PROBLEMS OF INTERNAL MEDICINE 219 



results in the end in the encroachment of the academic training upon 

 a period which should properly be given to one's life-work is, it seems 

 to me, often based on an old idea - - founded all too firmly, alas, on 

 methods that yet prevail in many of our medical schools - - that with 

 his degree in medicine the student has finished a theoretical educa- 

 tion, that he must now spend five or ten years in acquiring expe- 

 rience --at the expense, incidentally, of the public - - before he can 

 enter into his active life; that, therefore, unless some other branches 

 of early instruction be sacrificed to courses leading more directly to 

 medicine, so that he may enter upon his strictly professional educa- 

 tion at a period considerably earlier than is now the case, the phy- 

 sician of to-morrow will become self-supporting only at a period so 

 late in life as to render a medical career impossible to other than 

 those well supplied with the world's goods. With proper methods of 

 instruction this is a wholly false idea. Under fitting regulation of our 

 system of medical training, with due utilization of the advantages 

 offered by hospitals for clinical observation, the experience necessary 

 to render a man a safe and competent practitioner should not only be 

 offered, but required for a license to practice; and even if the length 

 of the strictly medical curriculum be extended one or two years 

 beyond that which is at present customary, it will not be time lost. 

 If one but look around him he will find, I fancy, that few men who 

 have had such a training wait long before finding opportunities for 

 the utilization of their accomplishments; the public in most instances 

 soon recognizes the man of true experience. 



But there is yet another side of the question which has hardly 

 been sufficiently emphasized, a side of the question which must come 

 strongly to one's mind when one considers the general education of 

 many of the men who are entering even our better schools of medi- 

 cine, a point of view which has been especially insisted upon by 

 a recent French observer. A large part of the success and usefulness 

 of the practitioner of medicine depends upon the influence which .he 

 exerts upon his patients upon the confidence which he infuses 

 upon his power to explain, to persuade, to inspire. It can scarcely be 

 denied that these powers are more easily wielded by the man of 

 general culture and education than by one of uncouth manner and 

 untrained speech however brilliant may be his accomplishments in 

 the field of exact science. I can do no better than quote the words of 

 Professor Lemoine: "C'est qu'en effet Paction morale qu'il peut 

 exercer sur le malade, et qu'il exerce d'autant plus qu'il est supe- 

 rieur par son intellectualite, est un des principaux elements de guer- 

 ison. On guerit par des paroles au moins autant que par des remedes, 

 mais encore faut-il savoir dire ces paroles et presenter une autorite 

 morale suffisante pour qu'elles entrainent la conviction du malade 

 et remplissent le role suggestif qu'on attend d'elles. Ne fut-ce que 



