The place of the university in medicine.

Present state of medicine The central role of the university in medicine is the prosecution of teaching and research. In this it resembles other subjects but medicine differs in the intensely personal nature of its practice. The late Sir James Spence (a great university man in medicine and one of our most distinguished Schorstein Lecturers) once said, ‘The essence of Medicine is the solemn occasion when, in the privacy of the home or the consulting room, a person who is sick, or thinks he is sick, asks for help from the doctor whom he trusts.’ An unfortunate consequence of this personal professional relation has been the tendmcy for doctors to treat with suspicion, and even with antagonism, any outside influence which might endanger or disturb it. During the past two centuries there has been a wide variety of such influences religious, philosophical, pseudoscientific, genuinely scientific, economic, and political. It has been the British tradition, following the teaching and example of the great Sydenham, to reject such deviations and to hold tenaciously to the central discipline of clinical medicine. In the past few decades, however, there have appeared two major influences which cannot be ignored or rejected, for they have extended the range of medical activity and responsibility far outside the purely personal. These are, first, the increasing complexity and sophistication of our society, and second, the revolutionary advances in the exact sciences with their inevitable application to diagnosis and treatment. Both these major influences are continuing to have widespread