6. Estimated from: Directory of International Scientific Organizations. Paris, UNESCO, 1950. 7. Estimated from: List of International and Foreign Scientific and Technical Meetings, July 1, 1958. Washington, National Science Foundation, 1958. Quarterly. 8. U. S. House of Representatives. Commerce. Committee on Interstate and Foreign Hearings. . . on Amendments to National Science Foundation Act and Related Legislation, May 13–16, July 24, 1958. Washington, GPO, 1958. 9. Science Liaison. Paris, UNESCO, 1954. 10. World Health Organization. The First Ten Years of the World Health Organization. Geneva, W. H. O., 1958. 11. Council for International Organizations of Medical Sciences (CIOMS) Bulletin. 9:23, Jan.-Je., 1958. 12. European Scientific Notes. London, U. S. Office of Naval Research. 13. World Medical Periodicals. N. Y., World Medical Association, 1957. 2d ed. 14. Glass, H. B. The New Orleans Conference of Biological Editors. AIBS Bulletin, 7 (3): 21–23, 1957. 15. Conference of American Scientific and Technical Abstracting and Indexing Services. Proceedings. Philadelphia, Biological Abstracts, 1958. 16. Scientific and Technical Translating. Paris, UNESCO, 1957. 17. Adams, S. Problems in Communicating Russian Science. Federation Proceedings 16: 716–720, 1957. 18. Kipp, L. J. The International Exchange of Publications. Wakefield, Mass., Murray Printing Co., 1950. 19. United States Book Exchange, Inc. % Library of Congress, Washington, D. C. A BRIEF HISTORY OF AMERICAN MEDICAL RESEARCH Organized medical research in the United States began with the opening of the Johns Hopkins Medical School in 1893, according to Sigerist (American Medicine, W. W. Norton & Company, Inc., 1934). Almost the same date, 1895, is chosen by another historian, Shryock (American Medical Research, Commonwealth Fund, 1947), as marking the beginning of what he calls the fourth epoch of American medical research-its emergence from colonial status to approach its present level of independence. Three earlier epochs are described by Shryock. The first, from mid18th century to about 1820, was marked by influence of the British. The second, lasting until about 1860, was influenced by French methods and teachings. And from 1860 to 1895, the German influence gave the inspiration for most medical research in America. Before 1820 very little was accomplished in medical research in this country, although progress in the physical sciences was significant and valuable observations were made in taxonomy. Lack of facilities and support hampered medical research during this period and for some time thereafter. Physicians were dependent on practice for a living. Those who studied abroad and saw research carried on in European countries were, for the most part, unable to engage in such unprofitable and ill-appreciated activities on their return to America. Medical schools were founded, but they were for the training of practitioners. Medical societies and journals came into existence, but again the emphasis was on practice. As Sigerist points out, there were no centers of learning which could in any way compare with those in Europe. Above all, there was missing "intellectual resonance, a mutual reverberation of ideas. Whoever gave up money-making to live for science was considered a crank." It should be pointed out here that while European influence on medical research in America was relatively short-lived before the last part of the 19th century, European contributions to medical and health knowledge and practice were strongly influential. Sigerist explains the time-lag in the development of research in America along the lines of that in Europe as follows: In every country which has been opened to western civilization, we can distinguish three successive stages in its relation to medicine. During the first stage, the population is indeed ready to accept treatment from academicallytrained physicians, but the means and the teachers to train these physicians do not as yet exist. They must either be imported, or the native sons must be sent abroad to study. In the second stage, the point has been reached where this training can be undertaken at home. The number of physicians has increased. Many of them keep in constant touch with scientific progress abroad, make this knowledge their own, and pass it on to their pupils. But it is as yet beyond their compass to undertake independent scientific work, to attack problems of medical research on a large scale. To be sure, we find at this stage individual men who are in advance of their time, but these are isolated examples and are moreover handicapped by lack of necessary equipment. In the final stage, research work has been introduced and is being pursued with greater and greater intensity. In the beginning, the assistance of foreign scientists, or native scientists educated abroad, will still have to be called upon, till there has been time to train a new generation to take their places. Only when a permanent institute of research has been established, can medicine be really said to have taken root. Science is the living source from which the practice of medicine derives its daily sustenance. If the source is too distant, practice becomes parched and devitalized. Every physician and every medical institution ought to keep in constant touch with scientific research. To stand still is to regress. America, too, has advanced along this line of development. In colonial times and even in the nineteenth century, medical students went abroad for their academic education. Then followed the founding of countless schools for the training of practitioners. Finally, with the opening of Johns Hopkins Medical School in 1893, there was established a scientific center of the first rank and with it the beginning of organized research. From this moment America ceases to be merely a passive recipient of knowledge. It takes its place in medical science. It begins to collaborate in the solution of medical problems. Slowly at first, but always faster and faster, the process of evolution unfolds. Young men are embracing research with overwhelming enthusiasm. And today America is beginning to pay its debt to Europe. These lines were written in 1934. In the last two decades, American medicine has gone far toward paying its debt to Europe, and the flow of students has reversed itself, turning in the direction of the United States. Individual physicians in America all through the pre-1893 period did make valuable contributions. In the earliest period, these were often made under great difficulties. Notable were the investigations of William Beaumont, U. S. Army surgeon, who first studied the process of digestion in the human stomach. A report of his findings, published in 1833, has become a classic. Beaumont was astute enough to take advantage of what has been called a lucky accident-that of having cared for a patient with a gunshot wound of the abdomen which failed to close. Heretofore studies of digestive processes had been made on animals. Although working in the backwoods, with a patient who ran away time and again, Beaumont was able to discover that the human stomach secretes mucus and gastric juice and to observe the gastric movements. He noted that digestion is influenced by psychic occurrences to a great degree, learned the effects of tea, coffee, and alcohol on digestion, and studied the digestion of individual foods. Most of the contributions of the century were in the realm of practical medicine, especially of surgery. The technical skill which characterizes Americans led naturally to the development of surgeons and to appreciation of their accomplishments by a people unusually able to understand technical developments, and unusually impatient for quick results. Yet, so far as research goes, when John Billings in 1876 wrote A Century of American Medicine, he was able to describe the total achievements of scientific study in a single chapter. The early English influence, according to Shryock, seems to have become somewhat of a handicap to progress in medical research in America. It imbued its followers with the idea of systematizing pathology and therapeutics. Since knowledge in these fields had not progressed enough for real systematizing of the kind that was then proving useful in the physical sciences, the result was a return to |