July 2, 1915] 



SCIENCE 



11 



preventive medicine. Every man who grad- 

 uates from a medical school should be 

 taught, some time during his course, the 

 underlying principles of hygiene. He 

 should know what the word ventilation 

 means, for instance, something about cloth- 

 ing, the kinds of exercise suitable for dif- 

 ferent individuals, the values of foods, how 

 a good water supply differs from a poor 

 one, what good milk is, how a city should 

 dispose of its sewage. Especially should 

 he be taught the mode of transmission of 

 the infectious diseases and the methods of 

 their prevention. This knowledge the well- 

 trained physician of the future must have, 

 not merely that he may advise his patients 

 properly and safeguard their health, but 

 that he may play his part in the community 

 where he lives and lift his voice on the right 

 side concerning that branch of city and 

 state government which most concerns him, 

 the department of health, too often alas 

 merely a pawn in the hands of unscru- 

 pulous individuals to move as they see fit 

 in the great game of politics. To accom- 

 plish this purpose, namely, the education of 

 the physician, every medical school in this 

 country should have its department or in- 

 stitute of hygiene in charge of a full-time 

 man with a corps of trained assistants. It 

 makes little difference whether the head 

 of this department is a chemist, a bacte- 

 riologist or a physicist, since the prob- 

 lems of hygiene must be approached 

 from various angles, but in the organiza- 

 tion of the department provision must be 

 made for teaching the subject with refer- 

 ence to chemistry, bacteriology and physics. 

 Didactic lectures in hygiene must be com- 

 bined with laboratory exercises and the 

 student must acquire first-hand knowledge 

 of water and milk analysis, disinfection, 

 sanitation, and especially the bacteriolog- 

 ical diagnosis and the prophylaxis of the 

 infectious diseases. In addition special 



courses should be offered in such topics as 

 school hygiene, serum-therapy, nutrition 

 and food valuations, etc. The research side 

 should also play a large part in any depart- 

 ment of hygiene. It is not sufficient to 

 teach what we know at present about hy- 

 giene. The bounds of our knowledge must 

 be constantly widened, new facts acquired 

 and new theories tested. 



The relationship of the department of 

 hygiene to the medical school should also 

 be made clear. It is essential that hygiene 

 be presented as a distinct and independent 

 science and not as a phase of bacteriology, 

 or of chemistry, or of physics. How far 

 the department of hygiene should engage 

 in teaching the elementary principles of 

 the sciences whose methods it uses is also 

 an important question but chiefly as it 

 affects bacteriology. This after all is a 

 matter of merely academic interest. Bacte- 

 riology must always be taught medical stu- 

 dents from the standpoint of the pathogenic 

 bacteria. If the pathological laboratory 

 has the facilities for teaching bacteriology 

 and the staff have the training there is no 

 reason why general bacteriology should not 

 be taught with pathology. Nor is there any 

 reason why bacteriology should not exist as 

 a separate department in the medical school 

 if funds are available for this purpose. At 

 the same time there is no reason why gen- 

 eral bacteriology should not be taught in 

 the hygienic institute so long as it does not 

 encroach upon the teaching of hygiene and 

 provided the head of the department has 

 received the proper training and under- 

 stands the fundamental principles of infec- 

 tion and immunity. Above all it must be 

 remembered that hygiene is a medical sub- 

 ject and a part of medicine. Its methods 

 are the methods of medicine and have been 

 developed in the medical departments of 

 the European and American universities. 



