Januakv 3, 1908] 



SCIENCE 



13 



interest in medicine scarcely extends be- 

 yond the circumference of his own body 

 or that of his family, and he measures the 

 value of the medical art by its capacity to 

 cure his cold, his rheumatism, his dys- 

 pepsia, his neurasthenia, all unconscious, 

 because he does not encounter them, of the 

 many perils which medicine has removed 

 from his path through life. What does he 

 know of the decline in the death rate by 

 one half and of the increase in the expecta- 

 tion of life by ten or twelve years during 

 the last century? How many are there 

 whose attention has been called to the sig- 

 nifieant fact that this increase in the ex- 

 pectation of life ceases with the forty-fifth 

 year because we have as yet no such insight 

 into the causes and prevention of the or- 

 ganic diseases of advancing life as we have 

 into the manner of propagation of infec- 

 tious diseases, which are responsible for the 

 larger part of the mortality of the earlier 

 years? The suffering and the waste of 

 energy, money, production and human lives 

 from preventable sickness and death are 

 still incalculable, but hoAV little heed do 

 legislators and authorities in our national, 

 state and municipal governments pay to 

 the appeals of physicians and enlightened 

 economists to make adequate provision to 

 cheek this waste! For this condition of 

 things the medical profession is largely 

 responsible in failing to enlighten the pub- 

 lic and in shrouding its art with the mys- 

 tery of an occult science, but it is beginning 

 to rise to its high mission of public educa- 

 tion in Avays of preserving health and of 

 preventing disease. 



I have touched on these matters relating 

 to the present and future state of the sci- 

 ence and art of medicine, not with the view 

 of recounting the achievements of modern 

 medicine, but to indicate something of their 

 importance to individual and to civic life 

 and to show that in fostering the teaching 

 and study of medicine the university finds 



a field worthy of its highest endeavors in 

 the propagation of useful knowledge and 

 in service to the community. 



From what has been said we may, I 

 think, assume with confidence that the best 

 and in time the prevailing type of Amer- 

 ican medical school is destined to be that 

 represented in medical departments in vital 

 union with universities. In so far our 

 system of medical education will conform 

 to that of Germany and France, but in an 

 important respect there is and will doubt- 

 less remain a difference due to the fact 

 that in those countries the courses of study 

 and the qualifications for the degree and 

 the license to practise are moulded into 

 practical uniformity by the regulations of 

 the state. Nothing is more characteristic 

 of the conditions of medical education in 

 our country than the great diversity of the 

 requirements and curricula of the various 

 medical schools, even of those of the better 

 sort. Entire uniformity is not to be ex- 

 pected and not to be desired, but at least 

 such a measure of agreement should be 

 secured as will permit students to pass 

 freely from one university to another and 

 to acquire, it is to be hoped, something of 

 the habit of wandering which is such an 

 enviable feature of student life in the Ger- 

 man universities. 



No problem of medical education in this 

 country is so perplexing or has given rise 

 in recent years to so much discussion and 

 difference of opinion as that of the prelim- 

 inary education to be required for the study 

 of medicine. If I could announce a uni- 

 versally satisfactory solution of this prob- 

 lem, I should claim the honors of an impor- 

 tant discovery, but as I can not do so I 

 shall forego on this occasion its detailed 

 discussion, with a self-sacrificing forbear- 

 ance which I trust may be commended by 

 my hearers. It must suffice to enumerate 

 the attempts at a solution, pi'emisjng, what 

 is generally recognized, that the difficulties 



