396 THE MEANS OF PREVENTION. 



feeling and great self-denial. It can only succeed in building up a 

 class of self-conceited, scarcely semi-educated empirics, who, having 

 acquired a certain amount of practical experience in the company 

 of Dr. Old Fogy, the much-overestimated " regular practitioner," 

 look upon the school as an uncomfortable hindrance, which keeps 

 them from jumping into a lucrative practice, and which is only to 

 be used in order to gain the legitimizing " M. D." with as little 

 study and expense as possible. 



There is not a strictly scientific medical school in the United 

 States. There are fifty-five too many. The needs of the country 

 demand about four large and well-regulated medical institutions ; 

 but as this is and will be impossible, it is necessary that we do our 

 utmost to reform the existing institutions. To this end, the State 

 must assume control of them, as it does of the public schools. The 

 corps of teachers should be selected by public competition, and it 

 must never be forgotten that not every man who can write well or 

 who has distinguished himself in original research is fitted by nature 

 to teach. The ability to logically and practically detail the results of 

 the world's knowledge is the requisite to be sought in a teacher ; if 

 these can be united with great original ability, all the better ; but 

 at a school there must be teachers as well as investigators. There 

 should be in each State a board of health, the technical members of 

 which should also constitute the medical board of examination. 

 The members of such boards, as well as the teachers of the medical 

 school and other State officers in connection with science, should be 

 well paid. It is an American disgrace and misfortune that men of 

 great original ability can seldom afford to work for the State. Too 

 many such positions are filled by dilettanti — rich men's sons who 

 dabble in science, and take such positions for the honor of the 

 thing. Or else they are men who, having grown old and experi- 

 enced^ are thought especially suited for such honorable positions; 

 whereas the period of combativeness and activity has passed away 

 with them. A man is only of use to the world so long as he is com- 

 bative. The same is true of our colleges. Men of ability, but poor, 

 must seek a living elsewhere, and are obliged to turn their backs 

 upon the laboratories they would delight in, and upon institutions 

 they would honor, in order to prepare for their old age, while snob- 

 bishness and mediocrity too frequently fill the places they should be 

 honored with. Hence, we seldom find men of vast scientific ability 

 filling the chairs of American colleges. At the medical schools the 

 conditions are in general still worse. We find many of the teach- 

 ers straggling between their duties to a dangerously sick or dying 



