768 



SCIENCE. 



[N. S. Vol. XVII. No. 437. 



ologist in diagnosis, and have tested and 

 judged the worth of therapeutic aids in 

 the treatment of disease. But as teachers 

 they have not made students investigators 

 or experimenters. Not one of the recent 

 great discoveries in medicine has been made 

 by such a man. He has used as clinical 

 material hundreds of cases of pneumonia, 

 rheumatic fever, tuberculosis and chronic 

 diseases by the score; his experience has 

 taught him to recognize these diseases, even 

 when the clinical manifestations are ob- 

 scure, but he is no more successful than 

 when he began to practice in saving the 

 life of the patient with pneumonia, in pre- 

 venting endocarditis in rheumatism, in 

 curing tuberculosis, or in checking the ad- 

 vance of a chronic hepatitis. It is time, 

 therefore, that the clinical teacher should 

 have the knowledge necessary to carry on 

 experimental investigation, with hospital 

 facilities for the work that the profession 

 may become purged of the shame of help- 

 lessness in curing so many of the common 

 diseases of mankind. 



The patients who will be received in 

 these hospitals will be fortunate. They 

 will receive the most painstaking examina- 

 tion and study, and the experiments made 

 on animals in the laboratory will benefit 

 the patients directly, inasmuch as more 

 rational therapeutic measures will be ap- 

 plied in cases so investigated. In addition 

 to the clinical teachers, who will devote all 

 their time to teaching and research work 

 in the special hospitals, there will be quite 

 as much need for the clinical teacher, who 

 is in private practice, in the general hos- 

 pitals. Under his direction the student 

 may himself investigate a hospital or am- 

 bulatory case, and undertake the care of 

 the patient. His rich and varied experi- 

 ence in hospital and private practice will 

 enable him to round out the student's col- 

 lege education. He will impart to the stu- 



dent a better idea of medicine as a whole. 

 He will coordinate and arrange the isolated 

 facts of clinical and laboratory investiga- 

 tion, and give them their true and relative 

 value. He will teach the student the art 

 of medicine ; he will teach him that human 

 sympathy and encouragement of the sick 

 and dying are a part of his duty as a 

 physician. 



It would be most practical to make the 

 clinical work of the third year a clinical 

 drill and experimental course, given in the 

 special hospitals, and assign the students 

 of the fourth year to the general hospitals 

 and to the clinical teachers who are in 

 private practice. All the general hospitals 

 and dispensaries controlled by the medical 

 schools could be utilized in the fourth year 

 for this purpose, and afford the student 

 an abundance of clinical material and the 

 benefit of the experience of many clinical 

 teachers. Many of the assistants in the 

 special hospitals, of the third year course, 

 would doubtless engage ultimately in pri- 

 vate practice, and would, because of their 

 scientific attainments, make excellent clin- 

 ical teachers in the fourth year. A medi- 

 cal school conducted on the high plane 

 advocated must necessarily be under the 

 control of a university. • Such a medical 

 school would cost an enormous amount of 

 money, and this can be commanded only 

 by the trustees of a university of the high- 

 est order. That the money for the purpose 

 of establishing and maintaining university 

 medical schools with research hospitals and 

 university clinical courses will be forth- 

 coming can not be doubted. The world is 

 awake to the great discoveries recently 

 made in medicine. The wealthy men of 

 this country have had their interest aroused 

 as never before in reference to the possi- 

 bilities and benefits which medical investi- 

 gation will give to mankind. They now 

 recognize that they and all posterity will 



