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histology of 1847 entirely, but still, as sure as an anatomical reference becomes neces
essary, newer and brighter and cleaner anatomies are passed by, and our dingy old favorite steps forward from his well-known corner, and seldom fails to clear
all difficulties. It is therefore at the expense of some struggle with our predilections that we find ourselves called upon to recognize the merits of a successor to our earlier companion and guide: the struggle over, we are constrained to declare that the edition of 1858 is a vast improvement upon all others. The author specifies the histological department as that in which most improvement has taken place, but no portion is devoid of evidences of careful revision: for example, we must acknowledge that two illustrations, pp. 408, 409, would have aided us in much perplexity in our student days; they illustrate the dissection of that perplexing part of cerebral anatomy where medulla oblongata, and pons varolii, and corpora quadragemina, and origins of nerves, and peduncles, and commissures, and ventricles, and fasciculi all come together, as if in a conspiracy to drive the anatomist to desperation, and have almost induced us to dissect another brain or two, so clearly do they elucidate that labyrinthine region. The eye and its tunics, the various plexus of nerves, many ligaments, bones, and other organs, receive large additional illustration; and in the histological department all the researches of Kolliker are set down with a fulness which renders the book a complete abstract of that author's researches. In this department we ought to mention two beautiful delineations of the minute anatomy of the supra-venal capsules, from Dr. Harley's paper on those organs, published in a recent number of the Lancet.
This is, in one sentence, the best edition of the best teaching anatomy now extant. [From the publishers, per W. T. Berry & Co.]
D. F. W.
In our September number, we endeavored to show what were the principles of action upon which the convention of Professors which is to meet at Louisville next May would be most likely to bring their deliberations to a successful issue. We endeavored to show that they would be unwise in attempting at present to lengthen the period now assigned to the medical curriculum, by increasing either the number of sessions or the number of months included in a session, and that their attention would be more profitably directed to the object of rendering the period at present devoted to it more efficient in carrying out the objects in view.
The measures which we think feasible for this purpose may be divided into two classes, those for improving the extra-academical portion of the student's training, and those for rendering more efficient the academic
Now, the first class might fairly be looked upon as beyond the action of the convention, because it depends for its carrying out upon men who are not Professors in colleges : indeed, this very matter of extraacademical training, which is the most momentous of all the vexed questions now before the profession, is one toward which the teachers in medical colleges stand in a most peculiar position. They are placed on their defence in regard to abuses over which they have no control whatever: they are asked angrily and indignantly, Why do you not require such and such qualifications in your students ? and no students are sent to them possessing such qualifications. Gladly would they receive such : they call earnestly for them, like Glendower calling “spirits from the vasty deep,” but the spirits do not come. The colleges have to do their best with the materials they can get : they have not the making of the materials, and cannot therefore be held responsible for their quality. The making these materials is in the hands of those who are raising all the clamor against the schools; and if these latter chose to maintain their defensive position, they might simply fold their hands and say that the responsibility does not rest with them. But we have always been in favor of the schools taking their own position in these matters, independently of external clamor; and it is to be remembered that they have been requested to act as an advisory council to the American Medical Association, and we are in favor of their giving that body the best advice in their power, especially as this department of the question can only be practically answered by those who are not members of colleges, and who therefore can be only influenced by the Association. What advice, then, shall be given to the Association ?
It is evident that the object to be attained is an efficient system of preparatory instruction, and instruction between the sessions of the colleges. We have elsewhere expressed the opinion that in this respect the practice of the profession in America has retrograded rather than advanced; and why? Because throughout the rural districts the practice has become universal of a nominal office tuition. Physicians no longer receive a premium with their students, and, being paid nothing for their instruction, they give them none. That students may get a good preliminary instruction, it must be made worth somebody's while to instruct them; and this can never be while nominal instruction is given for nothing. Let a well-educated physician offer to devote a considerable portion of his time and labor to the instruction of a class of students, and exact a premium for doing so, and he will be laughed at in a community where students are taken into a man's office for nothing, and, though for that nothing they are taught just what it is worth, have to be admitted into medical colleges on the strength of their having been engaged (nominally) in the study of medicine for such a time.
