Mat 19, 1916] 



SCIENCE 



693 



for their material, but did not often, except- 

 ing through the good will of the clinieian 

 and pathologist, control the supply; and, 

 excepting to a very limited extent, the labo- 

 ratories at the school rendered no especial 

 service to the hospital. 



In such a school of medicine a hospital 

 was an accessory, a very close and valuable 

 accessory to be sure, but yet an accessory to 

 the department of medicine. And in dis- 

 cussing matters of medical education the 

 hospital and the medical department of the 

 university might be considered separately. 



To-day the hospital must be considered 

 not as an accessory to the department of 

 medicine, but as its vital center. One can 

 scarcely conceive of a school of medicine 

 wholly independent of its hospital. The 

 laboratories for the study of the chemical 

 and anatomical and physiological phenom- 

 ena of disease can not well exist at a center 

 removed from the hospital, or under the 

 control of individuals other than those di- 

 rectly associated with the hospital manage- 

 ment. On the other hand, the hospital in 

 many instances has come to depend largely 

 on the cooperation of the university in the 

 performing of some of its most essential 

 functions. Professors, assistants, under- 

 graduate students all go to form a corps of 

 hospital servants invaluable to the institu- 

 tion. In a word, the relations between hos- 

 pital and school of medicine are so close 

 and intimate to-day that a discussion of the 

 organization of a medical or surgical clinic, 

 or of a department of pathological anatomy, 

 presupposes the assumption that hospital 

 and university be under one management or 

 in such close affiliation as to form a single 

 working body. For the ends aimed at by 

 both hospital and school of medicine are 

 closely related. The main, specific purpose 

 of the hospital is the care of the sick; that 

 of the school is the training of physicians. 

 The care of the sick can be carried out best 



through the employment of physicians of 

 the highest order, and for these the hospital 

 turns to the school. But to offer the stu- 

 dent the best possible training the school 

 must have opportunities for the study of 

 disease and of pathological material, and 

 for these opportunities it turns to the hos- 

 pital. The delicacy and complication of 

 modern methods of chemical and physical 

 diagnosis demand laboratories and labo- 

 ratory equipment which involve consider- 

 able and steadily increasing financial out- 

 lay ; they call, moreover, for students of the 

 best chemical and physical training to pre- 

 side over these laboratories. This has 

 brought it about that general hospitals 

 which are not integral parts of a univer- 

 sity must turn to universities for assistance, 

 or spend, for the installation of independent 

 laboratories and apparatus and for the em- 

 ployment of salaried heads of these depart- 

 ments, a sum of money which to many insti- 

 tutions is almost overwhelming. The uni- 

 versity laboratories of bacteriology, serol- 

 ogy, physiological chemistry and so forth 

 where studies which are, in many instances, 

 most practical, are to be made, should be 

 in or adjoining a hospital. Thus the econ- 

 omy and mutual advantages of cooperation 

 are clearly apparent. And more than this, 

 in the true university hospital which is cen- 

 trally situated, a community of interest is 

 constantly drawing together the clinical and 

 so-called scientific departments. This is 

 particularly true of the departments of 

 physiology, physiological chemistry and 

 pharmacology — and to the great mutual ad- 

 vantage of hospital and of university. 



To-day in the better equipped and organ- 

 ized institutions there is in ward and labo- 

 ratory, in hospital and school a common 

 effort to contribute to the advance of the 

 science and art of medicine in its broadest 

 sense. Both hospital and school are centers 

 of original research. However cordial and 



