Republican vindicator. [volume] (Staunton, Va.) 1849-1857, 1857-09-26
From, the Virginia Medical Journal
Clinical Teaching in Virginia.
A great deal has been said of the il

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American medical association, the journals,
the local societies and the would-be medi.
cal reforners of the present era, have all
advocated, with no ordinary zeal, the inn
portance of4providing students with the re-
quisite opportunities for studying disease at
the bedside Of the patient The profession
seems to regard this branch Of medical
education of such paramount value, that it
might naturally be supposed it would lend
its aid to recommend and build up those
schools, whose conductors use strenuous eff
forts 10 give their pupils reasonable means
for testing the practical value of lecture
room doctrines.
That this consideration, whatever they
may say, weighs but lightly with the medi-
cal men Of Virginia, can be proved without
much effort It Isl well known fact, that
even at the present day three-fourths of the
medical graduates from this State receive
their diplomas in Philadelphia. It is con-
coded, that in no department of medical
theory are oi,r schools unequal to their
Philadelphia competitors. Why, then, do
southern students leave US to go to north
ern institutions? The reply is short. Be
cause they are aduised 50 to do By their pre-
ceptors. Ask the advisers reason for thus
aiding to send southern youth and southern
capital to northern cities, and we are imre-
diately referred to the cliaical advantages
of the large Philadelphia hospitals. We
are told of the immense wards and Of the
thousands of cases at Blockley alms-house
Of the convenient location and pleasant lee
ture room of the Pennsylvania hospital.
How very touching appears this sacrifice
of self interest and State pride to the educa-
tional welfare of those who rely On their
Judgment. How marvelously kind must it
seem to those who profit by this gratuitous
zeal. Have these gentlemen ever inquired
into the comparative clinical facilities of
Philadelphia? Have they ever analysed
and ascertained the real worth of the semi
weekly cliniques of the Quaker city. Let
US see what is this much lauded, so-called,
clinical instruction.
On regular days, cases are paraded be-
fore the oyergrown and unexpectant classes.
Those who ean, squeeze around the bed, If
the lecture i'd In the ward, or the front row,
if it is II the leisure room-listen to the
grave professor, while he describes the pa
tents present symptoms. A recipe is writ
ten, IN operation is performed, dressing
is applied. All applaud whether they see,
OR hear, or not tie graceful operator, the
sagacious practitioner The bed disappears,
SO does the patient, seldom to be seen Sc
cond time, while others come to occupy the
same table, or the professor moves lnajesti-
cally on, followed, like comet, by his ga
scous train.
Ii is by such solemn fa-cos that man may
learn the multiform aspects Of diseases? 1t
is thus that they are enabled to follow its
protean phases; watch its progress view
the daily and hourly difficulties that arise !;
learn the remedies by which they are to be
combatted; form judgment of the relative
or absolute power Of these to relieve; see the
result in health or death? Can they thus
be taught to weigh the indication of the
pulse; of the respiration; Of the surface; of
the pupil; Of the various grades Of sensibil-
| ity, mobility, intelligence, &c, or 70 draw
correct interferences from the inspection of
the thousand and one organs and functions
Of the living body7 Is this all that is con-
veyed By the term clinical facilities, on
which are laid so much stress by those who
vaun! their advantages, and almost de-
nounce as useless all other teaching9 Can
FIVE Or six hundred students, struggling
with each other il The narrow wards of a
hospital, acquire much tact in detecting or
treating maladies By such method 3
Yet we are informed that this ID the grea.
advantage of a Philadelphia course and
therefore are we urged to rob our own and
adjoining Southern States of much treasure,
and Of the power to erect for themselves
great centres for medical learning
We do not pretend that this sort Of teach
ing is without good effect; that, in default
of "a better, it is absolutely valueless but il
must be evident to all, without much rehec.
| ton, that it cannot supply the opportunity
so greatly needed By those who are en-,
deavoring to qualify themselves for the
practice of our most arduous and RESPONSE
BILE profession.
Nor can this end be attained where hos
pitfalls are so situated or so governed, thai
admittance for the student is granted only
at stated periods, more or less widely separ
ated. What has heretofore given Paris it
world wide reputation for medical facilities
The simple fact that the student could go t,
the wards, rot only with the professors BIZ
also with the dressers and nurses, and ex
anime infinitely, from day to day, or hou
to hour, the condition and progress of what
ever case he might select for study. Ant
now, that all except the system of followin!
the attending surgeon or physician is pro
scribed, these immense hospitals have be
come as closed books, and we may safel
predict that Paris will no longer attract tn
foreign student as formerly.
If, then, it is important that the studen
should study disease at the bedside, the on
ly plan to be pursued is to have the hospito
III connection ,osth ne school, and subject
the control Of its ,faeulty Vet the two in
situations be situated as nearly as possibl
together, and open the wards of the enc {
the daily inspection 81 those who attend tn
lectures at the other. Permit the studen
to see the daily application of the dressing
to learn the nature Of the remedies used /; t
examine in some sort the patient for him
self. Let him watch eases from their in
ception to their termination, and have a flu
personal cognizance of whatever occurs
whether favorable or unfavorable In short
make the tacility for study SO great thu
, nothing, save an indisposition to learn. ca
be offered as an excuse for ignorance Of di
eaaSa ~ oll ire yariatios