Volume 1
A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae.
- Date:
- 1907-10
Licence: In copyright
Credit: A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![insensibly, tne practical advances of the laboratory and of the hospital reach the men with whom, after all, rests the final testing of all our efforts. The work in practical sanitation, the last word in the prevention of disease, the carrying out new methods of treatment, the exchange of the old accoutrements for the new weapons and the new methods of warfare, these rest with the rank and file of the profession who make efl'ective and translate into practice the new knowledge. The medical journals, the medical societies, the post-graduate schools all help in this good work, and both the profession and the public now appreciate how important it is that physicians should keep well abreast of the times. The difficulty lies often with the individual men who fall into routine and slovenly habits of practice, and who never get more than a superficial smattering of the science and of the art of medicine. Even the most industrious and ambitious, absorbed in a limited field, find it hard to get new life into the old material, and, confronted on all sides by difficult problems which press for solution, they turn for aid to the men who have made these problems their special study, and it is in such works as the present that these teachers and workers embody or codify, so to speak, the current knowledge of the day. After all, the important question for each young man to ask himself as he begins practice is: How can I carry on my education so as to get the best possible returns out of life and do the best that is in my power for my fellow-creatures? There are several cardinal defects which stand in the way of the evolution of the sound clinical practitioner: Lack of preliminary practical training. The medical curriculum is not yet so arranged as to give our young men enough clinical work in their senior years. So full and complicated has the course become that it is very hard for the teachers to adjust it to the new conditions. We ask too much, and expect too much, of the student; but if we could have him properly prepared at the schools and colleges, if everywhere the preliminary sciences were taught outside the medical school, there would be no diffi- culty in giving a man in four years a good start in his profession, and this is all that the best of teachers in the best of medical schools can do for him. In our well-organized physiological, anatomical, histological, embryological, chemical (physiological),, pharmacological, and patho- logical laboratories the teaching has become more and more thorough and practical, but when we come to the “bread and butter” subjects we are not always prepared to give teaching of the same character. The hospitals and dispensaries are numerous enough, and there is no lack of patients; but there is not that constant, close, personal contact of student with patient in which alone the art of medicine can be learned. There is not that control of hospitals by the universities necessary to ensure pro])er facilities for students, nor are the arrangements of the hospitals always such as to meet the demands of modern clinical work. There is still too much theoretical teaching for senior students, and in a majority of the schools the number of teachers in medicine, surgery, obstetrics and the specialties is wholly inadequate. In only a few hospitals is the out- patient department arranged for clinical teaching, and the clinical laboratory is not everywhere recognized as a sine qua non. If we could turn our third and fourth year students into the hospitals and make them part and jiarcel of its machinery (just as much as the nurses who have](https://iiif.wellcomecollection.org/image/b24907212_0001_0036.jp2/full/800%2C/0/default.jpg)
