January 3, 1908] 



SCIENCE 



15 



the influence and standing of the physician 

 in the community, enhance and widen the 

 intellectual pleasures of his life, instil an 

 interest in the history of medicine and give 

 him greater joy in the pursuit of a noble 

 profession. It is important, especially for 

 medicine, that this culture be imparted by 

 methods of liberal education which do not 

 blunt man's innate curiosity for the facts 

 of nature. 



There can be no more striking evidence 

 of the progress of medical education in this 

 country during the last quarter of a cen- 

 tury than that it is no longer the labora- 

 tory, but the clinical side of medical teach- 

 ing which offers the urgent problems. 

 Only a few years ago the cry was the need 

 of laboratories ; now, while a sufScient sup- 

 ply of good laboratories is still beyond the 

 resources of many medical schools, their 

 value is fully recognized and all of our 

 better schools possess them and are devot- 

 ing probably as much of the time and ener- 

 gies of teachers and students to work in the 

 laboratories as is desirable. There is even 

 some risk, I believe, that a subject which 

 can be studied with facility and advantage 

 in a laboratory may acquire, on this ac- 

 count, a position in the scheme of medical 

 studies disproportionate to its relative im- 

 portance. The structure of organized be- 

 ings, normal or diseased, for example, is 

 eminently adapted to laboratory study, and 

 for centuries normal anatomy had an edu- 

 cational value all its own, because it was 

 the only subject which students were taught 

 in the laboratory, whereas the study of 

 function, certainly not less important, is 

 much more difficult to approach by the 

 laboratory method, and even at the present 

 time normal physiology and especially 

 pathological physiology do not receive the 

 attention in medical education to which 

 their importance entitles them. 



It is interesting to note the impressions 

 which Professor Orth, of Berlin, an acute 



observer and most competent judge in all 

 matters pertaining to medical education, 

 received from his visit to this country three 

 years ago regarding our laboratories and' 

 clinics. In an address conveying these im- 

 pressions to the Berlin Medical Society he 

 expresses his astonishment and satisfaction 

 that, in contrast to the prevalent opinion 

 in Germany as to our medical schools, he 

 found that fully as much emphasis is 

 placed on laboratory teaching here as there, 

 that the laboratories which he visited are 

 as good, their arrangements in some in- 

 stances arousing his envy, and the methods 

 of teaching practically the same as in Ger- 

 many, whereas he gathered the impression 

 that the opportunities and methods of 

 clinical teaching are less satisfactory than 

 in Germany and not commensurate with 

 those of our laboratories. 



I do not desire to instil sentiments of 

 undue complacency regarding the condition 

 of laboratory teaching in our medical 

 schools, for there is still room for much 

 improvement in this regard. Many schools 

 are sadly deficient and even the best have 

 not all that is needed in the supply and 

 maintenance of laboratories, but the time 

 has come to give especial emphasis to direc- 

 tions of improvement in the teaching of 

 practical medicine and surgery. The 

 making of good practitioners should al- 

 ways be kept to the front as the prime 

 purpose of a medical school. 



I believe that in most medical schools at 

 present the clinic falls behind the labora- 

 tory in affording students opportunities for 

 that prolonged, intimate, personal contact 

 with the object of study, in this instance 

 the living patient, which is essential for a 

 really vital knowledge of a subject. To 

 secure this, amphitheater clinics and ward 

 classes alone do not suffice, valuable as these 

 are, but students under suitable restrictions 

 and supervision and at the proper period 

 in their course of study should work in the 



