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case but its family environment and its physical background. He is constantly striving to find the incipient causes of disease and to deal with those causes before they reach their deadly fruition. He must be much more than a physician in order to fulfil this task; for he must have a knowledge of bacteriology and sanitation, of health administration and statistics, above all of social relationships and social machinery which the curriculum of even the best medical schools can not attempt to supply.

So the public health nurse must be a trained nurse skilled in the relief of suffering and the bedside care of the sick, but she must be much more. Her work is primarily that of the health teacher, the messenger who carries into the home and interprets to the individual mother the gospel of good health. She must work largely alone, not under the immediate direction of a physician. She must know her bacteriology and her physiology, her sanitation and hygiene, well enough to teach their principles to others; and she too must deal with the individual, not merely as an individual, but as an element in a complex social group.

The bacteriologist in the laboratory and the epidemiologist in the field are two more of the specialists needed, whose work is concerned primarily with the war against the community infections. The former offers aids in early diagnosis and prepares sera and vaccines for the prophylactic and therapeutic treatment of these diseases; the latter by his detective work makes it possible to trace out the subtle pathways of infection by which they spread from one person to another through the complex web of community life. The public health or sanitary engineer is again an engineer plus. He must have mastered the underlying sciences of physics and chemistry, of structures and hydraulics, and he must also be familiar with the technical applications of his art to the particular problems of sewage disposal and water supply, ventilation, illumination and the like.

The statistician correlates and analyzes the records of births, deaths and illnesses, keeping an expert finger as it were on the pulse of

the nation's health. His work is the bookkeeping of public health, indicating the lines of profitable expansion and furnishing us with the credit balance of lives saved to the community as a result of various public health endeavors.

In the case of each of these experts, and in the case of the social worker who is operating in the field of public health, there is required sound elementary education in some fundamental branch of science with the addition of specific training in its applications to the field of public health. For the nurse who desires to become a public health nurse there are offered four-month and eight-month courses of special training in public health nursing. The physician who desires to become a public health physician, the engineer who desires to become a sanitarian, the bacteriologist who desires to become a public health bacteriologist, the social worker who desires to apply a fundamental knowledge of the principles of social readjustment within the field of public health, must similarly undergo a special training, if their services are to be made promptly and fully available. It is for this purpose that our leading universities and technical schools offer the Certificate in Public Health, which like the Master's degree is the equivalent of a year's graduate study. The C.P.H. course gives to the medical graduate the special training needed to equip him for the application of medicine in the field of public health, and in the same way enables men and women who have had college training in the fundamentals of bacteriology, engineering, sociology or statistics to fit into their special places in the general scheme of health protection.

To turn from these special phases of the public health campaign to the organization of the movement as a whole, it seems probable that the ideal public health administrator of the future will be the man or woman who has been first medically trained and has then specialized in a school of public health. If I am right in my belief that the public health movement of the future will go far in the direction of including medical and nursing service within its ample bounds, it is clear

that a man who has both a medical and a public health training will possess peculiar advantages as an administrator. It is for this reason that the principal eastern universities offer the highest degree in this field, the Doctor of Public Health, only to medical graduates and require that it be earned by a rigorous course of two years of academic study.

It will be long, however, before the supply of doctors of public health is nearly adequate to the demand, and for some time to come administrative positions, as well as laboratory and statistical positions, and those concerned with social reorganization, will be open to the college man or woman of marked ability who devotes a single graduate year to study for the Certificate in Public Health.

It can be said with very literal truth of the field of public health to-day that the harvest is ready and that the laborers are few. On all hands there comes to us the call for bacteriologists and statisticians, for industrial physicians and school physicians, for public health nurses, and for health officers. The American Red Cross is inaugurating a nation-wide campaign for the development of health centers throughout the country. Each one of the thousands of health centers to be started under this plan will call for an expert personnel which does not exist at present. The state of Ohio has just conducted a civil service examination for a list of candidates for 110 positions as full-time health officers within that state, at salaries ranging from $2,000 to $6,000 a year, with permanent appointment under the civil service law; and it was necessary for the state to organize a special course of instruction in order to have anything like the number of fairly qualified candidates for the responsible positions within its gift.

The science and the art of public health have progressed to a point where they can render to the public a service to be measured in the saving of hundreds of thousands of lives in this country every year. Public authorities and private agencies from one end of the land to another are realizing these possibilities of service and are ready to provide the necessary

