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SCIENCE 



[Vol. LVI, No. 1450 



Why the forcing of more health laws upon an 

 unwilling humanity ? Those who do not believe 

 in vaccination, antitoxins and the purification 

 of water and food supplies might, for a change, 

 be permitted to die. If our Christianity needs 

 to be invoked let us consider St. Lute. As 

 physician and teacher he preached that "Now 

 is salvation come nigh unto you." But with 

 the truth uttered he left his audiences to make 

 the final choice. 



The medical profession will increase or lose 

 its public power only as the collective expres- 

 sion of the people's faith in the individual 

 doctors who touch them. To toreed such faith 

 the doctor must get again his old courage and 

 cease to be the pussyfooter of our present day. 

 What is wanted is not a strutting vanity, com- 

 mon enough, but a consciousness in the doctor 

 of where he came from and where he is going. 

 To do this he needs 'to learn again that he is a 

 judge and obligated as such to get at evidence 

 first hand. The profession of medicine is an 

 openhanded one whose discoveries, practice and 

 points of view are free and obtainable for the 

 asking. Let the medical man then choose well 

 whom he will visit and learn from. Let him 

 discover what men actually do and not what 

 others tell him they do. This holds true also 

 for the evidence which he gathers from the 

 printed page. In the hustle of our modern 

 life the medical man has here fallen into the 

 group of the common. He does not read orig- 

 inals any more and hardly reviews. The thing 

 has become so attenuated that in his journals 

 and text-books he is literally consuming 

 reviews of reviews of reviews. As well may a 

 mau think to understand the psychology of 

 sheep because he feeds on lamb stew. 



The fundamental situation will not be 

 changed in the space of a night. New view- 

 points and idealism grow toest in young soil. 

 Whence our' interest in the education of the 

 new doctor. But medical education like all 

 so-called university education has fallen into 

 bad ways. There have been carried into it the 

 false ideals of the kindergarten and grammar 

 school. Education is conceived of, too much, 

 as something that may be bought for and added 

 to a son. And the present day university 

 course does cost only four years and four 



thousand dollars of anybody's money. This 

 idea must change. If there is a fundamental 

 law under which we live it is that of Lamarck. 

 Not through environment but through the de- 

 gree of reaction on our part to that environ- 

 ment do we develop or atrophy. 



But what is there in modern university edu- 

 cation which develops the senses to observa- 

 tion, the mind to logic and the soul to under- 

 standing? The medical student is to-day lec- 

 tured into coma — but the skill we are seeking 

 can be acquired only by doing. Whence will 

 come the man and the institution to teach again 

 by the apprentice system? When will we see 

 again, working students emulating masters? 



What is so badly started in the universities 

 and medical schools continues in the subsequent 

 professional life. There is an eternal clamor 

 for positions on hospital staffs, on boards of 

 control, on faculties of medicine. As in polit- 

 ical parties, groups of doctors are insiders or 

 outsiders. Wliat does it all matter and when 

 will it be learned again that only the man 

 counts and not the circumstance? Staff jobs, 

 faculty places and positions of power are the 

 husks of corn. Men collect jobs like political 

 badges, recognizing in all too few instances 

 that they are nothing but opportunities for 

 work — and who uses them? 



A doctor friend told me recently that he felt 

 cramped in a hospital which housed only eight 

 hundred beds. But Boerhaave changed all 

 European medicine with but twelve; Corrigan 

 rewrote the chapter on heart disease with but 

 six and Kiilz whose work fills one third of all 

 the tomes on diabetes had just two patients. 

 Could any practitioner have less? 



IV 

 Our modern medicine is tending in two direc- 

 tions, the one leading toward the ideals of the 

 five-and-ten-cent store and administrative mad- 

 ness. This group talks of "selling" its ideas 

 to the public. The other is recognizing that 

 the collective skill and power and position of 

 the medical group is only a composite of the 

 piled- together abilities of the individual doctor 

 and the reaction evoked from the individual 

 patient. Our time represents a call to return 

 to the fathers. The world is seeking, as of old, 



