Page:Hospitals, medical science and public health.djvu/14

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HOSPITALS, MEDICAL SCIENCE,

seems to be an opinion abroad that the pathologist, who may never have approached a patient since his graduation, can by some esoteric ingenuity put together the conditions of these problems in his laboratory; or indeed under these purer conditions find more comprehensible explanations. To endeavour in the laboratory thus to reproduce problems in simpler terms is no doubt a valuable part of scientific method; but surely it is a truism that such researches, unless incessantly brought to the touchstone of nature, are apt to lead to conclusions as abstract as the ingenious conditions out of which they arose are artificial. In the simpler sciences, it is true, such methods go farther; a mathematician, in no way conversant with machines, may be indispensable to the engineer; but even in the simplicity of mechanics the shortcomings of mere academic methods soon become conspicuous: how much more crippled then must be the academic pathologist who is denied full conversance with those infinitely more complex and multifarious machines we know as plants and animals! It seems absurd to labour such a point as this, and in a university so vigorously empirical as Victoria; still as we have long ceased to be surprised at the absurdities which convention and tradition maintain even in the hardest heads, even here these counsels may be useful.

How, then, are we to abolish so fallacious a distribution of work? The physician, who in the earlier phases of scientific medicine proved himself, on the very principles just proposed, to be the ablest of pathologists, can no longer, in the vast extension of the field, devote himself fully to pathological research. It is all he can do to carry the application of its discoveries into clinical practice. Moreover, the field of qualitative clinical work is filling up, and progress now depends on the far more arduous and exacting quantitative appreciations. Both physician and pathologist, each by his own methods, must work in the ward, at the facts; the pathologist must have almost as free a run as the physician—almost as free, for ultimately, of course, the physician will govern all that concerns the patient's well-being—and must accordingly have a laboratory of first instance in the neighbourhood of the ward; his departmental and research laboratories will, of course, be elsewhere, yet not so far away as to estrange him from the patients. By this concert the outlook of the physician also,