10 



SCIENCE 



[N. S. Vol. XLII. No. 1070 



example set by three of our leading med- 

 ical schools was not followed, the science of 

 hygiene failed to develop generally and in 

 many instances the older foundations of 

 hygiene were abandoned to make room for 

 subjects regarded as of greater necessity 

 in the medical curriculum. Thus the de- 

 partment of hygiene in Cooper Medical 

 School, now Leland Stanford, gave way to 

 a department of bacteriology. Recently 

 however Western Reserve has reorganized 

 its work in hygiene and has appointed a 

 full-time professor in this branch, a simi- 

 lar change has taken place in Tale and the 

 relatively new University of Chicago has 

 also established such a department. "With 

 all this hygiene as a major subject, with a 

 trained scientist giving up his entire time 

 to teaching its principles and studying its 

 problems, exists in but six of our thirty- 

 eight medical schools to-day. What a piti- 

 ful showing this makes in comparison with 

 Germany and Austro-Hungary where all 

 the twenty-two universities where medicine 

 is taught have their hygienic institutes or 

 with Great Britain where every graduate 

 in medicine must follow courses in public 

 health and pass examinations in it. I do 

 not mean that many of our medical schools 

 are not making a determined effort to de- 

 velop the subject of hygiene or that in- 

 struction in it is entirely lacking. Indeed 

 excellent courses in public health are given 

 in both Minnesota and Indiana. In the 

 three larger medical schools in New York 

 City hygiene or public health has now be- 

 come compulsory. At Johns Hopkins too 

 the faculty has long recognized the neces- 

 sity of further development along this line 

 and the beginnings small though they are 

 have now been made. I merely wish to 

 point out and emphasize that the science of 

 hygiene, one of the most important parts of 

 a medical curriculum, has never reached 

 the same development as an independent 



subject which has long been attained in 

 Europe, and which has already been 

 reached in America by the scientific 

 branches of medicine, anatomy, physiol- 

 ogy, chemistry, pathology and pharmacol- 

 ogy, or by the clinical, surgery, medicine 

 and gjTiecology and obstetrics. 



In the same way and possibly as the re- 

 sult of the same influences, hygiene plays 

 but an unimportant part in our state ex- 

 aminations for licensing practitioners of 

 medicine. In but a few states is there a 

 separate examination in hygiene and in 

 some the subject is not even mentioned. 

 Yet there is probably no field in which med- 

 ical men need training more than in hy- 

 giene and in no line of work will his efforts 

 be more beneficial or more appreciated by 

 the community than in the prevention of 

 the spread of infectious diseases by the ap- 

 plication of the sound principles of sanita- 

 tion. The medical profession of America is 

 neither indifferent to the great problems of 

 preventive medicine nor ignorant of its 

 principles however. The long and honor- 

 able career of the American Public Health 

 Association and the more recent develop- 

 ment of the Section of Hygiene and Pre- 

 ventive Medicine of the American Medical 

 Association testify to the contrary. The in- 

 difference to hygiene as a science lies in 

 our universities and in our medical schools 

 and the responsibility for the failure of its 

 development rests clearly upon them. 



PRESENT NEEDS 



The question now rises as to the especial 

 needs of hygiene, and the conditions which 

 must be met in order that it shall develop. 

 We may best consider this under three divi- 

 sions. 



There is first a definite need and even a 

 necessity for the training of medical stu- 

 dents in the science of health, whether the 

 science be labeled hygiene, public health or 



