Huntington Memorial Hospital and USC School of Medicine. The Third Willard J. Stone Memorial Lecture

"Medical Research of the Future," by Linus Pauling.

Pasadena University Club. April 2, 1946.

Ladies and Gentlemen: I am greatly honored to have been invited to give the 3rd Willard J. Stone Memorial Lecture, and it gives me a deep feeling of satisfaction to be able to take part in a ceremony honoring Dr. Stone, and through him all of the men of medicine upon whom so much of our welfare and happiness depend. I feel especially grateful to you for inviting me, somewhat of an outsider to the field of medicine, to meet here with you. I am reminded of a story in the autobiography of Dr. Walter Cannon, the great physiologist of the Harvard Medical School, who overheard a girl say to his daughter "How many patients does your father have?" And the daughter reply [sic] "Oh, he doesn't have any patients - he is one of those doctors who don't know anything."

My title is "medical research of the future"; and as the future is the extrapolation of the past, let us look first at the past. In Shakespeare's time there were "The rotten diseases of the south...." Some progress was rapidly made - I haven't heard of the fee simple of the tetter in more recent centuries. And there has been medical research and consequent progress in recent years. From 1900 to 1942 the life expectancy in America increased from 49 to 65, largely as the result of decrease in death rates of infants and children - in the last 20 yrs the death rate from children's diseases has decreased 87% - scarlet fever down 92%, whooping cough 74%, measles 91%, diphtheria 94%!

This has made the malignant diseases and degenerative diseases more and more important. Cardiovascular diseases now cause 45% of all deaths. Next the infectious diseases, with cancer a close third; and there are many diseases (common cold, arthritis, hay fever, peptic ulcer) which cause incalculable disability.

There was great progress made during the war - not on cancer and cardiovascular disease, but mainly on the infectious diseases - there was the production of penicillin, of dried plasma. I want to point out that this progress depended on basic research done before the war; and now we have used up the supply of basic discoveries. X-ray diagnosis and therapy followed the accidental discovery of x-rays by Röntgen in 1895 - and x rays were used in a hospital within three months. Penicillin was discovered accidentally by Fleming in 1929 and its value proved in 1937 by Florey and a $5000 research grant from the Rockefeller Foundation. Blood plasma was dried by Flosdorf and Mudd in 1935. The war just put these discoveries into use.

Why can we not attack cardiovascular disease and cancer effectively? First, until recently there has been no money - $2 per death for research in cancer, 21 cents per death for cardiovascular disease. But mainly there have been no leads to follow, no hints from basic science - our knowledge of cell division is not great enough, of vasoconstriction and vasodilation. The great need of medicine is in this fundamental region.

Let me illustrate what can be done by telling the story, which some of you have heard, of the work on a blood substitute. (Dan H. Campbell, Joseph B. Koepfli). ----.

Now in this case we knew pretty [well] what was needed and how to fill the need. In cancer and cardiovascular disease and poliomyelitis and arthritis we do not know enough - and it is astounding that the gap in the region of knowledge is so small and yet so important. The dark forest of the unknown extends between 10^-6 inches and 10^-7 inches - and it is in this little region that all the secrets of life and death are hidden - the gene, viruses, enzymes, causes of cell division, structure of proteins.

Let us imagine ourselves 250,000,000 times bigger, in height equal to the moon; and looking at an organism, New York City. --- ---

This, then, is the situation - the future of medical research depends upon the future of basic science, and its effectiveness in penetrating into this little strip of the dimensional forest. We in California should help - another medical school. with research on the $500,000 scale instead of $10,000; use of the great supply of clinical material at Los Angeles General Hospital; and use of the California Institute of Technology - where there are men with a mastery of basic sciences, interested in turning their attention to these problems fundamental to biology and medicine. Let us hope that progress can be made in solving the secrets of life and death.

Walt Whitman: "The two old simple problems, ever intertwined, close home, elusive, present, baffled, grappled by each successive age insoluble, passed on to ours today - and we pass on the same." And let us resolve that as we pass on the problems to our next generation we shall pass on also our contributions to their solution.