234 



SCIENCE. 



[N. S. Vol. XX. No. 503. 



dents would increase the demands on the 

 practitioner, so that larger returns would 

 follow. The poor student would sacrifice 

 and strive to get a degree, knowing then 

 he had a good asset. A diminution in num- 

 ber and an increase in quality is demanded 

 alike by the public and the profession. 

 Such diminution in number would mean 

 that the student would get back his invest- 

 ment quicker and in larger amount than 

 at present, hence good men would be at- 

 tracted. If we could abolish sentiment for 

 sense and educate accordingly, there might 

 be betterment all around. As it is now, 

 medical students receive part of their edu- 

 cation through the bounty of the state or 

 the charity of the public, as such education 

 can only be given in endowed institutions. 

 The public is taxed so that the prospective 

 physician can make a living. Is it right 

 that it should be? Perhaps a mechanic 

 should demand such right to make his son 

 a good workman. We must all admit it 

 is the duty of the state to educate the youth, 

 so that good citizenship is maintained ; we 

 can question whether the state should edu- 

 cate the members to obtain a livelihood. 



With the same indifference that the pub- 

 lic views an epidemic's march they allow 

 hospitals that are engaged in teaching to 

 suffer for the want of funds. Moreover, 

 they close their doors to the advent of 

 teaching in the hospitals under their con- 

 trol. We must admit those who do not 

 appreciate the true function of a hospital 

 have some ground for their contention. 

 Ruled by sentiment chiefly, unfortunately 

 an impracticable master, they sympathize 

 with the patient who still harbors the belief 

 of old that the medical student is one of a 

 class that prowl about not unlike harpies. 

 The public does not realize the difference 

 in the student of to-day and the student of 

 tradition. We can not hold to account the 

 governing body of the hospital who has 

 the point of view that it is harmful to a 



sick person to have them under the surveil- 

 lance of an alleged student rabble. We 

 must admit some patients become alarmed, 

 particularly in institutions where they 

 know they will have the sympathy of the 

 governing body. An analysis of motive 

 will show that the usual patient who will 

 not allow a judicious amount of clinical 

 demonstration when the sense of delicacy 

 is not offended, is truly selfish, in that there 

 is prevented that increase of knowledge and 

 development of skill whereby suffering of 

 others may be alleviated. A little encour- 

 agement from the officials would allay 

 alarm on the part of the patient. The de- 

 sire to help others is infectious, and when 

 one yields in a ward, others vie in the work. 

 The truth of the matter is that in hos- 

 pitals in which teaching is carried on, rare- 

 ly, if ever, do the patients complain. In- 

 deed, it is the experience of those teaching 

 institutions that judiciously conducted in- 

 struction is appreciated by the patient. In 

 one hospital we might name most of the 

 inmates are pay patients, giving $7 a week 

 willingly, because they know they are buy- 

 ing the services of the best practitioners in 

 the land — the teachers of medicine— which 

 service they could not get at tenfold the 

 figure. The fact that teaching hospitals 

 are overcrowded, not by the poor alone, but 

 by people independent of charity, shows 

 that clinical instruction is not a bugbear. 

 If the governing boards would Imow that 

 while a few patients might be alarmed, on 

 the whole most of them would be gratified 

 by the attention paid them, and their sense 

 of rectitude and manliness appealed to by 

 the satisfaction that they are doing some 

 good in enlightening students, so that 

 others could be relieved; that their admin- 

 istration would be stimulated to do work 

 beyond criticism; that the nurses would be 

 aroused to better activity while under the 

 observation of those not connected with the 

 hospital; that the internes would do their 



