ing as to the full influence of research. The advantages to the community resulting from research in medicine are advantages because re"search has done away with conditions which were disadvantageous to the health, the happiness and prosperity of the community—in short such research has removed the impediments to a higher, happier and more prosperous civilization. It is necessary, therefore, in order to emphasize the importance of what has been accomplished, to portray the conditions of community life and individual hygiene, of medical practise and medical thought, and of science and philosophy at such periods as immediately precede definite advances in medical knowledge. The first of these lectures, then, bringing the story down to the beginning of the nineteenth century, will be presented from this point of view. The second lecture devoted to the influence of physics and chemistry, and the third to the rise of bacteriology, will outline the development of laboratory methods of investigation, the story, essentially, of medicine in the last half of the nineteenth century. The fourth lecture will be a survey of present-day methods and problems, and the fifth lecture will be a discussion of the position of medical research in America, its facilities, needs and opportunities, with special reference to medical research as a function of the university.
Of medicine in the earliest stages of its development we have no knowledge. Not until we arrive at a period of civilization as highly developed as that of the Assyrians and Egyptians do we find references to the practise—the studied practise—of medicine as a healing art. For all that precedes that period we must rely on analogy with medical practises among the aboriginal races to-day. But we can, nevertheless, safely assume that the healing art in all times, no matter how simple its form, was the practise of methods having for their object the relief of pain or the repair of injuries caused by mechanical means. Such methods must have been, at first, instinctive and empiric, or the result of chance observation. Some may, indeed, have been analogous to the methods which an animal adopts to cleanse a wound or protect an injured limb. The use of irritants, of emollients and of scarification, the binding of wounds, the mechanical support of a fracture and assistance in childbirth are primitive practises doubtless resulting from chance observation or experience. It is readily conceivable that the use of stone tools and weapons in hunting and in war may have originated the idea of intervention by operation; and that surgical dexterity may have increased proportionately to the improvement of weapons in the bronze age. Likewise it must be assumed that chance experience led to a knowledge of the action of the vegetable and mineral substances of the early materia medica. But of these beginnings we have no historical knowledge.
Our first authentic knowledge of medicine, fragmentary though it