1, 1916] 



SCIENCE 



301 



generation, who having passed middle age 

 before the advent of certain theories were 

 entirely unable to use them in their reasoning 

 although according formal acceptance. It 

 were hardly fair to prescribe a more rigid re- 

 quirement for our medical teachers of the 

 present, though we may expect much more of 

 those now in the making. In the meanwhile, 

 shall the student be allowed to miss much 

 which is essential because the chemistry teacher 

 prefers to draw about himself the white mantle 

 of pure science and pass by on the other side? 

 Another question occurs. By inference there 

 has already been suggested a need for teachers 

 trained both in chemistry and in medicine. 

 The large number of published researches by 

 " John Doe, Ph.D., and James Smith, M.D." 

 suggests another field of usefulness for the 

 man who can unite the training indicated by 

 these two degrees, while the increased appli- 

 cation of chemical analyses to clinical diag- 

 nosis is a third factor in creating a demand 

 for such preparation. The last factor is worthy 

 of some special consideration. This increased 

 demand for chemical data in diagnosis is al- 

 ready marked, but it has only commenced. 

 There must be men to do the work — and the 

 practician is excluded. The methods con- 

 cerned are quantitative and their usefulness 

 depends upon the accuracy of the results. 

 Even assuming the possibility of developing 

 a quantitative conscience in a medical student 

 within the available time, analytical efficiency 

 can not be maintained by sporadic efforts — 

 and the maintenance of regular quantitative 

 work is incompatible with the practise of 

 medicine. The requisite skill can be provided 

 only by chemically trained men who give it 

 their regular attention, and this is the way it 

 is actually working out. The movement to- 

 ward concentrating medical practise in hos- 

 pitals is already well under way; an eminent 

 authority has predicted that it will soon be- 

 come universal. Already the hospitals are pro- 

 viding their corps of clinical chemists. Is it 

 not time to make some special educational 

 provision for the particular kind of combined 

 training which will peculiarly fit men to dis- 



charge the functions of teaching, research and 

 clinical control which have been indicated? 



It may be suggested that adequate prepara- 

 tion for such work may be secured even now 

 by pursuing the courses leading to the Ph.D. 

 degree in chemistry and subsequently going 

 on to the M.D. A few men do this and we 

 recognize the a priori advantages which they 

 possess over those who have only the one de- 

 gree. But it is not economically sound to 

 advocate this regimen for all who would so 

 qualify themselves. Of the four years re- 

 quired for the medical degree (already it is 

 five in those institutions which set the stand- 

 ards for to-morrow) more than half the time 

 is devoted to the subjects of anatomy, surgery, 

 obstetrics and minor allied subjects to which 

 present or prospective chemical methods are 

 only remotely related. It would appear both 

 desirable and feasible to provide in our medi- 

 cal schools (or some of them) a special course 

 for men already thoroughly trained in chem- 

 istry. Within two years could be compassed 

 intensive courses in biology, physiology, ad- 

 vanced physiological chemistry, pathology, 

 bacteriology and internal medicine with very 

 brief attention to such portions of other 

 branches as might appear desirable. With a 

 bachelor's degree including as much chemistry 

 as is now obtainable would it not be possible 

 to arrange such a special course as suggested 

 and, following this with a year of research, 

 grant at the end of seven years the Ph.D., 

 D.Sc, or a new degree of equal dignity? 



A few years ago the Division of Organic 

 Chemistry held a symposium upon methods of 

 teaching that subject. If there are enough of 

 the members of this Biochemical Division who 

 are interested in the suggestions raised, or in 

 allied considerations, it might be of advantage 

 . to provide at some future meeting for a similar 

 free discussion of the whole matter. Out of 

 such a frank canvassing of the situation there 

 should come results which would enable the 

 chemistry of the future to offer even more 

 substantial contributions than the chemistry 

 of the past has made to the science and art of 

 medicine. L. Junius Desha 



Memphis, Tenn. 



