, 1910 Series, Vol. V. MEN AND THINGS. Is It the Man or His Alma Mater?While so much discussion is being stirred up by the Flexner Report on American Medical Colleges (it will be noted that we have not been able to resist the temptation to indulge in a little comment ourselves) it will be interesting to look up the college history of some of our great physicians and surgeons, and in the light of their accomplishments, read the estimation, high or otherwise, which the report in question places on their Alma Maters. starter, the name of Dr. Simon Flexner immediately suggested itself. Since Brother Abraham Flexner wrote or compiled the report, it was certainly interesting to learn his opinion of the school from which Brother Simon obtained his diploma. Before disclosing the data which we were able to obtain, just a word may not be out of place concerning Brother Simon. For a If there is to-day a physician in America, or in fact, in any other civilized country who does not know of Dr. Simon Flexner and his work, he is hopelessly out of touch with his profession. Dr. Flexner stands to-day without doubt one of the most brilliant medical men of the present age of scientific medicine. As a laboratory worker his accomplishments have won him the sincere admiration and gratitude of his colleagues. His connection with the Rockefeller Medical Research Institute has provided splendid opportunities, which he has had the acumen and masterly ability to utilize for the benefit of all mankind. Probably there is no better exponent of the laboratory in its relation to medicine at large than Dr. Flexner. Assuredly no scientific investigator has shown Series so plainly the wonderful possibilities that rest in laboratory research or has laid such substantial foundations for active cooperation between the laboratory worker and the physician at the bedside. His own particular studies of meningitis, infantile diarrhea and many other diseases have enriched medical knowledge, and led to the most gratifying advances in their practical treatment. And so it is. Dr. Simon Flexner is a man whom his associates admire, respect and love; the world at large likewise admires his attainments and appreciates the splendid work he is doing and helping others to do for humanity. We have no desire to appear fulsome or extravagant in our commendation. single aim is to point out his undeniable place in medicine, a place that has called for the exercise of natural as well as acquired mental attainments, and an equipment in scholastic medicine that was undeniably potentially valuable. Our Whatever we have said, or may later say has been free from any intentional disrespect. Far be it from our intent, that anything in these pages should convey the slightest affront to one whom we so sincerely respect and esteem. But the situation carries such a trite and happy confirmation of our statement in last month's issue that "the world is interested in what a medical man is and can do, and not the college he graduated from," that we could not refrain from presenting the matter, even in this clumsy way. What we have stated about Dr. Simon Flexner-facts that no one will gainsayshow conclusively, though perhaps inefficiently, his great usefulness both to his confreres in medicine and to humanity in general. Measured by his scientific stature, his contributions to medicine and his achievements, Dr. Simon Flexner in the light of his brother's dicta concerning medical colleges and their capacities for developing useful physicians, should be a graduate of some one of the large and best equipped universities. But alas, fate ordained differently and according to the last edition. of the American Medical Directory Dr. Simon Flexner, the saver of babies' lives, director of one of the world's most famous and important scientific institutions, a splendid scholar, one of the world's great scientists, a man who already has achieved. wonders in his chosen field, and one who, if his life is spared will probably be responsible for the conquest of several of humanity's most fatal maladies, suffered the frightful handicap of equipping himself for his life's work at the University of Louisville, Medical Department, an institution one will shudder to think of in 1889 if what Brother Abraham says about it today is true. Following is his comment: "Laboratory Facilities- Teaching laboratories are provided for chemistry, pathology, bacteriology, physiology, and pharmacy. They are inadequate in appointments and teaching force for the thorough teaching of the fundamental sciences to so large a student body. The University of Louisville has a large, scattered plant, unequal to the strain which numbers put upon it. In the old days, Louisville, with a half-dozen "regular" schools, was a popular medical center, to which crude boys thronged from the plantations. The schools offered little beyond didactic teaching. Now, they have been arithmetically added together; the resulting school is indeed superior on the laboratory side to any of its component parts; but there are radical defects for which there is no cure in sight. The classes are unmanageably huge; the laboratories overcrowded and undermanned; clinical facilities, meager at best, broken into bits in order to be distributed among the aggregated faculty. To carry the school at all, a large attendance is necessary; but a large attend We realize that there are other phases of the question and a single case like this offers no real opportunities for comparisons or conclusions. But we still think it carries a valuable lesson and proves our contention that after all the personal equation is the all important factor. We need all the Simon Flexners we can get, and a school that can help one such man in each decade to embark on a career so useful to his fellows and all mankind, has justified its existence, Brother Abraham notwithstanding. Dr. Henry G. Piffard, Man, Physician and Friend. As we each and all of us wend our way down life's toilsome road, God knows there are few indeed who ever deserve the appellation "friend," with all that it means in its true and full significance. There are more than a few, however, among those who knew and associated with Dr. Piffard, who can look back and apply the word friend in all its meaning to this man. For those for whom he cared, no bother, no effort, no inconvenience was ever too great. great. Everything he owned, and every ounce of his strength and vitality was constantly at their service. This great and good man, whose recent death from pneumonia was such a shock to the scientific world, was born in Piffard, New York State, on September 10, 1842. He was graduated B. A. from the University of the City of New York in 1862, and M. D. in 1864, from the same institution. In 1874 he