Jt-LY 17, 1903.] 



SCIENCE. 



69 



into these students by didactic lectures, to 

 be pumped out again by the final examina- 

 tion. The quantity which was thus 're- 

 covered,' to use a chemical phrase, was 

 sometimes painfully small and generally 

 of little practical value. 



In a generally gloomy outlook for ade- 

 quate medical ti'aining a few brighter spots 

 developed. It is gratifying to know that 

 during this whole period Yale Jledical 

 School made a strenuous effort to main- 

 tain a higher standard. She early exacted 

 a matriculation examination and increased 

 the term of medical study ; she inaugurated 

 daily recitations in 1S55 to supplement 

 didactic lectures, and established labora- 

 tory courses in 1867. 



In 186-4 Chicago Medical College, now 

 the Jledical Department of Northwestern 

 University, graded its course of lectures 

 and made the minimum course three years. 



In 1870 Harvard Medical School initi- 

 ated a similar movement and taught medi- 

 cine progressively rather than cumula- 

 tively. The University of Michigan also 

 extended its course of instruction to thi-ee 

 years of nine months each, and made some 

 minor educational requirements for admis- 

 sion. For the most part, however, the 

 preliminary education required was ludi- 

 crously inadequate, when one considers 

 that the medical school essayed to fit the 

 individual to enter a learned profession. 

 In some catalogues it was specified that 

 the student should have a knowledge of 

 grammar, orthography, arithmetic and an 

 ability to write a composition of six hun- 

 dred Avords. In others it was stipulated 

 that the student should have a high 

 school education and a certificate of good 

 moral character. AYhenever any attempt 

 was made to raise the educational stand- 

 ard, pathetic appeals were made success- 

 fully in behalf of connnunities where it 

 was alleged that well-educated physicians 

 could not be maintained or appreciated. 



It is doubtful whether this unfortunate 

 state of affaii-s would have been remedied 

 for many years to come had the initiative 

 been left solely to those who were charged 

 with the responsibility of giving instruc- 

 tion in these so-called medical schools. 

 Fortunately, however, public-spirited 

 medical men were found in almost every 

 state in the Union who insisted that men 

 should not be permitted to practise until 

 they had shown their competency and edu- 

 cation by pa.ssing an examination before 

 an impartial examining board. This was 

 the beginning of a reform in medical edu- 

 cation which dates from about 1890, and 

 which has already changed the aspect of 

 medical schools. The object of medical 

 teaching up to this time had apparently 

 be<?n to fill up the profession by making it 

 easy for every one to enter. The object 

 now- seems rather to secure well-trained 

 men with an adequate education. 



AVith the advent of the new era came a 

 minimmn standard of educational qualifi- 

 cation for entering medical schools, a mini- 

 mum period of study and a minimum 

 grade of acquirement in oi'der that the 

 graduate of the school might be considered 

 eligible for an examination for a license 

 to practise, all of which were far in ad- 

 vance of what had existed. This has en- 

 forced a better preliminary education, a 

 graded course of study, and a higher 

 standard of attainment upon graduation. 



It has been said in the past, is now being 

 said, and will be said in the future, as an 

 excuse for poorly equipped physicians, that 

 well-educated physicians are not required 

 in rural districts or where the population 

 is sparse and the people are poor. An 

 early experience in semi-pioneer life con- 

 vinces me that this is an error. The well- 

 educated physician does not avoid the 

 country, nor does he leave the country for 

 the city after he is once established. The 

 list of eminent medical men who have lived 



