532 



SCIENCE 



[N. S. Vol. XLI. No. 1058 



search by the clinician, is the goal toward 

 which the better schools of the country are 

 striving to approach. It is this which led to 

 the recent conditional gifts of $1,400,000 and 

 $750,000 from the Eockefeller Foundation to 

 the Johns Hopkins and to the Washington 

 University. The spirit of modern medicine 

 is that of scientific inquiry into the cause and 

 cure of disease. This spirit can only be im- 

 parted by men who are themselves makers of 

 modern knowledge. It is said that science 

 does not explain all things and it is asked 

 why should science be followed? The answer 

 to this question should be, more science, to 

 explain the unknown facts. 



It is frequently set forth that there are two 

 subdivisions of medicine, medicine as an art 

 and medicine as a science. The impression is 

 conveyed that medicine as a research science 

 is not the object of a department of medicine. 

 For this reason, the cooperation of the scien- 

 tific departments is often asked. Innumerable 

 schemes for " correlation " have therefore 

 been presented to various medical faculties 

 throughout the country. " Correlation " in 

 this interpretation signifies that the scientific 

 departments are to give instruction in the 

 clinical years along the lines of the develop- 

 ments of modern scientific research. The oft- 

 repeated request for correlation in this sense 

 shows that there is something lacking in the 

 clinical instruction which should be there. 



The medical students of the United States 

 are thoroughly grounded in the fundamental 

 sciences during the early years of association 

 with their schools. The fundamental sciences 

 are largely unknown to the rank and file of 

 the clinical teachers. This leads the latter to 

 ridicule the knowledge which the students, 

 with much labor and care, have sought to 

 acquire. One of two results follow; either 

 the student joins the instructor in belittling 

 the laboratory teaching, or the student, being 

 better informed than the instructor, feels ill 

 satisfied with his opportunities. 



The situation is something like this. There 

 is a true scientific medicine based upon the 

 application of research medicine in the clinic. 

 The modern medical student is entitled to this 



kind of instruction for the fulfilment of his 

 highest development. Can he get this? The 

 answer is found in the argument offered in 

 England as well as in the United States, that 

 the department of medicine should be devoted 

 to the teaching of medicine as an art. It fol- 

 lows that the direction of research is outside 

 its capacity. 



Let this problem be examined a little more 

 closely. Many medical schools have recently 

 purchased costly string galvanometers for use 

 in affiliated hospitals. This apparatus is of 

 service in certain diagnoses. As an instru- 

 ment of research it might perhaps yield a 

 brilliant discovery if used by a man who had 

 been constantly engaged in the study of the 

 phenomena of the circulation during a period 

 of say five years. To the ordinary operator it 

 has no more power of revealing new truths 

 than would a Morse telegraphic outfit. 



The truth of the matter is that, as a coun- 

 try, we have produced few men in medical 

 science. This is frankly because the teaching 

 of medicine has not been in accordance with 

 modern science. The staff of the medical de- 

 partment should consist of men, themselves 

 devoted to medical science, capable of carry- 

 ing it on, brought up in the air of it and 

 blessed by the enthusiasm of it. Such men 

 should be produced under the leadership of the 

 professor of medicine. 



The true remedy is that the clinical de- 

 partments furnish instruction along modern 

 scientific lines. Other remedies are only 

 temporary palliatives. The medical school 

 owes a duty to the public. Personal ambition, 

 even though unconsciously exercised, should 

 not be allowed to frustrate the fulfilment of 

 the duty to the community which the college 

 lives to serve. 



The schools are brought face to face with 

 the question whether their policy will be to 

 advance along modern lines or stand stiU yet 

 a little while. 



It is impossible in any faculty to approach 

 this subject without hurting the feelings of 

 true and honorable men, men who deserve 

 well of their country and who are not to blame 

 for the present situation brought about by an 



