744 



SCIENCE 



[N. S. Vol. XXXIX. No. 1012 



the activity and development of the mental powers, 

 especially those connected with the habit of ob- 

 servation, as well as with the judgment and mem- 

 ory." Dr. Graves realized the importance of in- 

 dividual judgment which must be based upon 

 trained observation, and the dangers of the mem- 

 ory method which is always founded on authority. 

 He was interested in premedical education. 



This conference has been arranged for the pur- 

 pose of centering your attention upon the prob- 

 lems of medical education, and especially of pre- 

 medical education. It is evident to those of us 

 who are medical teachers that if we are to keep 

 medicine what it is said to be and what often it is 

 not — one of the learned professions — ^we must have 

 the assistance and the active cooperation of the 

 colleges of liberal arts and sciences. It is to the 

 colleges of arts and sciences that we must look 

 for sound preliminary education for medicine. 



For exercise and development of the powers of 

 obserTation the sciences, physics, chemistry and 

 biology, are most important. The laws of these 

 are constantly applied during the whole life of the 

 physician. Without them the study and practise 

 of physic becomes an affair of memory instead of 

 being one of reason. More and more the prob- 

 lems of medicine are coming to be chemical prob- 

 lems — biochemical, if you please. Biochemistry is 

 the chemistry of the tissues and fluids of the body. 

 These materials belong to that comparatively new 

 class which we call colloids which are investigated 

 most satisfactorily by physico-chemical methods. 

 Physics and chemistry are therefore the basis of 

 the study of the phenomena of life. There is not 

 room in the medical curriculum for these subjects. 

 They must belong in the premedical years — to the 

 courses in colleges of arts and sciences, and in 

 such colleges they must be thoroughly studied in 

 laboratory courses. They can not be studied in 

 lecture courses. We therefore wish to discuss the 

 matter of satisfactory courses in physics, chemis- 

 try and biology. 



It is almost unnecessary to say that with this 

 science training, language work should not be neg- 

 lected. .This is especially true of English. Many 

 of our otherwise well-trained students are deplor- 

 ably ignorant of their own language. They need 

 German and French, to be sure, but they need to be 

 able to use their mother tongue. We wish to dis- 

 cuss the matter of English, German and French. 



So much for the subject matter of premedical 

 courses. 



The quality of the students is just as important. 

 The medical schools of the first grade are inter- 



ested in teaching a few good students, not in teach- 

 ing large classes. The United States is already 

 overstocked with doctors. It needs no more physi- 

 cians, but it needs better ones. The influence of 

 these facts is shown already in the attempts of cer- 

 tain schools to limit the number of students ia 

 their classes. With good students in small classes 

 we expect to obtain better results than we could 

 possibly expect even with good students in large 

 classes. Mass teaching is never successful. 



Small classes of good students in medical schools 

 will be useful in another direction. The teaching 

 will improve. The colleges of arts and sciences 

 can affect the character of medical teaching by 

 sending only well-prepared students to medical 

 schools. Good students are critical and teachers 

 are very susceptible to criticism. 



So, for the good of both colleges of arts and 

 sciences and of medical colleges, a cooperative ar- 

 rangement should have the greatest value, and such 

 an arrangement should ultimately affect to a con- 

 siderable extent the whole medical profession and, 

 through it, the general public. 



There is another important aspect in this pro- 

 posed closer association of medical schools and 

 colleges of arts. You know that, as a rule, tb» 

 state standards for practise tend to lag behind — 

 to be influenced by medical schools of the lower 

 grades. If the colleges of arts wiU let it be knowa 

 to their students that without two specified pre- 

 medical years in college science they can not prac- 

 tise in the Dakotas, in Iowa, in Minnesota, Colo- 

 rado, Indiana or Kentucky — that is to say that 

 certain states will not consider them sufficiently 

 well-educated to practise — the colleges themselves 

 will be benefited; the medical schools will )>e 

 helped; the schools of a low grade will be embar- 

 rassed, and the state boards will be stimulated to 

 be more active in enforcing standards which will 

 make it more possible to protect the public from 

 the half -educated doctor. 



I hope that at this conference we may be able to 

 come to some understanding which will make it 

 possible for us all, and for others who are not here 

 to-day, to work toward the ends ■w'hich I have sug- 

 gested. It is for the benefit of all the people that 

 we are working. The people are subject to ill-pre- 

 pared doctors; they are preyed upon by quacks 

 and charlatans. ' ' The higher the standards of edu- 

 cation in a profession, the less marked will be the 

 charlatanism. ' ' 



Following these remarks a series of short 

 prepared papers were devoted to the methods 



