October 11, 1907] 



SCIENCE 



459 



advances in knowledge there is still much 

 in medicine that is empiric, and a quick 

 intuition and sympathetic manner may go 

 further than actual scientific ability. A 

 large part of every-day practise is country 

 or village practise, and among a class of 

 people who do not care for or understand 

 refinement of any sort. Among such 

 people general culture is not appreciated 

 and may even be a detriment to actual 

 success. This may sound paradoxical, but 

 the observation has been made over and 

 over again that the rough-and-ready man 

 who is familiar with the language of the 

 field and shop and who can speak it with 

 the people is successful, where the user of 

 the choicest English may fail utterly, not, 

 of coiirse, because of the English, but be- 

 cause of acquired mental peculiarities 

 which may go with it. The practitioner 

 can not be too far ahead of the people with 

 whom he has to deal. Considering prac- 

 tically the medical man's patrons, it must 

 be admitted that in the United States his 

 income is relatively low. Of course I am 

 not thinking here of the fortunate surgeon 

 who has achieved a reputation in a large 

 city and whose fees may be anything he 

 chooses to ask, but I refer to the every-day 

 practitioner of general medicine, the man 

 who has been called the family physician, 

 and who is expected to attend to all kinds 

 of ailments. For the time he spends and 

 the work he does his pay is far from high, 

 and possibly not high enough to warrant a 

 longer time in preparation. From what 

 was intimated above, it does not follow 

 that a longer course of study would bring 

 greater pecuniary reward. Wages of 

 those who work with the hands only have 

 advanced more rapidly than has the some- 

 what uncertain income of the professional 

 man. 



With these and similar facts before him 

 the young man through with the high 

 school hesitates at the outset of a course 



which may lead him through eight years 

 of work before he begins to earn a living, 

 and, all sentiment aside, that is what most 

 men have to work for. And medical men 

 who have been at the grind for years, also 

 hesitate in recommending such a course of 

 study. What preparation, then, can be 

 made for the medical school which is more 

 in harmony with actual conditions if not 

 with ideals^ Is it possible to find a com- 

 promise course which will mark an ad- 

 vance, and yet not be so extensive as to be 

 impracticable? 



At the present time the best of our medi- 

 cal schools seem to require graduation from 

 a four years' high school course for ma- 

 triculation, and this, we are all agreed, is 

 not enough. Many authorities are asking 

 that, following the high school course, two 

 years of regular college work should be 

 taken before the regular medical course of 

 four years is begun. This is probably a 

 just requirement, but it appears to be 

 still in advance of what may be insisted 

 upon. As a compromise the Council on 

 Medical Education has recommended a pre- 

 liminary year of work in sciences and 

 language, in addition to the high school 

 course of four years, as the practical min- 

 imum which should be accepted by medical 

 schools in good standing. A very con- 

 siderable number of the best schools have 

 promised to adhere to this scheme. 



In order to work out some of the details 

 of .such a plan a special committee on pre- 

 liminary medical education, consisting of 

 Professors George A. Piersol, of Philadel.- 

 phia, Charles R. Bardeen, of Madison, and 

 the ■writer of this article, was appointed last 

 fall, and has since made a brief report with 

 some recommendations. At the outset, it 

 may be said that the members of this com- 

 mittee, as individuals, are agreed that a 

 four-year college course preliminary to 

 medicine is an extremely valuable acquire- 

 ment, and should be recommended wherever 



