Clinical investigation: Past, present, and future

In this editorial the author examines briefly the past, present and future of clinical investigation in general and particularly in Switzerland, where the same problems are encountered as in other European countries and North America. The main problems reside in the fragmentation of internal medicine into subspecialties with their own separate meetings and journals, at the expense of multidisciplinary sources of information on medical progress, thus widening the gap between the practitioners and the scientific community. Through examples, it is pointed out that the progression of medical knowledge follows the path from basic research in biochemistry, cellular biology, animal experiments, clinical investigation and finally clinical medicine not unidirectionally but bidirectionally. Thanks to the Swiss National Science Foundation, the Medical Schools of the five Universities and many private foundations, a considerable effort has been made in past decades to foster basic and clinical research, resulting in a most favorable position for our country on the international scene. There is a fear that political and administrative decision could jeopardize the present situation and imperil the future. Finally, citing Osler from his work ''Aequanimitas'', the author stresses that ''the true test of a nation's life... is to be found in its intellectual and moral standards'', and that ''the measure of the value of a nation to the world is neither the bushel nor the barrel, but mind''.