732 



SCIENCE 



[N. S. Vol. XXXVII. No. 959 



in a life of clistingnislied service in the 

 profession. In the present instance, the 

 selection has obviously been made rather 

 as an encouragement to future work than 

 as a reward for past performance; I can 

 only be grateful for the generosity shown 

 me and for the powerful stimulus to 

 worthy effort which such confidence begets. 



Turning now to the work of the associa- 

 tion itself, it is plain that the great changes 

 which have taken place in medicine since 

 the foundation of the society in 1886 have 

 modified old needs as regards associations 

 and created new ones. Our attention has 

 been called repeatedly to the changing 

 needs by our presiding officers, most em- 

 phatically, perhaps, by Dr. Councilman in 

 1904 and by Dr. Adami last year. 



Methods of medical education in the 

 United States have passed through a veri- 

 table revolution. The proprietary medical 

 schools, useful enough in their time, be- 

 came insufficient and have been largely 

 replaced by medical departments of uni- 

 versities, privately endowed, or aided by 

 the states. The laboratory disciplines, 

 under the stimulus of the great advances 

 of biology, chemistry and physics in the 

 second half of the last century, have ex- 

 perienced an unprecedented expansion, 

 and the army of medical teachers and in- 

 vestigators has thus been recruited by a 

 series of new battalions, made up of men 

 trained in pathology, bacteriology, physi- 

 ology, psychology,, physiological chemistry, 

 pharmacology, anatomy, histology and em- 

 bryology. Many of the teachers and in- 

 vestigators in these purely laboratory 

 branches are men limited in clinical ex- 

 perience to their undergraduate training; 

 some of them, indeed, have entered upon a 

 career in these fundamental medical sci- 

 ences, after a preliminary apprenticeship 

 in laboratories of biology or chemistry 

 without taking even an undergraduate 



course in medicine. Meantime a high de- 

 gree of specialization has been taking place 

 also in the clinical branches. With the 

 advent of anesthesia and asepsis in surgery- 

 came the opportunity for unexpected divi- 

 sions of labor in surgical fields, while the 

 introduction of instruments of precision, 

 and of the methods of pathology and bac- 

 teriology, of biology and chemistry, in the 

 work of internal medicine led to the inten- 

 sive development, by skilled workers, of its 

 various special domains. 



One result of the almost explosive prog- 

 ress in the purely laboratory branches, has 

 been to place the clinical subjects, and 

 especially internal medicine, in almost an 

 embarrassing situation. Internal medicine 

 is, of all the biological sciences, the one to 

 which the largest number of other sciences 

 contribute facts for application. Internal 

 medicine is usually designated as one of 

 the "applied sciences." But all the sci- 

 ences, with the possible exception of math- 

 ematics, are largely "applied science." 

 Thus, physics consists in part of applica- 

 tions of mathematics; chemistry of appli- 

 cations of mathematics and physics; biol- 

 ogy of mathematics, physics and chem- 

 istry ; physiology of physics, chemistry and 

 biology, and so on, with avalanche-like in- 

 crease of the sciences to be applied, until 

 internal medicine is reached with all the 

 laboratory subjects offering it their aid. 



Now each of these sciences, though 

 largely applied science, is compelled to 

 grow in its own way; each science is cre- 

 ative and has to devise methods of its own ; 

 even when a new fact in a science basal to 

 it is applicable, the application has actu- 

 ally to be made. Take physiology as an 

 example. A new discovery in physics, or 

 in chemistry, does not enrich physiology 

 until physiology makes use of it; indeed it 

 may long lie unapplied since its fruitful 

 application in physiology involves a physi- 



