May 15, 1903.] 



SCIENCE. 



765 



they afford? . Are their teachers of the 

 sciences of the fundamentals of medicine 

 capable? They can not hope for better 

 conditions, because the time when a stu- 

 dent's tuition will pay the school for his 

 instruction, if he is properly taught, will 

 never return. Medical education of the 

 future must be based on the status of med- 

 ical science. That basis is recognized now, 

 but is attempted in the great majority of 

 our medical institutions in a very super- 

 ficial way. 



SCIENTIFIC MEDICINE. 



The great and important discoveries of 

 Pasteur and the practical methods devised 

 by Koch in bacteriology marked a new era 

 in medicine. Before the facts made clear 

 by these discoveries, the hypotheses and 

 theories of other days have disappeared. 

 Our knowledge of man and the lower ani- 

 mals and of the diseases and evils which 

 afflict them has been revolutionized within 

 the last twenty years. The advance in 

 medical knowledge has been greater in that 

 period than in all preceding time. Medi- 

 cine now embraces many more subjects, 

 chiefly fundamental ones, than were known 

 twenty years ago. Formerly a very super- 

 ficial knowledge of a few isolated facts in 

 general chemistry and human physiology 

 and a memorized knowledge of human 

 anatomy and of materia medica enabled the 

 student to learn the practice of the art of 

 medicine and surgery. Now, the problems 

 which confront the clinician and investi- 

 gator in medicine and surgery compel him 

 to have a good and working knowledge of 

 general, physical and physiologic chemistry, 

 of general biology, bacteriology, pathology, 

 physiology, embryology, pharmacology, his- 

 tology and anatomy. The physician who 

 has not a practical knowledge of these fun- 

 damental subjects can not clearly imder- 

 stand the methods of others engaged in 

 scientific investigation, nor can he ration- 



ally utilize the discoveries of others in his 

 work. Medicine to-day is applied science. 

 If we utilize the knowledge of to-day in 

 an attempt to cure and prevent disease, 

 it must also be an experimental science. 

 No one can practically apply or rationally 

 experiment with what he does not know. 

 The fundamental studies of medicine must, 

 therefore, be acquired by all who desire to 

 successfully apply them as sciences. The 

 successful experimental application of these 

 sciences has given us within ten years a 

 knowledge of the method by which the in- 

 vading bacteria affect the host, and has 

 likewise developed a principle of wide ap- 

 plication as a preventive and cure of cer- 

 tain diseases by the use of antitoxic sera. 

 It has confirmed the principle of preventive 

 inoculation, accidentally discovered by 

 Jenner, and has enabled us to apply the 

 principle in other diseases than smallpox. 

 It has enabled us to know the methods of 

 transmission of certain infectious diseases, 

 and to know how to stamp out scourges like 

 yellow fever, the plague and malaria. 



Through the evolution of Listerism, it has 

 enabled the surgeon to invade every region 

 of the animal body, and to save scores of 

 lives formerly doomed to death. The free- 

 dom with which the surgeon may now 

 operate has not only saved lives, but, in- 

 directly, the knowledge of disease processes 

 so studied during life has taught us many 

 new facts in symptomatology, and has 

 cleared away many fallacies concerning 

 pathologic processes. It has given us 

 many new methods of clinical study, and 

 furnished data from the blood, the spinal 

 fluid, the exudates, the sputa, the sweat, 

 the feces, and urine, which enable us to 

 recognize disease much more readily than 

 before. 



Much as has been accomplished by ex- 

 perimental medicine in a comparatively 

 brief period of time, there are vast fields 

 to which the method has not been applied. 



