November 25, 1904.] 



SCIENCE. 



715 



with every arrangement for the comfort 

 and even luxury of the patient, with a 

 medical staff utterly insufficient in number 

 or training to properly study the individual 

 case, not to speak of carrying on scientific 

 investigations— the service, usually under 

 the direction of a busy, driven practitioner 

 with barely time to make a short daily visit 

 — large wards under the direct control of 

 one or two young men whose time is wholly 

 occupied by routine work — every care taken 

 for the present comfort of the patient — 

 little provision for enlightened study or 

 treatment of his malady— no opportunities 

 for a contribution on the part of the insti- 

 tution to the scientific progress of the day. 

 Better far for* the sufferer were he in the 

 dingy ward of an old European hospital 

 where he might be surrounded by active 

 inquiring minds recording the slightest 

 changes in his symptoms, ever ready to 

 detect and, as far as the power in them lies, 

 to correct the earliest evidences of perver- 

 sion of function. What our hospitals need' 

 is men, students, whether or no they have 

 arrived at the stage in their career— which, 

 after all, is but a landmark, not a turning 

 point— that entitles them to the right of 

 independent practise, the enthusiastic, de- 

 voted student who, in watching and study- 

 ing the patient, is contributing alike to the 

 interests of the sufferer, the hospital and 

 himself. 



The three main functions of a hospital, 

 the care of the sick, the education of the 

 physician, the advancement of science, are 

 not to be met alone by the building of 

 laboratories and operating rooms and lec- 

 ture halls, by the furnishing of the refine- 

 ments of luxury to the patient, useful ad- 

 juvants though these may be. What the 

 hospital mainly needs is men, men to study 

 and think and work— students of medicine. 



It can not be denied that in this respect 

 we in America are behind our cousins of 

 the old world. Despite our many honor- 



able achievements, the part which we are 

 taking in the modern study of the physi- 

 ology of disease is still not what it should 

 be. 



Ere long we must come to realize that 

 our duty to the sick man consists in some- 

 thing more than to afford him that which 

 most sick animals find for themselves — a 

 comfortable corner in which he may -rest 

 and hide from the world ; that our duty to 

 the public is to give them as physicians, 

 men of the widest possible general training, 

 ready to enter upon independent practise 

 with an experience sufficient to render them 

 safe public advisers; that our duty to our- 

 selves is to miss no opportunity for the 

 study of pathological physiology at the 

 bedside of the patient ; that the accomplish- 

 ment of these ends depends in great part 

 upon the appreciation by our universities 

 and hospitals of the mutual advantages 

 of cooperation in affording every oppor- 

 tunity for the scientific study of disease 

 while offering to the patient the privileges 

 of enlightened observation and care. 



But there are everywhere signs of a 

 future rich in achievement. An improving 

 system of medical education, the increasing 

 opportunities for scientific research offered 

 as well by the generosity of private citizens 

 as by the wisdom of state and national 

 governments, the community of effort 

 which results from closer fellowship among 

 students of all nations, are omens of great 

 promise. The remarkable developments of 

 the last twenty years in all branches of the 

 natural sciences have brought a rich store 

 of suggestion and resource for application 

 in our laboratory, which is at the bedside 

 of the patient. Let us look to it that our 

 clinical methods keep pace with those which 

 are yielding so abundant a harvest in these 

 neighboring fields of scientific research. 



William Sydney Thayer. 

 Baltimore. 



