PRESIDENTIAL ADDRESS. D4] 
method? From the days of the first successful abdominal operation to the 
present day, research in laboratory or in the operating theatre has pioneered 
the way, and the sooner this simple truth is known to all men the better for 
medical science. Every time any surgeon first tries a mew operation there is in 
it an element of experiment and research of which the ethical limits are well- 
known and definable, and any person who logically thinks the matter out must 
see that it is the research method which has placed the science and art of 
surgery where it stands to-day. Exactly the same thesis holds for medicine. 
How could any physician predict for the first time, before he had tried it 
experimentally on animal or man, the action of any new drug, the effect of any 
variation in dosage, the result of any dietary, of the employment of any course 
of physical or chemical treatment, or of anything in the whole of his armamen- 
tarium? Yet the public are rarely told any of these wholesale truths, but are 
rather left to speculate that each medical and surgical fact sprang forth as a 
kind of revelation in the inner consciousness of some past genius in medicine 
or surgery, who, in some occult way, knew of his own certain foreknowledge 
what would be the definite effect of some remedy or course of treatment before 
he tried it for the first time on a patient, or perhaps had the ethical conscience 
and genuine humanity to test it on a lower animal before he administered it to 
man. : 
It may, in short, be taken as an axiom of medical science that everything 
of value in medicine and surgery has arisen from the applications of experimental 
research. Nor can future advance be made by any other method than the 
research method. It is true that accident may teach occasionally, as it did, for 
example, in the dreadful burns unwittingly inflicted on themselves and patients 
by the early experimenters in X-ray therapy and diagnosis. But accident is 
only the most blundering type of experimentation, and results obtained by its 
chance agency do not really invalidate the universal law that man only learns 
by experience or, in other words, by research. Research is, after all, only the 
acquisition of fresh experience by the trained expert, usually led on to his 
experiment by inductance from other known facts. 
It has been said above that all that is valuable in medical science has been 
acquired by research ; the converse may now be pointed out, that much that was 
valueless, dangerous, and even disgusting in medicine in earlier days was 
incorporated into the medical lore of the time, and often remained there for 
generations stealing lives by thousands, because physicians had not yet adopted 
the research method, and so based their practice upon ignorant and unfounded 
convention. It is noticeable in literature that up to somewhere in the beginning 
of the nineteenth century physicians and surgeons were often as a class looked 
upon by scholars and educated people with a certain amount of contempt. 
There were notable and fine exceptions in all ages, but, taken as a whole, the 
profession of medicine was not held in that high esteem and admiration that 
it is amongst all classes to-day. Take, for example, Burns’s picture of Dr. 
Hornbook or Sterne’s account of Dr. Slop in ‘ Tristram Shandy,’ and similar 
examples in plenty are to be found in the Continental literature. The reason 
for the change is to be found in the comparative growth of medical science 
as a result of the research method. The physicians of those days were very 
often ignorant quacks employing the most disgusting and dangerous remedies, 
or methods of treatment, based upon no experimental knowledge and handed 
down in false tradition from ignorant master to ignorant and often almost 
illiterate apprentice. It is only necessary to peruse the volumes written on 
materia medica of this period to shudder at the nature of the remedies ap- 
parently in common use; the details are unfit for modern publication. 
Even in the first half of the nineteenth century patients were extensively bled 
almost to exhaustion in a vast variety of diseases in which we now know with 
certainty that life would be endangered by such treatment and chance of recovery 
diminished. Thus, in a text-book published in 1844 by the Professor of 
Medicine in the most famous University in medicine of our country, and a 
physician in ordinary to her Majesty Queen Victoria, it is said that in the 
treatment of pneumonia ‘the utmost confidence may be placed in general Blood- 
letting which should always be large and must almost always be repeated some- 
times four or six times or even oftener. Blistering and purging, under the 
