35. THE NEW BIRTH OF MEDICINE

by Sir Clifford Allbutt

By the new birth of medicine I mean its enlargement from an art of observation and empiricism to an applied science founded upon research; from a craft of tradition and sagacity to an applied science of analysis and law; from a descriptive code of surface phenomena to the discovery of deeper affinities; from a set of rules and axioms of quality to measurements of quantity. When I turn back to the medical textbooks of my pupilage, to the wise and scholarly Watson, or the respectable Alison, and contrast them with the textbooks of today, I marvel that a change so vast, so profound, so revolutionary, should have come about in one lifetime. Many a generation had to pass before Harvey's researches established animal mechanics; many again before the half-lights on animal heat of Willis, Mayow, and Boyle were brought to quantitative verifications. In Medicine observation cannot carry us very far, not so far, let us say, as in astronomy; and skill and sagacity, if they do not die with the individual, keep in the axioms and exercises of the school but a transitory life. No observation of a thunderstorm could unravel its affinities to the action of a load-stone on a scrap of iron; no observation of diet could reveal the relation of food protein, by way of the amino-acids, to the tissues; no observation bestowed on scurvy or beri-beri could detect the occult and elusive but all-potent influence of the vitamins; no observation of secretory and muscular action could reveal the play of surface tension in muscular contraction, nor its relation to lactic acid and oxygen. By what sagacity could the shrewdest observer, let us say of heart disease, perceive the likeness of the formations of a soap bubble, or a raindrop, to the contraction of a muscle fibre in terms of its length; or that muscular contraction is not so much a chemical as a physical system with a negative temperature co-efficient? Again the relation of the hormones to the development of men and women, and to the phases of their respective organs of growth, function, and of reproduction, is an issue of the academic laboratory. The prodigious harvest in the present campaign that Medicine has reaped from the original researches of a chemist into the occult causes and laws of fermentation by microbes, and from a field apparently so alien as of the silk-worm disease, we are now celebrating.

(from Science in Writing, compiled by T. R. Henn (Harrap, 1960))