May 25, 1888.] 



SCIENCE. 



249 



of the army, navy, and marine-hospital service, and having a totally 

 insufficient State representation. 



In conclusion, Dr. Walcott urged the proper organization of some 

 central health authority, whether in the form of a bureau of health 

 or a board of health ; provided, only, that some part of the great 

 resources of the nation might be turned to the protection of that 

 greatest of all property, human life. The address was referred, 

 with the thanks of the association, to the Committee on Publication, 

 from the section on State medicine. 



Too Many Medical Students. 



The president of the American Medical Association, Dr. A. Y. P. 

 Garnett of Washington, took for the subject of his presidential 

 address ' The Mission of the American Medical Association.' Its 

 paternal relation to the entire profession of the United States imposes 

 upon it duties and responsibilities of the gravest character. He said : 

 " Taking a retrospective view through nearly half a century of ex- 

 istence, we have no reason to be discouraged. But, while we feci 

 gratified by contemplation of the fruits of our labor in the past, it 

 is obviously important that we should not be flattered into a belief 

 that we have accomplished our mission, and permit ourselves to 

 lapse into supine indifTerence with regard to a pre-eminently im- 

 portant object which remains to be worked out through the instru- 

 mentality of this association. I refer, gentlemen, to radical and 

 thorough reform in the present system of medical education in the 

 United States." He submitted the following propositions ; — 



"Proposition First. That a standing committee, to be called 

 the Committee on Legislation, shall be appointed for each State and 

 Territory, and the District of Columbia, to consist of five members of 

 the medical profession in good standing, three of whom shall have 

 no official connection with any medical school or college, whose 

 duty it shall be to carry out, as far as possible, the following in- 

 structions : 



" a. Each one of said committee, or a majority thereof, shall 

 attend the sessions of their respective Legislature from time to 

 time, as their duties may require, for the purpose of using all hon- 

 orable means looking to the reduction of medical schools in the 

 United States, and the consequent diminution of the annual num- 

 ber of graduates ; that, as a practical measure to this end, they urge 

 the passage of a law requiring that in the future granting of char- 

 ters for creating medical schools there shall be a clause in every 

 such charter requiring that all schools or colleges thus created shall 

 demand a full term of four years' study before granting a diploma 

 thereof, and that no student shall be admitted to matriculate who 

 has not passed satisfactory examination, oral and written, in the 

 ordinary branches of academic study ; and, further, that any col- 

 lege failing to show a greater number than fifty matriculates annu- 

 ally for three consecutive years shall forfeit its charter and be abol- 

 ished. 



" b. That they use all diligent efforts to secure an ordinance 

 creating in each State and Territory where no such board at pres- 

 ent exists, and in the District of Columbia, a board of medical 

 examiners, which shall have no connection with any medical school, 

 and which shall be required to examine all applicants for license to 

 practise medicine in the States, Territories, and the District; and 

 that any person who may be detected practising any branch of the 

 healing art without a license granted by the said board shall be 

 subject to such penalties as the law may provide. 



" That this committee may be authorized by statute to select and 

 nominate to the governors of the States, Territories, and the Dis- 

 trict of Columbia, seven competent learned members of the medical 

 profession, to constitute such a board of examiners, who shall have 

 exclusive power to issue licenses to practise the art and science of 

 medicine and surgery. 



" c. That the chairman of the said committee of five be required 

 to submit at each annual meeting of the association a report embra- 

 cing a full statement of what has been accomplished by each. 



■'Proposition Second. That the faculties of the several medical 

 schools within the limits of the United States be once more urgently 

 requested to call a convention at some central point for the pur- 

 pose of consultation and adopting some general and uniform sys- 

 tem of medical education, more comprehensive and rigid in its 

 requirements, and more in accord with the spirit of the age and 



advanced progress of medical science, suggesting four years' term 

 of study, the requirements of a preliminary education including 

 some knowledge of the classics ; that any college or school which 

 shall refuse to enter into such arrangement as may be decided upon 

 by the said convention shall be excluded from all connection with 

 the American Medical Association, and its alumni shall not be rec- 

 ognized as members of the regular profession." 



