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SCIENCE 



[N. S. Vol. XXXIX. No. 993 



archives, it is important that he begin under 

 the instruction of one who by experience is 

 able to present the sequence of evidence 

 which leads up to the establishment of even 

 the most elementary truths of his science. 

 If the scientific attitude be acquired at the 

 beginning, the student's mind is prepared 

 for the constant acquisition of new knowl- 

 edge, which he comes to be able to assimilate 

 with less effort, and with immensely greater 

 profit to himself. 



An unfortunate feature of every course 

 is the necessity of examination. The ne- 

 cessity exists for two reasons : 1. To offer a 

 disciplinary method by which each student 

 is compelled to study the subject. 2. To 

 ascertain whether he has mastered his sub- 

 ject sufSeiently. It is not the purpose in 

 the present paper to enter in any detail 

 into this much-discussed pedagogical prob- 

 lem. It is certain, however, that in no 

 other respect is the teaching of such a sub- 

 ject as physiology likely to be rendered in- 

 efficient and unpractical more than by too 

 much examination. As we have stated be- 

 fore, a record of the general behavior of 

 each student in the quizzes, in the practi- 

 cal courses, and in the symposia, should be 

 kept, so as to serve as the main basis upon 

 which his proficiency is determined, the 

 finer grading being based on a comprehen- 

 sive final examination, which should be 

 partly oral and partly written in nature. 

 In this final examination opportunity 

 would be offered to sort out those students 

 whose standing, as judged from the class 

 records, is uncertain. 



Occasional written "tests" are no doubt 

 of some use in permitting the students to 

 measure their standing, and in supplying 

 them with a motive for reviewing their 

 work. But it is a mistake to offer these 

 tests too frequently, for it makes the stu- 

 dent consider the obtaining of high grades 

 as the main aim and object of his studies. 



By his success in getting high grades, the 

 crammer, who merely memorizes what he 

 hears or reads, comes to be considered as 

 the really successful student, whereas the 

 thinker who accepts nothing until he un- 

 derstands it is discouraged because he can 

 not keep the pace. 



And finally as to the future of the phys- 

 iological student, how is his fund of knowl- 

 edge to help him most in becoming an 

 efficient diagnostician and therapeutist? 

 The answer is by keeping him in constant 

 touch with physiology during the time 

 that he is acquiring his clinical knowl- 

 edge. To accomplish this is, however, a 

 most difficult problem, for it requires that 

 the teacher of clinical medicine shall him- 

 self be well informed in the modern teach- 

 ings of physiology, a qualification which 

 unfortunately but few of our clinical ex- 

 perts possess, or which they make any ef- 

 fort to acquire. There has no doubt been 

 a great change in the nature of the teach- 

 ing of clinical medicine during recent 

 years. The old-fashioned empirical dog- 

 matism is gradually giving way to more 

 logical and scientific methods, but even in 

 our best-manned school clinics, there yet 

 remain many who by their attitude towards 

 such a science as physiology and towards 

 the newer methods of refined diagnosis, 

 which depend on the application in bedside 

 work of physiological methods, make it 

 very difficult to realize the above ideal. 

 Naturally enough the unthinking student 

 prefers to be taught cut-and-dry systems 

 of diagnosis and treatment. In his text- 

 books of medicine, he finds tabulated 

 groupings of symptoms by which he may 

 distinguish one disease from another, and 

 he expects that, having learned how to diag- 

 nose, all he has to do is to learn the pre- 

 scribed treatment for the disease. By 

 learning his medicine in such a manner — 

 and of course it is in such a way that he 



