458 



SCIENCE. 



[N. S. Vol. XXIV. No. 615. 



however high their attainments, in con- 

 sequence of the separation of the medical 

 school from any control over the appoint- 

 ments to the hospital staff, can not antici- 

 pate with any degree of assurance similar 

 promotion in their chosen lines of work, 

 and consequently the medical faculty has 

 not so wide a field of choice in filling the 

 clinical chairs as in filling those of the 

 auxiliary sciences. 



The removal of these deficiencies on the 

 clinical side of medical education in 

 America requires som^e reorganization of 

 its staff on the part of the hospital and the 

 control by the medical school of its hos- 

 pital, or, at least its voice in appointments 

 to the hospital staff. So far as our re- 

 sources permit, we have, I think, accom- 

 plished this- reform at the Johns Hopkins 

 Medical School and Hospital. 



The welfare of the patient is the first 

 obligation of the trustees of hospitals and 

 of physicians in attendance, but nothing is 

 more certain than that cordial cooperation 

 between medical school and hospital best 

 subserves the promotion of this welfare. 

 Fortunate the hospital and fortunate the 

 patients brought into such relations with 

 the Harvard Medical School. 



As is strikingly illustrated by the new 

 buildings of this school, the educational 

 machinery of medicine to-day is vastly 

 complicated and costly compared with the 

 simplicity of the days when a lecture room, 

 a dissecting room, a simple chemical labora- 

 tory and a clinical amphitheater were all 

 that was needed. The purpose of medical 

 educatioia, however, remains to-day what 

 it has always been and will continue to be 

 — the training of the student for the fu- 

 ture practise of his profession, and to this 

 end in a harmonious scheme of educa- 

 tion the various medical sciences all work 

 together. Right action requires abundant 

 knowledge, nowhere more so than in med- 



ical practise, and the all-sufficient justifica- 

 tion for the position held by the various 

 sciences in the preliminary and the pro- 

 fessional education of the physician is that 

 they furnish knowledge and discipline of 

 mind needed in the preparation for his fu- 

 ture work. The social position of the 

 medical man and his influence in the com- 

 munity depend to a considerable extent 

 upon his preliminary education and gen- 

 eral culture. For this reason as well as 

 for his intellectual pleasure in his profes- 

 sion and as a sound foundation for his 

 future studies the student should enter 

 the medical school with a liberal education, 

 which should include training in the sci- 

 ences fundamental to medicine. 



The unity of the various medical sci- 

 ences is manifested not only in their his- 

 torical development and in their coopera- 

 tion in the scheme of medical education, 

 but especially in their contributions to the 

 upbuilding and progress of medicine as a 

 whole. 



There is no branch of medicine or even 

 of physical science which has not played 

 an important part in the evolution of our 

 present medical knowledge and beliefs. 

 The great lesson taught by the history of 

 this development of medicine through the 

 centuries has been the unconditional rever- 

 ence for facts revealed by observation, ex- 

 periment and just inference as contrasted 

 with the sterility of mere speculation and 

 reliance upon transmitted authority. The 

 great epochs of this history have been 

 characterized by some great discovery, by 

 the introduction of some new method, or 

 by the appearance of some man of genius 

 to push investigation and scientific infer- 

 ence to limits not attainable by ordinary 

 minds. The history of medicine has a 

 greater unity and continuity and extends 

 over a longer period of time than that 

 of any other science. 



