May 16, 1913] 



SCIENCE 



733 



ological research. The number of phys- 

 ical, chemical and biological facts as yet 

 unapplied to physiological problems is so 

 enormous, and the number and powers of 

 physiological workers relatively so limited, 

 that progress, though rapid, in phj'siology, 

 can by no means keep pace with that of its 

 underlying sciences, no matter how de- 

 sirable this may seem. 



The clinical subjects are similarly situ- 

 ated though in transcendent degree. It is 

 almost a wonder that the clinician is not 

 suffocated by the physical, chemical, bio- 

 logical, anatomical, physiological, pharma- 

 cological, pathological, parasitological and 

 psychological facts which are being heaped 

 upon him with clamor for their applica- 

 tion. Moreover, the facts have arrived so 

 suddenly that they find the clinician, in 

 many instances, unable to understand 

 them, much less to apply them. Certain 

 chemical, physiological and anatomical 

 facts the clinician of the last generation 

 had, indeed, trained himself to apply by 

 study in the post-mortem room, in the his- 

 tological laboratory and in the laboratory 

 for urinalysis. But recently, and all at 

 once, the air has become thick with appli- 

 cable facts of the most diverse origin, and 

 only the younger clinicians have had op- 

 portunity for securing a training permit- 

 ting of an imderstanding of even a part of 

 them. 



For some years past, students have been 

 entering the clinics for instruction after 

 three or four years of education in the 

 methods and facts of the basal sciences 

 from physics to pathology. They have 

 been surprised to find, in many instances, 

 their clinical teachers relatively unac- 

 quainted with the present-day content of 

 the laboratory disciplines, and have often 

 i^een astonished at the delay in attempting 

 to apply in clinical studies facts of those 

 laboratory branches which seem to them 



obviously applicable to the work of diag- 

 nosis and therapy. Such personal observa- 

 tions by students working in the clinics 

 have been a sharp spur to clinical men, 

 and have undoubtedly gone far toward 

 accelerating the application of laboratory 

 facts and methods in the study and treat- 

 ment of the sick. At times, of course, 

 criticisms have been too severe or unjust. 

 Students are prone to be harsh critics; 

 their "young hot blood tingles to be up and 

 doing"; often they know little of the cir- 

 cumstances which delay progress. In cer- 

 tain regrettable instances students may 

 even have been led by a zealous but ill- 

 informed pre-clinical teacher to believe 

 that the workers in the clinical branches 

 are not to be regarded as "scientific," but 

 rather as "merely practical" men. This 

 is an attitude occasionally assumed — hap- 

 pily less often now than a few years ago — 

 by representatives of various sciences to 

 all sciences to which they contribute facts 

 for application, that is, to all sciences ex- 

 cept those which are basal to their own. 

 I can recall the time when an occasional 

 teacher of physics, or of chemistry, hinted 

 that the representatives of physiology or 

 of physiological chemistry were amateurish 

 or unscientific because the work in these 

 branches is subject to conditions often in- 

 consonant with profitable measurement in 

 dynes or with graphic representation of 

 stereochemical conceptions. But the older 

 may well profit from the criticism of the 

 younger, even if it be arrogant or unjust. 

 The veteran, when taken to task by the 

 recruit, may be amused, but if wise, in- 

 stead of being oifended, he will listen and 

 will try to rejuvenate himself. In any 

 case, he will rejoice in the vigor and op- 

 timism of the youth, and a part of his 

 reward will lie in the consciousness of help- 

 ing to train a group of successors who will 

 surpass him. 



