drainage, impure food, unfavorable occupational surroundings,—matters, all of them, for social regulation,—at once harbor our parasitic enemies and reduce our powers of resisting them. To the intelligent and conscientious physician, a typhoid patient is not only a case, but a warning: his office it is equally to heal the sick and to protect the well. The public health laboratory belongs, then, under the wing of the medical school. It is the clearing-house into which data from an entire state should pour. Tax-supported institutions are most favorably circumstanced in this respect. The material which they readily accumulate is at once a basis for teaching, for investigation, and for practical sanitation. Thus the laboratory sciences all culminate and come together in the hygienic laboratory; out of which emerges the young physician, equipped with sound views as to the nature, causation, spread, prevention, and cure of disease, and with an exalted conception of his own duty to promote social conditions that conduce to physical well-being.
From the standpoint of medical education, a detached academic or scientific treatment of pathology and bacteriology would sacrifice needlessly much of their value. Both subjects are, indeed, full-grown biological sciences,—university subjects, capable of cultivation only in special laboratories, closely affiliated with general biology and chemistry. But the medical student in the brief five hundred hours which he can at most secure for them gains the clearest insight into their philosophy and their bearing by following out their principles mainly in the small group of phenomena illustrated in human disease. Experimental pathology concerns him because it enables him later to conceive his clinical problems intelligently. From an early hour in his pathological work, the student may then begin in the autopsy-room to saturate himself with the clinical spirit. This is not to be confused with the premature "cutting" or the impatient "prescribing'" to which the old-fashioned medical student was addicted. "Cutting" and "prescribing" may still be two years distant; but meanwhile it is both possible and "important to keep ever before the student the part which the work he is doing plays in leading to a more complete comprehension of disease."[1]
One closes a brief review of the medical sciences with a feeling akin to dismay. So much remains to find out, so much is already known,—how futile to orient the student from either standpoint! Practically, however, there is no ground for despair. Enough can be achieved to give him precise conceptions in each of the realms touched upon; and the actual value of these conceptions and of the habits grounded on them depends less on the extent of his acquisitions than on his sense of their reality.[2] Didactic information, like mere hearsay, leaves this sense pale and ineffective; a first-
- ↑ Report of Committee on Pathology, Council on Education, Amer. Med. Assn., Bulletin of Amer. Med. Attn., Sept. 15, 1909, p. 47.
- ↑ That method rather than any particular content is the very essence of scientific discipline is admirably pointed out by Professor Dewey in his address "Science as Subject-matter and as Method," Science, xxxi., no. 787, p. 122. "Science has been taught too much as an accumulation of ready-made material, with which students are to be made familiar, not enough as a method of thinking, an attitude of mind, after the pattern of which mental habits are to be transformed."
