October 12, 1906.] 



SCIENCE. 



457 



pathological anatomy. As if to replace 

 these losses anatomy gave birth to com- 

 parative anatomy, embryology and micro- 

 scopic anatomy as more or less separate 

 branches. 



During the past century physiological 

 chemistry and pharmacology have sepa- 

 rated from physiology, and comparative 

 pathology and experimental pathological 

 physiology are asserting their independ- 

 ence from pathological anatomy. 



Hygiene and bacteriology are of recent 

 and more independent growth. The latter, 

 lusty stripling, with the rise of medical 

 zoology, especially protozoology, is seeking 

 a more comprehensive and appropriate 

 designation. The latest and, perhaps, the 

 most significant development is the clinical 

 laboratory in its various forms. 



Specialization in scientific work should 

 not be decried ; it is demanded by the neces- 

 sities of the case and has been the great 

 instrument of progress, but the further 

 division of labor is carried, the more neces- 

 sary does it become to emphasize essential 

 unity of purpose and to secure coordina- 

 tion and cordial cooperation of allied sci- 

 ences. Especially urgent is full recogni- 

 tion of the unity and cooperation of the 

 clinic and the laboratory. 



During the last two decades we have 

 witnessed in this country the extraordinary 

 rise of practical laboratory instruction 

 from the weakest to the strongest and best 

 organized part of the medical curriculum 

 of our better schools. Our laboratory 

 courses are, I believe, in several instances 

 more elaborate and occupy more time than 

 corresponding ones in most foreign uni- 

 versities. 



As was emphasized by Dr. Dwight and 

 Dr. Shattuck in their remarks yesterday, it 

 is, however, an error to suppose that from 

 the point of view of science any funda- 

 mental distinction exists between the clin- 



ical and the so-called laboratory subjects 

 other than that based upon differences in 

 the subject-matter of study. The problems 

 of the living patient are just as capable of 

 study by scientific methods and in the 

 scientific spirit and they pertain to inde- 

 pendent branches of medical science just 

 as truly as those of anatomy, physiology 

 or the other so-called laboratory subjects. 

 All of the medical sciences are interdepend- 

 ent, but each has its own problems and 

 methods, and each is most fruitfully culti- 

 vated for its own sake by those specially 

 trained for the work. 



There is a highly significant and hopeful 

 scientific movement in internal medicine 

 and surgery to-day characterized by the 

 establishment of laboratories for clinical 

 research, by the application of refined 

 physical, chemical and biological methods 

 to the problems of diagnosis and therapy, 

 and by the scientific investigation along 

 broad lines of the special problems fur- 

 nished by the living patient. The most 

 urgent need in medical education at the 

 present time in this country I believe to 

 be the organization of our clinics both for 

 teaching and for research in the spirit of 

 this modern movement and with provision 

 for as intimate, prolonged, personal con- 

 tact of the student with the subject of 

 study as he finds in the laboratory. 



In addition to undergraduate instruc- 

 tion our laboratories at present furnish 

 better opportunities for the prolonged, ad- 

 vanced training of those intending to make 

 their careers in anatomy, physiology, pa- 

 thology and other sciences, than are 

 afforded by most of our hospitals to those 

 who aim at the higher careers in medicine 

 and surgery. A further clinical disad- 

 vantage is that while the former class after 

 good scientific work may reasonably look 

 forward to desirable positions as teachers 

 and directors of laboratories, the latter, 



