16 



SCIENCE 



[N. S. Vol. XXVII. No. 079 



dispensary and should have free access to 

 patients in the public wards of hospitals, 

 acting in the capacity of clinical clerks and 

 surgical dressers as a part of the regular, 

 orderly machinery of the hospital. 



In order to place the clinical side of 

 medical instruction on the same satisfac- 

 tory foundation as that of laboratory teach- 

 ing, two reforms are especially needed in 

 most of our medical schools. 



The first is that the heads of the prin- 

 cipal clinical departments, particularly the 

 medical and the surgical, should devote 

 their main energies and time to their hos- 

 pital work and to teaching and investiga- 

 ting without the necessity of seeking their 

 livelihood in a busy outside practise and 

 without allowing such practise to become 

 their chief professional occupation. This 

 dii'ection of reform has been forcibly urged 

 in this city and elsewhere by my colleague. 

 Dr. Barker, whom we have reclaimed from 

 yoxi, in notable papers and addresses. 



The other reform is the introduction of 

 the system of practical training of students 

 in the hospital, which I have indicated, 

 and Avith it the foundation and support 

 of teaching and investigating laboratories 

 connected with the clinics, to which I have 

 already referred, necessitating the posses- 

 sion of a hospital by the medical school or 

 the establishment of such relations with 

 outside hospitals as will make possible these 

 conditions. This subject, as thus outlined, 

 I made the theme of an address at the 

 opening, six months ago, of the new Jeffer- 

 son Medical College Hospital in Philadel- 

 phia, and I shall now recur only to the 

 point which I endeavored there to estab- 

 lish, that the teaching hospital subserves 

 the interest of the patient not less than that 

 of the student and teacher and is the best 

 and most useful kind of public hospital. 



Hospitals make generally a stronger ap- 

 peal to public and private philanthropy 

 than the support of medical education, but 



I do not hesitate to affirm that a general 

 hospital in a university city, whether main- 

 tained by public funds or by private 

 benevolence, serves the community and the 

 interests of its patients far better when it 

 is readily accessible and freely available 

 for the purposes of medical education than 

 when it is divorced from connection with 

 medical teaching. Witness the great pub- 

 lic hospitals in Vienna, Berlin, Munich, 

 Leipsic, Paris, London, Edinburgh, Dublin 

 and a few in this country. It is most 

 deplorable both for the hospitals and for 

 the medical schools that these two institu- 

 tions, which should be linked arms of med- 

 ical education, should have developed in 

 this country so far apart, that state and 

 municipal authorities and private founders 

 should have so little realization of the in- 

 estimable advantages which close associa- 

 tion with a good medical school can confer 

 on a hospital, and that the immense possi- 

 bilities of public hospitals in our large 

 cities for the education of students and 

 physicians and for the advancement of 

 medical knowledge should be utilized to so 

 small an extent, often not at all. 



It would be one of the greatest benefits 

 to the cause of higher medical education 

 if the University of Chicago, for its medical 

 department, should come into possession of 

 a good general hospital and fortunate the 

 hospital which enters into this relationship. 

 This university, the source of so many im- 

 portant contributions to the advancement 

 of knowledge and of higher education, will 

 then be, in larger measure than it now finds 

 possible, a center of similar service to 

 medicine. 



Medical education partakes fully of the 

 freedom, so amazing often to many of our 

 European colleagues, with which we un- 

 hesitatingly try all sorts of educational 

 experiments in this country — it is to be 

 hoped and expected for the ultimate benefit 

 of systems of education, whatever the im- 