funds and to give the necessary powers to properly qualified experts. The lack in the whole scheme of things at the present moment is the lack of personnel. As a prominent official of the Rockefeller Foundation said to me the other night, "The way they are appropriating money for public health in the southern states frightens me, because we haven't the men to send to them to help them spend it wisely." We stand, I believe, at the beginning of a new phase of human history, a phase in which the physical and mental health and efficiency of the human being will be transformed by science as the physical background of civilization has been transformed in the past half century. In the name of the need that confronts us for the personnel to carry on this work I believe we have the right to say boldly to the college men and women of America that we need them in this great business. We can promise to the college graduate, whether his leanings be toward work in the laboratory, toward sanitation in the field, toward the tasks of social propaganda and social reconstruction -we can promise to the medical student, and we can promise to the graduate nurse that each and all of them will find in the public health movement of the future careers which will compare favorably in security and in material rewards with the average return which is won by the college and medical graduate in other fields. Above all we can promise the opportunity of a kind of service which brings a satisfaction deeper than any material reward. There are great unsolved problems waiting for the Pasteurs of the future. Influenza, pneumonia, cancer and the rest of the unconquered plagues will some day yield to the patient assault of science, and it may well fall to the lot of young men who are entering our laboratories to-day to write the obituary of these diseases as Walter Reed did that of yellow fever in 1900. Two of Reed's letters to his wife after he and his associates had made the great discovery that ensured the conquest of yellow fever in the ensuing year, are so full of the solemn dignity of such a victory that I will quote them.

Six months ago, when we landed on this island, absolutely nothing was known concerning the propagation and spread of yellow fever-it was all an unfathomable mystery-but to-day the curtain has been drawn.

And later on New Year's Eve, he wrote:

Only ten minutes of the old century remain. Here have I been sitting, reading that most wonderful book, "La Roche on Yellow Fever," written in 1853. Forty-seven years later it has been permitted to me and my assistants to lift the impenetrable veil that has surrounded the causation of this most wonderful, dreadful pest of humanity and to put it on a rational and scientific basis. I thank God that this has been accomplished during the latter days of the old century. May its cure be brought out in the early days of the new.

Yet we need not wait for any of the great discoveries of the future to make the public health campaign of the present day bear fruit. We want sanitary statesmen as much as investigators. We need organizers and propagandists for the cause of health, capable of building wisely the great scheme of health protection of the future and of enlisting in its support the enthusiastic cooperation of the peoples of the earth To the administrator, as much as to the investigator comes the consciousness of a reward for his labors, fuller and more immediate than that which can be earned in many walks of life, for he can know that in a given city in a given year so many hundreds or thousands of men and women and children are alive and well who would have been in their graves except for him. What old Sir John Simon said of industrial diseases is true of every kind of preventable malady which afflicts mankind.

The canker of... disease gnaws at the very root of our national strength. The sufferers are not few or insignificant. They are the bread winners for at least a third part of our population. . . . That they have causes of disease indolently left to blight them amid their toil. . . is surely an intolerable wrong. And to be able to redress that wrong is perhaps among the greatest opportunities for good which human institutions can afford. C.-E. A. WINSLOW

YALE SCHOOL OF MEDICINE

THE ORGANIZATION OF RESEARCH1

THIS is an age of organization. Almost within the lifetime of some of us the industries, with the exception of agriculture, have passed in large degree from the individualistic to the corporate form. Combinations not merely of national but of international scope exercise a large measure of control over manufacturing and commercial activities, while associations of the greatest varietycommercial, charitable, reformatory, laborhave multiplied until their name is "legion." Almost every conceivable calling, from the midwife's to the undertaker's, is organized. Since science is a product of human activity its methods must necessarily be influenced by the spirit of the time. In particular, the successes of groups of scientific men in making important contributions to the solution of the technical problems raised by the entry of the United States into the world war has led to an emphasis upon the advantages of organization and cooperation in research which was very much in evidence at the last meeting of this association. This was particularly evident, perhaps among the biologists where it was, in the words of another, the dominant note," but the same note has been sounded by various prominent writers both before and since that meeting. It seems desirable, therefore, in view of this apparently strong trend of both public and scientific opinion, to inquire somewhat carefully into the extent to which it is justified and as to the probability that a more complete organization of research will enable it to render more efficient public service. In attempting to do so I shall, of course, have reference particularly to agricultural research-implicitly if not explicitly.

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In the early history of science, research was necessarily upon an almost purely individualistic basis. Men of genius here and there were laying the foundations of the present amazing superstructure not only without

1 Address of the vice-president and chairman of Section M-Agriculture, American Association for the Advancement of Science, St. Louis, December, 1919.

public support but subject sometimes to scorn and even persecution but more often to an indifference not reaching the level of contempt. By slow degrees, however, it began to dawn upon the public that the investigations of these dreamers really had some significance for the practical conduct of life. Very gradually at first, but with an accelerated velocity as time went on, the scientist came to be recognized as a useful member of society although even yet he seems too often regarded in the light of a sort of "medicine man who can be called upon to work magical incantations in times of need or peril or as a magician who, by some sort of legerdemain, can accomplish the seemingly impossible.

