778 



SCIENCE 



[N. S. Vol. XLII. No. 1092 



accurately, and thoroughly, to record his 

 observations clearly and concisely, and to 

 reason logically from his findings to sound 

 deductions — that is the main purpose and 

 function of any educational process, be it 

 medical, pathologic or any other. "We in 

 America seem especially obtuse in our fail- 

 ure to recognize this vital truth, as is shown 

 conspicuously in the character of our ex- 

 aminations. We have made some progress 

 in our teaching methods, though we have 

 jet much to learn, but we continue to test 

 the results of our work by methods a half 

 •century out of date. In examinations for 

 .graduation, for licensure to practise (with 

 ■exceptions now in a few states) and in com- 

 petitive examinations for interneships in 

 the best hospitals, the papers set are wholly 

 written papers of such sort as to test only 

 the volume of facts which the candidate has 

 been able to cram into his cranium — a test, 

 in other words, of but one mental faculty, 

 the memory, and that by no means the 

 most important. Into the student's real 

 power to see and hear and feel things, to 

 know what he observes, and to draw sound 

 conclusions from his findings — in short his 

 ability to do the things he is to be called 

 upon to do as an interne and a practitioner 

 of medicine, we make no real inquiry what- 

 ever. If we are to give our students the 

 proper conception of what they are attend- 

 ing the medical school for, and an effective 

 stimulus to really develop all of their men- 

 tal faculties, along medical lines, we must 

 radically change the character of our ex- 

 aminations. 



The teachers of pathology are in an espe- 

 cially advantageous position to set an ex- 

 ample in this regard, and to exert a pro- 

 found influence for the betterment of our 

 methods of examination. 



Another serious mistake is the growing 

 tendency to crowd some of the clinical sub- 

 jects into the sophomore year. In one 



school, for example, courses in medicine, 

 surgery, obstetrics, ophthalmology and der- 

 matology now occupy a considerable portion 

 of the time of the second semester of the 

 sophomore year; at another, the sopho- 

 mores take medicine, both clinical and 

 didactic, surgery and pediatrics ; at a third 

 school, medicine, surgery, obstetrics and 

 dermatology occupy 10 hours weekly of the 

 25 or 30 available, while in yet another, 

 medicine, surgery and obstetrics are begun 

 at this time. The time available for the 

 fundamental sciences of anatomy, general 

 pathology, etc., is all too short when the 

 .full time of the two years is devoted ex- 

 clusively to them. The education which the 

 student is obtaining in these fundamental 

 subjects in these two years is the only sys- 

 tematic instruction he will ever get in those 

 branches, and must serve him for a life 

 time. Most students leave the medical col- 

 lege at graduation with a resolve to review 

 these branches from time to time, but very 

 few indeed ever do so. Deficiencies in 

 clinical training are readily amended, be- 

 cause the subjects are right in line with the 

 physician's daily work; shortcomings in 

 the fundamental bi-anches can be corrected 

 only at a considerable sacrifice of time, 

 money and energy. 



I have indicated that I would lay much 

 less stress on pathologic anatomy than has 

 been and still continues to be the custom in 

 most schools, and more, increasingly more, 

 time on experimental pathology, chemical 

 pathology, serology, and the other newer 

 developments of the subject. As to patho- 

 logic anatomy much can be done to famil- 

 iarize students with the gross and micro- 

 scopic appearance of diseased tissues and 

 organs (and this with the minimum expen- 

 diture of effort by both student and 

 teacher) by having displayed in a well- 

 lighted central place, frequented by the 

 student body for study or lounging, patho- 



