NOVEMBEB 8, 1907] 



SCIENCE 



619 



guilt and it is high time that we resented 

 the implication that the medical schools of 

 this country are, as a class, unmindful of 

 their high responsibilities and are employ- 

 ing questionable methods in the conduct of 

 their work. There are poor medical schools 

 as there are poor schools of all kinds, 

 but no general charge of incompetency or 

 dishonesty can lie against them as a class, 

 and we should no longer remain silent 

 when such charges are either directly or 

 impliedly made. 



Now first of all it seems to me we must 

 guard against anything that savors of 

 trades-unionism in medicine. Physicians 

 should be banded together that they may 

 promote the interests of their profession in 

 proper ways, but any action that looks like 

 closing the doors, or putting up the bars, 

 for the purpose of lessening the number 

 of medical men, and restricting competi- 

 tion, ought not to be tolerated. We are 

 often told that the number of physicians 

 in the United States is out of all propor- 

 tion to the population and greatly exceeds 

 that in any other country, but this fact in 

 itself has no particular significance and 

 may be cause for thankfulness. Condi- 

 tions are different. If these practitioners 

 are competent, and can make a living, let 

 us not complain but rather thank God that 

 the American people are better supplied in 

 this respect, as in so many others, than 

 those of Russia, or even Prance, Germany 

 or England. With those who start with 

 the assumption that our social system needs 

 to be conformed to the European or mon- 

 archical type I have no argument, but there 

 is danger that well-disposed and entirely 

 patriotic persons, who are possessed with a 

 zeal for reform and advance which is not 

 tempered by a wise discretion, will by 

 much fussing and compiling of statistics 

 and the everlasting iteration of certain 

 ideas bring about changes which will not 



be betterments. Such are the people who 

 would reduce everything to a strict numer- 

 ical expression. They pursue their in- 

 vestigations with a foot-rule and hour- 

 glass, place implicit faith in statistics, and 

 would reduce all to a system. They would 

 determine the competency of a student to 

 enter upon the study of medicine by the 

 special courses he has taken, and the hours 

 devoted to each, and whether his work is to 

 be counted or not is to be decided by a 

 measurement of floor-spaces of the recita- 

 tion rooms and laboratories in which he 

 has been instructed, and the cash value of 

 the apparatus employed. They would 

 measure his- subsequent progress by mathe- 

 matical computations in which the factors 

 are forty or fifty divisions of the medical 

 curriculum, each subdivided into lectures, 

 recitations, clinics, demonstrations and 

 laboratory work, and the value of each de- 

 termined by a laborious conversion of these 

 into hours, which must be so apportioned 

 as to preserve a certain ratio, and the sum 

 total of which must not fall below a pre- 

 scribed minimum. And whether this in- 

 struction which he has received has been 

 good or bad is to be determined by a con- 

 sideration of the population of the place in 

 which the medical school is situated, the 

 value of buildings and apparatus, the ratio 

 of students to floor areas, the number of 

 cases treated in affiliated hospitals and dis- 

 pensaries, and other such data. This is not 

 fanciful. No month goes by that we are 

 not requested to supply such information 

 as this to individuals who are preparing 

 papers to read at society meetings and con- 

 ferences, to committees and councils of 

 societies, and to state examining and licens- 

 ing boards. These tiresome statisticians, 

 with their arbitrary standards and mathe- 

 matical deductions, seem to be in the as- 

 cendancy at present, but their enthusiasm 

 needs to be restrained and saner views will 



