Sam. R. Burroughs, Chairman, Guy's Store, Texas.

tion of man approximates a system of knowledge more or less akin to this movement, collective investigation is peculiarly adapted to medicine in its multitudinous bearings. It is in possession of measures that, when properly executed, afford much hope of a dissipation of those misty halos of doubt and uncertainty which still encircle the citadel of disease in its natural history, etiology, pathology and treatment.

On the whole, if your committee be allowed the expression of an opinion, we regard the work worthy the best efforts of any medical society, and, since time has given it birth, the confines of eternity, alone, should chime its requiem.

It is a conceded fact that no important achievement. can be secured without continued pursuit in the successive and ascending gradations involved, and that the first step to be taken in this imposing movement of collective research, must be the impartation of as thorough knowledge as may be practicable, of its objects, aims and ends, to those who are to be called into its service. Hence, entertaining these views, the committee have thought proper to express themselves as not being in the least degree discouraged by the small number of returns thus far received, and beg to submit a brief history of the movement:

Origin—A somewhat extensive correspondence developed the fact that the present system of collective investigation found its modern origin and application to scientific medicine in the labors of the British Medical

APPENDIX-Report of Committee on Collective Investigation,

Association, at its Cambridge meeting, in 1880. Action, however, had been urged in this direction as early as 1864, by Drs. Ransome and Mahomed.*

Definition-Collective research has for its object the collection of accurately recorded clinical facts, relative to every disease that disturbs the human organism, from the hands of the largest number of observers possible, and from every clime; the analysis of these facts, as bearing upon every phase of each individual disease, together with whatever may be determined by environment in each class of maladies; the utilization of these truths in the development of every principle that may, individually or collectively, lead us to a truer knowledge of the etiology, natural history, pathology, prognosis and treatment of disease in its manifold presentations.

History-The great value of this movement was so forcibly elucidated in Professor Humphry's Presidential Address before the British Medical Association at the time above mentioned, that that body instructed, by resolution, its Committee of Council to consider and report upon the best measures for entering upon and conducting the work to a successful issue. A sub-committee was appointed by this council, and the former made its first report, consisting of a plan of organization and operation, submitted in the form of a number of resolutions, at the Ryde meeting, in 1881, which was unanimously adopted.

*Collective Investigation Record, page 2, July, 1883.

Sam. R. Burroughs, Chairman, Guy's Store, Texas.

Sir William Gull delivered, before the Metropolitan Counties branch of the British Medical Association, a most instructive and exhaustive address in support of collective research, in which he asserted that "the whole sympathies of his life were in the direction of this movement."

At the same meeting, and immediately following Sir William Gull, Sir James Paget delivered an eloquent, incisive and unanswerable argument in favor of this system of collection of data. His first sentences are of such intrinsic worth, and should admit of such broad application, we beg to repeat them. He said: "I cannot but admire how well a large assembly, such as this, representing, as it does, a yet larger association, has declared itself to be in the state of mind most favorable to the acquirement of knowledge-the state of partial ignorance. The list of questions which is published upon each of the papers sent out by the committee indicates that we are not ashamed to confess our doubts on some of the most important things that come before us; that we are prepared to start confessedly ignorant on many points upon which we are supposed to have complete and final knowledge. I think that, in common with most scientific men, we may hold that this, though rare, is a just state of mind, even though there are large groups of men, and those much esteemed, who rarely express doubt on anything, and thereby command the assent of those who listen to them. Certainly

APPENDIX-Report of Committee on Collective Investigation.

there is no state of ignorance so hopeless, so profound, as that which cannot even doubt."

The subject of collective investigation was brought to the attention of the International Medical Congress at its Copenhagen meeting, by Sir William Gull, and it is to be hoped that much good may be effected by international co-operation.

It was not until July, 1883, that the British committee were in condition to issue the first number of what they choose to call the "Collective Investigation Record." Anterior to this date, all communications to the members of the Association, and the profession generally, were made through the Journal of the Association; but the accumulation of data furnished by the returns, and other important material demanding the widest publicity, became so great that an imperative necessity arose for the relief of the Journal, in the publication of the material collected by the committee in the form of their various reports, in a separate volume. It is an octavo volume, containing nearly two hundred pages, and represents the judicious expenditure of a vast amount of clerical labor, zeal and energy, as well as serves as an index of the intellectual culture and administrative genius of the distinguished members of the committee.

This volume contains, first, a valuable report on the communicability of phthisis, based upon 1078 returns, which, together with many other facts of great worth, lends a strong color to the fast growing opinion that phthisis is communicable under certain restricted con

Sam. R. Burroughs, Chairman, Guy's Store, Texas.

ditions. However, on this point the committee says: "One fact these returns seem to establish beyond any question, and that is, that if phthisis is a communicable disease, it is so only under circumstances and conditions of extremely close personal intimacy, such as sharing the same bed, or the same room, or shut up together in numbers in close, ill-ventilated apartments.'

Of 405 observers, 261 affirm, 39 are doubtful, and 105 negative. "One hundred and ninety-two observers report cases of supposed communication of phthisis occurring between husband and wife."

If collective investigation can but establish truth with regard to this question, it will confer on the human race a benefit, the good effects of which will be felt throughout the limits of time. No more important question could demand elucidation; certainly, none could touch the delicate and treasured chords of the marital state; of society; the duration of life-the pendulum of average longevity-with a deeper or more acute stroke.

Following this, comes preliminary reports on acute pneumonia, chorea, acute rheumatism and diphtheria.

While these reports contain much valuable information, the number of cases on which they were, severally, based, was too small for general deduction and specific determination, and were wisely held over for the accumulation of numbers sufficient to warrant final analysis.

In July, 1884, the second volume of this estimable publication was issued, and it comes to us laden with many valuable truths; it contains a complete report on