November 5, 1920] 



SCIENCE 



419 



tional discipline offered the medical student 

 at the College of Physicians and Surgeons, a 

 leading institution, in the period embraced by 

 the years 1872 to 1875. 



' In 1872, when Welch entered, the College of 

 Physicians and Surgeons had been in opera- 

 tion for sixty-five years and led all its com- 

 petitors in the number of its students and in 

 teaching facilities. The college occupied a 

 ibuilding of its own on Twenty-third Street, re- 

 garded as commodious, and was a part of Co- 

 lumbia University. The term of instruction 

 ■had been extended from four to five months, 

 •and three instead of two sessions of attend- 

 ance upon lectures were required for gradua- 

 tion. The precarious supply of material for 

 ■dissection and for instruction in operative 

 surgery and the method of obtaining it had 

 ■been superseded and made fairly adequate by 

 legal enactment. The courses in anatomy and 

 to a less degree those in medical chemistry 

 comprised the entire provision for objective 

 or practical teaching, aside from the out-pa- 

 tient clinic at the collie and the clinical lec- 

 tures given at the New York and Bellevue 

 ■Hospitals and the Almshouse. A voluntary 

 course of lectures on pathological anatomy 

 ■with demonstration of organs removed at 

 autopsy was offered during the summer ses- 

 sion by Francis Delafield. 



While the preceptorial system was stiU in 

 vogue and the medical student was still ex- 

 pected to obtain the main part of his clinical 

 ■training during the long interval between ses- 

 sions, in the office and on the rounds of his 

 .preceptor, the few outst-anding students could 

 hope to enter Bellevue Hospital for an interne- 

 ship, which might begin even six months be- 

 fore graduation. But the didactic lecture, of 

 ■which the instruction still chiefly consisted, 

 ■was expected to fill the mind of the student 

 with the medical lore of the day, while it 

 served also to impress bis imagination with 

 the vigorous personality and high authority of 

 the eminent teachers under whom he sat, in a 

 manner now wholly foreign to the spirit of 

 medical teaching. 



But to the aible, energetic and ambitious stu- 

 dent the plan, imperfect as it was as an edu- 



cational discipline, admitted of a choice of 

 subject and disposition of effort not contem- 

 plated in the system. And thus we find Welch 

 in the early period of his medical studies en- 

 ticed away from the lecture halls into the more 

 alluring atmosphere of the dissecting room 

 and very soon serving as prosector to the pro- 

 fessors of anatomy. 



' With the curriculum as indicated, it is ob- 

 vious that no opportunity existed to acquire 

 thorough training in any subject, aside pos- 

 sibly from the grosser aspects of human 

 anatomy. The provision for pathology was ex- 

 tremely meager. Although a chair of physiol- 

 ogy and pathology, filled by Alonzo Clark, had 

 been created in 1847, in the early seventies of 

 the last century, pathology had not become an 

 independent subject of teaching, but was at- 

 tached to the chair of medicine, still, as it 

 happened, under Dr. Clark, who had been 

 transferred to the professorship of pathology 

 and clinical medicine. 



There is no reason to suppose that Clark 

 treated pathology otherwise than by lectures, 

 with perhaps at most the occasional use of 

 specimens from the deadhouse. On the other 

 hand, Francis Delafield, who had become ad- 

 junct professor of pathology and clinical 

 medicine, was already studying assiduously 

 with the microscope the pathological changes 

 in the kidneys in Bright's disease and still 

 other morbid processes, as viewed indeed from 

 the standpoint of the new cellular pathology 

 just struggling into the light. But of oppor- 

 tunity for the student himself to acquire even 

 the rudiments of the technique of the micro- 

 scopic study of the organs and tissues in 

 health and disease, there was none. It was 

 not, therefore, just at this juncture in Welch's 

 history that his interest in pathology asserted 

 itself. 



A compelling circumstance was, however, 

 imminent. Among the prizes offered to stu- 

 dents was one provided by Dr. Seguin, then 

 the professor of diseases of the nervous sys- 

 tem, for the best report of his clinical and 

 didactic lectures. It consisted of a Varick 

 microscope fitted with superior French triplex 

 lenses. This prize was won by Welch, and it 



