Page:Popular Science Monthly Volume 66.djvu/91

Rh salient features of medical research, of medical practise, and of medical instruction in America.

In matters of research, the most fruitful line of investigation has been along the line of the mechanism of immunity from contagious diseases. To know the nature of microorganisms and their effect on the tissues is to furnish the means of fighting them. 'The first place in experimental medicine to-day' says Dr. W. H. Welch, 'is occupied by the problem of immunity.' That medicine is becoming a scientific profession and not a trade is the basis of the growing interest of our physicians in scientific problems, and this again leads to increased success in dealing with matters of health and disease. The discovery of the part played by mosquitoes in the dissemination of malaria, yellow fever, dengue, elephantiasis and other diseases caused by microorganisms marks an epoch in the study of these diseases. The conquest of diphtheria is another of the features of advance in modern medicine, and another is shown in the great development of surgical skill characteristic of American medical science. But the discoveries of the last decades have been rarely startling or epoch-making. They have rather tended to fill the gaps in our knowledge, and there remain many more gaps to fill before medical practise can reach the highest point of adequacy. The great need of the profession is still in the direction of research, and research of the character which takes the whole life and energy of the ablest men demands money for its maintenance. We need no more medical colleges for the teaching of the elements. We need schools or laboratories of research for the training of the masters.

In the development of medicine there has been a steady movement away from universal systems and a priori principles, on the one hand, and, on the other hand, from blind empiricism, with the giving of drugs with sole reference to their apparent results. The applications of science—all sciences which deal with life, with force and with chemical composition—must enter into the basis of medicine. Hence the insistent demand for better preliminary training before entering on the study of medicine. "Only the genius of the first order," says a correspondent, "can get on without proper schooling in his youth. What our medical investigators in this country most need is a thorough grounding in the sciences, especially physics and chemistry."

The instruction in medicine, a few years ago almost a farce in America, has steadily grown more serious. Laboratory work and clinical experience have taken the place of lectures, the courses have been lengthened, higher preparation for entrance has been exacted, though in almost all our schools these requirements are still far too low, and a more active and original type of teacher has been in demand. Even yet, so far as medical instruction is concerned, the hopeful sign is to be found in progress rather than in achievement. A college course, having as its major subjects the sciences fundamental to