714 



SCIENCE. 



[N. S. Vol. XX. No. 517. 



These words express, it seems to me, a 

 large measure of truth. May it not be 

 that in the tendency to the neglect of the 

 humanities we are taking a false step? 

 May it not be that if, on the other hand, 

 we teach them earlier and better,, we shall 

 find in the end that no essential time is 

 lost, while we shall gain for medicine men 

 not only with minds abler to grasp the 

 larger and broader problems, but with ma- 

 terially fuller powers for carrying on the 

 humbler but no less important duties of 

 the practitioner of medicine? 



In that which I have just said I have 

 touched upon the necessity of the require- 

 ment of a considerable amount of clinical 

 experience as an essential for the license to 

 practise medicine. To meet the enormous- 

 ly increased demands of the present day, 

 medical education has become, of necessity, 

 much more comprehensive, and must there- 

 fore extend over a longer period of time. 

 The methods of research, anatomical, phys- 

 ical, chemical, which the student must 

 master, the instruments of precision with 

 which he must familiarize himself, are al- 

 most alarmingly multifarious; and experi- 

 ence in the application of these methods 

 and in the use of these instruments de- 

 mands increased time. Many of these pro- 

 ceedings, it is true, the physician will rarely 

 be called upon to use personally in prac- 

 tise, for such measures must in great part 

 be carried out by special students or in 

 laboratories provided by the government. 

 Nevertheless, with their significance and 

 value he must be familiar — familiar from 

 personal observation and experience. 



But after all there are few diagnostic 

 signs in medicine and not so many of the 

 improved methods of clinical investigation 

 yield diagnostic results, while to familiar- 

 ize one 's self with methods and instruments 

 of precision is a very different matter from 



cais de mfideeme. VI. Session. Paris, 1902, 8°, 

 T. II., p. xli. 



acquiring real experience and skill as a 

 diagnostician or a therapeutist. It is only 

 by gathering together and carefully weigh- 

 ing all possible information that one is 

 enabled to gain a proper appreciation of 

 the situation and approach a comprehen- 

 sion of many conditions of grave import 

 to the patient. And in forming a sound 

 judgment with regard to these vital ques- 

 tions, that which comes from experience in 

 the close personal observation of the sick is 

 far the most important element. Bedside 

 experience constitutes to-day, as it always 

 has, and always will, the main, essential 

 feature in the training of the physician. 

 But this experience if it is to bear its full 

 fruit, must be afforded to the student at 

 a time when his mind is still open and 

 receptive and free from preconceived ideas 

 —under conditions such that he may be 

 directed by older trained minds into proper 

 paths of observation and study, for few 

 things may be more fallacious than experi- 

 ence to the prejudiced and the unenlight- 

 ened. 



That such experience may be freely of- 

 fered to the student, there is a grave neces- 

 sity for a more general appreciation, by 

 institutions of medical training as well as 

 by the powers in control of public and 

 private hospitals and infirmaries, of the 

 mutual advantages to be gained by a cor- 

 dial cooperation. It must be acknowledged 

 that, in this country at least, despite the 

 cultivation of improved methods of clinical 

 investigation, there still prevails in the 

 mind of the public the perverted idea that 

 this bedside observation, this application of 

 new methods of research and study, are 

 for. the advantage of the student or in the 

 interest of general science rather than for 

 the benefit of the sufferer himself. It must 

 further be recognized that a wholly mis- 

 taken conception of the true function of a 

 hospital is widely prevalent. It is all too 

 common to see large and ornate institutions 



