48 The Philippine Journal of Science 1920 
that have been roused by these observations that I wish to 
present and I can assure you that I am impartial, and without 
prejudice for the one side or the other. 
The first and most pertinent question is, of just how much 
benefit is the laboratory to the practitioner? My unequivocal 
answer is that, to a man who knows enough medicine to practice 
it conscientiously, its value is in direct proportion to the degree 
of his independence of it. In other words, if he is a good man 
he knows when and how to call on the laboratory, and it is 
under these circumstances that the relations between the two 
are the best, and least liable to lead to disappointment. I mean 
to state that, particularly among the younger men and the 
careless older ones, there is a great tendency to depend too much 
on the laboratory for diagnoses and to substitute, for the time- 
consuming, careful study of the patient and the skilfully applied 
principles of physical diagnosis, a dogmatic report from the 
laboratory. To my mind there are two factors responsible for 
this. In the case of the young doctor, it is the fault of the 
school, where the laboratory work is necessarily very much 
emphasized, so that because of the lack of proper coordination 
between this and his clinical studies, he comes to have an 
exaggerated idea of its importance. This is more truly the 
case in the larger schools than it is in the smaller, the object 
in the latter being to turn out good, practical doctors and not 
highly trained scientists. I have seen second-year medical 
students so intent on doing research and turning out some 
“Arbeit” that they have lost their perspective and held in con- 
tempt the experience of the older man who is plodding along 
by the bedside. There is still room for question as to the ad- 
visability of allowing undergraduates to become engrossed in 
research, for this very reason, except in so far as it is valuable 
as a feature in the training of their powers of observation and 
inquisitiveness, and thus strengthening their foundation, rather 
than having it end as research per se. In the case of the older 
man, he has taken up the laboratory just as he has any other 
fad in medicine and particularly so, for in it he sees a way to 
save time and energy, even though it be at the patient’s expense, 
both monetary and otherwise ; and so both classes have neglected 
the development of the art of medicine or allowed it to slump, 
and have come more and more to depend on the laboratory to 
take the place of neglected God-given powers of observation 
and study. There comes to be a tendency to let George do it, 
