December 3, 1915] 



SCIENCE 



775 



progress made in the introduction of more 

 rational and effective methods. 



Pathology in my student days was not 

 recognized as an essential subject in the 

 medical curriculum. Indeed at the first 

 college I attended it was not only not taught, 

 but was ridiculed by some of the most in- 

 fluential members of the faculty, as "Dead- 

 house Medicine." In the second college 

 mentioned, perhaps at that time the most 

 progressive medical college in this country, 

 a few incidental exercises, by a subordinate 

 teacher, who presented some post-mortem 

 specimens to the class, comprised all that 

 was offered. How great has been the ad- 

 vance in the subsequent quarter century is 

 in no wise better illustrated than by the 

 number and character of the contributions 

 made by undergraduate students to the 

 transactions of this society. 



Meanwhile, pathology itself has been ex- 

 tending its scope very rapidly. The term 

 pathology no longer stands for mere patho- 

 logical anatomy, the study of the end re- 

 sults of disease but has come to signify, as 

 its etymology implies, a comprehensive 

 study of the phenomena of disease in the 

 living, the behavior of cells, tissues, organs 

 and systems, in an abnormal environment, 

 or their reaction to abnormal stimuli — an 

 exhaustive search for the causes of these 

 abnormalities, physical, chemical and bio- 

 logic, and the rationale of the processes by 

 which these etiologic factors bring about the 

 phenomena which we caU disease. Indeed, 

 some of the more recent text-books on medi- 

 cine include, under the heading of pathol- 

 ogy, the discussion of etiology, symptoma- 

 tology, pathogenesis and pathologic anat- 

 omy, everything, in short, but diagnosis, 

 prognosis and therapy. 



The methods by which this comprehensive 

 knowledge is sought are more and more be- 

 coming the methods of exact, carefully con- 

 trolled experiment on animals. The mere 



study of post-mortem changes, important 

 though it is, comes yearly to occupy a 

 relatively less important role in the task of 

 the pathologist. Infection and immunity, 

 serology, protozoology, chemical pathology, 

 these and other phases of the subject, newly 

 born in the last decade or two, are rapidly 

 changing our whole conception of pathol- 

 ogy, are greatly enlarging its scope, and 

 are, as it seems to me, necessitating a con- 

 stant readjustment of this branch to other 

 branches in the medical curriculum, and 

 improvements in our methods of instruc- 

 tion by which the coming generation of 

 practitioners must be educated in pathology. 



The pedagogics of pathology involves a 

 consideration of (1) its relative importance 

 in the curriculum — that is, the number of 

 scheduled hours that should be assigned to 

 the subject; (2) its proper sequence in the 

 program of courses to be determined by the 

 prerequisites which are essential for its in- 

 telligent study, and by its relation to the 

 more advanced clinical subjects for the 

 pursuit of which some knowledge of pathol- 

 ogy is necessary, and (3) the methods to 

 be employed in the teaching of the subject, 

 and this depends largely on one's concep- 

 tion of the scope and content of pathology 

 as a science. 



A survey of the curricula of about forty 

 of the leading university medical schools of 

 the United States discovers the fact that 

 while there are considerable variations in 

 the courses in pathology offered in these 

 schools, as to the three points just men- 

 tioned, on the whole the differences are less 

 marked than are those in the clinical sub- 

 jects. 



The amount of time assigned to the sub- 

 ject is somewhat difficult to determine, as 

 some of the topics taught in most schools 

 under the general heading of pathology, are 

 offered in others in connection with bac- 

 teriology, while other topics, for example, 



