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When in my own school I look around me and see these young men thirsting for opportunities for usefulness and distinction, I am often heartsick at our want of facilities for this purpose, and I long with an intense longing for some wise and munificent friend of humanity who will endow postgraduate scholarships, and laboratories for just such an end. Our hospitals do a magnificent work in charity, helping the sick and the forlorn, the weak and the suffering in a way which appeals to the charitable instincts of our fellow-countrymen, and to this appeal they have responded most generously. But I venture to say that the medical school which trained a Lister, a Pasteur, a Koch, has done more for humanity than all the hospitals of this country combined. The modest laboratory at Würzburg consisted chiefly of a Ruhmkorff coil and a Crookes' tubeand Roentgen. Other Roentgens and Listers we have among us if we but knew it. These are the men who are the world's real illustrious heroes.
It is especially in these days that in America we need such researches, for our tropical possessions have brought us face to face with new problems which we can only justly meet by the most careful investigations. It is to our credit that several of our medical colleges have already established schools of tropical medicine, which show that the profession, as well as the public, are rising to the level of our responsibilities and duties.
It is also a cheerful sign of the times that at Harvard a School of Comparative Medicine has been established, which will lead to other similar schools in connection with our medical colleges for the broad study of disease both in man and in the lower animals. All such knowledge should be correlated, and we may well learn from the diseases of animals how to care for man, as thus far we have learned chiefly from the diseases of man how to care for animals. The endowment of this school with the modest sum of $100,000 is an omen of future good. So, too, the somewhat similar school at Buffalo
bids fair to add immensely to our knowledge and therefore to our ability to heal.
What now has the American public done for the medical school? Let us contrast it with the endowments in theology. Our academic institutions have such an enormous sum-total of endowments that I do not even consider these. Let us, however, compare theology and medicine, remembering that theology is almost wholly a literary study, dealing not with the facts of nature, requiring no laboratories and no large corps of assistants and therefore conducted at a minimum of cost. In 1898 (United States Education Report) 84 theological schools reported endowments of $18,000,000; 71 schools do not report this item: 19 out of 151 medical schools report endowments of $1,906,072. Five theological schools have endowments of from $850,000 to $1,369,000 each. Yet in 1899 there were only 8000 students of theology for whom this enormous endowment was provided as against 24,000 students of medicine. Each theological student had the income of an endowment of $2250 provided for his aid; each medical student the income from $83. As against 171 endowed chairs of theology there were only 5 in medicine.
I do not grudge a dollar to the theologian, but I plead for his medical brother that, with a vastly more expensive education, he shall have a reasonable provision made for his training.
I have already indicated to some extent the direction which these endowments of medical schools should take. They may be classed in three categories:
First, the endowment of professorships. By doing this the present salary of the professor would be made available for the other wants of the school. The endowment may well take the form of a memorial, either of the generous donor, or, still better, of some distinguished former occupant of such a chair whose name would always add luster to it.
Secondly. The endowment of the laboratories which, as I
have indicated, are so costly, both in their installation and in their yearly expenses.
Thirdly. The endowment of post-graduate scholarships and research fellowships, these being intended especially for those who will devote their time to original research. Students cannot take much time for original research; their regular studies absorb all their energies. Research must be done chiefly by young graduates under the direction of stimulating and energetic members of the faculty.
It is not, I trust, too much to hope, if not now, that in the near future the American Medical Association will set a fruitful example by giving each year "Scientific Grants in Aid of Research." The first object of the Association must be, necessarily, to place itself on a strong financial basis. It should own its own building, its printing and publishing plant, and, as soon as possible, should have a reserve fund of considerable proportions. Nothing conduces to the stability and conservativeness of any institution like a good bank balance. The British Medical Association has to-day an excess of assets over liabilities of nearly $380,000, chiefly invested in its building at 429 Strand, London. The American Medical Association has made a fair start with a surplus of over $27,000 last January, and, with its large and, let us hope, rapidly increasing membership, it will before long assume a rank second only to the British Medical Association. Last year* the Scientific Grants Committee allotted £741, or somewhat more than $3500, for research work, distributed to three research scholarships, the holders of which were paid $750 each a year, and 33 grants in aid of research work, varying in amounts from $25 to $100. Among those to whom grants were made occur the well-known names of Beevor, Vaughan Harley, Kanthack, Leuff, Manson, Noel Payton, and Risien Russell. I should hope that the American Medical Association might even now begin by a modest appropriation, * British Medical Journal, 1899, ii, p. 219.
say of $500 a year, which should be allotted by the trustees, or by a special Committee on Scientific Grants, after a careful investigation of the merits and the character of the person to whom such grants were made. No grant should exceed $100, or possibly even, at first, $50 in amount. The results of such grants would be not only absolute additions to our knowledge, but the cultivation of a scientific spirit which would permeate the whole profession and elevate its objects and aims.*
In pleading for these endowments of medical schools, it is but a plea for a return to the profession of a tithe of what they have given. Two years ago I carefully investigated the value of the services rendered to the poor in the city of Philadelphia by the medical staff of the Jefferson Medical College Hospital alone, and I found that 129 medical men were then attached to the hospital and their services, calculated on a very moderate basis of the ordinary fees, I valued at over $500,000. To a profession which gives so freely of that which is most difficult to give, its own life-blood, surely the public for its own protection may give reasonable endowments to the medical schools. It will be returned to the community tenfold in better educated, better trained, and more successful doctors. More devoted, self-sacrificing men and women they never can have.
*I am glad to say that the Association has made such Annual Grants ever since this address, and they are already bearing good fruit.—(W. W. K., 1905.)
THE IDEAL PHYSICIAN.*
HEN casting about for a suitable topic on which to address you, I was much perplexed at first, but finally bethought me that perhaps I could not do you a better sevice than to sketch in very brief outlines the characteristics of the ideal physician. Let me address you, therefore, as aspirants for the realization of this ideal.
Few of us, perhaps, at the close of life, can say that we have realized our ideals. But unless we have a high ideal, the trajectory of our life will never have risen to any noble height. "Hitch your wagon to a star," said Ralph Waldo Emerson. Even though you fail you will more nearly reach the firmament than if you had never made the attempt.
The physician may be regarded from three points of view: (1) His personal life; (2) his professional life; and (3) his public life.
Personal Life.-The ultimate basis of esteem is personal character. Wealth for a time may lend its glamour; intellectual attainments for a time may dazzle the judgment; power for a time may achieve apparent success, but when the testing time comes, as come it must to every man when some great temptation to do wrong confronts him, wealth and intellectual power are as if they were not; character is the one thing that tells in this life and death struggle. Having that, you will win the fight and be crowned with the laurel of
*The Commencement Address delivered to the students of Rush Medical College in Affiliation with the University of Chicago, June 21, 1900. Reprinted from the Journal of the American Medical Association, June 23, 1900.