824 



SCIENCE 



[N. S. Vol. XXX. No. 780 



the teachings of the masters, unless there 

 exist logical and credible grounds for di- 

 version, stamps its possessor as one who 

 is, m so far, without the pale of those who 

 know. 



But why should any one be without the 

 pale % There is a wide-spread idea that the 

 greatest evil in the world is ignorance, 

 that education is its antidote, and that, 

 with learning made easy, sanity and tem- 

 perance and all things of good report will 

 be the lot of mankind. While this repre- 

 sents obviously an extreme view, it is prob- 

 ably applicable to the majority of men in 

 their relation to the majority of things. 

 But biologists are agreed that what a man 

 is is the result of the action of two forces, 

 heredity and the environment, nature and 

 nurture. AVhile an educational environ- 

 ment may conduce to sanity, a man may, 

 on the other hand, be handicapped by an 

 ancestral perversion, which all the educa- 

 tion in the world can never overcome. But 

 the difficulty is further increased by the 

 fact that the norm is ever changing, and, 

 indeed, must ever change if the world is to 

 progress. It follows, therefore, that the in- 

 sanity of to-day becomes the sanity of to- 

 morrow, if we are clever enough to bring 

 the world around to our way of thinking. 

 Stevenson said: "Give me the young man 

 who has brains enough to make a fool of 

 himself"— but it was the brains and not 

 the fool that Stevenson really wanted. 



In meditating much on the question as 

 to the sphere in which human abnormality 

 is most pronounced, I have come to believe 

 that it is in beliefs and practises relating 

 to the human body in health and in dis- 

 ease. And since the study of the human 

 body in health and in disease is to be your 

 life work, and since it will be your fate to 

 come into intimate contact with many of 

 these beliefs and practises, it has seemed 

 to me fitting to devote the hour at my 



disposal to a consideration of some of 

 them. 



Before you leave these halls to practise 

 your profession you will come to know that 

 there has grown up in the course of many 

 centuries an enormous mass of knowledge, 

 for the most part well-ordered and ra- 

 tional, which constitutes the medical sci- 

 ence and art of to-day. It is the contribu- 

 tion of many superior minds of all the 

 world's ages. Some of its truths were 

 known to the early Greeks, and from them 

 down to the modern laboratory and clinic 

 it has received a continual stream of ac- 

 cessions. But it is not accession only that 

 has taken place, for to a large extent there 

 has occurred a process of selection, a re- 

 jection and replacement of what has proved 

 unsuitable, so that the medicine of to-day 

 represents the survival of the fittest. 

 Though the sifting process continually 

 goes on and though everywhere there are 

 points in dispute and unsolved problems, 

 there yet exists the great fund of accepted 

 medical knowledge, constituting a stand- 

 ard, according to which individual opin- 

 ions concerning the body in health and 

 disease are to be judged. It is convenient 

 to classify this mass of knowledge, and so 

 we recognize the specific divisions, not al- 

 together sharply separated, such as anat- 

 omy, physiology, hygiene, bacteriology, 

 pharmacology, therapeutics, surgery and 

 neurology. In so far as one believes in the 

 accepted principles of any one of these 

 divisions he is pronounced by his fellows 

 therein sane: in so far as he rejects them 

 without adequate reason, he is looked at 

 askance and with suspicion. And so it is 

 with regard to specific matters within any 

 one of these divisions. Obviously the 

 amount of knoAvledge that the layman pos- 

 sesses of these various branches of medi- 

 cine can be only small. The man on the 

 street is pitifully ignorant of his own body 



