 thai can only I"- compared to the description in 

 D foe's 'Journal of the Plague year.'" 2 This briel 

 sentence sums up the agon] ol a nation. 



Another domain in which the laboratory with its 



experimental methods is indispensable is the stud) ol 



the action of drugs, together with the elaboration of 



therapeutic substances. Thus adrenalin, which 



ici in performing bloodless opera- 

 tion-, is a drug manufactured in the living body itself, 

 bui the synthetic chemisi ha-, built ii up in the labora- 

 tory. Salvarsan was invented as 1 ! it • result of years 

 gation, in which both the biologist and the 

 chemist played essential parts. 'This drug, which has 

 placed in t In - hands of the therapist a weapon of 

 previously undreamt-of potency in the treatment of 

 one of the gravest and most prevalent infective dis- 

 5, syphilis, represented the zenith of the life- 

 work of a man of genius, but it is certain that without 

 the gigantic lone of Germany's chemical industry 

 Ehrlich's scientific triumph could not have had it- 

 ical accomplishment. The search for drugs which 

 shall exert specific actions in the living bod) affords a 

 most promising field of investigation, and oilers rich 

 results in the amelioration of suffering. Much atten- 

 tion has been devoted to this subject tit the Bland- 

 Sutton Institute, and in the flavlne compounds, be- 

 longing to the group of acridine dyes, substances have 

 been found which possess unique properties as anti- 



leen utilised with gi 1 al ad\ an- 

 tage b\ surgeons in their efforts to combat and to 

 insequences of septic infection in 

 war wounds. 3 



Future Work of fin' Laboratorit 5. 



enterprise, however, is still in its infancy. 

 There is 1 pect here for the co-operation 



of chemists and biologists, for it is only by such team- 

 work that tht complexity of modern problems can 

 be resolved. The investigation of mam diseases has 

 now reached a stage al which it is futile merel) to 

 ask what are the gross marks which they leave behind 

 when they have wrecked health or destroyed life, or 

 whai an the agencies which cause these ravages and 

 how we can prevent their attacks. Now we must 



proceed further and inquire what are the first evi- 

 dences of the operations of these enemies and b\ what 



me aiis ran an actual cure be- effected. The diseases 



in which this most important sic]) can be taken are 

 ail to., few. It must be remembered, however, 

 that prevention is not always possible; therefore, one 

 must still 'Ibis subject demands 



1 5 attention; it is a general belief that sanatoria and 

 the propaganda of education directed towards tin pre- 



ruberculosis will eradicate this dire disease. 

 Rut even if tuberculosis ma) soon da) become ex- 

 tinct, it is certain that for at least several generations 



me will continue' to be- a clamant need, 



which still we have nothing definite to satisf) . 



inisation of the Work of Hi,- Laboratoi 



ii Idi d by the- labot aton supplies 



in sing pr..p. irtic in of cases the 



indications which tgnosis 



: Wells and R. G. i'crtans mernl.ers of the American Red 

 tl .n to Rumania. 

 ; h «■»> ovrine to the action of lh- Mr aral Research Committee that the 

 flavine compound* were rendered available. 



1 1 1 patient, bul mui H 



of tbi - . and il is most 



unfortunate that it ha be en entitled 



"clinical research." The name is totally mislead 

 an.l no polic) more inimic tl progress could be- con- 

 than thai of mam hospitals whit h make 

 arrangements solel) fot ibis class ,,i hackwork. It is 

 essential thai such investigations should occup) onl) 

 a portion of the time- ol the laboratory's staff, and 

 that portion by nee means the majoi one. rhe chronic 

 and Imp. l.ss diseases which occup) so great .-1 part of 

 the medical wauls of a hospital, and of which the 

 ning is obscure, the progress relentless, and the 

 end desperate; epidemii diseases, which yearl) cost 



the- Cit) of London alone about half a million pounds; 



tuberculosis, which probabh extorts a greater toll of 

 active adult lives than anv other single disease — all 

 tb.se proclaim the necessity for the laboratory workers 

 and the clinicians to co-operate- in attacks on disease, 

 not merely from the point of view of the individual 

 patient, but also on a collective basis and with the 

 view of perfecting further methods of prevention and 

 of cure. 



It was stated Iatel) in the dail) Press that in Aus- 

 tralia the- blow-fly had caused in one season a loss of 

 sheep to the value of 300,000/., and that, in an 

 endeavour bv scientific methods to put an end to this 

 and similar losses, an outlay of 5000L had been decided 

 on. How much more urgently does the whole subject 

 of human disease demand investigation on a scale 

 never hitherto contemplated! In the past this might 

 have been deemed a luxury, in the future it will be 

 recognised as a bare necessity, and of the belligerent 

 countries that which most rapidly builds up its national 

 health will have gone far towards reaping the fruits 

 of victory. By what administrative methods this can 

 be accomplished is a question not discussed here ; 

 but one point is clear : that the problems of disease 

 must be solved bv the hospitals with the aid of their 

 laboratories, where alone is to be found the stimulus 

 afforded bv the problems always present in insistent 

 form. But the problems must be grappled with on a 

 far broader basis than has hitherto been attempted. 

 Medical science is essentially applied science, and the 

 institutes of medical science, if they are to be efficient, 

 must not merelv retain the services of all departments 

 of biological science, including biological chemistry, 

 but also include synthetic chemists and physicists. 

 The importance of such a plan has been most fully 

 recognised in America, and has its completesl material 

 embodiment in the Rockefeller Institute fot Medical 

 Research with the hospital attached thereto, the yearh 

 income- of which, derived from endowment, amounted 

 t 0,000/. in IQ17. 



It is specially desirable, too, thai the facilities avail- 

 able in the research laboratories of the great _ manu- 

 facturing concerns should be co-ordinated in this 

 scheme. Short of the most thorough comprehensive- 

 ness, research in practical medicine is likely to fail to 

 tackle the problems which are of paramount import- 

 ance. 



Prospective Results. 



Bur any scheme of this kind which depends for its 

 continuance on payment by results is foredoomed to 

 failure. This principle has been accepted even for the 

 industrial laboratories; how much more readily ought 

 it, then, to bi recognised where the elusive phenomena 

 of life are under investigation, and where the_ gains 

 take the form of preservation of health and diminu- 

 tion of the burden of human suffering! Health is one 

 Of the greatest assets of a people, and Ibis work, 

 which will enhance the- value of thai asset to an almost 

 . . > , , ,._ i s of the highi si national necessity. 



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