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SCIENCE 



[N. S. Vol. XLIV. No. 1131 



ing rather more than less perfunctory as the 

 actual preparation of medicines, its most 

 clearly recognized application, passed out of 

 the hands of medical men. And chemistry is 

 one of the subjects in which examination is 

 required by official licensing boards. But it 

 would require a most gifted intelligence to be 

 able to deduce from the adventitious subject- 

 matter of most of these examinations any 

 suggestion that chemistry is a fundamental 

 part of medicine rather than some extraneous 

 attachment. 



Let me explain what I mean by perfunctory 

 position in the medical curriculum. Until the 

 very recent general upheaval, medical instruc- 

 tion in all branches left much to be desired 

 (to be conservative in expression). Rather 

 than an exception to this statement, the old 

 so-called " medical chemistry " was a glaring 

 case in point. Crowded with descriptions of 

 natural occurrences and methods of prepara- 

 tion of drugs, indications, effects and dosage, 

 clinical symptoms of poisons and their labora- 

 tory detection — so much was usurped from the 

 provinces of pharmacy, materia medica, phar- 

 macology and therapeutics that little space 

 was left even in the ponderous " Textbooks of 

 Medical Chemistry" for references to funda- 

 mental chemical principles. When included 

 at all these latter were carefully segregated 

 within the paragraphs of their original men- 

 tion — paragraphs which could be omitted quite 

 as easily as those on the oxides of iodine with- 

 out impairment to the continuity of the text. 

 And in practise it would appear that these 

 paragraphs on chemical principles were omitted 

 with even greater facility. 



We may well congratulate ourselves that 

 " all that's put behind us," far away if not 

 long ago. Instruction in chemistry in the 

 medical colleges is now exclusively in the 

 charge of full-salaried teachers, most of whom 

 are trained chemists. Matters extraneous to 

 chemistry are no longer allowed to preempt 

 the place which belongs to the fundamentals 

 of chemical theory and the present-day courses 

 in chemistry, as given in most medical col- 

 leges, are of quite the same degree of excellence 

 as those in other professional or academic in- 

 stitutions. 



It is satisfying to regard this improvement, 

 but facts are not wanting which raise other 

 questions. May we still be lacking somewhat 

 of the highest possible efficiency? In the 

 Standards of the Council of Medical Educa- 

 tion of the American Medical Association, de- 

 fining the " Essentials of an Acceptable Med- 

 ical College," this dictum is laid down, " Non- 

 medical men should be selected as teachers in 

 medical schools only under exceptional circum- 

 stances and only because medical men of equal 

 special capacity are not available." The ob- 

 vious advantage sought is the wider point of 

 view of men trained to the practical applica- 

 tions of their subjects to other branches of 

 medicine and able to direct the minds of stu- 

 dents to these interrelationships. There is no 

 department of instruction in which this ad- 

 vice of the Council has been so consistently 

 disregarded as in the selection of chemistry 

 teachers — and for the very good reason indi- 

 cated, that "medical men of equal special 

 capacity " were not (and are not) available. 

 Medical instruction in chemistry is, therefore, 

 for the most part in the hands of men ade- 

 quately enough trained in chemistry but with- 

 out formal education in medicine. As one of 

 that very class, I venture to raise the question 

 as to whether we have always sufficient catho- 

 licity. Is it not possible that we sometimes 

 overlook the fact that we are training men to 

 be physicians, not chemists? In our very 

 righteous indignation at the inefficiency of the 

 old " medical chemistry " may we not have 

 swung the pendulum a little too far away 

 from the point of practical contact? 



To the last question it may be replied with 

 perfect logic that when we have laid an ade- 

 quate foundation of sound theory it is for the 

 physiologist, the pathologist and the internist 

 to build upon it according to the particular 

 needs of his subject. But, like the gas laws, 

 this logic applies strictly only under ideal con- 

 ditions. As a practical fact the pathologists, 

 internists, etc., concerned are not infrequently 

 men who have succeeded less on account of 

 any knowledge of chemical principles than in 

 spite of the handicap of their inadequate in- 

 struction in that subject. Most of us have 

 known chemists, the great men of a passing 



