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to the wave of medical improvement that had swept over our methods of education. One of the best evidences of this is the large number of colleges within the very last few years -nay, within the last two years-that are urging and insisting upon a four years' medical course. It was but last week, in reading the medical journals, that I found, away off in distant Oregon, that the State Board of Medical Examiners had issued notice that after 1898 no person would be admitted to practice in the State of Oregon who had not had four years of medical study. We must look to it that in the East we are not outdone by the West. Not only our medical colleges, but our State Boards, must exact such a large and wise requirement as that, or we will be overrun with the horde of doctors that cannot find a place in the West.
Among the methods of study I can only allude to two. One is that we have not in this country at all such service as there is abroad by the Chefs de Clinique. It may possibly exist; but I am not personally aware of such instruction to practitioners as draws not only students from all parts of our own country, but-as I hope will not be far hence-from Europe as well. Only the other day I was reading a report by Dr. Laurent, of Brussels, on the medical schools of this country. He remarked in the very beginning of it that some people thought there was not very much to be learned from this country; but he added very significantly, "On marche là-bas à pas de géant." I believe that these giant strides will soon carry us to a position such that men from abroad will be able to come here and get in our own schools exactly the teaching that many of us have had in Paris or Vienna or Berlin from the Chefs de Clinique, or from men who occupy similar positions here. Its use in training the chefs themselves as clinical teachers would by no means be its least useful function.
Second, a great deal has been said of late in reference to the value of recitation as opposed to didactic instruction.
Now, I believe thoroughly in recitations. I am glad to see that Harvard has established them. I believe they ought to be official; that is to say, compulsory. Every man of the class should go before the examiner from day to day, and not merely before the professor for an examination at the end of his term; and he should be marked by this official quizmaster, and his standing be determined by his recitations as well as by his final examination. But, gentlemen, I do not believe that the time will ever come when the living voice, and the personality of the speaker, will be discontinued and forgotten. I shall never forget, for instance, one story that was told by dear old Charles D. Meigs, whom you remember, perhaps, as being rather worsted in the fight with Dr. Holmes over the contagiousness of puerperal fever. It was an illustration to emphasize the point which he wished to inculcate in his obstetrical lectures, that the child should be put to the breast very early. He gave a description, which I will not attempt to rival,-for it is one of the most beautiful pieces of poetry in prose that I ever heard,-of the birth of Cain. He pictured the beautiful bower to which Eve retired and the pains that she suddenly felt, which-for it was a novel experience to her-she thought must be due to some grapes that she had eaten the day before that had disagreed with her. Finally, she fainted away for a moment. Then, on waking, she found her slippery little Cain, and, lifting him up in surprise in her arms, he fell into nature's cradle, and immediately took the breast. It was a very simple little story, but it was beautifully told; and to this day, more than thirty years since, it is as fresh to me in its grace and in its lesson as it was then. And, again, I shall never forget the power of Samuel D. Gross. When, in lecturing on diseases of joints, he began with the question of treatment, looking round the amphitheatre very quietly, he said, "The first requisite in the treatment of inflammation of a joint is rest," then after a pause, "rest"; and then, rising to his full height
and folding his arms, he bent majestically forward, and repeated, "In the name of God, REST." Now you might read that ten times in a book, and forget it the next minute; but once hear it from the lips of Gross, with his tall form, fine figure, and handsome, earnest face, and I would defy you ever to forget it.
THE ADVANTAGES OF AN ACADEMIC TRAINING FOR A MEDICAL CAREER.*
HE time is rapidly approaching when all over the country our colleges will send forth several thousand young men to begin their active work in life. The necessity for a wise decision as to what shall be each man's career needs no comment.
The Editor of the "Brown University Magazine" has asked me to present to its readers some of the advantages which attend an academic training before entering upon a medical career. Before doing so, however, I must add a word of commendation of the excellent work of the Brown University Medical Association, which has done so much to foster the medical idea among the students of the University, and to suggest changes and improvements in the college curriculum which adapt it to the requirements of future students.
As a teacher of surgery for now just thirty years, I feel that I may speak with some confidence as to these advantages, and it is with no little pleasure that in my own case I have always recognized the fact that whatever success may have attended either my writing, my practice, or my teaching has been due chiefly to the training I received in my dear Alma Mater. The logical acumen of Chace, the inspiration from Lincoln, the rhetorical grace and fine criticism of Dunn, the historical generalizations of Gammell, and the extraordinary knowledge of Sears all had a most influential part in forming my mind and shaping my subsequent life. I can
* Reprinted from the Brown University Magazine for April, 1896.
never be grateful enough to them and their colleagues in the then Faculty, and I feel it is but a very small repayment on account of a large debt when I can do anything for Brown University.
That college men take precedence of others who have missed such invaluable training is shown by the statistics some time since quoted by the "Medical Record." Of 912 physicians deemed worthy of notice in Appleton's "American Cyclopædia of Biography," 473 are college-trained men. The "Record" estimated that during the present century about 300,000 men have entered the medical profession. Of these, therefore, nearly 1000, that is about 1 in 300, had gained more or less prominence. But on the basis of there being about 500 of these latter who were college men, the chances of distinction and influence for a college-bred man in medicine were increased from 1 in 300 to 1 in 60, or five times as great as if he had not had such intellectual training.
Never has there been a time when the demand for the best and ripest intellect in medicine was more pronounced than at present. The medical horizon is broadening most rapidly. The complexity of the problems constantly presented by disease and by the conditions of modern social life and the multiplicity of the means of investigating them; the logical methods necessary for the solution of these problems; the laboratory facilities which are required to that end; the relation of medicine to public health in matters of sanitation both for the individual and for the public, in peace and in war, in city and in country, all attest the marvelous activity of the medical mind.
To anyone about to enter upon such a life, the question will naturally occur: what are the requirements for such a professional career?
They may be stated, I think, under four headings: first, that a man shall have a strong body and an active mind; secondly, that he shall have the ability to acquire knowl