156 



SCIENCE 



[Vol. LVI, No. 1441 



varying according to local conditions, can be 

 put on the full-time plan in the beginning. 

 This can be done with the confident expecta- 

 tion that the principle which is the more sound 

 toward improving education will win out in 

 the end. ' 



The development of modern scientific medi- 

 cine with aU its expert skill, and especially the 

 skill of modern surgery, has bix)ught the same 

 possibilities of exaggerated financial reward 

 into medicine that has followed the develop- 

 ment of machinery into industry. Moreover, 

 in the practise of medicine, a chair in a great 

 institution serves as the same enormous finan- 

 cial asset as advertising in business. These 

 facts are conspicuous and hence overestimated. 

 The number of men making conspicuous wealth 

 in medicine is not large. The skill of the 

 physician deserves an adequate reward. Un- 

 fortunately it has been made to appear as if 

 the fundamental reason for the full-time 

 scheme was an attack on commercialism in 

 medicine. It is not true; the fundamental 

 reason is much more profound, more construc- 

 tive, it concerns the development of higher 

 ideals of research and teaching. It is true 

 that the development of the full-time scheme 

 makes large demands in terms of ability; it 

 needs men with ability for research, for teach- 

 ing, and for organization, but men for whom 

 ideals and the chance for a brilliant achieve- 

 ment may outweigh the pursuit of excessive 

 wealth. I say excessive wealth advisedly; the 

 advantages to the community have ah'eady 

 been so enormous in the development of scien- 

 tific medicine, and it is so logically the next 

 step to bring clinical medicine under the prin- 

 ciple underlying this progress, that it should 

 be possible to give adequate support to this 

 new development. 



I said at the beginning that there had been 

 considerable opposition on the part of the med- 

 ical profession to the full-time scheme. This 

 opposition I believe to be due to a lack of 

 understanding of the principles involved and 

 to the difliculties of transition. One certainly 

 hears some suggestion, vaguely expressed, per- 

 haps not wholly consciously formulated, of a 

 fear of preventive medicine. To this there 

 can be only one answer. To preventive medi- 

 cine the medical profession must adjust itself. 



It is obvious that eliminating typhoid, malaria, 

 typhus, smallpox, cholera and so forth have 

 so far not emptied our hospitals nor dimin- 

 ished the need for doctors; indeed, along with 

 preventive work, many conditions have come 

 into the range of treatment which were foi'- 

 merly untouched, so that up to the present 

 time the effect of preventive medicine has been 

 expressed largely in a lengthening of the ex- 

 pectation of life. This fact, together with the 

 eliminating of many of the weaker schools of 

 medicine, makes it sure that the effects of pre- 

 ventive medicine on the profession belong to 

 another generation, not to ours. When the 

 time comes, the medical pix)fession will make 

 the only possible adjustment of training fewer 

 physicians. 



In conclusion, I may say ithat I do not think 

 that all the problems associated with the 

 practical extension of the full-time scheme to 

 the clinical side have been solved. Adjust- 

 ments may have to be made, perhaps radical 

 ones, but I profoundly hope that the plan will 

 be given an adequate trial and that it can win 

 the support of those who are teaching in our 

 medical schools, because I believe it of the 

 utmost importance to the community to range 

 the ablest minds in the medical profession on 

 the side of preventive medicine. Besides an 

 occasional school of hygiene and public health 

 we need to have all of the leaders of medical 

 education engaged in research to advance med- 

 icine. It is my sincere conviction that the 

 opposition to extending the modern standards 

 of professional education to clinical medicine 

 will yield readily to sound constructive leadei'- 

 ship on the part of those who desire this re- 

 f oiin. 



Florence E. 'Sabin 



The Johns Hopkins Medical School 



PRELIMINARY REPORT ON AMERI- 

 CAN BIOLOGICAL STAINS 



As previously mentioned in this journal,' a 

 committee was organized under the auspices 

 of the National Research Council last fall for 



1 ' ' The Standardization of Biological Stains, ' ' 

 Science N. S. LV, 43-44; Conn, H. J.: "Amer- 

 ican Biological Stains Compared with Those of 

 Griibler," Science, N. S. LV, 284-285. 



