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ment party 'arrogant,' as if the charge did not apply rather to active agitators, who are dissatisfied with arrangements over which they have no direct agency-although such agency would doubtless be most grateful to them.
It has been often said, that the present is eminently an age of improvement; and with this sentiment we fully accord. The profession, within the last few years, has advanced at a more rapid pace
than probably at any former period of the same duration in medical history. We believe that there never were in the ranks of the profession so many who have had the benefit of medical instruction in the schools; and we doubt whether there was, at any time, so great a proportion of readers; and whether in all respects the profession was as respectable. Improvements may be, and are, suggested; some of them feasible ; but most of them not; and it must ever be borne in mind, that modifications of educational systems which have been wisely suggested, and sustained by long experience, ought not to be made hastily; and that every great change is an experiment, which in a government-or system of twenty-nine governmentslike ours, may not be found as satisfactory in practice as it seenis to be sound in theory.
Let the youth intended for the medical profession have-as we remarked in our last number—the intellectual and moral training that befits the well educated gentleman; let boards of examiners see that the candidate for practice has the necessary qualifications, and there can be no well founded cause of complaint on the score of insufficiency of attainments.
The standard of qualification must ultimately be determined by such examining boards; and if they do their duty, the wildest reformer can see no necessity for periodical meetings of the profession with the expressed intention of pointing out, and attempting to rectify, defects, some of which are doubtless real; but even if real, their repeated promulgation is calculated to do more harm to the profession in its connexion with the people than all the vagaries of the empiric, and all the follies of homeopathy and mesmerism, against which certain journalists appear to direct their shafts, whilst they pass over in silence the employment of secret agents by members of our own profession, who, by publishing the results of their experience with such agents,
become the open abettors of quackery, and scarcely more elevated in the moral scale than the quacks themselves. Reform-it appears to us—is as imperiously demanded on the part of many of those already in the profession, as of such as are preparing to enter within its pales. We know it will be said, that the imperfectly educated, the low in the social scale, are more apt to embrace those very practices, and such may be the fact; still truth must compel us to admit, that examples are occasionally given by those who occupy high places, and whose conduct becomes the more injurious in consequence. Instances of this kind have been recently sufficiently and lamentably notorious, and may suggest interesting reflections to the members of the Convention who are about to congregate in this city.
But:—to the lectures before us:
That of Dr. Dugas professes to be a sketch of the improvements in medicine during the present century. As in many similar productions, there is in it, we think, an overstrained eulogy of the medical profession. In the latter part of the following quotation, too, the exception appears to us to be brought forward as the rule; for so far as our own observation has extended, the mass of aspirants for medical honors have been impelled to enter the profession solely by their desire to obtain through it an honorable mode of subsistence.
“ In Europe, where the Church, the Bar, the Army and the Navy are the high roads to political as well as to social preferment, we find the members of these professions almost exclusively derived from the wealthy and aristocratic classes of society. In our country, those who are ambitious of political station asually select the Bar. The medical profession is, on the contrary, made up of those whom neither wealth, nobility nor political ambition, prompts to seek any other than scientific distinction—that which can neither be bought with gold nor acquired by hereditary transmission, but which must flow from personal merit alone. It cannot be conceded that many enter this profession as a means of earning a livelihood; but it is an innate love of knowledge, a desire to look into the mysteries of nature, which prompts them, unconsciously perhaps, to select this in preference to other pursuits in which less scientific re. search is necessary." p. 6. VOL, X.
The progress of medical knowledge in all its departments, during the present century, is a field which might be tilled most productively; but the author before us has scarcely broken the surface; so that the announcement on the title-page is not satisfactorily fulfilled. Not inuch opportunity—it is true—is afforded for detail in a discourse of the kind, but many of the materials might, we think, have been better selected.
We do not know what amount of authority the lecturer has for the following broad assertion.
“ Modern medicine has been peculiarly successful in facilitating the treatment of infantile diseases. At a time when the patient's testimony was the only source of information, a correct knowledge of the diseases of those deprived of language or of intelligence, as children and idiots, was unattainable; whereas, with the aid of physical signs and the method of exclusion, by which all organs ascertained to be in a healthy state are excluded from farther observation, there are few, very few, cases in which any difficulty will be experienced in the formation of a correct diagnosis.” p. 14.
Or for the following.
