Yale, and Macallum, of Toronto; Delafield, Welch and Prudden in New York and Fitz in Boston appear to have been among the first to control university laboratories of pathology in which at least a few men gave much of their time to teaching or investigation, but the great impetus to research in pathology and bacteriology coincides with Welch's affiliation with the Johns Hopkins Hospital, and experimental pathology as a sustained effort was first broadly cultivated by Flexner. Investigation in pharmacology by modern exact methods, in laboratories devoted to that subject, is the result of the labors of Wood at Pennsylvania, of Cushny at Ann Arbor, of Abel at Baltimore, of Herter in New York and of Sollman in Cleveland. The first university institute of hygiene was that established at Pennsylvania in 1892. These are the names which the compiler of American medical history one hundred years from now will compare, in discussing the development of our laboratories, with those of the period of 1820 to 1860 in Germany. Why? Because these men established not merely teaching laboratories, but stimulated investigation, inculcated exact methods and trained men, and thus made an impression upon the medicine of their time. This is true not merely of their influence in furthering research, but of their influence in advancing the fundamental principles of proper medical education. As soon as it was demonstrated that laboratories were indispensable to proper medical education, the day of the medical school worthy of university rank arrived and the proprietary medical school as an important factor in medical education became a thing of the past. Moreover, as I have intimated, the principle of laboratory instruction and laboratory research which gave to laboratory effort the strongest place in the curriculum has had a distinct effect on the clinical teaching of medicine and surgery, so that in some of our better schools the individual student now has that opportunity for immediate contact with the patient which allows the direct exercise of his powers of observation, of the use of instruments of precision and of exact procedures which assure the acquirement not only of knowledge, but power to obtain knowledge. The result is the recognition of the clinic as a place for the exercise of exact methods in the teaching of the clinical branches and in the investigation of disease. Both fields of activity, the hospital and the laboratory, now have the "common purpose to advance medical knowledge and thereby bring healing to the nations."
With this conception of a common purpose guiding medical education and medical research and with the present unanimity of opinion concerning the absolute necessity of control of a hospital by the university, the duty of the latter to research is clear. If the purpose of the machinery of medical education is to "bring healing to the nations"; if "the business of medicine is to get people out of difficulties through the application of science and dexterity manual and psychical" (Cabot),