132 THE MICROSCOPE. [June 



It does not lie within the scope of this paper to discuss the first 

 of these excuses, further than to say that that is a gap in medical 

 instruction which is being filled very rapidly. There are now 

 a large number of medical colleges in the United States in which 

 ample instruction is offered in normal and pathological histology, 

 bacteriology, and urinology. There is also a continually increas- 

 ing number of medical men who are more or less competently 

 employing the microscope in their general practice. 



As to the use to which the general practitioner should put his 

 microscope, there is a great difference of opinion. The gener- 

 ally accepted view as to the future position of the microscope is, 

 in my opinion, far too sanguine, and I also question its advisa- 

 bility. It is too much to expect that the average general practi- 

 tioner will employ his microscope in original investigations. 

 The microscope should be used by the physician for diagnostic 

 purposes, for the examination of urine, sputum (for the bacillus 

 tuberculosis), gonorrhoea! pus, and for little else. The diagnosis 

 of pathological tissues (tumors, etc.) should be left to the ex- 

 pert. 



Every physician should be able to use the microscope intelli- 

 gently in the examination of the urine. The technique of micro- 

 scopical urinology is not difficult, and the apparatus required is 

 neither extensive nor expensive. The time necessary for such 

 examinations is not great, and no practitioner can feel that it is 

 time w^asted, or that he could employ it more profitably at some- 

 thing else. The general practitioner should also be able to make 

 a satisfactory examination of sputum for the tubercle bacillus, and 

 urethal discharges for the gonococcus, in a great majority oi 

 cases. The technique is somewhat more difficult and the time 

 required somewhat greater than in the examination of urine. 

 Nevertheless in all but a small minority of cases it should not be 

 necessary to call in the services of an expert. 



On the other hand, how^ever, the examination of pathological 

 tissues, for the sake of making a diagnosis, should be left to those 

 who have devoted special study to them. By this it is not to be 

 understood that the practitioner should not study the tissues, nor- 

 mal or pathological. Far from that! Every physician should be 

 possessed of a clear and definite knowledge of the structure of 

 the different organs and tissues in both normal and pathological 

 conditions. He should not, however endeavor to be both prac- 

 tical pathologist and practical physician. He will find that he 

 has undertaken too much. Technique as applied to pathology 

 (and bacteriology) is too complicated, the time required is too 

 much, and the experience necessary to give weight to his decis- 

 ion is too great, except in the most outspoken conditions. He 

 will find that his time and work can be much more advanta- 

 geously employed. He will find it far more profitable for him 



