620 



SCIENCE 



[N. S. Vol. XXVI. No. 671 



ultimately prevail. Their information is 

 often inexact because it is voluntarily and 

 often carelessly given; their methods of 

 computation are faulty, and their conclu- 

 sions therefore unreliable. Their method 

 takes no account of the past record and 

 acknowledged reputation of institutions, of 

 the experience, devotion and ability of 

 teachers, and other elements the value of 

 which is not determinable by the quanti- 

 tative methods in which they so much de- 

 light, and in the ease of the student it has 

 no way of measuring natural aptitude, 

 quickness of perception and the zeal which 

 is often born of necessity. For myself I 

 do not believe that either institutions or 

 individuals can be measured up in this me- 

 chanical manner, and I do not think that 

 such methods will be tolerated if they ever 

 come to be rigorously applied in determin- 

 ing the standing of colleges and passing 

 upon their credentials. It is not denied 

 that great differences exist in the quality 

 of the work done in the medical schools 

 of this country, but I am clearly of opinion 

 that the present tendency is to attach alto- 

 gether too much importance to the institu- 

 tions ia which a man's education has been 

 obtained. Do we not need to change our 

 thinking in many respects? Institutions 

 do not make men. They only aid a little 

 in their development and the things which 

 we have taught ourselves are the most 

 valuable to iis in the real work of life. 

 ' ' They do most by books, ' ' says Sir Thomas 

 Browne in his "Christian Morals," "who 

 could do much without them, and he that 

 chiefly owes himself unto himself is the 

 substantial man," and Darwin has said 

 with greater deliberation and more seri- 

 ously, and I beg you well to weigh his 

 carefully chosen words, "I am inclined to 

 agree with Francis Galton in believing that 

 education and environment produce only a 

 small effect on the mind of any one and 



that most of our qualities are innate." 

 Manners are the result of, and much of 

 our behavior is influenced by, education 

 and environment, but our qualities are 

 born in us and training has little effect 

 upon the mind. Hence the mistake in at- 

 taching too much importance to time spent, 

 and courses pursued, in institutions, and 

 there is great danger that our laws regu- 

 lating the practise of medicine and other 

 callings may be patterned after too narrow, 

 inelastic and mechanical a model and serve 

 to restrain rather than encourage the de- 

 velopment of the vocations they control. 



Another tendency needing restraint is 

 exhibited by certain specialists and faddists 

 who urge upon colleges the necessity for 

 giving instruction in all sorts of special 

 subjects more or less closely related to 

 medicine. Lest I give offense to some of 

 these enthusiastic propagandists who push 

 their projects with energy worthy of more 

 important causes, I will make no catalogue 

 of them. These zealous advocates read 

 papere at society meetings ; interrogate the 

 colleges in tones implying that they are 

 guilty of wilful neglect in failing to in- 

 clude their fondly cherished fads in their 

 curriculums; and they organize societies 

 and write books on their specialties. Un- 

 fortunately they take no account of the 

 demands now made upon medical students 

 and the relatively small importance of 

 their particular branches, and they over- 

 look the fact that such subjects as they 

 would have taught in systematic courses 

 are either already included in other de- 

 partments, or else are of such a nature 

 that the physician who has need of special 

 knowledge concerning them can easily 

 secure it for himself when the want is felt. 

 Unless the colleges resist this kind of pres- 

 sure from without that is brought to bear 

 upon them either their courses must be 



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