ments to be had, even if the student had the time and money that are necessary for such an undertaking. But if he is taken into the hospital wards day after day and week after week and allowed to examine cases in the manner indicated, he is indeed a stupid fellow who will not acquire a sufficient knowledge of the more common diseases to enable him to feel somewhat "at home" when he first enters into active practice.

Another point to which I want to give added emphasis is the importance of giving more time and attention to therapeutics. I think, or rather, possibly, I should say I fear, this is a subject that is too much neglected by most medical colleges. While I would not be understood as in any degree speaking lightly of laboratory methods, on the contrary the student can not be too familiar with them, still what the patient wants is to get well, and that, too, in the shortest space of time possible. What matters it to him if the hemaglobin is ten per cent more or less, or if the red blood cells are reduced five hundred, what he wants most is to get out and get to work. I would urge, then, the importance of more time. to therapeutics. With this therapeutic nihilism that is creeping into the profession in certain quarters and for which Osler, possibly more than anyone else, is responsible, I have no patience. I am satisfied that in many cases were it not for the timely and well directed efforts of the physician, that most unwelcome of all guests, the undertaker, would be summoned. Clinical and laboratory methods should go together, they are handmaids, but the former should not be made suffer or be neglected for the sake of the latter.

Conferences in which an exchange of views is given upon any given case or lecture is a most admirable method of teaching, and one that should be used during the last two years of student life. In this way many points that are obscure or overlooked are brought out and firmly fixed in the mind of the budding doctor. The writing of papers upon some subject assigned by the teacher gives added thoroughness, as well as better modes of expression. Lastly the rigid quizzing, to which reference has been made, should never be omitted. It is the best part of the whole day's work and one from which the student derives the greatest amount of benefit.

MEDICAL COLLEGE CURRICULUM LAST TWO

YEARS.*

JOHN URI LLOYD, PHR. M.,

Professor of Pharmacy and Pharmaceutical History, Eclectic Medical Institute Cincinnati.

Let me first express my admiration for the admirable paper that Dr. Oliver has presented the society in this, its first meeting, and let me next join in expressing my appreciation of the opportunity given me to say a word in connection therewith. It seems, however, as though the gentlemen who have discussed this paper have so completely covered the subjects open for discussion as to leave me but the opportunity of expressing myself informally concerning the outer edges that touch upon the subject.

I would like to go on record as asking you to bear kindly in mind the fact that the subjects that engage the attention and care of all the professions teaching medicine are as yet in a state of evolution. As yet there is no closed line of thought. We are all searching in the hopes that we may stumble upon something that will add a bit to the sum of human knowledge and to the alleviation of human suffering. The field in which we are thinking and in which we are working is limitless, and it is necessary that in order that it should be at all touched, different men should be working on different roads. In fact, we may say that the majority of us are not upon a road at all, but are searching unexplored regions, in which, as we pass along, we make markings that may eventually become avenues.

It seems to me as though the struggling thought in medicine and in pharmacy may be compared with an attempt to dis

*Discussion of Dr. J. C. Oliver's paper (March issue) read before the Ohio Association of Medical Teachers, Columbus, Ohio.

cover the source of a river that we know has a source because it is a river. Take, for example, the Mississippi river. Some men may pass up the stream until they finally meet the rapids and the narrows and the channels and the tortuous way that leads beyond the explorations that man has as yet made. Another man may come from the east and pass around through Canada and over the mountains, through the forests, but yet be directing his footsteps no less toward the source of the river than the man who is passing up the stream.

Take another man, who comes from the west. He likewise passes through the unknown country, and although he treads in exactly the opposite direction from the man from the east, he is making toward the source of the same river, and these men are all hoping that they may discover the origin of the stream. The man who does not discover it may find a wealth greater than he who does, so that the explorer can not say that his time is wasted, even though the object of his search is discovered by another party.

So it is in medicine and in pharmacy. There are many roads broken out, other lines lie ahead of these striding on the roads that are broken, and other men still, multitudes of them, are thinking about problems that reach into unexplored directions. It is a mighty labyrinth but not without a plan, and the men engaged in these various directions, each with his own ambition, are all alike to be credited with the earnestness with which they are struggling to the betterment of the professions and of science.

I would therefore close by reiterating that we should not lose sight of the fact that in the evolution that medicine and pharmacy are together making, I being a chemist and thinking of the chemical side of the subject, would say, we should not lose sight of the fact that the whole is a problem yet in the course of incipient evolution. We are stepping up different stairs in this up-hill problem, but are thinking and directing our energies toward the same object, which we all hope will be furthered by the meeting we are now holding in Columbus.

THE RELATION OF THE LITERARY AND MEDICAL

COLLEGES.*

RALPH P. DANIELLS, B. S., M. D.

Professor of Physical Diagnosis, Toledo Medical College, Toledo, Ohio.

The courtesy has been extended to me of coming before you at this meeting to speak on the relations which should exist between the literary college and the medical school. The first American medical schools were connected with colleges or universities, but as time advanced and an extended area of new country opened up the demand for physicians so increased that many medical schools were established without this connection, and at present only about onethird of our medical schools enjoy such relations. The apparent reason for this is that, while connection with a college is desirable, the general requirements for the doctor's degree have been so low that students could enter a medical college after four years in a high school, the college or university training being looked upon as good if one could afford it, but by no means essential, the purely technical medical studies being considered sufficient for the training of a skilled physician. Partly to this cause and partly to the fact that until comparatively recently the college curriculum has given little instruction in those sciences which constitute the foundation of a sound medical education may be attributed the severance of that close relation between the medical school and the college, a condition with which we started and to which we are surely returning.

In common with other departments of education, medical education has advanced greatly within the last twentyfive years, yet at the present time there is no uniformity in the entrance requirements of medical colleges. These vary

*Read before the Meeting of the Ohio Association of Medical Teachers, December 26, 1905, Columbus, Ohio.

greatly, ranging from a high school diploma to a bachelor's degree from a recognized college or university, together with a reading knowledge of scientific French and German. Are these last requirements too great? Can the man with a high school training as preparation become as broad and liberal a physician as the one with four years more of academic training, and are these last four years of sufficient value to the future physician as to warrant the time and money which must be expended in obtaining them?

To answer these questions we must ask what the physician should be, what work in life he is expected to undertake. When a man essays the duties of a physician he takes upon himself obligations of the highest nature. The physician is an important member of his community. His relations to his patients are peculiar and intimate. He should be worthy of the highest esteem and confidence and should be prominent and influential in all affairs that affect good citizenship. His education, therefore, should be as liberal as is possible, for "the value of a broad foundation in general culture as a basis for any life work can not be overestimated," and especially is this true in medicine. Such an education he will best acquire in the environment of a college with its social and intellectual associations, where his teachers are earnest in their purpose, masters in their departments, and interested in the dvelopment of a high type of manhood.

But more than this, the physician must be thoroughly trained for his professional duties, for medicine is an applied science and one that is now making most rapid strides, more advance having been made in the last half century than in all previous ages. These advances demand that today histology, anatomy, bacteriology, physical and physiological chemistry be thoroughly taught, subjects hardly touched upon when our medical instructors were on the benches, but now a necessity, not only that the physician may be able to appreciate the present status of his profession, but that, after he has left the medical school, he may be able to keep up with and intelli