Page:Carnegie Flexner Report.djvu/101

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THE LABORATORY BRANCHES
83

As a rule, chemistry advances little beyond the high school level; at the best, elementary organic chemistry is included.[1] The equipment is ordinary; there is nowhere the faintest evidence of independent scientific interest, nowhere any interplay between the chemical and other laboratories. The ground covered satisfies the state board prescription, enabling the student to pass the state board examination. Nothing more is intended; the teaching is accordingly in large measure didactic and quiz drill. It cannot be otherwise; for even in the cases where sufficient desk space is provided, competent assistants are lacking. The instruction therefore quickly deteriorates into demonstration and drill.

The teaching of anatomy clings to thoroughly conventional lines. Embryology is practically unknown; osteology is taught by lectures instead of by practical methods, such as modeling, or the like; histology is relegated to pathology because the anatomical department possesses no microscopes, in the first place, and because the practitioner teacher rarely understands their use, in the second. The laboratory is a mere dissecting-room, in which the student is required to dissect part of a cadaver under the guidance of upper-class students or recent graduates.'^Into none of the schools mentioned have modern ideas as to the conduct of this department permeated. Well conducted anatomical laboratories are in these days clean, attractive, sweet-smelling places; the cadavers, neatly covered when not in use, are moist, thoroughly well preserved, and not repulsive even to a layman. The dissecting-rooms under discussion are rarely clean, always unattractive, and not infrequently unpleasant. They contain tables, cadavers, and a vat; usually nothing more. Not infrequently the school skeleton is defective, as at Creighton, the College of Physicians and Surgeons, Milwaukee, and at the Kansas City Hahnemann. The models, charts, cross-sections, bone-sets,[2] drawings, microscopes, that complete the outfit of the modern anatomist, are conspicuously absent. Large and financially prosperous schools, such as the Medico-Chirurgical (Philadelphia), the University of Maryland (Baltimore), in immediate proximity to institutions like the University of Pennsylvania and the Johns Hopkins, where the subject is properly conducted, have profited nothing by opportunities to modernize their teaching. Of course it could not be otherwise. The professor is a busy physician or surgeon. He lectures to ill prepared students for one hour a few times weekly, in a huge amphitheater, showing a bone between his

  1. The Medico-Chirurgical College of Philadelphia offers decidedly more. The instruction there occupies part of three years and requires 544 hours of work. Nothing could better illustrate our contention that, with medical students on the high school or equivalent basis, anything like a thorough treatment of the pre-medical sciences within the medical curriculum is fatal to the medical curriculum itself. Chemistry here takes up over one-eighth of the entire medical curriculum. Of course physics and biology deserve something too, though they get practically nothing. What would happen to the medical curriculum if a similar effort were made to teach them thoroughly? For the time being, the instruction limps along without them. When their necessity is generally recognized, as that of chemistry is now recognized, it will be impossible to attempt them within the medical school, and the battle for the preliminary scientific training will have been won.
  2. At Cornell (Ithaca) a complete set of bones is given out to each student. There are over 100 complete skeletons. This makes a striking contrast with numerous schools that do not possess a single complete skeleton.