0LE0M.4RGARINE IN MASSACHUSETTS. — The Legislature of 

 Massachusetts has passed a law prohibiting the sale of oleomarga- 

 rine in that State. The State Board of Health advised the Legisla- 

 ture against the passage of the bill, holding that oleomargarine was 

 not injurious to health. 



The Typhoid Bacillus. — Another epidemic of typhoid-fever 

 has been traced to infected drinking-water, the typhoid bacillus hav- 

 ing been discovered in the water. The outbreak occurred in a board- 

 ing-school at Ouimper, France, one-sixth of all the inmates being 

 attacked, and one in eleven dying. 



The Number of Medical Students. — The British Medi- 

 cal Journal gives the following as the number of medical students in 

 the following universities in the winter session just elapsed : in 

 Vienna, 2,287; Munich, 1,369; Berlin, 1,316; Wurzburg, 956; 

 Leipzig, 794; Prague, 566 ; Graz, 501 ; Griefswald, 471 ; Breslau, 

 382 ; Freiburg, 350. 



MENTAL SCIENCE. 

 Reflex Speech. 



Acts performed at first with great effort, by constant repetition 

 become so thoroughly ingrained in the nervous system that they 

 are performed without the slightest effort, or even maybe performed 

 in spite of a more or less strong effort to resist them. When this 

 occurs, an originally voluntary act is said to have lapsed into the 

 automatic or reflex stage ; the act has become mechanical ; and 

 pressing the proper key will produce the appropriate re-action. In 

 a recent issue of the fotirnal of Menial Science, Dr. G. M. Robert- 

 son calls attention to the fact that there exists a large number of 

 colloquial phrases that have become automatic. Speech, though at 

 first learned with great difficulty, becomes the most natural chan- 

 nel for expressive movements. We are daily asked, " How are 

 you ? " and as frequently reply, " Very well, thank you." And the 

 best proof of how very automatic and unreflective this answer is, 

 is given by the innumerable cases in which this is said even when 

 we are not well. This is present in a perfectly healthy mind, 

 but it remains obscured. When we are excited or confused, or, 

 better still, absent-minded, the phenomenon becomes more promi- 

 nent. Ask an absent-minded friend, " How are the family to-day .' " 

 or " How is your brother Tom } " and he tells you, " They are well, 

 thanks ; " and immediately adds, " What kai/e I been saying ? Why, 

 my father is laid up with gout," or " Tom has broken his arm." 



All reflexes are controlled in health, but appear in exaggerated 

 forms in disease. This speech-reflex becomes very marked in de- 

 mentia, where there is a gradual breakdown of the mental structure, 

 and, as is the universal law, the highest, least stable products are 

 the first to decay. The power of intelligent speech is lost or enor- 

 mously reduced, but the more deeply acquired habit of automatic 

 responses is retained. One such demented patient showed prac- 

 tically no intelligence : he never even asked for food or drink. He 

 underwent a severe surgical operation without saying a word, but his 

 reflex speech was preserved. Here are samples of it : " How are 

 you.?" — "Oh, just about the ordinar', thank ye." — "How are 

 you feeling to-day ? " — " Oh, pretty weel, thank ye." — " How's all 

 with you } " — "I'm doin' pretty weel." — " You're not so well to- 

 day .' " — "I don't think I am." — " How's the wife this morning .' " 

 — "Oh, she's very weel, I'm thinkin'." — "Will you take your 

 hands away?" — "Yes, I'll do that." Intelligent though these 

 answers seem, they were not so ; for he was all the while suffering 

 from a serious illness, he knew nothing about his wife, and, though 

 he promised to keep his hands away, he did not do so. 



Another patient named Ross, though chattering all day, had really 

 no intelligent speech. Within a minute he would say such incoher- 

 ent nonsense as, " If you would just come be ! Oh, dear, dear ! Oh! 

 that is the whole clash. That's what ! Oh, dear, dear me ! " and so 



