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;^CIENCE 



[N. S. Vol. XXX. No. 761 



fession have exposed its Aveaknesses in the 

 merciless way appropriate to their role, 

 and reformers havg cried alond its deficien- 

 cies from the house-tops. One naturally 

 inquires what is the cause of all this stir? 

 What has happened to create such dissatis- 

 faction with a system that formerly was 

 accepted without comment? The ills and 

 accidents which afflict mankind are not 

 greater or more numerous than in former 

 times. The pestilence still walks in dark- 

 ness and destruction wastes at noonday as 

 of old, but not more so. Indeed we flatter 

 ourselves that we are better off than our 

 ancestors in these regards. But we take a 

 different attitude toward them. Our fore- 

 fathers did what they could to escape these 

 ills and in biblical phrase sought to their 

 physicians with more or less satisfactory 

 results. But what they could not avoid or 

 prevent they accepted submissively as an 

 act of God, a phrase which some one has 

 defined in comprehensive manner as in- 

 cluding all those acts which no reasonable 

 man can foresee. In these latter days, on 

 the contrary, there is a wide-spread feeling 

 that man should be able to apply his intelli- 

 gence so as to reach a more satisfactory 

 understanding and control of disease and 

 pestilence. The reason for this change of 

 attitude toward nature is to be found, with- 

 out doubt, in the great increase in our 

 scientific knowledge. Physics, chemistry 

 and biology have added immensely to our 

 comprehension of the processes of nature, 

 living as well as dead, and this acquisition 

 has awakened in us a keen desire to apply 

 all this knowledge practically in saving 

 ourselves as far as may be from sickness 

 and death. If we can find out the secrets 

 of the stars and bend the forces of nature 

 to our use and pleasure, can we not also 

 imravel to some extent those mysteries of 

 life and death which after all are the phe- 

 nomena of paramount importance to us in 



this universe in which we find ourselves 

 placed. This same desire to apply scien- 

 tific knowledge to practical medicine was 

 apparent in Europe early in the nineteenth 

 century. Investigations of the laws con- 

 trolling inanimate nature had spread rap- 

 idly to a similar study of the properties of 

 living matter, although the transition was 

 attended by some convulsive qualms among 

 the timid and superstitious. Foolish and 

 ineffectual attempts were made to discour- 

 age the bold pioneers by charges of impiety 

 or by predictions of the necessary futility 

 of all efforts to solve such great mysteries. 

 In medicine, especially, this kind of opposi- 

 tion was very common, and the enlightened 

 members of the profession contended 

 against many unnecessary difiiculties in 

 their efforts to introduce the methods and 

 results of science into the practise of medi- 

 cine. Our own country was very slow in 

 feeling the effect of this movement. We 

 are all aware that medical education and 

 therefore medical practise in this country, 

 speaking in general terms, were until recent 

 years far below the standard maintained in 

 Europe. Conditions among us, in fact, 

 were such that for a time things went from 

 bad to worse. Our curve of efficiency kept 

 falling, while in other civilized lands it rose 

 more or less parallel with the growth in 

 scientific knowledge. There thus came to 

 us a certain distinct and admitted inferi- 

 ority in medical matters which has not yet 

 been fully overcome. Many excuses and 

 reasons might be offered for the backward- 

 ness of our development in medicine, but 

 the excuse most frequently made was and 

 is that our growing country has need in 

 the outlying districts for an inferior type 

 of physician willing to work hard for little 

 pay, and consequently entitled to receive 

 his degree in medicine at little expense of 

 time or money. A need of this kind un- 

 doubtedly existed, but it scarcely justified 



