March i6, j888.] 



SCIENCE 



125 



disease. I have in contemplation introducing a department for study 

 and original experiment in bacteriology in our school." 



No. 24. " A competent instructor in bacteriology, trained in Ger- 

 many." 



No. 25. " A well-equipped bacteriological laboratory, with a 

 special instructor." » 



No. 26. " A special instructor, a pupil of Koch, gives bacteriologi- 

 cal instruction." 



No. 27. " The facts and investigations are clearly set forth, leav- 

 ing the subject open to further investigation. We believe that 

 blood-poisoning may not be due to germs. Much depends on 

 ptomaines. Decomposition does not depend on germs. Suppura- 

 tion has a cause within the body independent of germs. Germs 

 may be the result of decomposition or animal chemical changes. 

 At all events, we are not satisfied on these points." 



No. 28. " I can speak of obstetrics only. The student is taught 

 a rigid aseptic practice, and is daily drilled in the methods of steri- 

 Jizing hand and instruments, etc." 



Qtiesiion 6. Do you think the general principles of the nature of 

 infectious diseases, and the methods and meaning of infection, 

 ■should be taught the general public through the public school.' 



The responses to this question have been quite varied, and are of 

 ■course in all cases personal opinions rather than official replies. 

 These replies are interesting as indicating various opinions on pub- 

 lic-school teaching, and a number of them are given below ; but 

 since in some cases the request was made that the reply should not 

 be quoted, the replies are given without reference to the source from 

 ■which they are obtained. 



Ten replied with a simple affirmative : others replied as follows : — 

 " I think that this subject, in connection with general sanitary 

 ■science, might and should be introduced into the studies of the 

 common school." 



" Not yet, except in the way of and in regard to necessary disin- 

 fection, cleanliness, and general hygiene." 



" Am free to say that the attempt to teach bacteriology generally 

 ■would be a most misdirected effort." 



" It would unquestionably be avantageous could suitable teachers 

 be obtained ; but I shudder to think of the statements which would 

 •pass current if the subject were made obligatory in even the high 

 schools." 

 " Not at present, but after the subject is more fully understood." 

 " No, they would make a botch of it, and teach inore falsehood 

 •than truth. It needs more acquaintance with the subject than can 

 be expected of non-medical or non-expert teachers." 



" Yes. If physiology and healthy function are taught, of much 

 »more importance would it be to sow the seed of understanding how 

 to keep those functions healthy in all ways. An elementary work 

 -on preventive medicine, including bacteriology, should be taught 

 ithe young. It should be so prepared that the mind could grasp it 

 without being prepared by a medical education." 



" To some extent it should ; but so very much is crowded into the 

 "Children's heads, that they become dazed, and are mere parrots 

 when they get through." 



" No, certainly not ; first, because not one percent of the scholars 

 in the public schools have reached the stage of maturity and men- 

 tal discipline necessary to enable them to comprehend or profit by 

 the teaching of such subjects ; second, because the public schools 

 are already over-crowded with so many branches of higher and more 

 abstruse character, that not twenty-five per cent of the scholars are 

 ■allowed time enough to gain an adequate knowledge of the most 

 rudimentary and practical branches of knowledge. Consequently 

 it is much easier to find boys and girls who can repeat Latin, French, 

 or German, finger a piano, recite verbatim answers from a manual 

 of physiology, etc., than to find those who can write a letter con- 

 taining one or two hundred words without violating some of the 

 most important rules of orthography, syntax, and penmanship." 



" I do not think any one connected with this school would ad- 

 vise the introduction of bacteriology in our public schools," 



" First teach the profession, and through them the public. No 

 objection, of course, to extending knowledge in every possible way, 

 but don't think it yet time to expect much through public schools. 

 We must first show more facts." 



" No harm, little good." 



From the circulars sent to the training-schools for nurses, no 

 responses have been received. This is the more to be regretted, 

 since, if preventive medicine is of value to any one, it is to nurses. 



A few words in final summary and review may not be amiss. 

 The question naturally arises, whether the responses from the 

 schools above given can fairly be taken as an average, and whether 

 we can judge of the whole body of medical schools by the replies 

 received from those in the above list. I think it cannot be as- 

 sumed that this is possible. The above list includes nearly all of 

 the larger schools, and those in which most advanced methods would 

 be expected. It seems quite natural, also, that those institutions 

 which have given any considerable attention to this subject would 

 be more likely to respond to the circular sent by Science than those 

 which had not yet regarded the subject as of sufficient importance 

 for careful study. It is almost certain, therefore, that, if responses 

 should be received from the remainder of the medical schools, there 

 would be found a much larger proportion in which the subject is 

 considered only incidentally or not at all, a much larger proportion 

 in which the germ-disease theory is regarded as of little or no im- 

 portance. 



The fact that no responses have been received from the training- 

 schools for nurses can hardly be interpreted as having other signifi- 

 cance than that the subject of bacteriology has not received enough 

 attention in these schools to warrant any opinion on the matter. 



From the replies above summarized, even though they are less 

 general than could be wished, I think we can fairly draw the fol- 

 lowing conclusions : — 



1. The germ-theory has in the past few years been rapidly ac- 

 quiring acceptance, is almost everywhere regarded as a subject 

 worthy of most careful consideration, and is nowhere looked upon 

 as an absurd speculation, as was the case a few years ago. The 

 causal connection between specific microbes and definite diseases 

 is not yet, however, everywhere acknowledged by physicians. 



2. Quite a number of special bacteriological laboratories have 

 been established in connection with our larger medical schools. 

 They are under the charge of competent directors, and are places 

 where original research is being carried on, and where students have 

 an opportunity to familiarize themselves with the subject in a prac- 

 tical manner. American medical schools are thus doing their share 

 in this research in this matter, and in the endeavor to advance our 

 knowledge of bacteria and their relations to disease. 



3. A large number of our schools, probably a large majority of 

 them, do pay considerable attention to bringing to the notice of 

 their students this subject in its theoretical and practical bearings. 

 In some cases it is only done incidentally, in others by a few odd 

 lectures, and in others by regular courses of lectures and laboratory 

 instruction. As much is being done in this line as can be expected, 

 when we remember that not a few of the medical courses are, of 

 necessity, little more than periods of cramming to give the stu- 

 dents just enough knowledge to enable them to make ordinary 

 practitioners. The course is frequently so short as to make it 

 hardly a possibility to treat scientifically any subject not directly 

 bearing upon the treatment of disease. It will be noticed that the 

 amount of attention given to the subject is not regulated by the 

 amount of importance placed upon it by those who have answered 

 the circulars. In some cases where the theory is rejected it is still 

 taught in the school ; and in others, where it is fully accepted and 

 regarded as of great importance, the amount of teaching is yet very 

 slight. This indicates that it is usually difiiculties of finance or 

 otherwise which in many cases have delayed the adequate consid- 

 eration of the matter. 



4. It would be the opinion of probably a majority of physicians 

 and teachers, both of those who believe in the importance of the 

 subject and of those who do not regard it as of much import, that 

 the time has not yet come when bacteriology can be taught to ad- 

 vantage in the public schools : at least, this cannot be done until 

 some thoroughly competent person shall have carefully summarized 

 the facts in the form of a short, clear account, which could be used 

 as a text-book. It must be borne in mind, however, that many 

 physicians are, for reasons similar to those given above, opposed to 

 the teaching of physiology in the public schools. This is, however. 



