Nashville patriot. [volume] (Nashville, Tenn.) 1858-1860, 1858-08-10
To Medical Students.

There are other reasons why, in our judg-
ment, Western students of medicine will not
do well to go to the Eastern cities to attend
medical lectures.
The great inducement held out by the
colleges in New York and Philadelphia is
that of their large hospitals aud the tacil-
ties which they offer for clinical study. 1t
cannot be denied that for the study of the
diseases incident to their own locality, their
hospitals afford an immense number OF cases;
and these institutions might be made great
school for clinical study. But, as those
hospitals are conducted, and especially in
consequence of the large number of students
collected at the msnamed clinical lectures.
they are really of little value for the purpose.
Clinical is bedside study. The clinical stu
dent should be able to see the patient S
tongue feel his pulse, listen to his breathing,
percuss his chest, &c. That is not clinical
study in which he cannot see and examine
the patient just as the clinical teacher does
and just as he himself will have to do when
he comes to practice medicine. In Phila-
delphia and New York the clinical
lectures are given in large amphitheatsrs,
with five or six hundred students in
attendance. The places near the teacher
are VIGOROUSLY filled 10y the attaches
of the hospitals so that the most that the
stranger student can STE is sick man on the
couch who is said by the lecturer to have
this or that disease. Is this clinical study?
What does the student hear or profitable
more than he can hear in the didactic lecture
of the college? There can never be clinical
teaching in the proper sense IN such insutu-
tIons under the circumstances we have
mentioned. In Paris or London, when clinical
medicine Is taught, the teacher goes round
the ward followed by some twenty or thirty
students, so that each one can see and examine
the patient for himself; when the visit in the
ward. Is over, he takes few of the more
important cases into the lecture room in
order to make them the subjects of fuller
comment or explanation. Is this practicable
when the classes amount TO one thousand
pupils! The very crowd of pupils makes the
thing useless exc pit TO the favored few.
Contrast this with what is seen in Louisville
The hospital faculty here is furnished by the
medical schools. The students can, il they
will, see every patient in the hospital. The
resident graduates and the teach rs in their
daily attendance take with them SO far as the
rules of the hospital will permit. the students
who desire ethical study. There is no crowd
of students in one another's way: but every
one in his turn has his chance Tor bedside
OILS. rvatioh. This is clinical study.
Then again, in class OF four or five hun
dred, there il and there can be no opportunity
for those frequent examinations of the student
upon the preceding lectures, which are so
essential Tor fixing the facts aud doctrines
Taught upon the memory of the student
When Il young gentlemen expects 10 be
examined At almost every lecture. he pays at
teution TO what is said; he notes it down and
remembers il. Is il reasonable 10 suppose
that this stimulus is no incentive to study!
There j. still another evil growing out of
the large numbers in attendance upon these
SCHOOLS, and that is this: There is no
opportunity for that personal intercourse,
that free familiar question aud answer. which
often teaches more than the public lecture.
The student Is often perpleSed-in doubt
about "A certain matter-and word from his
pr'ceptor will clear il up better that whole
hours Of study. How does tue professor,
stalking solemnly from his lecture room,
saluting his class with STATELY condensation
compare with the genial Skoda, or Rokistanki,
WIN, pipe in mouth perhaps, make the teach
! ing part OF kindly eoaver>ation ofquestion
and answer. These are evils growing almost
Of necessity out of the crowding of too many
papils into one school Of Earning osassslls
Jo1raai