, 
THE TEACHING OF PRACTICAL SURGERY. 875 
geon. The teacher must then enforce to the highest possible 
degree the most careful technique in every detail. 
As teachers we can go one step higher, and teach clinical 
surgery upon patients of value, with the student as operator. 
It has the immeasurable advantage of having the student do under 
the teacher’s direction, precisely what he is to accomplish later 
without supervision other than the critical public eye. The 
disadvantages noted in operating upon worthless subjects are 
severally removed. It is not cruel, according to humanitarian 
ideas because it is intended to benefit the animal or its owner, 
it puts the student into direct contact with the diseased part it¬ 
self, and he has a definite, beneficent object in view, calculated 
to fully arouse the proper enthusiasm in any but a pitiably 
dull student. It is the only way to teach covered surgery. 
A student can learn to castrate cryptorchids only by 
castrating them, and what is true of this operation, is 
more or less so of others. This method too has its objection¬ 
able features. 
1. It does not admit of a regularly arranged curriculum. 
2. It requires much time of the teacher, and places much 
responsibility upon him. 
3. It may be less safe for the patient. 
The first objection is not serious. The practitioner can 
make no curriculum, he can not on one day have a spavin to 
fire, on the next median neurectomy, and on the third the re¬ 
moval of the lateral cartilage for the cure of quittor, but must 
accept cases as they come, and adapt himself to the 
work at hand. Clinical instruction can be graded approxi¬ 
mately. All may take part in physical diagnosis, in secur¬ 
ing the animal, in dressing wounds, and the least exper¬ 
ienced students can be initiated into the simpler opera¬ 
tions, and carried forward to themore complex or detained 
for further repetition upon the simpler, as his progress may 
dictate. \ , 
The second objection relates wholly to the teacher and col¬ 
lege. Clinical instruction by such a method places the instruc- 
