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SCIENCE 



[N. S. Vol. LIV. No. 1392 



of clinical research by the methods of the nat- 

 ural sciences, the unification of science and the 

 practise of medicine, the encouragement of 

 scientific investigation by the practitioners, 

 and the diffusion of a scientific spirit among 

 its members." Broadly speaking, these simmer 

 down to the better care of the sick, the broad- 

 ening of the bounds of medicine, and the de- 

 velopment of the physician himself. 



To the public generally, medical investiga- 

 tion makes no great appeal. The research 

 worker is commonly regarded as impractical. 

 Yet the routine practise of to-day is based on 

 the investigation of yesterday. Wassermann 

 tests, renal functional tests, and spinal fluid 

 findings constitute substantial phases of the 

 medical practise of to-day. Yet, we did not 

 have them fifteen years ago. The public and 

 many physicians fail to appreciate that prac- 

 tise is based on investigation, and that clinical 

 investigation means better care of the sick, 

 greater public health, and happier communi- 

 ties. 



Investigation is complex. It demands cer- 

 tain mental attributes. The most essential 

 is a veritable lust for truth. This has to be 

 supported by skill in experimentation, accu- 

 racy in observation and record, correct inter- 

 pretation of findings, and due appreciation of 

 their significance. The lust for truth must 

 result in active search which recognizes 

 no sacrifice. Skill in experimentation 

 involves insight and ability in the selection 

 and the carrying out of well-controlled ex- 

 periments. Accuracy in observation implies 

 capacity to see, a knowledge of the subject, 

 and an aispreciation of the phenomena ob- 

 served. Accuracy of record demands precise 

 and prompt notations, made preferably during 

 the course of experimentation, for, as a rule, 

 observations made to-day and recorded to- 

 morrow are lost to science. Correct interpre- 

 tations of findings and due appreciation of 

 their significance demand a well-trained mind, 

 critical judgment, and a familiarity with the 

 subject in relation to contemporary science. 



This may be stated in a somewhat different 

 way. Investigation consists of four funda- 

 mental factors: (1) the clear conception of 



the problem, that is, a definite " Fragestel- 

 lung"; (2) the selection or development of 

 methods capable of solving the problem; (3) 

 ability to recognize relationships, to orient the 

 problem to existing facts; and (4) accurate 

 measurements and records. 



The spirit of investigation is a living force, 

 born within or rendered kinetic by contact 

 from without, which, when first awakened, is 

 usually feeble and requires cultivation, but 

 when fully developed directs action and con- 

 trols destiny. It is difficult to define, to un- 

 derstand, to acquire, to cultivate, and to com- 

 municate. 



The cultivation and the diffusion of the 

 spirit are our problems. Once the investigator 

 is imbued with the spirit, investigations will 

 proceed and bring results. But in diffusing, 

 the spirit must be communicated so that it may 

 be acquired by another. Consequently we 

 must consider its acquisition as well as its 

 cultivation and diffusion. 



Acquisition of the Spirit of Investigation. — 

 The statements of Hippocrates relative to the 

 attributes desirable in the student for instruc- 

 tion in medicine apply equally well to the 

 prospective investigator. Hippocrates says: 



Whoever is to acquire a competent knowledge of 

 medicine ought to be possessed of the following 

 advantages: a natural disposition, instruction, a 

 favorable position for the study, early tuition, 

 love of labor, leisure. !Pirst of all, a natural talent 

 is required, for when nature opposes everything 

 else is vain, but when nature leads the way to 

 what is most excellent, instruction in the art 

 takes place, which the student must try to appro- 

 priate to himself by reflection^ becoming an early 

 pupil in a place well adapted for instruction. He 

 must also bring to the task a love of labor and 

 perseverance, so that instruction taking root may 

 bring forth proper and abundant fruit. 



Instruction in medicine is like the culture of the 

 production of the earth, for our natural dispo- 

 sition is, as it were, the soil; the tenets of our 

 teacher are, as it were, the seed; instruction in 

 youth is like the planting of the seed in the ground 

 at the proper season; the place where the in- 

 struction is communicated is like the food imparted 

 to vegetables by the atmosphere; diligent study 

 is like the cultivation of the fields; and it is time 



