Nashville patriot. [volume] (Nashville, Tenn.) 1858-1860, 1858-07-26
TO Medical Students.

We have learned, with surprise and regret,
that there is a growing disposition the
part of students of medicine to go to the East
for the purpose of attending lectures. We
think that this course is nnwise, if they intend
to practice in the Southwest; and we think so
for several reasons.
In the first place, we have no idea that
students can learn in any Eastern school how
to treat Western diseases. 1t is a notorious
fact that there are many diseases which are
found nowhere but in the Mississippi valley
1t is equally true, if not so notorious. that
there are certain ubiquitous Influences, get
ting more energetic as you go South, which
impress upon all the diseases of this region
certain peculiaritics of type that are unknown
in the East The malarial poison pervadcs
in greater or less intensity every individual
and incorporates itself with every disease
Every maady is tainted and complicated by
il. Pneumonia in New York is a simple in
hammatory affection of the lung. Dyscntery
in Boston is nothing more than inflammation
of the larger bowel. These maladies are in
those places simple and uncomplicated; and
the appropriate treatment of each resolves
itself into the plain proposition of depletion.
But these Diseases occurring in the South
west. although they have the same name and
the same visible morbid anatomy, are yet so
different in their essential nature as TO require
a treatm Mt in some cases almost directly
oppos, d TO that which is requisite in their
Eastern cOngencrs.
1t is fact, well known to practitioners of
medicine here. that medical gentlemen educa-
ted in the East when they come to the valley
of the Mississippi and undertake to practice,
are utterly at fault in the application of
remedies. even in those affections which,
theoretically, are common to both localities.
The pneumonia in kentucky is not the
pneumonia of New York. The dysentery OF
the Ohio valley is not the dysentery of the
eastern slope of the Alleghanies.
Dr. Bartlett. IA most distinguished teacher
and writer, admitted to gentlemen in this city
that he was completely perpleXed by the
diseases of this locality: though Identical in
name and pathological anatomy, they were
so different in nature. tendencies, complca-
ton and in the treatment required, that he
had to study them anew. Western diseases
must be studied in the West. Diseases must
be studied in their proper localities. Would
a sane man go to Montreal to study
yellow fever! Does a man go to Boston TO
learn the plague or to Philadelphia to &C
quaint himself with leprosy? The diseases
ere not there to be seen, and the teachers
are not familiar with the diseases.
1t is true, these maladies are described in
books. Teachers who have not a personal
experience can repeat in lectures that which
is written. But such teachings are not what
the student wants. As well might man
teach surgery who has never set broken leg
or amputatrd IA limb. Broken legs are desert
bed aud their treatment fully laid down in
Thousand treatises, written too by men of the
largest learning and the most distinguished
ability. Yet who would waste his time in
listening to a professor VINO had learned his
surgery in books or his operations i'll the
dead-room!" The thing is absurd.
Ii this is true of surgery, which, so to speak.
is cosmopolitan, how much more is it true of
the teaching of those more complicated aud
obscure diseases, such as the various febrile
affections, which are local or Indigenous in
and peculiar to certain localitiesl
Besides, the description of Western diseases
has not yet been written. True, the vast
theme is touched. as it were, here and there,
it medical periodicals, but where in all the
literature of medicine has the subject been
discussed in unity of purpose or comprehen-
sivencss of design! The mere rrading
physician hears Of them now and then-now
OF this and now of that--not uninterruptedly
and continuously, but, like strain of distant
music, now lost and now heard on the shit
ing eddies of the evening air. With such
literature OF Western diseases, can foreign
teachers teach them!
Besides this, there is in the living presence
of disease a something that Cannot be con-
veyed in writing. 1t must be seen. The
value of clinical teaching ISL this. The whole
experience OF schools has taught the inestima-
bic value of bedside study. No description,
oral or written however clear, graphic, or
lifelike, can approach in value single look
at the thing described, whether that thing is
a man. "a horse. IA landscape, or a disease. Do
Eastern hospitals furnish Western diseases.
II is true a man with Western fever in his
blood may sicken in Philadelphia. or one IRON
Cuba with yellow fever in New York. But
til, Sc cases, few and scattering as they are.
poorly shadow forth the cougestive chill of
Green river or the vomito OF Havana Is the
sneaking cur of the menagerie the ierce mon
arch of the African forest!
Oar young friends had better study in
schools, if they inteud 10 prac-
tice in Southwestern States--LosasriAe Jour
nal.