How, then, can men be induced and encouraged to give real instruction to medical students ? how can students be induced to make it worth their while ? Common sense dictates the answer : by the whole profession uniting to abolish this practice of gratuitous and nominal tuition. Let it be made unprofessional, as gratuitous practice has been. The profession, acting through the Association as their organ, have done the one—they undoubtedly could do the other. The question arises, will they? We fear they will find it much easier to clamor against the schools about that degradation in medical qualifications, for at least a half of which they and not the schools are responsible, than to correct an evil which they and they only can correct. But, as we said before, the teaching members of the profession have been called upon to give their advice, and we are disposed to give it; therefore, we would have
the teacher's council say to the Association, Extend your code of ethics to this matter, and condemn, with all the force of your acknowledged great authority, this practice of nominal gratuitous tuition. Brand it as you have done the undermining of resources which should support the conscientious physician by gratuitous practicing, or practicing under price. Declare in words parallel with those already on your Code, that “A wealthy physician should not give instruction gratis to those able to pay for it, because his doing so is an injury to his professional brethren desirous of deriving an honorable maintenance by medical instruction. The office of a medical teacher can never be efficiently carried out as an exclusively beneficent one; and it is defrauding the common funds for its support when tuition-fees are dispensed with which might be justly claimed.”
And if by inserting such a clause in your Code, and backing it by action as vigorous as that by which you have struck down other unprofessional conduct, you shall have cleared the way for its establishment, then devise among yourselves a judicious system of preliminary instruction; and when you have done that much, it will become our duty to refuse to receive any student who shall not bring us a certificate that he has attended a preliminary course and satisfied his preceptor pecuniarily, and by his qualifications ascertained upon examination. There would be much practical sense in such a mutual understanding: there is none in calling upon us to insist upon a preliminary examination, where no measures are taken to qualify students for such an examination.
Such a line of policy on the part of the profession would render possible the establishment of preliminary classes and even schools, and especially the establishment of such classes under the auspices of the colleges now existing, for the private instruction of students both before and between the academical sessions. Under this head we would observe, however, that some colleges have of late taken a step, doubtless with laudable purposes, much more likely to discourage than to promote such private enterprises. We allude to the establishment of classes for private instruction between their sessions, making such instruction gratuitous to those who afterwards pursue their academical curriculum in their establishments. We conceive that this arrangement carried out would act just as prejudicially in destroying resources for the support of private instruction as the practices against which we have been already protesting. The reason why private instruction, paid for, and therefore efficient, is not in existence, is, that all practices of this kind keep down the demand for it; and there is no exception to the rule that supply depends upon demand.
This, then, is what we think, acting as an advisory counsel, the Convention ought to do as regards extra-academical instruction. With regard to any measure that may be advisable for the greater efficiency of the academical curriculum, we question very much whether this merely advisory position ought to be adopted. We think that (supposing a sufficient number of schools to be represented) a practical result would be more probably obtained by the schools agreeing as to what measures of improvement they will sustain one another in adopting, and then soliciting the Association to give the force of their coöperation in carrying out those improvements. It comes to this: the Association has never abandoned its claim to the privilege of reforming the schools. It does not now, as it did in the meeting of 1857, attempt to dragoon them into throwing themselves into its hands; but it still deems itself authorized to prescribe measures to them, asking, however, their advice as to what those measures shall be. This, to speak frankly, looks like begging for the power which before they imperiously demanded. We are in favor of yielding it neither to their demands nor their prayers; but believing that the members of colleges best know what needs to be done, what are the obstacles to be overcome, and what are the limitations imposed by circumstances upon their present action, we are in favor of their determining for themselves what it is desirable for them to do, and what they will do. Having done so, we believe that it would be desirable to submit their improvements to the Association, and request the influence of their sanction, which could not but be of great value in procuring the concurrence of the profession at large in those alterations. But this could be done without in any way binding themselves to be determined as to pursuing or not pursuing those measures, by the granting or withholding of that sanction.
It is true that the Convention is formed for the purpose of advising the Association; but we do not see that in consequence of that it is debarred from consulting about matters affecting the interests and usefulness of the bodies which it represents, apart from its transactions with that Society. Its existence does not depend upon that body. It does not exist at all, as yet; and it can only come into existence by the voluntary act of the colleges who are to elect it; and we can see no impropriety in their electing a body of representatives whose first duty it should be to consult with one another upon matters mutually affecting the corporations represented, and, as one of their incidental duties, give to the Association the advice which that body has asked for. To make the Convention the creature of the Association, would be to deprive it of all possible prospect of usefulness. We are in favor of making it, if it