Apkil 9, 1915] 



SCIENCE 



533 



altered trend of educational thouglit. It is, 

 therefore, extremely difficult to speak of these 

 matters without seeming to be both unkind 

 and unjust. On the other hand, if no word is 

 spoken, blame for cowardice is incurred. 



It is the current opinion of the laboratory 

 departments that medicine should be taught 

 as a science by men who are scientific investi- 

 gators. It is their hope that departments of 

 medicine can be recognized so that this re- 

 form can be put into effect. We must think 

 not of ourselves but of the present and the fu- 

 ture. Only reorganization along modern lines 

 will bring the best trained students. One 

 needs but have one's touch on the scientific 

 pulse of the country to realize the absolute 

 verity of this statement. 



The medical teaching of Friedrieh Miiller 

 is conceded to be the best in the world. This 

 is his own description of it. 



At half -past eight I go to my institute, at ten 

 to the wards. May I explain? My clinic (at 

 9 A.M.) is in the theater and to this theater the pa- 

 tients are brought, and I show the patients before 

 my students and examine and explain the eases. 

 This takes an hour, and then I go with a part of 

 my students, which changes every day, to the 

 wards and instruct them personally. This takes 

 another hour. Then I go round the wards with 

 my assistants and it is one or half -past one when I 

 have finished. At least three times and in the 

 winter term four times a week I go to my institute 

 in the afternoon and give a general lecture. I lec- 

 ture upon the diseases of the brain, the diseases of 

 metabolism, diseases of the respiratory system and 

 so on over certain parts of the whole province of 

 medicine. My assistants are in part municipal, 

 paid for by the state. I have one assistant in bio- 

 logical chemistry, another in chemistry, one work- 

 ing on nervous diseases, one doing bacteriological 

 work and making a vast number of tests, Wasser- 

 mann tests and so on. If I have a case, say, of 

 typhoid fever, I give the proofs to the assistant 

 last named, if I have a nervous case, to the nerve 

 specialist. Any question of metabolism or chemis- 

 try I work out with my chemical assistants, and I 

 work with them. I go on with research work and 

 I do this work in connection with my assistants. 

 ... I have my own laboratories. I have a large 

 laboratory for chemistry. I have a laboratory for 

 physical examinations and especially for patholog- 

 ical anatomy, then one for bacteriology and for 



the Wassermann test, and so on. We have a large 

 building for laboratory work connected with my 

 clhiic and governed by me. ... Is it really neces- 

 sary to incur such great expenses? Would it not 

 be possible to conduct the school for the common 

 practitioner in the old well-established manner? 

 No. The general medical practitioner has always 

 and everywhere to deal with the highest good, with 

 the health of his fellow creatures and he must be- 

 come more and more even in the remotest village 

 the promoter of public health and therefore he 

 must be an educated man. In his responsible vo- 

 cation he must have some ideal which elevates him 

 above the daily sorrows and disappointments of 

 life. And he will find his refuge in his science. 

 Only a good scientific education will enable him to 

 follow the progress of medicine with critical under- 

 standing. Without a good scientific training he 

 would sink into mere routine. 



Let these words sink into the understand- 

 ing. 



Objection may be raised that no man in 

 America is fit to conduct a clinic in any way 

 similar to Friedrich MiiUer's. To say that is 

 to insult the intellectual capacity of the coun- 

 try. It is admitted to-day that we lead the 

 world in biology and in biological chemistry. 

 To state that it is impossible to conduct med- 

 ical instruction along the lines of what is ad- 

 mitted to be best, is inexcusable sophistry. 



In conclusion, it is suggested that depart- 

 ments of medicine be organized under the 

 leadership of individuals who will develop 

 scientific research, and who will be placed 

 upon a salaried basis with prohibition of pri- 

 vate practise during a period of five years. 

 The facilities for medical research in the hos- 

 pital should be freely open to all at present in 

 connection with the schools. The proper de- 

 velopment of this scheme would take the whole 

 of a man's time during the first five years. At 

 the end of that time it will be evident whether 

 it is necessary for a master of medical science 

 to have that sharpening of the wits which an 

 outside consulting practise is supposed to 

 produce. 



These words have not been written in a 

 spirit of i>ersonal antagonism to men of the 

 older order, for the writer has lived long 

 enough to desire to avoid arousing such antag- 

 onism. But he feels that they bear the mes- 



