Apeil 2, 1920] 



SCIENCE 



331 



effect upon the development of medicine as a 

 science. Twenty-five years ago, however, it 

 became dimly recognized that this distinction 

 between medicine and pathology is not a real 

 one, at least that pathological anatomy is an 

 essential part of the science of medicine. The 

 improvement in the teaching of medicine 

 which occurred at that time and the resulting 

 increase in medical knowledge may be directly 

 traced to this new conception. 



It is of importance that medicine should now 

 be generally recognized as an independent sci- 

 ence, just as physiology and anatomy are in- 

 dependent sciences. Medicine may then he 

 defined as the science dealing with the phenom- 

 ena of disease. 



Let us grant now that there is or may be a 

 science dealing with disease. How can this 

 science best be fostered and how can this new 

 science be most effectively utilized? As our 

 medical schools are now organized, they are 

 composed, on the one hand, of a group of de- 

 partments devoted to the teaching and develop- 

 ment of the so-called contributing sciences, 

 anatomy, physiology and pharmacology; and 

 on the other hand, of a large group of distinct 

 departments, the chief function of which is to 

 train men for the practise of medicine. As I 

 have previously stated, however, anatomy, 

 physiology and pharmacology have only the 

 same relation to medicine that chemistry and 

 physics have to anatomy and physiology. That 

 the departments of anatomy, physiology and 

 pharmacology are not independent university 

 departments, but are included in the medical 

 school, is in my opinion only accidental and is 

 not an essential condition for the development 

 either of these sciences or of medicine. The 

 inclusion of these departments in the medical 

 school has occurred chieily because almost all 

 the students working in them expect later to 

 study medicine. Not so many years ago, how- 

 ever, practically all students of chemistry like- 

 wise expected to study medicine, and in many 

 colleges the department of chemistry was also 

 included in the medical school. To-day only 

 a relatively small number of the students of 

 chemistry look forward to the study of medi- 

 cine, and in consequence, the department of 



chemistry constitutes a part of the medical 

 school in only a. very few universities. 

 ■ The present organization of the medical 

 school, therefore, has been largely influenced by 

 expediency and by the effort to obtain econ- 

 omy in administration. With a satisfactory 

 university administration, the department of 

 medicine (and under this term I include all 

 the departments of the medical school that are 

 engaged in the study of disease) niight per- 

 fectly well constitute the whole medical school, 

 probably with considerable advantage to the 

 departments of anatomy and physiology. 

 With the present laws governing medical prac- 

 tise, however, it is necessary that the grouping 

 of various departments into medical schools 

 be continued. There is no serious disadvantage 

 in this so long as there is a full realization of 

 the reasons for this grouping, and so long as 

 the relation of the various departments to each 

 other and to the university, and esi>ecially the 

 relation of the department of medicine to the 

 university, is kept clearly in mind. 



During the past fifty years a marked im- 

 provement has taken place in the departments 

 which are concerned with the so-called con- 

 tributing sciences. In many schools these de- 

 partments now rank among the strongest uni- 

 versity departments, both in the quality of the 

 instruction and in the contributions which 

 they make to the advancement of knowledge. 

 One of the most important of the factors 

 which have contributed to this improvement 

 has been the release of these departments from 

 the restrictions imposed upon them by those 

 engaged in the practise of medicine. No 

 longer are the teachers themselves practitioners 

 of medicine, no longer is the efficiency of the 

 department judged entirely by the contribu- 

 tions made to the immediate demands of prac- 

 tise. That is, they have become true univer- 

 sity departments. 



The department concerned with medicine, 

 however, has not developed in the same way. 

 There the demands of practise and the needs of 

 practitioners are still the controlling factors in 

 organization and development. As one result 

 of this there has been developed within the de- 

 partment of medicine numerous branches hav- 