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Along with this growing recognition of the economic and commercial value of its results, scientific research began in time to be regarded more and more as a public function and to be more or less adequately supported, either by private endowment or notably by governmental action. The latter has been especially the case with agricultural research. I need not rehearse to this audience the familiar story, beginning with the foundation of the first public experiment station at Moeckern in 1852, the growth of the European experiment stations, the founding of the early American stations by state action, the enactment of the Hatch and Adams Acts, the increasing appropriations by the states and the enormous growth of the United States Department of Agriculture. For agricultural research it has been a period of expansion and organization upon an unprecedented scale and it is scarcely to be wondered at that the real nature of the end aimed at was sometimes lost sight of in the consideration of the means by which it was to be reached nor that the proper freedom of research should have been in some degree menaced, on the one hand by bureaucratic administration and on the other by the pressure for immediately useful results.

It is unnecessary to remind you that this tendency gave rise to a wholesome reaction. For several years it appeared necessary to stress the fundamental significance of the in

itiative and independence of the individual investigator but by the time the United States entered the war it may be said that this view had received fairly general recognition and there was perhaps a tendency to excessive individualism and a certain lack of coordination and cooperation in agricultural research. With our entry into the war began a new era in scientific activity as well as in world politics. Urgent war needs led to a concentration of scientific effort upon special problems of the most varied character and to a degree of cooperation and coordination until then unknown. The results were almost spectacular and as a natural consequence there has come a revival of interest in cooperative work and the demand for better organization of research which has already been referred to. Probably the most conspicuous as well as the most familiar example of this is found in the statement made by The Hon. Elihu Root before the Advisory Committee on Industrial Research of the National Research Council.2 He says:

Scientific men are only recently realizing that the principles which apply to success on a large scale in transportation and manufacture and general staff work apply to them; that the difference between a mob and an army does not depend upon occupation or purpose but upon human nature; that the effective power of a great number of scientific men may be increased by organization just as the effective power of a great number of laborers may be increased by military discipline.

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The fact remains that while the rest of mankind has gone far along the way which we (the scientific men) have discovered and pointed out we still remain largely isolated and intrenched in the feudal towers of our individualism. Here behind moat and wall we shape and fashion those intellectual darts with which at our annual tourneys we hope to pierce the haughty pride of some brother baron. Yet common sense, the common good, the very progress of our profession demands that we abandon this ancient outworn attitude.

And Coulter says:

Our isolated, more or less competitive investigations have resulted in a certain amount of progress; but it has been very slow compared with what cooperation would have secured.

Nor do the advocates of organization lack apparently convincing examples of success in scientific cooperation. Not to speak of the striking wartime achievements in the applications of chemistry, physics and engineering, one may name such typical illustrations in the field of agriculture as those cited by Shear, namely, the cooperative work of several bureaus of the Department of Agriculture upon the chestnut blight problem and upon the spoilage of fruits and vegetables in transit and especially the work of the War Board of the American Society of Phytopathologists, while in a related field the work of the Interallied Scientific Food Commission, although cut short by the German collapse, may also be cited. Shear speaks of this trend cooperation as a "tide in the affairs of men."

But not withstanding all these emphatic dicta, may it not be well to call a moment's halt to consider whither this tide is carrying us and whether it really "leads on to fortune." May there not be a certain danger of overlooking the significance of the individual? We must beware of being stampeded by the brilliant successes of the war time into an undue exaltation of the virtues of cooperation and organization. Both are doubtless very valuable but many of their ardent advocates seem to overlook the fact that the recent highly successful essays in cooperation which they emphasize were chiefly directed to the solu4 SCIENCE, April 18, 1919.

5 Scientific Monthly, October, 1919, p. 342.

tion of immediate technical problems by the application of knowledge acquired largely by individual research. The striking results of war-time cooperation were very largely of the nature of inventions rather than of discoveries. The achievements in sound-ranging, in ballistics, in submarine detection, in aviation, in gas warfare, in the control of plant diseases and the like were possible only as the fruition of long and patient researches into the fundamental laws of physics, chemistry, and biology conducted quietly by individuals or by little groups without public notice or applause. It is just as true to-day as it ever was that the permanent and significant advances of science depend in the last analysis on the initiative and originality of individuals. Nothing can alter this fundamental fact.

But on the other hand the fullest recognition of the paramount importance of the individual investigator should not blind us to the great significance of the experiences of the last few years. Let us first consider what they teach us as to the sort of problems best suited for cooperative effort. What is the field of cooperation as contrasted with individualism?

As just noted, the problems of war-time cooperation were largely the problems of practise and it is these practical problems which seem to offer the greatest opportunity for cooperation. Such problems, however, constitute one extreme of an intergrading series whose other extreme is the problems of socalled "pure" science. Using Coulter's® terminology and speaking of the former as superficial and of the latter as fundamental problems, it may be said that in general as we pass from the superficial toward the fundamental, cooperation becomes a less and less promising method for research. Usually the best thing that can be done for the man of scientific vision, who is capable of the most fundamental kind of research, is to supply him with the necessary equipment and facilities and then let him alone. Committees and cooperators are in danger of being hindrances rather than helps. Comparatively few of us 6 SCIENCE, April 18, 1919, p. 365.

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