The 155th Field Ambulance, R.A.M.C., T.A., under command of Lt. Col. J. W. Keay, T.D., proceeded to Stobs Camp, Hawick, for a fortnight's training in the field, with the 155th Brigade, 52nd Division. Passes. The following have recently passed the Final Examination, and Triple Qualification have been admitted L.R.C.P.E., L. R.C.S.E., and L.R.F.P. & S.G.-Amy B. R. A. Perriton, India; Alexander H. Forman, Glasgow; Montague A. Watson, Southend; Edward N. Jamieson, Edinburgh; Matthew M. Tannahill, Glasgow ; Charles C. Robson, Edinburgh; V. C. G. Menon, India; Patrick Murray, Ireland; Harold V. Ritchie-M'Kinlay, South Africa; Cyril F. Deutrom, Ceylon; William A. Ekanayake, Ceylon; Samuel B. Jones, M.B.E., Antigua, B.W.I.; Harmanis Amarasinghe, Ceylon; Mary C. Semple, Paisley; James Donnelly, Greenock; Oliver H. D. Oliver, Corbridge; Sinnatamby Thambipillai, Ceylon; Archibald Menzies, Glasgow; Robert S. Caldwell, Paisley; Myer Goldberg, Edinburgh; Edward S. Greaves, British Guiana; James H. MacAlpine, Nyasaland; Sudhindra N. Bandyapadhay, India; James M. Anderson, M.B., Ch.B., Morayshire; Simon Levenson, South Africa; Arthur E. Coyne, Florida, U.S.A.; James G. O'Keeffe, St Helens, Lancs; Darwish M. Safwat, Egypt; Joseph F. Sweeney, Victoria, Australia; George M. Rose, L.D.S., Glasgow; Daniel T. Gemmell, Glasgow; Charles Campbell, Glasgow; Vernon Bell, Norden, near Rochdale; Donald M. Gray, Edinburgh; David R. Paterson, Glasgow; and Hillel Schulgasser, Lithuania. ANALYTICAL NOTES PRESCRIPTION GLAXO. THIS is a modification of Glaxo so prepared that when mixed with water in the proportion of 1 to 8 it gives a reconstituted milk of low protein content approximately in composition to human milk. It is indicated in cases in which, either from idiosyncrasy or feebleness the infant has difficulty in digesting protein, and in view of the difficulty of preparing milk mixtures of this composition in the ordinary way, it should be found useful. GLAX-OVO. THIS is a brownish powder which when mixed with boiling water makes a palatable beverage resembling good cocoa or chocolate. It contains the vitamin which exists in cod liver oil and malt extract, incorporated with milk powder and cocoa. It certainly makes a drink which is "grateful and comforting," and its merits are apparent in view of its composition. DORSILLA MILK FOOD. (PRIDEAUX'S PURE CASEIN CO., LTD.) DORSILLA is a dried milk produced in the famous dairy counties of Dorset, Somerset, and Wilts. It contains the full amount of fat, and is made up with the addition of milk sugar. When suitably diluted it is well adapted for the feeding of infants, and ensures a pure milk, free from bacterial contamination, ranking with Grade A certified milk. INSULIN. (MESSRS BURROUGHS, WELLCOME & Co.) INSULIN has been successfully prepared by Messrs Burroughs, Wellcome & Co. as one of their "Tabloid" products, each of which is equivalent to one average dose of 10 clinical units and which, when dissolved in 0.5 c.c. of sterile distilled water, is equivalent to an equal volume of standard Insulin, to which it has been found in all respects equal. The "Tabloid" product offers several advantages, not least of which are ensured sterility, stability, and accuracy of dosage. They are convenient to administer, are readily portable, and may be dissolved within the syringe. BOOKS RECEIVED. BEAUMONT, G. E., and DODDS, E. C. Recent Advances in Medicine. BUCHANAN, ANDREW. Midwifery Mechanics. (J. & A. Churchill) 10s. 6d. net. (Oxford University Press) BURRIDGE, H. A. An Introduction to Forensic Medicine. CULPIN, MILLAIS. The Nervous Patient. (H. K. Lewis & Co., Ltd.) John Smith & Co. (Glasgow), Ltd.) LIPSCHUTZ, ALEXANDER. The Internal Secretions of the Sex Glands. (W. Heffer & Sons, Ltd.) MARTINDALE, W. HARRISON, and WESTCOTT, W. WYNN. The Extra Pharmacopoeia. Vol. I. Eighteenth Edition. 7s. 6d. net. 10s. 6d. net. 10s. 6d. net ̧ 4s. 6d. net. 18s. net. 3s. 6d. net. 21s. net. 35s. net. Is. 6d. net. (H. K. Lewis & Co., Ltd.) 27s. 6d. net. MUIR, ROBERT. Text-Book of Pathology. (Edward Arnold & Co.) PAGE, C. MAX. British Red Cross Society Junior First-Aid Manual. (Cassell & Co., Ltd.) PAGE, D. S., and MORTON, EVA. The Pneumococcus and Pneumococcal Affections (John Bale, Sons, & Danielsson, Ltd.) ROAF, H. E. A Text-book of Physiology. (Edward Arnold & Co.) TANKARD, ARNOLD ROWSBY. Stepping-Stones in the Progress of Science (John Bale, Sons, & Danielsson, Ltd.) TOCHER, J. F. The William Ramsay Henderson Trust Reports. A Record of Measurements, Weights, and other Facts relating to Man. (Oliver & Boyd) TRANSACTIONS OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA. . WESSELOW, O. L. V. de. The Chemistry of the Blood in Clinical 16s. net. 25s. net. Is. 6d. net. (Ernest Benn, Ltd.) 15s. net. Edinburgh Medical Journal December 1924 THOUGHTS ON MEDICAL DISCOVERY.* By SIR RONALD ROSS, K.C.B., K.C.M.G., F.R.S., Director in Chief, the Ross Institute and Hospital for Tropical Diseases, London. WHEN you did me the honour of inviting me to deliver the Inaugural Address this evening, I determined to risk your indulgence by taking as my subject not any particular line of medical work, but the wider theme of Medical Discovery. By the word "discovery" I mean any advance, however small, in general knowledge; and by the words "medical knowledge" I mean all those branches of knowledge which are concerned in the prevention or cure of disease of any kind. Discovery is thus the increment, the differential coefficient of the curve of knowledge; and I propose to submit for your consideration to-night some thoughts which I have long endeavoured to mature regarding what may be called "the natural history of discovery," especially how it came to be made in the past and how it can best be encouraged in the future. On commencing a preliminary survey of the field, we shall see at once