560 



SCIENCE 



[N. S. Vol. XXXVIII. No. 981 



courses in physiology, but even in anatomy 

 and pathology lecturers do not entirely confine 

 themselves to the discussion of non-psycholog- 

 ical matters. Wliile it may be possible to 

 teach anatomy, physiology and pathology with- 

 out reference to psychological matters, in 

 practise this is probably rarely done. In con- 

 sidering the present status of psychology in 

 the medical curriculum, account should, there- 

 fore, be taken of the inclusion in anatomy of 

 a modicum of psychology and in dealing with 

 such matters as sensation, perception, etc., the 

 lack of strict separation of psychological facts 

 and theories from those of a physiological 

 nature. 



2. How far do tlie third (or fourth) year courses 

 in nervous and mental diseases take up the biolog- 

 ical sides of neurology and psychiatry? 



From the answers which were received, it 

 is apparent that this question was quite gen- 

 erally not understood. The fact that it was 

 not understood does, however, give some in- 

 formation regarding the teaching of neurol- 

 ogy and psychiatry. Of the 5Y answers, 27 

 were " no " ; 24 were of a doubtful character, 

 and only 6 were definitely positive. Careful 

 reading of the doubtful answers shows that 

 16 of these should be grouped with the defi- 

 nitely " no " replies. The fullest replies, which 

 were received from the professors of neurology 

 in schools SO and 37, indicate plainly that 

 their teaching of psychiatry and neurology is 

 broadly biological, and not the narrow clinical 

 teaching which characterizes so many of these 

 courses. It is also apparent that in a very 

 large proportion of our medical schools, 

 neurology and psychiatry are taught as clin- 

 ical subjects — diseases are described, differen- 

 tial diagnostic signs are discussed and meth- 

 ods of treatment are suggested. The broader 

 aspects of these subjects are apparently not 

 even hinted at in many schools, although a 

 superficial reading of many of the answers 

 which were received might lead to the opposite 

 conclusion. Thus we read: 



"All work in neurology and psychiatry is bio- 

 logical. I know of no other kind" (25); "Three 

 months" (57); "15 lectures" (66). 



It will be appreciated that answers such as 

 the latter two indicate either a lack of under- 

 standing of what is meant by the " biological 

 sides " of neurology and psychiatry, or there 

 has been an unwarranted exaggeration of the 

 amount of time given to this part of the 

 subject. 



3. Are there elective or graduate courses in 

 medicine which deal with the relations of neurol- 

 ogy, psychiatry and psychology, and how much 

 time is given to them? 



Only two schools {3 and 23) out of 60 which 

 answered this question replied in the affirma- 

 tive. School 23 reported an elective course, 

 but gave no other information regarding it. 

 School 3 reported a course of 6 hours on the 

 relations of psychology and neurology. An- 

 other school H) reported an " optional course, 

 with interneship in hospital," and a fourth 

 school (J^3) an " elective course of 32 hours, 

 junior year." The remainder were negative. 



It is apparent that students and graduates 

 in medicine who incline toward practise in 

 diseases of the mind and nervous system have 

 few or no opportunities in the medical schools 

 of this country to acquire a broader acquaint- 

 ance with the subjects of neurology and psy- 

 chiatry, than the clinical courses which are 

 offered. It is also true that one seeking in- 

 formation regarding relations between such 

 closely allied subjects as psychiatry, neurology 

 and psychology must turn from the medical 

 schools to some other source. At times, 

 courses have been given in connection with 

 psychiatric institutes or hospitals for the in- 

 sane to fit their own appointees for the work 

 they may be expected ^to perform, for it is 

 notorious that the internes entering hospitals 

 for the insane are not only ignorant of the 

 facts of neurology and psychiatry and are 

 unable to make diagnoses except in the 

 simplest cases, but that at the same time they 

 do not appreciate any of the possible interre- 

 lations of these subjects and that the burden 

 of their special education must be borne by 

 the older members of the staff. With the ex- 

 ception of an apprenticeship in a hospital for 

 the insane, and this is not always adequate, 

 there is at present no possible means of get- 



