10 
presentation of certain definite ideas which 
have formed themselves in my own mind as 
the result of the late discussion, and must 
leave to others a more comprehensive treat- 
ment. 
Foremost in importance is the idea that 
the number of lectures is too great, prob- 
ably, in every course given, and that the 
laboratory work and the personal clinical 
work occupy too small a proportion of the 
student’s time. The practical work is the 
instructive work ; it is the source of real 
knowledge. The actual direct contact with 
the objects and with the phenomena 1s 
knowledge. The very best that can be said 
of a lecture or a book is that it describes 
well the knowledge which someone posses- 
ses. There is no knowledge in books, and 
that motto ought to be inscribed over the 
library door. <A book or lecture can serve 
only to assist a man to acquire knowledge 
with lessened loss of time. Knowledge 
lives in the laboratory ; when it is dead we 
bury it, decently, in a book. Now real 
knowledge is what the medical practitioner 
needs, the personal mental image of things 
seen, felt and heard; he needs to establish 
a short circuit between sensations and the 
true psychic concept, but if you train him 
to interpolate books you are likely tomake 
the circuit so long that there will be no true 
concept at the end of such a resistance path. 
Our greatest discovery in scientific teach- 
ing is the discovery of the value of the lab- 
oratory and its immeasurable superiority 
to the book in itself. A le¢ture is a spoken 
book, and must, therefore, also yield to the 
superior claims of first-hand knowledge. 
It is the corollary of the value of labora- 
tory instruction that the examinations 
should be practical, or, in other words, 
that the conventional written examination 
should be given up. All the clinical work 
is, of course, to be classed as laboratory in- 
struction, and the time ought not to be far 
distant when students will be required to 
SCIENCE. 
[N.S. Vou. X. No. 236. 
make diagnoses from patients directly as 
the test of their proficiency. No one who 
has examined students in both ways is 
likely to question the superiority of the 
practical examination over the written. It 
is a real test of real knowledge, and is fair 
to the student for that very reason, and it 
avoids the two defects of the old-fashioned 
examination paper : first, the defect of test- 
ing memory rather than mental power ; 
second, the defect of offering rewards for 
cramining. A practical examination has 
the great advantage of emphasizing to every 
student the necessity of personal familiarity 
with the objective basis of his studies. 
A second important idea is that the re- 
quirements for a medical degree shall no 
longer be uniform for all candidates. That 
-this idea will be adopted is necessarily the 
belief of every one who advocates the elec- 
tive system. 
A new arrangement of studies has been 
adopted by the Faculty of the Harvard 
Medical to go into effect next year. It is 
the result of prolonged careful debate. It 
is based upon three leading principles, con- 
centration, correlation and sequence of sub- 
jects. The system consists in a division of 
studies by half years and by half days 
within the half year. The elementary 
anatomy will be confined to the first term 
of the first year, but will occupy half of 
every day ; the other half of every day will 
be occupied by histology, embryology and a 
special course on the brain. In the second 
term a similar system will be followed, half 
a day for physiology and half a day for 
physiological chemistry. In the first term 
of the second year this simple dual plan is 
pursued with pathology and bacteriology ; 
beyond this the arrangement is more elabo- 
rate, and for the third and fourth years is 
not yet fixed. 
The new plan is, of course, an experi- 
ment, but is fully expected to prove a suc- 
cessful one, because it will make the work 
