460 



SCIENCE. 



[N. S. Vol. XXIV. No. 615. 



of diagnosis and clinical study, medicine 

 has gained new and higher points of view 

 in passing from too exclusive emphasis 

 upon the final stages of disease revealed 

 by morbid anatomy to clearer conceptions 

 of the beginning and progress of morbid 

 processes as indicated by disturbances of 

 function, and above all has penetrated to 

 the knowledge of the causation of an im- 

 portant class of diseases, the infectious. 

 As a result of this rapid growth of knowl- 

 edge in many directions has come a great 

 increase in the physician's power to do 

 good by the relief of suffering and the 

 prevention and cure of disease. 



In this connection I wish especially to 

 emphasize the mutual helpfulness of the 

 various medical sciences in the develop- 

 ment of medical knowledge and practise. 

 Attention is generally so concentrated upon 

 the final achievement that there is danger 

 of losing sight of the manifold sources 

 which have contributed to the result. Let 

 my medical hearers consider, for example, 

 the indispensable share of embryology, of 

 anatomy, gross and microscopic, of physiol- 

 ogy, of pathological anatomy, of clinical 

 study in the evolution of our knowledge 

 of the latest contribution to diseases of 

 the circulatory system — that disturbance 

 of the cardiac rhythm called 'heart-block.' 

 Similar illustrations of the unity of the 

 medical sciences and of the cooperation of 

 the laboratory and the clinic might be 

 multiplied indefinitely from all classes of 

 disease. 



The same phenomenon is exhibited in 

 medicine as in all science that the search 

 for knowledge with exclusive reference to 

 its practical application is generally unre- 

 warded. The student of nature must find 

 his satisfaction in search for the truth and 

 in the consciousness that he has con- 

 tributed something to the fund of knowl- 



edge on which reposes man's dominion over 

 reluctant matter and inexorable forces. 



How readily better action attends upon 

 increased knowledge is shown by the part 

 which the art of medicine is playing and 

 is destined to play even more prominently 

 in the world's progress. The value of 

 this work of modern medicine is to be 

 measured in paTt, but only in part, by the 

 standard applied by the average man, 

 namely, improvement, which, indeed, has 

 been great, in the treatment of disease and 

 injury. It is, however, its increasing 

 power to check the incalculable waste of 

 life, of energy, of money from preventable 

 disease that places medicine to-day in the 

 front rank of forces for the advancement 

 of civilization and the improvement of 

 human society. Economists and other 

 students of social conditions have begun to 

 realize this, but governments and the 

 people are not half awake, and medicine, 

 shaking off all mystery, and with a sense 

 of high public duty, has before it a great 

 campaign of popular education. 



The knowledge which has placed pre- 

 ventive medicine upon a sound basis and 

 has given it the power to restrain and in 

 some instances even to exterminate such 

 diseases as cholera, plague, yellow fever, 

 malaria, typhoid fever, tuberculosis and 

 other infections has come from exploration 

 of the fields opened by Pasteur and by 

 Koch. This power and the certainty of 

 increasing it have given great strength to 

 appeals for the endowment of medical re- 

 search and the construction of laboratories. 

 What is all the money ever expended for 

 medical education and medical science com- 

 pared with the one gift to humanity of 

 Walter Reed and his colleagues of the 

 army commission— the power to rid the 

 world of yellow fever? 



Great as has been the advance of medi- 

 cine in the past half century, it is small 



