demonstrative and practical instruction, but the results were better than the system. Our teachers were men of fine character, devoted to the duties of their chairs; they inspired us with enthusiasm, interest in our studies and hard work, and they imparted to us sound traditions of our profession; nor did they send us forth so utterly ignorant and unfitted for professional work as those born of the present greatly improved methods of training and opportunities for practical studies are sometimes wont to suppose. Clinical and demonstrative teaching for undergraduates already existed. Of laboratory training there was none."[1] As much could perhaps be said of a half-dozen other institutions. The century was therefore never without brilliant names in anatomy, medicine, and surgery; but they can hardly be cited in extenuation of conditions over which unusual gifts and perseverance alone could'triumph. Those conditions made uniform and thorough teaching impossible; and they utterly forbade the conscientious elimination of the incompetent and the unfit.
From time to time, of course, the voice of protest was heard, but it was for years a voice crying in the wilderness. Delegates from medical schools and societies met at Northampton, Massachusetts, in 1827, and agreed upon certain recommendations lengthening the term of medical study and establishing a knowledge of Latin and natural philosophy as preliminary thereto. The Yale Medical School actually went so far as to procure legislation to this end. But it subsequently beat a retreat when it found itself isolated in its advanced position, its quondam allies having failed to march.[2] As far back as 1835, the Medical College of Georgia had vainly suggested concerted action looking to more decent methods; but no step was taken until, eleven years later, an agitation set up by Nathan Smith Davis resulted in the formation of the American Medical Association, committed to two propositions, viz., that it is desirable "that young men received as students of medicine should have acquired a suitable preliminary education," and "that a uniform elevated standard of requirements for the degree of M.D. should be adopted by all the medical schools in the United States." This was in 1856; much water has flowed under the bridge since then; and though neither of these propositions has even yet been realized, there is no denying that, especially in the last fifteen years, substantial progress has been made.
In the first place, the course has now at length been generally graded[3] and ex-
- ↑ Wm. H. Welch: "Development of American Medicine," (Columbia University Quarterly Supplement, Dec., 1907.
- ↑ Wm. H. Welch: "The Relation of Yale to Medicine" (reprinted from Yale Medical Journal for Nov., 1901) p. 20, and note 28, pp. 30, 31.
- ↑ A certain amount of ungraded teaching is still to be found, especially in the south and west. For example, at Chattanooga, no examinations are held at the close of the first Year; the examinations at the close of the second year are supposed to cover two years' work, the practical outcome of which is obvious. More frequently, clinical lectures are delivered to the juniors and seniors together,—at least, as far as a single amphitheater is capable of containing the combined classes. This is the case at the University of Louisville. At certain other schools, the work is only partially graded, e.g., the Memphis Hospital Medical College, Tennessee Medical College, University of Arkansas, Birmingham Medical College, Ensworth Medical College (St Joseph, Mo.), Hahnemann, San Francisco, Kansas Medical (Topeka), Woman's Medical (Baltimore), Maryland Medical, Mississippi Medical, American
