220 INTERNAL MEDICINE 



pour cette raison, je me rangerai parmi ceux qui demandent le main- 

 tien d'etudes classiques tres fortes comme preparation a celles de la 

 medecine, car le meilleur moyen de rehausser le prestige du me*decin 

 c'est encore de 1'elever le plus possible au dessus de ses contempo- 



rains." 



These words express, it seems to me, a large measure of truth. May 

 it not be that in the tendency to the neglect of the humanities we are 

 taking a false step? May it not be that if, on the other hand, we 

 teach them earlier and better, we shall find in the end that no essen- 

 tial time is lost, while we shall gain for medicine-men not only with 

 minds abler to grasp the larger and broader problems, but with 

 materially fuller powers for carrying on the humbler but no less 

 important duties of the practitioner of medicine? 



In that which I have just said I have touched upon the necessity 

 of the requirement of a considerable amount of clinical experience as 

 an essential for the license to practice medicine. To meet the enor- 

 mously increased demands of the present day, medical education 

 has become, of necessity, much more comprehensive, and must 

 therefore extend over a longer period of time. The methods of re- 

 search, anatomical, physical, chemical, which the student must 

 master, the instruments of precision with which he must familiarize 

 himself, are almost alarmingly multifarious; and experience in the 

 application of these methods and in the use of these instruments 

 demands increased time. Many of these proceedings, it is true, the 

 physician will rarely be called upon to use personally in practice, for 

 such measures must in great part be carried out by special students 

 or in laboratories provided by the Government. Nevertheless with 

 their significance and value he must be familiar familiar from 

 personal observation and experience. 



But after all there are few diagnostic signs in medicine, and not so 

 many of the improved methods of clinical investigation yield dia- 

 gnostic results, while to familiarize one's self with methods and in- 

 struments of precision is a very different matter from acquiring real 

 experience and skill as a diagnostician or a therapeutist. It is only 

 by gathering together and carefully weighing all possible informa- 

 tion that one is enabled to gain a proper appreciation of the situation 

 and to approach a comprehension of many conditions of grave im- 



1 Indeed the moral influence which he (the physician) is capable of exercis- 

 ing upon the patient and which he exercises to an ever increasing degree with 

 his intellectual superiority, is one of the most important of therapeutic agents. 

 One heals by words at least as much as by drugs, but one must know how to 

 say these words and to exercise a sufficient moral authority, that they may 

 bring conviction to the patient and carry the full weight of suggestion which 

 is intended. Were it but for this reason I shall range myself among those who 

 demand the maintenance of extensive classical studies as preparation for those 

 of medicine, for the best means to uphold the prestige of the physician is still 

 to raise him as far as possible above his contemporaries. Congr&s fran$ais de 

 medecine, vi Session, Paris, 1902, 8, t. n, p. xli. 