“ There is no disease in which the usefulness of our profession is more signally illustrated than that commonly called bilious fever, for whilst, if left to the unaided efforts of nature it will almost invariably terminate fatally, it now rarely if ever does so under early and skilful medication.” p. 15.
Or for the following. “The Medical College of Georgia may justly claim the merit of having been the first to promulgate the great reformation in the treatment of paroxysmal severs.” p. 16.
The lecture “on practical education in medicine" by Dr. Watson naturally dwells, but in no measured terms of eulogy, on the New York Hospital, which, if we were to judge from the Announcements and other advertisements of the Medical De. partment of the University of New York, affords to the student of medicine facilities not enjoyed elsewhere, and of which we would infer from the same sources he is not slow to avail himself. Under this impression, indeed, students have been induced—we had almost said enticed-to visit New York, when they have been surprised to find scarcely any in attendance. So late, indeed, as the winter of 1845-6-according to the New
York Journal of Medicine-not more than twenty of the students actually took the Hospital ticket ; and in the lecture before us Dr. Watson grievously deplores their scanty attendance.
“ There were probably,” he says, “ between six and seven hundred medical students in this city (New York) during the last winter. I was on duty in the second surgical department of this hospital during the greater part of that time, and strange to say, it was a rare thing to see the fuce of a single student in any of my wurds during the whole of my attendance."
With what propriety, then, can the array of cases of sickness treated in that institution be adduced by any Medical College as an incentive to the medical student for preferring New York to Philadelphia, when in the latter city there are not only opportunities for clinical instruction, but these opportunities are actually embraced by numerous students. During the last official yearwespeak from authority--not fewer than one hundred and fortysix students took the ticket at the Pennsylvania Hospital; and from Jan. 1846 to Jan. 1847—the University of Pennsylvania requiring their candidates for graduation to have attended one course of hospital instruction--not fewer than two hundred and eightyThree.
Dr. Watson properly urges the importance of clinical instruction, and who denies it? But it is an interesting question, whether it be to the welfare of the patient or to the advantage of the student that masses shall congregate daily in the wards, disturb the febrile and inflammatory, and examine individually, and in succession, the physical signs in thoracic and other diseases. There can be, from the philanthropist but one answer we apprehend to the question ; and hence the clinical teacher is compelled to select cases—as was long the custom at the Philadelphia Hospital and is still at the College clinics--for illustration in the amphitheatre,the student having, at the same time, ample opportunity for witnessing the surgical and general management of the hospital.
So far, then, as facilities are afforded and embraced, there would seem to be no comparison between the advantages actually derived from clinical attendance by the students of Philadelphia and of New York.
The author of the lecture gives a brief history of clinical instruction in this country and elsewhere, into which we cannot
follow him. We have only space for one or two comments and rectifications. He is not quite as cosmopolitan as we could desire. Not only the hospital to which he is attached, but other institutions in the city of his residence, occupy, we think, too high a place in his thoughts. For example, he says:
“The cause of education in our well-appointed colleges and especially in the rival schools of this city, (rivals be it ever hoped only in their ability for usefulness,) is every year becoming more and more elevated.”
Quod est demonstrandum. We pause at least for the evidence.
Dr. Watson is a reformer-doubtless the advocate of a judicious reform-as we were wont to hear of the advocates of a judicious tariff. The following sentiment appertains to many as well as to himself.
“Gentlemen, the medical institution which first comes up to the reasonable demands of the profession in this respect, and, possessing the facilities, requires of its graduates practical acquirements equal to those at present enjoined upon the students of European schools, will find its interest in the measure.”
We do not believe in this. Such an institution may be able to exclaim with Francis the first, “ tout est perdu sauf notre honneur,” or it may have to submit to its benches being filled by a "select few.” We have now in mind a distinguished literary institution, in which it was determined to “raise the standard,” and to render its highest honours difficult of attainment. This was done; and whilst the graduates of other institutions were annually numerous, this distinguished school did not confer its highest degree at any time on more than half a dozen; and in some years, we believe, not a single candidate presented himself. It may be said, that they who succeeded would be more respected and successful than the alumni of other institutions where graduation was more easy; but we have had no evi. dence of this; on the contrary we do not know a single case in which marked advantage has accrued to the graduate for the toil which he had to undergo for this more elevated collegiate distinction. Let a department of higher mathematics be established in our colleges, and even if filled by a La Place or a Gauss, it might be attended by a few pupils; whilst the benches appropriated to lower mathematics under an ordinary teacher would