Science and Medicine 217cine. “All else which may go under the name of medicine,” declared a
president of the AMA, “is sham and fraud.”^78 A Canadian physician ad-
dressing students at the McGill University Medical School argued that if
practitioners of medicine did not “approach their patients with the cer-
tain method and moral force of a scientist,” they were no better than
“tradesmen who trade in medicine; men not much better than quacks,
who by superfi cial observation and improper criticism remain at a low
mental and moral level all life.”^79 And so it seemed.
Scientifi c medicine became so inextricably identifi ed with the labora-
tory that many practicing physicians felt left out. Thus in 1900 the editors
of the Boston Medical and Surgical Journal called for a redefi nition of the
term to make it inclusive of the activities of clinicians observing at the
bedside as well as scientists working in the laboratory. While acknowledg-
ing that the growth of laboratory medicine represented “the most impor-
tant advance of the past few years,” the editors noted that
the use of the word “scientifi c” in a narrow sense as applied to laboratory
work had done much to arouse prejudice and establish false standards. By
degrees there had grown up a distinction, heard on every hand, between
what was termed “scientifi c medicine,” and “practical medicine,” naturally
with the implication that practical medicine as personifi ed in the practitioner
was not scientifi c. In other words, “scientifi c” as popularly used in medical
writing and discourse demanded a laboratory and the accessories a laboratory
implies, whereas the man who examined his patients from day to day in most
painstaking and accurate fashion should be looked upon perhaps as a faithful
and conscientious practitioner but not as a scientifi c investigator.The image of the laboratory had become so dominant “that he who often
aimlessly looks through a microscope, or with narrow vision describes a le-
sion, is placed upon a pedestal as a man of ‘scientifi c’ tendencies, while his
colleague who faithfully describes a symptom is denied any such distinc-
tion,” continued the editorial. “In the popular mind all that is accurate and
‘scientifi c’ has come to be regarded as a product of laboratory methods.”^80
Well into the twentieth century and even the twenty- fi rst, some phy-
sicians continued to grouse about too little science in medicine and too
little appreciation of what there was, no matter how much patronage and
acclaim came their way. They saw scientifi c medicine under siege by a host
of antivivisectionists, right to lifers, and alternative healers. They witnessed
medical schools turning from scientifi c workshops into profi t centers run
by unsympathetic managers and falling “prey to unprecedented levels of
greed, commercialism, and intellectual dishonesty” vaguely reminiscent