with abnormalities of structure and function and their causation. Now the agents and forces which invade the body to its disadvantage play their game, too, according to law. And to learn that law one goes once more to the same fundamental sciences upon which the anatomist and the physiologist have already freely drawn,— viz., biology, physics, and chemistry.
Nor do these apparently recondite matters concern only the experimenting investigator, eager to convert patiently acquired knowledge of bacterial and other foes into a rational system of defense against them. For the practical outcome of such investigation is not communicable by rote; it cannot be reduced to prescriptions for mechanical use by the unenlightened practitioner. Modern medicine cannot be formulated in quiz-compends; those who would employ it must trouble to understand it. Moreover, medicine is developing with beneficent rapidity along these same biological and chemical lines. Is our fresh young graduate of five and twenty to keep abreast of its progress? If so, he must, once more, understand; not otherwise can he adopt the new agents and new methods issuing at intervals from each of a dozen fertile laboratories; for rote has no future: it stops where it is. "There can be no doubt," said Huxley, "that the future of pathology and of therapeutics, and therefore of practical medicine, depends upon the extent to which those who occupy themselves with these subjects are trained in the methods and impregnated with the fundamental truths of biology."[1] Now the medical sciences proper—anatomy, physiology, pathology, pharmacology—already crowd the two years of the curriculum that can be assigned to them; and in so doing, take for granted the more fundamental sciences—biology, physics, and chemistry—for which there is thus no adequate opportunity within the medical school proper. Only at the sacrifice of some essential part of the medical curriculum—and for every such sacrifice the future patients pay —can this curriculum be made to include the preliminary subjects upon which it presumes.
From the foregoing discussion, these conclusions emerge: By the very nature of the case, admission to a really modern medical school must at the very least depend on a competent knowledge of chemistry, biology,[2] and physics. Every departure from this basis is at the expense of medical training itself. From the exclusive standpoint of the medical school it is immaterial where the student gets the instruction. But it is clear that if it is to become the common minimum basis of medical education, some recognized and organized manner of obtaining it must be devised: it cannot be left to the initiative of the individual without greatly impairing its quality. Regular provision must therefore be made at a definite moment of normal educational progress. Now the requirement above agreed on is too extensive and too difficult to be incorporated in its entirety within the high school or to be substituted for a considerable
