These are the conditions, therefore, partly inherent in the progress of medical science and partly depending on the attitude of the public which are today determining the rapid increase of medical specialism; and we may now pass on to consider whether this trend toward specialism is really advantageous to the public itself. There can be no question, I take it, that up to a certain point, the development of specialists is not only desirable but necessary if the medical profession is to be thoroughly equipped to prevent the public from becoming sick and to restore them to health when they are suffering. Thus, for instance, in the application of the results of the most modern research in the basic sciences, both to the diagnosis and treatment of disease, it is important that the physician should be thoroughly trained in the principles of the underlying sciences if the patient is to derive the maximum benefit that medicine can confer. It is, therefore, well to have specialists in heart disease who, as students of experimental physiology and pathology, have acquired a knowledge of circulatory disturbances in animals which is subsequently of assistance in treating disease in man; to have specialists in diabetes who are at the same time competent chemists, since their experience in the laboratory is of daily help in regulating the diets of their patients; and to have specialists in infectious diseases who have devoted years to bacteriology because their observations on the course of infections in animals and the effect of sera and vaccines on experimental infections are of practical value at the bedside. There have also been many strictly clinical advances which are the direct outcome of the intensive study of disease in man. Among these may be mentioned the modern highly refined operative procedures. The surgery of the eye, the ear, the nose and throat, or the brain, for example, involves such intricate technical methods and such a high degree of manual dexterity that it is done best by the surgeon with constant experience and practice in the same general type of operation. It is entirely reasonable that all of us prefer to have our tonsils taken out by a laryngologist and not by a general surgeon, and such specialists in medical practice must be available in every community. In another quarter, moreover, and in one which is of vital, although of less immediate concern to the layman, the need of specialists is even greater. This is the field of medical research. Our knowledge of disease has advanced so far that further progress will probably be slow, and little is to be expected except as the result of prolonged and concentrated labor. The nuggets lying on the surface have been picked up and the hidden gold will be found only by him who digs deeply and whose training has taught him where to dig. Here is needed not only the specialist, but the specialist with that unusual gift of vision