THE REFORM OF THE MEDICAL CURRICULUM 659 



with in my day. The question is — How are they dealt with — 

 any more usefully than formerly? I doubt it. Murder will 

 out, and out it comes when Dr. Wade tells us that " Chemistry 

 for medical students bears precisely the same relation to phy- 

 siology and pathology as anatomy does, the chemist dealing 

 with the nature and relation of the materials and the anatomist 

 with the nature and relation of the structures the function of 

 which, in both cases, it is the part of the physiologist to inves- 

 tigate." Chemistry as thus defined by Dr. Wade is a kind of 

 dry-bones business — and so it usually is ; the chemistry the 

 medical man needs, however, is not for the most part anatomical 

 but functional : physiology, therefore, in a large measure, over- 

 laps it. This is what Dr. Wade and his friends do not see — 

 but they must come to recognise it, sooner or later. 



Students, in his laboratory, says Dr. Wade, dissect chemically 

 and, where possible, reconstruct artificially, compounds such 

 as urea. Suppose they do — how much better off are they ? 

 As ordinarily conducted, the exercise is an almost worthless 

 one, in my opinion. And from a medical point of view, 

 it doesn't really matter what urea is : a harmless waste 

 product, containing oxygen and nitrogen in their lamest form, 

 its importance is generally much overestimated in chemical 

 circles, just as we now have reason to suppose it was by 

 Fick and Wislicenus, who spent much unnecessary effort on the 

 Faulhorn in worship of its supposed functional significance. 

 The student does not really dissect it when he gets ammonia, 

 etc., from it any more than an anatomist dissects a bone when 

 he gets calcium phosphate from it; probably, moreover, urea 

 is not what he is commonly taught to suppose it is — carbamide. 

 Long absorbing conversations which I had with Peter Griess — 

 the prince of nitrogen chemists — in days of yore rise in my 

 memory when I write this : he would not listen to its being 

 called carbamide. 



The really important problems centring around urea are 

 not taught — the wonderful inter-relationship of the closely 

 allied forms of the compound CON 2 H 4 ; the condition of 

 equilibrium in which urea, carbamide and ammonium cyanate 

 subsist in solution : although probably of high physiological 

 importance, these subjects are considered to be far too difficult 

 for the medical student to tackle ; really they are the points 

 which he should be led to study very thoroughly. From the 

 medical point of view, the substances which accompany urea 



