PROBLEMS OF INTERNAL MEDICINE 221 



port to the patient. And in forming a sound judgment with regard 

 to these vital questions, that which comes from experience in the 

 close personal observation of the sick is far the most important 

 element. Bedside experience constitutes to-day, as it always has, 

 and always will, the main, essential feature in the training of the 

 physician. But this experience, if it is to bear its full fruit, must be 

 afforded to the student at a time when his mind is still open and 

 receptive and free from preconceived ideas under conditions such 

 that he may be directed by older trained minds into proper paths of 

 observation and study, for few things may be more fallacious than 

 experience to the prejudiced and the unenlightened. 



That such experience may be freely offered to the student there is 

 a grave necessity for a more general appreciation by institutions of 

 medical training as well as by the powers in control of public and 

 private hospitals and infirmaries, of the mutual advantages to be 

 gained by a cordial cooperation. It must be acknowledged that, in 

 this country at least, despite the cultivation of improved methods of 

 clinical investigation, there still prevails in the mind of the public the 

 perverted idea that this bedside observation, this application of new 

 methods of research and study are for the advantage of the student 

 or in the interest of general science rather than for the benefit of the 

 sufferer himself. It must further be recognized that a wholly mis- 

 taken conception of the true function of a hospital is widely prevalent. 

 It is all too common to see large and ornate institutions with every 

 arrangement for the comfort and even luxury of the patient, with 

 a medical staff utterly insufficient in number or training to study 

 properly the individual case, not to speak of carrying on scientific 

 investigations. The service, usually under the direction of a busy 

 driven practitioner with barely time to make a short daily visit 

 large wards under the direct control of one or two young men whose 

 time is wholly occupied by routine work every care taken for the 

 present comfort of the patient little provision for enlightened 

 study or treatment of his malady no opportunities for a contri- 

 bution on the part of the institution to the scientific progress of the 

 day. Better far for the sufferer were he in the dingy ward of an old 

 European hospital where he might be surrounded by active, inquiring 

 minds recording the slightest changes in his symptoms, ever ready to 

 detect, and as far as the power in them lies, to correct the earliest evi- 

 dences of perversion of function. What our hospitals need is men, 

 students, whether or no they have arrived at the stage in their career 

 which, after all, is but a landmark, not a turning-point that 

 entitles them to the right of independent practice, the enthusiastic, 

 devoted student who, in watching and studying the patient, is 

 contributing alike to the interests of the sufferer, the hospital, and 

 himself. 



