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unquestionably it is largely because this function has come to be generally recognized that medical art and teaching have reached the position of dignity they now hold. There is however a broader application of this function of teaching that has not yet become widely known, and that must be applied specifically and broadly, as it is in occasional instances, in order that the best advantage of modern methods may be taken in developing and advancing our knowledge of disease. This consists in a union of the forces of the laboratory and of the hospital staff in a more definite and complete way than has yet been accomplished, and would require a unity of purpose and a sinking of individual position and privilege that might be difficult to secure.

There are problems in medicine-and the number increases -that cannot be solved by one man, or even by one department; they must be treated by a collection of the best men of the community having knowledge of the subject, brought together for purposes of consultation and sympathetic investigation. The hospital wards should furnish the material, the laboratories the means for study in this line, the clinicians using their knowledge for the binding together of the observations made. A way in which such collective investigations could be carried on is this-it may be put in practice by existing hospitals or by new ones. Let the board in control turn its attention to some single problem pressing for solution the question of typhoid fever for example. Why is it, that after so many advances in knowledge, the apparent mortality from typhoid fever is no less to-day than it was eighty years ago? (R. H. Fitz. Typhoid fever at the Mass. Gen. Hosp. during the past seventy-eight years. Mortality, Intestinal hemorrhage. Perforation. Relapse. Trans. N. Y. State Med. Assoc., 1899-B. M. and S. J., 1899.) Certain wards might be set aside for the collection of cases of typhoid fever—or in the case of a small hospital, its entire capacity might be devoted to the care of cases of

this disease. Let it be understood that for a term of years nothing else would be received. Coöperation with other hospitals would secure sufficient material. The control of the wards should be placed not with a permanent staffbut with a set of specialists selected for their fitness to handle various parts of the problem. All needed laboratory facilities should be added, and then for a period of three, five or more years, the whole of this complete force should be engaged in the study of the problem set before it. The advantage of such a method of collective study cannot be over-estimated. From the point of view of the hospital— especially if small- the reputation and efficiency to be gained by such concentration of effort could not be reached in any other way; the patients would benefit by the attendance of men and the use of methods specialized and perfected to the highest degree; humanity in general would be likely to benefit by improvement in methods, the result of such combined effort and study concentrated upon one problem.

The partial results to be thus obtained are seen in certain diseases in the results of treatment in the South Department of the Boston City Hospital, where known methods are applied by skilled experts to a limited series of diseases. The plan here suggested, however, involves the effort to penetrate unknown paths, and this upon a large scale with a clearly marked map of campaign.

Other problems could be taken up, as their importance become apparent, and the attending staff could be changed to suit the requirements. If I have succeeded in making this suggestion at all clear, I hope it may appeal to my hearers as it does to me-as giving promise of most fruitful results when carried out.

The final fermentative suggestion I have to make is this. A most important development for freedom of learning will be, an extension of agreement among University

Departments in Medicine by which the migration of students may be fostered and encouraged. It will be impossible for any one institution to gather within its walls all the leaders in all branches of medical knowledge. But the best interests of the student and of medicine - require that the learner should have the opportunity to profit by as much of the best as can be provided for him. This may be accomplished by creating such parallelism in medical teaching in a number of leading institutions that similar years of the course shall be practically equivalent; so that, if a student has completed a year's study in one institution, he shall be competent to continue his work in any one of a number of others. He should be allowed to do this without examination and upon simple certificate. If this could be carried out, it might happen that such a student would attend several different institutions in his course for a medical degree. He would be certain to go to more than one, unless the excellence of instruction in all Departments of each should be more nearly equal than it is easy to suppose possible. The stimulation to teachers would be not the least of the benefits that would arise from the adoption of this plan.

I have thus endeavored to present some of the fermentative changes through which the future growth of medicine is to be influenced.

I know that the accomplishment of some of the suggestions made is likely to be long delayed. Some of them, on the other hand, are nearing completion, and the prospects for progress, for liberal training, and for thoroughness are nowhere brighter than in medicine to-day.

[Besides references in the text, see The Doctorate of Philosophy in Medical Science.-Science, Aug. 28, 1903, and Journal of the American Medical Association, Sept. 26, 1903, p. 789.]

ARTICLE XXXVIII.

THE PHYSICAL RELATIONSHIP OF FINSEN LIGHT, RÖNTGEN RAYS AND RADIO-ACTIVITY.

BY WALLACE C. SABINE, A.M.

OF CAMBRIDGE.

READ JUNE 8, 1904.

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