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SCIENCE 



[N. S. Vol. LI. No. 1318 



the facts and phenomena relating to some field 

 of knowledge which is more or less definitely 

 outlined, and which is large enough and im- 

 portant enough to deserve such treatment. As 

 new facts are constantly being discovered in 

 all realms of knowledge, all sciences are in a 

 constant state of development. 



The abnormalities and functional disturb- 

 ances of man surely constitute a large and im- 

 portant field of human interest. Marked ad- 

 vances in knowledge concerning the phenom- 

 ena and nature of disease have already been 

 made, especially in recent years, and this 

 knowledge is constantly being arranged, and 

 the phenomena are being studied in their re- 

 lation to each other and to other phenomena. 

 Medicine, then, is developing just as other sci- 

 ences have done and are doing ; its subject-mat- 

 ter is receiving the same kind of treatment that 

 is succeeding in other domains of human 

 knowledge. Therefore, on account of the im- 

 portance of the subject, and because of the 

 advances which have already occurred in our 

 knowledge concerning disease and the prog- 

 ress which has been made in the scientific 

 treatment of this knowledge, medicine deserves 

 to rank as an independent science. 



If physiology may be an independent science, 

 if anatomy may be an independent science, 

 why not medicine? Why should medicine be 

 only an applied science, any m.ore than anat- 

 omy or physiology? Anatomical and physio- 

 logical knowledge may be applied to practical 

 affairs as well as medical knowledge. Why 

 should medicine be inseparably associated with 

 tbe doctor's consulting room any more than 

 anatomy with the surgeon's operating room or 

 the artist's studio? 



Since definition is more important than argu- 

 ment, let us consider what we mean by medi- 

 cine, or better, the science of medicine. First, 

 let us consider what it is not. It is not anat- 

 omy, it is not physiology, for these sciences 

 deal with the normal or healthy; it is not 

 pharmacology, strictly speaking, for as this sci- 

 ence has so far developed, it has dealt with the 

 nature of drugs and their action on normal 

 animals. These sciences, however, together 

 with such fundamental sciences as chemistry 



and physics, are frequently spoken of as the 

 medical sciences, the institutes of medicine, or 

 indeed collectively as the science of medicine. 



To define exactly what medicine is is not 

 easy. Medicine deals with disease, the anti- 

 thesis of health ; it deals with the abnormal, the 

 departure from the average. When we come to 

 consider whether medicine includes all aspects 

 of disease, or only certain ones, we meet with 

 difficulties. The accepted use of the term does 

 not aid us, for there is no universally accepted 

 use, even among the most strict and thoughtful 

 men. The dictionaries define medicine as the 

 science and art dealing with the prevention, 

 cure or alleviation of disease. Pathology, on 

 the other hand, is defined as the science treat- 

 ing of the nature, causes, progress, manifesta- 

 tions and results of disease. According to the 

 definitions, therefore, pathology has to do vrith 

 the nature of disease, medicine with the appli- 

 cation of that knowledge. That these defini- 

 tions are purely academic, however, and not 

 real, is made evident by referring to the text- 

 books dealing with these subjects, for we must 

 consider that the text-books of the day present 

 not only the accumulated knowledge concern- 

 ing the subjects treated, but also the contempo- 

 rary conception of the boundaries of these sub- 

 jects. 



If we refer to any text-book on medicine, 

 whether it be labelled practical medicine, the 

 practise of medicine, or merely medicine, and 

 look up any disease, it will be found that nine 

 tenths of the subject-matter deals with the 

 " nature, causes, progress, manifestations and 

 results " of the disease, under the headings 

 etiology, symptomatology, complications, prog- 

 nosis and so forth, and only one tenth deals 

 with prevention and cure. On the other hand, 

 most text-'books of pathology do not treat of the 

 " nature, causes, progress and manifestations " 

 of disease at all ; they consider only the morph- 

 ologic changes resulting from disease. It is 

 evident, therefore, that the definitions of 

 pathology and medicine quoted above are obso- 

 lete, even though practitioners of medicine 

 may not take cognizance of the fact. In my 

 opinion, the old implied distinction between 

 pathology and medicine has had a blighting 



