108 



SCIENCE 



[N. S. Vol. XXXVIII. No. 



Thus one of the ideals of the profession 

 — namely, the prevention of disease — has 

 in recent years made advances toward reali- 

 zation beyond the dreams of the most san- 

 guine a generation ago. 



Medicine, like the law, is in a measure en- 

 gaged in attempting to remove the reasons 

 for its existence. As the feeling for justice 

 and equity grows and the social conscience 

 gains in strength, the law is freed to take 

 up new and larger questions. So when we 

 come to the province of medicine there 

 opens before us a new order of things, aris- 

 ing from our progress in the control and 

 elimination of disease. 



The prevention of many important forms 

 of disease has been carried far, but that is 

 only the first step. This condition must be 

 maintained. Here, as elsewhere, eternal 

 vigilance applies. Moreover, new con- 

 quests in this field are yet to be made and 

 much devoted labor and keen thinking are 

 needed to that end. This brings the physi- 

 cian more and more into the service of the 

 community at large. 



It is in this connection, however, that we 

 find a depressing maladjustment between 

 the community and the physician. All will 

 admit that he who does good to the many 

 is certainly entitled to as definite reward 

 as is the man who benefits a single person. 

 Surely that proposition needs no argu- 

 ments in its support. Nevertheless, to put 

 the case quite mildly, as matters stand, the 

 man dealing with the single patient is 

 usually the more certain of his remunera- 

 tion and the more directly recognized. Yet 

 of the two his service is the less. 



A fair adjustment of this defect in our 

 social dealings has not yet been found — 

 though certainly it will be. Despite this 

 drawback, however, it can not. fail to be a 

 great encouragement for all of us to ob- 

 serve that those working for the public in- 

 terest and the general good are many and 



industrious— too occupied with fruitful 

 studies to make much talk about their own 

 misfortunes. 



You can not fail to have noted that the 

 progress I have mentioned has been largely 

 in connection with those forms of disease 

 which are due to pathogenic organisms. 

 With these we may contrast the great group 

 in which increasing age and functional 

 misuse and strain seem to be the more 

 prominent factors. 



Advances in this field might be noted 

 too, but, passing over these, emphasis is to 

 be laid on the fact that for the proper 

 understanding and control of such diseases 

 one is always seeking help from chemistry 

 — organic, physiologic, biologic, as the case 

 may be. To be sure, the use of chemical 

 ideas by physicians is almost as old 33 

 medicine itself, yet the call for such ideas 

 has never been so urgent as to-day, and this 

 call taxes a portion of medical training 

 which, in the past at least, was under-em- 

 phasized. It amounts almost to a sudden 

 rearrangement of medical demands, for 

 the commoner ailments, only slowly to be 

 reduced by the gradual enlightenment of 

 the laity, tend to become more and more 

 those which must be met through the con- 

 trol of nutrition and other modifications of 

 our daily life. 



Of course when a period of rapid change 

 like that at present in progress occurs in 

 any profession or occupation, there is al- 

 ways created a really tragic situation by 

 reason of the fact that some among the 

 older men have not been taught and can 

 not learn the newer ways, and thus inevi- 

 tably suffer disadvantage. For them the 

 new ways are bad — and for them the times 

 are out of joint. Naturally the capacity 

 to progress is a highly variable gift, but 

 many instances go to show that it is often 

 thought to be exhausted where there is still 

 much remaining in reserve. 



