The times. [volume] (Washington [D.C.]) 1897-1901, 1901-02-03


most remarkable and beneficent
discoveries which has ever
blessed the human race. the dis
covery of the means of preventing small
pox. On May "A, 1886 DR.. Edward Jenner
inoculated James Phipps. When we re-
member that 1900 900 persons died in
single year in the Russian Empire from
smallpox; that in 170i in Iceland, out OF a
population of ao,eoo. co per cent. or $500.
died: that in Jenner's time IAN adult per
son who had not had smallpox was
scarcely met with or heard of in the
United Kingdom, and that owing to his
discovery smallpox is now one of the
rarest diseases the strong words L have
used seem fully justified. But the eight
zenith century was not to witness the end
of progress In medicine. The advances in
the nineteenth century have been even
more startling and more beneficent. What
these advances have been in the depart
ment of medicine has been related by
Prof. osler. 1t is my province to speak
only OF surgery.
METHOD OF TEACHING.
The first advance which should be men
toned is a fundamental one: namely,
methods of medical teaching. At the be-
ginning. OF this century there were only
three medical schools in the United States,
the Medical Department Of the University
of Pennsylvania, established in l765; the
Medical Department of Harvard, estab-
lshed in 1888, and the Medical Department
of Dartmouth. established in 1871. The
last report of the Commissioner of Educa-
ton gives list Of 1856 medical schools now
in existence in this country, many of them
still poorly equipped and struggling for
existence. but large number OF them
standing in the first rank, with excellent
modern equipment. both in teachers, lab
oratories, hospitals, and other facilities.
The medical curriculum then extended
over only two years or less and consisted
Of courses of lectures at the most by seven
professors who. year after year. read the
same course of lectures without illustra
lions and with no practical teaching. The
medical schools, even when connected
with universities. were practically private
corporations. the members Of which took
all the fees, spent what money they were
compelled to spend in the maintenance of
what we now should call the semblance OF
an education, and divided the profits. I'm
til within about twenty years this method
prevaileFln all our medical schools. But
the last two decades of the century have
seen a remarkable awakening of the med
zeal profession to the need of a broader
and more liberal education. and that, as
a prerequisite, the medical schools should
be on the same basis as the department
Of arts in every well-regulated college. To
accomplish this the boards of trustees
have taken possession of the fees of stu
dents. have. placed the faculties upon sal
aries. and have used such portion of the
incomes of the institutions as was needed
for constant and yet rapid development
along the most liberal lines.
U.-CoLLEGE HOSPITALS.
The first step has been the establish
ment in connection with most schools of
general hospitals in which the various
teachers In the college should be the
clinical instructors and where the students
would have the means not only of hearing
theoretically what should be done to the
sick. but of actually examining the pa
tents under the supervision of their In
structors. studying the cases so as to be-
come skilled in reaching a diagnosis. and
Indicating what in their opinion was nee
essary in the way either of hygiene. medi
cine, or surgical operation. More than
THAI, in most of the advanced schools to-
day the students assist the clinical facu-
ties Of the hospitals in the actual perfor-
nance OF operations. so that when they
graduate they are skilled to a degree ut
tori yea
LABORATORIES ESTABLISHED.
Another step which was equally i'm
portant and in some respects even more
so, has been the establishment of labora.
tories connected with each branch of in,
struction. A laboratory Of anatomy (the
dissecting ROOM every medical school has
always had, but all the other laboratories
are recent additions. Among these may be
named a laboratory of clinical medicine
a laboratory of therapeutics, in which the
action OF drugs is studied laboratory Of
chemistry; a laboratory Of microscopy; a
laboratory of pathology for the study of
diseased tissues; "A laboratory of embryol-
ogy or the study of the development of
the human body and Of animals; labor
atory OF hygiene; a laboratory Of bacteri-
oIogy; a laboratory OF pharmacy; sur
gIcal laboratory. in which all the opera
lions OF surgery are done on the cadaver
by each student; q laboratory Of physi-
ology; and in many colleges private rooms
In which advanced WORK may be done for
the discovery of new truths.
In all these laboratories, instead of sim
ply hearing about the experiments and OBJ
10
handle the drugs, the chemicals. the APP
paratus, TO do all the operations To look
through the microscope, etc; in other
words. to do all that which is necessary
for the proper understanding OF the case
in hand. In fact. ii may be said that In
View of the opportunities ard the require.
ments of modern hospitals, it Is undoubt-
sdly true that hospital patient, the poor
est OF the poor, often has his case more
thoroughly studied and more carefully
treated than the wealthy patient who IS
attended at his home. On the other hand.
however, so many labora tories with their
expensive apparatus and large staff Of
assistants mean an enormous increase in
the expense of IA medical education, for
which the student does not pay anything
like an equivalent. Hence the need in all
OF our best modern medical schools for en-
dowments. In order that such work may
be carried on properly and yet the stu
dent net be charged such fees as 20 be
practically prohibitory. excepting for the
rich, or at the least the well TO do. / do
not hesitate to say that by reason Of these
facilities at the end Of the second year
many diligent student of today is better
fitted to practice than was the graduate
OF half century ago.