that discovery and the process of search (which sometimes leads to discovery) are very common phenomena in the whole of Nature. Thus rivers and winds and even the solid masses of the mountains are compelled to seek and to find their most convenient courses and configurations. Plants and animals must not only discover their food but also those environments which suit them best; and in the higher scales of animal life, in the nests of bees, ants, birds, and many mammalia, we observe more conscious efforts of research and discovery always proceeding in the wonderful world around us. When we come to man we witness the higher development of the process in modern science and civilisation. Being the Inaugural Address of the 188th Session of the Royal Medical Society, delivered at Edinburgh, 17th October 1924. What strike us most in the picture are, first, the amazing extent and yet the slowness of the advance; and secondly, its intermittent or, rather, its undulant course. How many centuries have elapsed since our ancestral species first descended from the trees and took to hunting on the hard ground not even the palæontologists can tell us with certainty: evolution itself is a part of discovery, unconscious or conscious. After that, weapons, habitations, and clothing were, we may opine, the earliest discoveries; and then came crops and herds, fire, boats, and wheeled vehicles, the use of animals for draught or riding, fortifications, villages and cities, and social ordinances. We are not disposed to contemplate with pleasure or pride the earliest members of our own profession, the "medicine men of savage tribes; but nevertheless they must have been not only the first physicians but also probably the first priests and philosophers. In the barbarous tribes of to-day-as for instance the Andamanese, which I know-we can still witness the position reached by men before the subsequent accumulation of discoveries and inventions created what we call our present civilisation, our own age of engines, electricity, radiations, and scientific inquiry into everything. The interval is immense. I have heard it argued, on the contrary, that after all discovery and invention have not given us much; but one wishes that those who say so would go and live, let us say, in an Andamanese jungle without even clothes and bows and arrows-which were only the first gifts of discovery! But, as I said, the advance has been amazingly slow until recent times. We cannot estimate the ages which were required to evolve such simple implements as pottery and bows and arrows. The Stone Age and the Bronze Age occupied many millenniums before we came to the Iron Age. Seven thousand years have elapsed since the earliest known civilisations of Egypt, Mesopotamia, India, and China; and, until the last few centuries, life was not so very different in Europe to what it was in those countries so long ago. Personally, I always suspect that the archæologists underestimate the depths of the past; or that still older civilisations will be disclosed some day. What untold numbers of human beings have existed since those times! and yet progress has been so slow. This is my first point. If I were to argue that on a general average not one man in a million ever adds anything to general knowledge, I should probably be greatly overestimating the proportion. This is an age of discovery, and yet the suggested proportion is conceivably too high even for to-day. What must it have been in many previous times? We know from history that whole ages have elapsed without adding any noteworthy discovery or invention to the stock of human knowledge. Civilisations have grown up in single spots and then dwindled away, leaving great periods of time during which not only have no advances been made but previously acquired knowledge has faded and been forgotten. Sir Flinders Petrie, in his remarkable Revolutions of Civilisation (Harper, 1912), recognises no less than eight cycles of alternating advance and decay in Egypt during the last ten thousand years. In each of these, progress in discovery, invention, and art occurred only during a short period at the height of the cycle and was then followed by decay. One reads much the same thing in the histories of China, India, Mesopotamia, Greece, and Rome. In the slack periods, little or no additions to knowledge at all are made. The history of science is eloquent on the point. For example, ancient mathematics practically began with Thales and Pythagoras about 620 B.C. and almost ended with Diophantus about A.D. 280-a period of only nine hundred years. This was followed by almost utter darkness as regards mathematics for a period of twelve hundred years, until the renaissance of the science with Ferro, Cardan, and Copernicus in the fifteenth century. Now it is remarkable that the same great period of Græco-Roman mathematics covers also the great periods of Græco-Roman philosophy, medicine, literature, art, and military predominance, all of which commenced and ended at about the same epochs. These are well-authenticated facts: what is the explanation? Is it that the intellectual efflorescence of nations is limited by some great law of Nature which we perceive only dimly at present ?-that there is some periodic law as regards the vigour of nations, which automatically ordains their advance and their decay? If we can define science as the discovery of natural laws, invention as the discovery of processes, and art as the discovery of beauty, we shall obtain a single formula to include all those movements which make for what we call civilisation; and from the very brief survey which I have just attempted we can already extract two propositions with certainty, namely, that discovery is a rare phenomenon, and secondly, that it tends to be closely localised both in place and in time. After the Græco-Roman |