Medical Science and the Future †

In 1810 when this School was established the average expectation of life of a child born in that year was 34 years. A child born today can look forward to a life span of somewhat more than 70 years. Thus the expectation of life of Americans has doubled during the 150 years of the existence of this School of Medicine. Only 50 years ago the death rate from all causes was twice as great as it is today. In the case of certain diseases medical research during the last half century has brought about almost unbelievable reductions in the fatality rate. Pneumonia, termed by Osler at the beginning of this century as the most fatal of all infectious diseases, now has a mortality rate about one tenth of that prevailing at that time. Deaths of children from infectious diseases are only a fiftieth of that at the beginning of this century while death from the hazards of childbirth has fallen to a comparable extent. When I became a medical student, and I hasten to add that this was less than 50 years ago, I was taught that severe diabetes and pernicious anemia were incurable diseases. Surgical intervention for brain tumors was regarded as a hazardous procedure to be attempted only by very few. The surgical relief of certain types of heart disease, whether congenital or acquired, was not even contemplated. Today we all know that diabetes and pernicious anemia are controllable, while the extraordinary achievements of surgery, not only in the relief of diseases of the central nervous or circulatory systems but in other previously unapproachable areas of the body, excites our awe and admiration. It would seem quite appropriate, therefore, that when we are gathered to celebrate the 150th anniversary of one of the schools of medicine in this country, we should inquire into the reasons why these remarkable changes in our ability to subdue at least some previously fearsome diseases has come about. We do this recognizing that much remains to be accomplished. Cancer, heart disease, and the distressing consequences of mental disease still exact a large and increasing toll. Nevertheless, the achievements of