PAPERS ON MEDICINE AND PUBLIC HEALTH 247 



teaching, that is operative chnics, be very much reduced. 

 Instead give all the time possible to examination of pa- 

 tients by the students. I know nothing that palls on the 

 student so soon as examination of the normal individual, 

 so waste no time having students examine each others ears, 

 noses or throats. They can learn the technic of examina- 

 tion just as well on the patient and learn something of di- 

 sease at the same time. They will run across plenty of 

 normal ears, noses and throats in doing this so that they 

 will have ample opportunity of getting a normal standard 

 for comparison. 



If at the State University the classes were divided into 

 sections of not more than six or eight and given fifty hours 

 of such practical work instead of the eighteen hours now 

 required, while the didactic and clinical work was cut to 

 ten hours, I am sure that the graduates would know much 

 more about the subject than they do now. 



I would suggest that the following is a practical way to 

 get the most out of this work. Divide the class into small 

 sections, require each student to have access to a good text 

 book, and to own the common instruments for examina- 

 tion, such as a set of ear specula, a nose speculum, a ton- 

 gue depressor, two sizes of throat mirrors and an appli- 

 cator. Then at the beginning of each hour assign a patient 

 to each student for examination. Let the class spend a 

 half hour examining the ears, noses and throats of their 

 patients under the guidance of the instructor. At the end 

 of the half hour call the class together and have each stu- 

 dent report on his case while the instructor examines the 

 patient and sees that the student has reported correctly. 

 If he has missed an important point let the instructor call 

 his attention to it, and possibly require the student to re- 

 examine his patient. At the same time let the other mem- 

 bers of the class make suggestions, ask questions, and in 

 other ways discuss the case. If the case has any unusual 

 points about it, let all the section see it. Between this ses- 

 sion and the next one require each student to read up his 

 case and, if desirable, present an outline in writing at the 

 next session of the section. In addition to this, assign each 

 student a subject for a paper at the beginning of the 



