Februaky 10, 1922] 



SCIENCE 



145 



fecting himself first in the technique of dia- 

 gnosis and treatment of surgical conditions and 

 then, in his laboratory, concerning himself 

 with the development of methods of surgical 

 diagnosis and treatment. In other words, the 

 surgeon ordinarily devotes himself to surgery, 

 just as the physiologist ordinarily devotes him- 

 self to physiology. When border line work 

 is undertaken there should be provided an op- 

 portunity for cooperation between departments 

 either by means of direct help or through ad- 

 vice. 



In the development of our theme it has been 

 furthest from oui- intention to give the im- 

 pression that the effort made in the United 

 States to contribute to medical science has been 

 futile; as a matter of fact, we are now ac- 

 complishing as much as a great many other 

 ■countries. But it is clear that we are not do- 

 ing as much as we should and our purpose has 

 been to ascertain the causes of our backward- 

 ness in the hope of pointing the way to their 

 removal. In Germanj', it has been seen, the 

 ascendancy was gained through wise action 

 •of a paternal form of government in supply- 

 ing the conditions that are most conducive to 

 securing men. In a democracy, such as the 

 United States, the same end can be gained only 

 by the much slower process of education. Not 

 alone is it necessary to obtain the interest of 

 men capable of supplying brains for the de- 

 velopment of medical science, it is equally 

 necessary to educate the enlightened public up 

 to the point of understanding that just as in 

 the case of astronomy, or of physics, or of 

 ■chemistry, it is only by the diligent employment 

 of the scientific method that progress is pos- 

 sible; that by that method alone will an un- 

 ■derstanding ever be gained of the manner in 

 which the human body functions in health and 

 disease. The adoption of the designation 

 "Medical Science" for this division of the 

 American Association and for what formerly 

 was the "Medical Division" of the National 

 Research Council is taken to indicate that the 

 value of science in medicine is coming to be 

 appreciated by scientific men and presages 

 ■a recognition of its worth by the enlightened 

 public at, let us hope, not too remote a date. 



When that has come about, and not until then, 

 will medical science in the United States come 

 into its own. 



But is the goal still worth fighting for? Is 

 it possible, to quote Herter, that the "golden 

 nuggets that are near the surface of things 

 have been for the most part discovered?" In 

 a general sense this figure unquestionably 

 represents conditions as they now are. It is 

 incomplete, however, in that it applies only 

 to the working of claims already staked out, 

 and fails to allow for the possibility that 

 venturesome spirits from time to time may 

 succeed in opening up new territories in which 

 surface mining may again bring forth rich 

 yields. And it fails to allow for the possi- 

 bility of an improvement in machinery which 

 may make deep mining as profitable as placer 

 mining. Great as is the headway that has been 

 made, it does not require a very intimate ac- 

 quaintance with medicine to realize that such 

 unopened domains still exist. But whatever 

 the future may have in store for us we must, 

 I think, in the interests of progress, if for 

 no other reason, maintain that a way will be 

 found by which to explore them. One has 

 only to recall in this connection the remarkable 

 development of the sciences of bacteriology and 

 immunology that has occurred in a little over 

 one generation; or, to go outside of medicine, 

 to consider the revelations in radio activity in 

 our own time and the remarkable influence 

 they have had upon our fundamental concep- 

 tions of matter and force, conceptions which 

 have as yet scarcely made themselves felt in 

 medicine, in order to realize that there still 

 must be plenty of opportunity for revelations 

 in medical science if only it could be re- 

 cruited with master minds capable of reading 

 the signs which still elude us. If the United 

 States is to supply her share of the progress 

 that is to come a way will have to be found 

 of bringing into the field of medical science 

 the talents which, in the opinion of those best 

 able to judge, are most likely to see the light. 



Joseph Erlangee. 

 Washington University 

 School of Medicine, 

 St. Louis, Mo. 



