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SCIENCE 



[N. S. Vol. XXXVI. No. 936 



will be manhood in your little men of which 

 you do not dream." 



And to such a system of instruction in 

 medicine, a system which may form great 

 men if great men come within its reach, 

 this beautiful library is dedicated. And 

 all resources of Stanford University stand 

 pledged to make this purpose good. 



I said just now that medical research is 

 now on the firing line of the advance of 

 science. It has left behind it as outworn 

 garments all medical theories, and all 

 schools of medicine. The medical advance 

 is the work of no school, the offspring of no 

 preconceived theory. 



One of my early students, on graduating 

 in medicine, was asked to what school he be- 

 longed. His answer was "I have nothing 

 to do with schools. I am trying to practise 

 medicine." Just as soon as men seriously 

 try to practise medicine, schools of medi- 

 cine cease to exist. These belong to the 

 metaphysics of the dark ages, when men, in 

 default of science, tried to practise phi- 

 losophy. 



At the most or at the best, a school indi- 

 cates merely a preference for one mode of 

 therapeutics over another, or over all 

 others, a matter of very minor importance 

 as compared with knowing the nature of 

 the ailment in question and of causes which 

 brought it about. Accuracy of scientific 

 knowledge is fatal to the prearranged 

 theory of treatment of disease, the basis of 

 any school of theoretical medicine. Ac- 

 curacy of knowledge goes beyond sjonp- 

 toms or surface indications. It is with 

 symptoms and symptoms only, in default 

 of knowledge, that varying schools of med- 

 ical therapeutics become possible. When 

 we know the actual conditions which give 

 rise to symptoms, all methods must rest on 

 these conditions. 



All art is based on science. Science is 

 human experience tested and set in order. 



Art is knowledge in action. An art which 

 is not based on knowledge becomes a mys- 

 tery or a trade. The practise of medicine 

 through the ages has been one or the other 

 or both. It is a trade when the physician 

 apprentice follows his master about, learns 

 his ways, his prescriptions and his profes- 

 sional dignity. It is a mystery when prac- 

 tise is based on some theory of therapeutics 

 which goes outside of human experience 

 for its justification. 



Science is alike to all men who have 

 grasped its data and its conclusions. Art 

 will vary with the personality of the indi- 

 viduals who practise it. Sound medicine 

 must rest on science. Whoever treats the 

 ills of the human body successfully must 

 know this body in health and in disease. 

 He must know the range of its disorders, 

 its abuses, its dislocations and its parasites. 

 Those who try to heal without knowledge 

 of the actual conditions with which they 

 deal are of necessity impostors. 



The limit of "medical freedom" is a 

 very plain and natural one. Let the pa- 

 tient take whatever kind of treatment he 

 may wish, but let no treatment be admin- 

 istered by persons who have no knowledge 

 of the fundamental facts of medical sci- 

 ence. If the requirement of technical 

 knowledge is fatal to any school of thera- 

 peutics, it is time that that particular form 

 of robbery should be done away with. 

 Taking chances with the lives of others for 

 the money there is in it is not a profession 

 to be encouraged. 



The basis of the varying schools of medi- 

 cine lies not in science, but in the varying 

 theories of symptoms. In the old days, 

 when microorganisms were unknown, where 

 physiology was elemental and pharmacol- 

 ogy itself a form of metaphysics, it is not 

 strange that symptoms engrossed the at- 

 tention of the practitioner and that there 



