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PATHWAYS OF MEDICAL PROGRESS

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Science  12 Jan 1940:
Vol. 91, Issue 2350, pp. 25-31
DOI: 10.1126/science.91.2350.25

Abstract

During the three decades that have passed, medical science has ascended to a high plateau of achievement. The climb has involved several pathways; among them: (1) the physiological approach toward disease as experiments which nature performs on organisms, (2) the more intelligent interpretation of the functional reactions of the body in disease in accordance with latest discoveries in physiology, (3) the supplementation of observable phenomena through use of laboratory instruments, (4) the assumption of active investigation both on patients and experimental animals by clinicians themselves, (5) the shuttling of problems between clinical and experimental laboratories and (6) correlated research in clinical and physiological departments.

As we look down from the heights we have reached, we have reason to be pleased with our progress; but when we look ahead we become aware that there are still high mountain ranges to be climbed. We realize that their ascent can not be accomplished by employing merely the methods, equipment and strategy that have proved successful so far; we must improve the application of principles that are old and well established, and evolve others that are new. Above all, we from laboratories and clinics must join hands to help each other climb; and through correlated team-work overcome the great obstacles that jealous nature places in our way.

I have ventured to suggest a few directions which such mutual help may take. They include (1) means by which new fundamental discoveries can be utilized more quickly by clinicians and practitioners of medicine; (2) plans by which younger clinical investigators can be given approximately the same opportunity for training in research technique as their colleagues entering experimental sciences; (3) pleas that the shuttling of problems between hospitals and laboratories of fundamental science may continue in order that the ultimate significance of clinical results may be better understood and that the applicability of fundamental discoveries to nature's experiments may be tested; (4) judicious combination of talents of laboratory and clinical workers, whenever this leads to greater economy of effort and does not infringe upon the primary duties of each participant to his calling.

The spirit of correlation which is involved in all these plans of advance is a silent force which grows not only through mutual interest in each other's problems but also through frank respectful criticism of each other's trends. With such a spirit of correlated effort science marches on.