142 



SCIENCE 



[Vol. JjV, No. 1415 



new statistical study might reveal. These dif- 

 ficulties do not apply, not at least in the same 

 degree, in the case of the awards by the Nobel 

 Prize Commission. There have been in all 18 

 awards of the prize for eminence in medical 

 science. Foui- times it has gone to Germany 

 and once it has come to America. And it may 

 not be entirely irrelevant to our theme to add 

 that the recipient in America is foreign born 

 and foreign trained. 



Accepting this verdict of the world on 

 the quality of medical research in the United 

 States it behooves us to search for the 

 causes of our shortcomings in the hope 

 that a way to improvement may be found. 

 The first thought the situation raises is that 

 our failure to measure up favorably in produc- 

 tive scholarship with the best that has been ac- 

 complished elsewhere possibly is to be ascribed 

 to the recentness of our entrance into the field. 

 This is scarcely possible. Germany required 

 •the time of but one generation to acquire her 

 pace. We are now well along in the second 

 generation, almost indeed, at the beginning of 

 the third, and while, as has been aaid, we have 

 developed more workshops and more posts 

 than now exist in Germany, not alone have we 

 ■not caught up with her, but she seems still 

 to be gaining on us, though perhaps at a di- 

 minishing rate. By way of illustration we 

 need to refer only to the 19 new journals of 

 medical sciences which she has launched in the 

 last 20 years, in comparison with our 15. 



No, the difference in our relative positions 

 continues to exist not because of the tardi- 

 ness of the manifestation of our interest in 

 medical science, but for several reasons of 

 which the first consists in our failure as yet 

 to provide sufBciently or sufficiently generally, 

 the ideal academic relations both material and 

 personal which the German government could 

 and did supply from the very beginning, and 

 which, as has been pointed out, made possible 

 her phenomenal start. To further embarrass 

 the healthy development of medical science 

 in the United States new conditions have de- 

 veloped which I would not presume to men- 

 tion were it not for the importance attributed 

 to them in so many of the statements sub- 



mitted to the committee on pre-clinical assist- 

 ants. Due to the rapid, in part forced, spread 

 of the medical sciences through the profes- 

 sional schools of the country, for which but 

 few could make adequate provision; due fur- 

 ther, to a depreciation in the purchasing power 

 of money, more rapid than the advancing scale 

 of emoluments, which were rather meager even 

 at the beginning, aggi-avated by a concomitant 

 elevation of the general scale of living per- 

 mitted by industrial prosperity; and due to 

 the establishment of university clinical depart- 

 ments upon endowments permitting a more 

 adequate support than is possible in any pre- 

 clinical department; due to all of these and to 

 other factors to be mentioned later, it is becom- 

 ing increasingly difficult for preclinical de- 

 partments to secui-e recruits of any kind, let 

 alone recruits who have given evidence, or 

 even promise, of being able to make note- 

 worthy contributions to the advancement of 

 science. In some quarters the view is held 

 that these conditions are merely temporary 

 and consequent upon the war. As a matter 

 of fact, however, they were beginning to make 

 themselves felt years before, and not alone in 

 this country but in Germany even. In 1911 

 Barker writes, "when the financial rewards of 

 most of the lines in medicine are distinctly al- 

 luring, only a vein of eccentricity or idealism 

 can induce a young man of ability to enter 

 a career which assures a comfortable living 

 for but a few fortunate leaders"; while Abra- 

 ham Flexner in 1912 states that "assistants are 

 scarcer (in Germany) than formerly when the 

 deprivations attendant on a scientific career 

 were less deterrent than they now appear to 

 be." The investigation carried out by the Na- 

 tional Research Council in 1920 demonstrated 

 unmistakably that the scientists themseJveg' 

 now regard the situation just as did the clini- 

 cian and the educator ten years ago. I have 

 been told that after reading the report of the 

 National Research Council a certain financier, 

 presumably a university trustee, concluded 

 from the statements of departmental heads 

 quoted therein that university men had lost 

 their idealism. Be this as it may, it is futile 

 to deny that scientific men are any less, or 



