draws the line accurately between the known, the partly known, and the unknown. The empiricist fares forth with an indiscriminate confidence which sharp lines do not disturb.
Investigation and practice are thus one in spirit, method, and object. What is apt to be regarded as a logical, is really but a practical, difficulty, due to the necessity for a division of labor. "The golden nuggets at or near the surface of things have been for the greater part discovered, it seems safe to say. We must dig deeper to find new ones of equal value, and we must often dig circuitously, with mere hints for guides."[1] If, then, we differentiate investigator and practitioner, it is because in the former case action is leisurely and indirect, in the latter case, immediate and anxious. The investigator swings around by a larger loop. But the mental qualities involved are the same. They employ the same method, the same sort of intelligence. And as they get their method and develop their intelligence in the first place at school, it follows that the modern medical school will be a productive as well as a transmitting agency. An exacting discipline cannot be imparted except in a keen atmosphere by men who are themselves "in training." Of course the business of the medical school is the making of doctors; nine-tenths of its graduates will, as Dr. Osier holds, never be anything else. But practitioners of modern medicine must be alert, systematic, thorough, critically open-minded; they will get no such training from perfunctory teachers. Educationally, then, research is required of the medical faculty because only research will keep the teachers in condition. A non-productive school, conceivably up to date to-day, would be out of date to-morrow; its dead atmosphere would soon breed a careless and unenlightened dogmatism.
Teachers of modern medicine, clinical as well as scientific, must, then, be men of active, progressive temper, with definite ideals, exacting habits in thought and work, and with still some margin for growth. No inconsiderable part of their energy and time is indeed absorbed in what is after all routine instruction; for their situation differs vastly from that of workers in non-teaching institutions devoted wholly to investigation. Their practical success depends, therefore, on their ability to carry into routine the rigor and the vigor of their research moments. A happy adjustment is in this matter by no means easy; nor has it been as yet invariably reached. Investigators, impressed with the practical importance of scientific method to the practising physician, tend perhaps to believe that it is to be acquired only in original research. A certain impatience therefore develops, and ill equipped student barks venture prematurely into uncharted seas. But the truth is that an instructor, devoting part of his day under adequate protection to investigation, can teach even the elements of his subject on rigorously scientific lines. On the other hand, it will never happen that every professor in either the medical school or the university faculty is a genuinely productive scientist. There is room for men of another type,—the
- ↑ C. A. Herter: "Imagination and Idealism in the Medical Sciences," Columbia Univ. Quart., vol. xii., no. 11, p. 16.
