May 4, 1900.] 



SCIENCE. 



©91 



in a professional school, should be so di- 

 rected as to impart at the same time the 

 greatest possible amount of useful informa- 

 tion. 



Let us now consider how far the didactic 

 and the laboratory methods of instruction 

 are each adapted to secure these two objects 

 of medical education. For the purpose of 

 training" for power no one can doubt the 

 value of the laboratory method. Contact 

 with the phenomena themselves and not 

 with descriptions of them has a stimulating 

 effect upon the mind of a student, the im- 

 portance of which it is difficult to exagger- 

 ate, but it does not follow from this that the 

 lecture, the recitation and the text-book 

 are worthless as methods of training. It is 

 here that some of the advocates of labora- 

 tory methods have committed what appears 

 to me a serious error such as is too apt to 

 characterize all reform movements, the 

 error, namely, of assuming that because 

 one proposition is true, another proposition, 

 not logically inconsistent with it, must be 

 untrue. "These gentlemen," as Professor 

 Howell* has expressed it, " having become 

 possessed of the golden truth that the best 

 knowledge is that which comes from per- 

 sonal experience, seem disposed to deny all 

 value to knowledge communicated from the 

 experience of others." We are told, for in- 

 stance, by Dr. Burr,f that the didactic lec- 

 ture " dates from the time when print- 

 ing was unknown and manuscripts were 

 rare and almost priceless and the onlj' 

 means of communicating knowledge was by 

 word of mouth. To-day it is in large part 

 an anachronism, because the time devoted 

 to it could be put to better uses." 



In his able address J at the last Yale Uni- 

 versity Medical Commencement my col- 

 league, Dr. C. S. Minot, expressed himself 



143. 



'Tlie Michigan Alumnus, Jan., 1900, Vol. VI., p. 



t Philadelphia Medical Jownal, Oct. 21, 1899. 

 X Science, July 7, 1899. 



as follows : " The very best that can be said 

 of a lecture or a book is that it describes well 

 the knowledge which someone possesses. 

 There is no knowledge in books. * * * 

 A book or a lecture can serve only to assist 

 a man to acquire knowledge with lessened 

 loss of time. Knowledge lives in the lab- 

 oratory ; when it is dead we bury it de- 

 cently in a book. * * * A lecture is a 

 spoken book." I venture to believe that 

 Professor Minot's students will hardly agree 

 with this estimate of the lifeless character 

 of either his written or his spoken instruc- 

 tion. 



In place of these rather disparaging 

 views of the importance of a didactic lec- 

 ture, I am inclined to accept Dr. Weir 

 Mitchell's* opinion that " The best lectur- 

 ing does not so much think for you as in- 

 vite you to think along suggested lines of 

 enquiry." If, as has been claimed, " the 

 passive attitude of listening does not de- 

 mand of the students intelligent thought, "f 

 the fault must lie with the lecturer and not 

 with the method of instruction. In every 

 department of medicine advanced instruc- 

 tion necessarily deals with subjects which 

 lie within what Foster has called the 

 ' penumbra ' of solid scientific acquisition, 

 and about which conflicting views are, 

 therefore, certain to be held. It is in in- 

 viting thought, with regard to the evidence 

 on which these views rest, that the experi- 

 enced lecturer has his best opportunity to 

 train the minds of his hearers. Other op- 

 portunities are also afforded by the histor- 

 ical presentation of subjects about which 

 differences of opinion no longer exist, for 

 there are few things more instructive than 

 to follow up, step by step, the lines by 

 which our knowledge has advanced, noting 



* University Bulletin, Vol. III., p. 85. Phila., 

 Dec, 1898. 



^^. B. Cannon, A.M. The Case Method of 

 Teaching Systematic Medicine. Boston Med. and 

 Surg. Journ., Jan. 11, 1900. 



