August 19, 1904.] 



SCIENCE. 



233 



knowledge. It shoiild have the exactness 

 of intellectual discrimination; it should 

 have the fullness of noble scholarship ; it 

 should embody a culture which is at once 

 emotional and esthetic and ethical, as well 

 as intellectual." 



That a desire to relieve suffering, to ex- 

 tend sympathy, to save life, is the impulse 

 of the physician, we all admit, but where 

 is the man among us who will not also 

 admit that a scientific habit more quickly 

 brings it about and more surely sustains 

 and fortifies the humane instinct through 

 the trials and tribulations of exacting prac- 

 tise 1 That prosecution of professional du- 

 ties soon becomes commercial that does not 

 have for its basis a true spirit of scientific 

 inquiry. How miserable must that life be 

 which conducts an exacting, drudging, 

 daily routine with only material reward in 

 view. Few are the practitioners who have 

 this sordid view; we can be as sure medi- 

 cine would soon be forsaken if this view- 

 point alone were considered. Hence in the 

 laboratory of the first two years must be 

 aroused and fostered the stimulus for life- 

 work. 



The final years should be clinical years, 

 and the last should be in a hospital. The 

 medical school that allows its students to 

 think siTch opportunity is not due them is 

 most unfair to them. As our schools are 

 now constituted, most of them can not give 

 such requirements. The students should 

 know, however, such requirement is neces- 

 sary. "What has been said regarding the 

 preliminary college education applies equal- 

 ly forcefully to the hospital training. He 

 is thrice armed who enters the arena thus 

 equipped. Medical schools that can not 

 give such education are cruelly unkind and 

 unjust to the students by having them think 

 it is not essential. Medical colleges that 

 pass off a hospital training for one that is 

 not truly such fake their students. The 

 student who pays well for his training has 



the right to demand such as to fit him for 

 immediate action. 



It is not the fault of the medical school 

 alone that he can not get it. The public 

 that cries out when there is mistake in 

 diagnosis, fault in treatment, and that 

 shakes its head at the deficient education 

 of our students, must share the blame with 

 the medical school. The public admits that 

 its individual members may at any moment 

 almost be at the mercy of a half-educated 

 physician. It is not necessary to recount, 

 for it is well known, how on land or sea, 

 by day or night, some event may arise in 

 an individual life, the care of which may 

 mean life or death. Even with this knowl- 

 edge they withhold means to relieve them- 

 selves. They admit the necessity of a hos- 

 pital training. But they, and particularly 

 the public in control of hospitals not used 

 for teaching, say each medical college 

 should have its teaching hospital. They 

 do not appreciate that to give an education 

 which involves a hospital course would re- 

 quire an expenditure of $500 a year for 

 four years by each student. It has been 

 estimated that the cost of maintaining a 

 plant and paying salaries sufSeiently large 

 to accommodate 600 students would require 

 the above outlay by each student. Unfor- 

 tunately, it is impossible to expect students 

 to pay such figures, as it would render 

 entrance into the profession almost pro- 

 hibitive. It is manifestly impossible, as 

 medical schools are constituted now, to 

 educate all the students of the land proper- 

 ly. Hospital training can not be given ex- 

 cept by a few favored institutions, because 

 the doors of hospitals are closed either by 

 the governing body of the hospital or by 

 the teachers in the medical schools. 



We believe, personally, if a decree should 

 be issued that no medical school, including 

 its hospital, should exist except on the fees 

 derived from students, but little hardship 

 would follow. The lessened supply of stu- 



