July 17, 1903.] 



SCIENCE. 



71 



equal degree. Hence the problems of dis- 

 ease and cure may become most intricate, 

 and over and over again many of the phe- 

 nomena are in danger of being confused 

 and wrongly interpreted. It has, for ex- 

 ample, taken a long time to recognize the 

 fact that the rise of temperatui'e in pneu- 

 monia, typhoid fever or tuberculosis is not 

 the disease itself, but merely a symptom 

 of the disease process. Even now we find 

 many physicians whose theory of treatment 

 in these disorders is to combat the rise ot 

 temperature by antipyretics, and who hon- 

 estly think that the patient is cured by sub- 

 duing what is merely one of the symptoms 

 of the disease. The same was once true 

 of those who thought maniacal excitement 

 was cured by mechanical restraint and by 

 powerful remedies which paralyzed and 

 deprived the patient of his ability to throw 

 himself about. We now know that he was 

 not cured by thus removing the evidence 

 of his disease— in other words, by keeping 

 him quiet— but, on the contrary, his pros- 

 pects of cure were infinitely lessened by 

 the restraint which the strait-jacket and 

 drug thus imposed upon him. 



The demonstration of the presence of a 

 specific organism as the causative factor 

 in the development of many diseases has 

 consequently been a great boon to medi- 

 cine and has become essential to a proper 

 recognition of the disease and its best mode 

 of treatment. The time may come when 

 the cause of every disease will be equally 

 well Imown, and to ascertain it is one of 

 the great aims of medical research. Un- 

 fortunately, the end is not yet, and in the 

 ca.se of some diseases we must content our- 

 selves with our present half -knowledge. 



We now come to the important question : 

 'How shall medicine be studied?' Here 

 we find ourselves confronted by two theo- 

 ries as to the preliminary training requisite 

 for entering upon such study. On one 

 side we find a strong tendency to shape all 



pi-eliminary training to prepare the student 

 for medical study. If the preliminary 

 training is to be in a college, we find al- 

 ready in a number of institutions such an 

 arrangement of the course as practically 

 to commence the study of medicine in the 

 third year of the college course and to 

 complete the medical education within two 

 years after graduation from college. In 

 the University of Michigan, Cornell Uni- 

 versity, the Univei-sity of Chicago and 

 other similar institutions of high standing 

 this plan has been outlined and will be 

 eventually adopted. Although the bache- 

 lor's degree will be considered a prelim- 

 inary to entering the medical school, the 

 studies of the college will be .so combined 

 with those of the medical school as to per- 

 mit the student to complete his medical 

 course within six years after he has entered 

 college. 



On the other side, there is a tendency 

 to divorce the medical education from the 

 college course and to pursue the latter for 

 general culture, irrespective of its bearing 

 upon medical study later. Much may be 

 said in favor of both theories of education. 

 The last-mentioned theory unquestionably 

 presents the broadest view and, if the stu- 

 dent has ample leisure, offers the best 

 promise of a true education. It can not 

 be denied, however, that the former view is 

 likely to be more generally adopted and 

 promises to dominate medical education for 

 a time at least. If the student always 

 knew when he entered college that he was 

 to pursue the study of medicine, he might 

 possibly, in these days of elective st\idies, 

 be able to choose wisely the branches which 

 would be-st fit him for his subsequent work. 

 In many instances, and perhaps in the 

 majority, the decision to enter the profes- 

 sion grows up slowlj' and may not be fully 

 attained until he has finished his course of 

 preliminary study. It is altogether prob- 

 able that he has secured a broader mental 