was appointed Professor of Diseases of the Skin in the Medical Department of the University, a position he filled for many years, and was an Emeritus Professor at the time of his death. He was one of the early Space precludes a more elaborate or extensive eulogy on the life of this faithful physician, true scientist and loyal friend. To say that he is missed only partially expresses the void his passing has left. There are too few of his kind, and while his loss to those who enjoyed his daily association, cannot be expressed in mere words, there is great satisfaction in having known and worked with such a man. He left not one, but many of us stronger and better, prouder of our calling and more appreciative of the opportunities it offers. No greater tribute can be given to his memory. The death of William James, professor of philosophy at Harvard, which took place on August 26th at his summer residence at Chocorua, N. H., from heart disease, in the 69th year of his age, robs science of one of its leading exponents in this country. It is too much the fashion now-a-days to gird at "philosophy" as a nebulous imaginative study, built upon the unstable base of introspection and projected into space without any adequate prop of support. It is true that arm-chair philosophy pure and simple has been responsible for too many of the erroneous dogmata that have until recent years shackled the efforts of science to break from the shell of speculation and emerge into the daylight of demonstrable knowledge. But James was no mere armchair philosopher and psychologist. had enjoyed a good practical training in the biological sciences, and where science and philosophy touch hands he demonstrated that fact by the employment of the scientific method. It is true that he did not himself do any considerable work in the experimental side of psychology, but in his He "Principles of Psychology," published now twenty years ago, he indicated the lines which modern developments of experimental psychology have perforce largely followed in the course of natural development. Among his other works that have attracted wide attention, and deservedly so, are "Varieties of Religious Experience" and the Lowell Lectures on "Pragmatism." Whatever may be the degree of agreement or disagreement that his theses. shall ultimately encounter at the hands of developing science in regard to the link between the inner and the outer animal, his name will deserve honor as that of a pioneer in the pathway to light. How to study medicine. In the October issue of the Outlook appears an article entitled "How to Study Medicine," by Henry S. Pritchett, president of the Carnegie Foundation. It is, of course, addressed especially to those young men who, for various reasons, are contemplating the taking up of the study of medicine, or to their parents or guardians. It is a very convincing statement of the main principles that underlie the investigations of the Foundation on which its report was founded. Dr. Pritchett deals with the current argument that "commercial medical schools" are "to serve the poor boy," in this wise: "The fact is, that a poor boy has no right to go into the practice of medicine with any lower qualification than the rich boy. The practice of medicine is. one of the great human professions which affect profoundly, not only the health, but the moral and social lives, of a community. No man has a right to go into it unless he will fit himself fairly for the work." , 1910 Series, Vol. V. So far as the actual cost of the medical education itself is concerned, no sane person can cavil at this statement. The expense of acquiring a medical education, however, is not, and cannot be, confined solely to the actual school fees for tuition and medical training. There is also to be considered the cost of going and living away from home. The greater the distance from home, the greater the cost of travelling. In some places, too, suitable board, etc., can be obtained far more cheaply than in others. Again, in a college where the "poor boy" is likely to find himself associated chiefly, if not entirely, with others in circumstances like to his own, standards of living will be lower, and he will be less likely to feel a natural, even though entirely unnecessary, sense of humiliation at being unable to do as the majority of his fellow students do, to dress as they dress, to share in their amusements, and generally to comport himself as they do. That many of these smaller proprietary, or so-called "commercial," schools do aim by "alluring advertisements" to offset the defect of inadequate facilities and opportunities for training and teaching, particularly in the highly important fundamental sciences, cannot be denied. The true solution of this problem, however, even after a most careful and sympathetic consideration of Dr. Pritchett's article, still remains, in our opinion, essentially as we stated in our editorial of last month. Dr. Pritchett himself says that "Educational opportunities in America are to-day so generous that any poor boy with the right stuff in him who desires to enter medicine can secure, not only the neces sary medical education, but the requisite general education." Let the State licensing bodies ordain a reasonably high standard of general education as a pre-requisite to registration as a medical student in any medical school in their respective jurisdictions, ensuring its enforcement by themselves conducting the preliminary test examination for entrance, and the hopelessly inadequate medical schools will die for lack of support at the hands of an intelligent body of intending students, rich and poor alike, and the same pressure of student opinion will soon compel the surviving schools to elevate their teaching facilities to an adequate level. Most states already require an examination for a license to practice medicine, irrespective of the school at which the physician graduated. Let them carry this principle of selection a little further, by licensing also candidates for the study of medicine, and not only will the average status of licensed practitioners be raised, but many individuals, doomed from the first to the devious by-paths of charlatanry and disreputable practice, will be estopped at least from entering the medical profession to disgrace it by their methods. Aviation, it would appear, is not yet undisputed victor in the transportation championship. The fact that no less than fifteen among the pioneers of aviation are said to have given up its further pursuit as a regular thing, in consequence for the most part of the nervous and cardiac derangements that it induces, would seem to indicate that the disadvantages of the air as a highway are too general and too farreaching to render it after all generally |