The daily morning journal and courier., 1901-11-02

| ment of the county municipalities cal
 receive any benefit from clinical teach l ings in hospitals. Clinical teaching il the county hospital should certainl. l prove of some benefit to the student | but he is but small part of the bod, polite and the damage done to thos who are under his investigation far off | sets the benefit to himself or society | The attending physician may, of course | extend his knowledge and receive in | creasing fame by discourse i'll medica l practice. but that, too, rests upon ar | Individual rather than upon the com l munity at large. As we have nothing to do with the thousands of the sick people who will soon be under the care
 of these students and are only interest ed in the present and the return tc
 usefulness of patients under our charge we cannot, therefore, consider this a part of the argument of benefit.
 I was confirmed in this belief by what the patients at the hospital told
 me. The chief cause of their complaints
 to me in my daily rounds was that they
 were examined too much and that the
 noise made by bodies of students com
 ing into the wards and by physicians
 explaining various cases to their classes
 in the wards made the place a bedlam.
 The patient came in and was examined.
 He was removed to his ward and ex-
 amined by the house physician in
 charge. If his case was serious the at
 tending physician was sent for and he
 was again examined. If the case prov
 ed interesting the attending physician
 had struck oil or material and the pa-
 tient immediately became an object of
 interest to medical science and a sub
 ject for a course of lectures. Should
 the case not be interesting the patient
 drops back into oblivion for all scien-
 tifc intents and purposes and except for cursory examinations on the part
 of the house physician is simply there
 for the purpose of having his nerves
 racked by the examination of some
 more interesting case in the same room and maybe in the next bed.
 We have nearly 100 physicians on the
 hospital attending staff, most of whom lecture in colleges and formerly took their classes through the hospital wards for bedside clinics. The examinations were not always confined to classes in charge of physicians, which have ire quently been known to exceed thirty in number. The privilege of examination went with all purchases of clinical ticket There were no regular hours for such visitations, and the consequence was general disorder in the wards and great confusion and excitement among the patients, interruption in the general work and noise which, providing the patient was nervous, might well nigh be classed as fatal.
 I spent a good deal of my time in questioning the inmates of the hospital and found out that a general dread existed among the patients owing to the custom of bedside clinics. In some instances this dread amounted to posi- tive agony, which might be compared to the agony of Christian martyrs awaiting their turn in the Coliseum to make Roman holiday. Those of the patients who might be classed as ma terial dreaded the punchings and the handlings and the lectures that were sure to be forthcoming in their cases. Those that were not material were kept in anxiety, terror and dread. At any they might be material and at almost all of the moments of the night and day their rest was disturbed and their treatment retarded by the pres ance and disturbances of the bedside clinic.
 So I thought that as the county hos pital had on it's staff the most eminent scientists and physicians its inmates were entitled to exactly the same treat nent that these eminent physicians for their private patients They all insist as first principle of re- ,overy upon silence, rest and absence # excitement. If any inmate of the hospital could pay for treatment out side he would have the street roped off, an-bar spread in front of his house, he door-bell untitled, felt shoes on the rained nurses and the neighboring 'hildren hushed or transported. In the county hospital these people come to IS helpless, almost without power of bought, and, at any rate, without pow 1T of decision.
 The head of the institution must | hink for them, must protect them and | must see that they get the best care of | which the institution Is capable. l can- | lot surrender myself solely to the pur- ,oses of education at the sacrifice of | instincts, and as no man | an get well under the influence of | oise and excitement it is my plain | uty to reduce these two evils of tn hospital to the minimum There is no question that the side clinics are noisy ! nd confusing and create excitement ot only with the patient under con- iteration but among the other patients q the wards, I regard the hospital in- hates not as material, but as citizens f the community, by the restora tion of yhom to health and strength the com lunity will be benefited by the effect their labors. Tn cutting off the bed idle clinics I think that l have accom- llshed something toward helping the patient to recover. We must t the future take care of itself.
 I have a very high estimate of the alue of the county hospital as an edu- ational factor, but l feel that it fully ompletes it's functions in that direction y means of the clinics held in the am- hitheater. These clinics run from in ,e morning to 10 o'clock at night, and 5 I have previously stated there are xty-seven lecturers engaged therein. atients are shown and operations are :