May 2-3. 1903.J 



SCIENCI 



811 



few places exceptionally good, for the 

 training of yoimg men for positions as 

 teachers of anatomy, pathology and bac- 

 teriology. Any young man in these de- 

 partments who by good hard work makes 

 for himself a name is fairly sure, before 

 long, of being called to some important 

 post as a professor, director of a labora- 

 tory, or some similar position. Biit the 

 opportunities for work in clinical medicine 

 and clinical surgery are far more re- 

 stricted, since opportunities for both the 

 exercise of their clinical skill are less fre- 

 quently open to them and the opportuni- 

 ties of combined physiological, pathological, 

 bacteriological and anatomical research 

 along with their clinical work is but 

 scantily provided for. This plea is rein- 

 forced by the recent paper of Sir Michael 

 Foster {Nineteenth Century, January, 

 1901, p. 57). These special graduates, 

 bright young men, determined to devote 

 themselves to one or another department 

 of medicine or surgery, are the men who 

 bring honor to the school at which they 

 obtain their training, and are invaluable 

 to the community. They are the future 

 Jenners, Pasteurs, Virchows, Listers, Da- 

 Costas and Grosses, and our hospitals 

 shoiild provide for these exceptional men 

 exceptional facilities. 



The third object of a hospital is the pi'o- 

 motion of knowledge, and so, fourthly, the 

 good of humanity. Physicians and sur- 

 geons engaged only in private practice do 

 not generally keep notes of their cases, and 

 rarely publish important contributions to 

 knowledge. I find in 100 books taken con- 

 secutively in my library that 85 were 

 written by hospital men and only 15 by 

 authors not connected with any' hospital 

 so far as was indicated on the title page. 



In order that proper investigations may 

 go on, trustees should enforce a perrnanent 

 record of all the cases treated in the hos- 



pital, properly indexed, from which the 

 staff may derive their data for papers and 

 books. Each large hospital should have its 

 pathological resident as well as the clinical 

 residents in the various wards, so that post- 

 mortem records shall be well kept, patho- 

 logical, bacteriological and chemical in- 

 vestigations of various secretions, or blood 

 counts, etc., shall be properly made and 

 permanently recorded in such a manner as 

 to be accessible. 



It is too often the case that trustees, as 

 I have said, regard their duties and re- 

 sponsibilities at an end when they have 

 taken care of the funds and elected the 

 staff. They may say that after all this 

 is their real duty, and that all that I have 

 advocated is medical and surgical, and the 

 responsibility for it should devolve on the 

 staff and not on the trustees. I do not 

 take so narrow a view of the duties of 

 trustees. When they have elected a physi- 

 cian or surgeon, if he neglects his duty, 

 it is their business to displace him and fill 

 his place with another man who will attend 

 to his duty, and the duties that I have indi- 

 cated pertaining to the increase of knowl- 

 edge as well as of its diffusion are quite as 

 much within their province as it is to see 

 that the funds are invested to the best 

 advantage. The intellectual funds as well 

 as the invested funds must bring in good 

 dividends. 



If trustees and staff work together for 

 such a purpose and in such a manner, they 

 will create an ideal hospital which will do 

 more good to the patients than any other 

 type of hospital. It will attract the best 

 physicians and surgeons in every commu- 

 nity, will acquire the best reputation, not 

 only local, but it well may be national, and 

 do the most for the good of science and 

 the benefit of humanity. 



It may be said that this is an unduly 

 strenuous view of the duties of trustees, 



