mental training of the student body in method and to afford the various members of the faculty their own several workshops. Each department needs beds and accompanying facilities enough to care for typical clinical cases for instruction and for such other cases as the teacher himself wants to study under the most favorable conditions. Beyond this requirement, other local hospitals may well provide supplementary illustrative material, particularly for advanced students. Once more, a long list of such supplementary opportunities scattered through the town is no substitute for the fundamental teaching and working hospital, on the existence of which even a fairly satisfactory use of additional and imperfectly controlled clinical material depends. Indeed, without such a teaching hospital, the school cannot even organize a clinical faculty in any proper sense of the term.
The control of the hospital by the medical school puts another face on its relations to its clinical faculty. What would one think of an institution that, requiring a professor of physics, began by seeking some one who had his own laboratory or had got leave to work a while daily in a laboratory belonging to some one else? That is the position of the medical school that, in order to gain even limited use of a hospital ward, has to cajole a staff physician with a professorial title! When the hospital belongs to the medical school, appointments are made on the basis of fitness, eminence, skill. A man is promoted if he deserves it; if a better man is available elsewhere, he is imported. Opportunities are his in virtue of the university's choice: it is absurd to reverse the order. The men thus freely selected will be professors in the ordinary acceptation of the term: they hold chairs in an institution resting on a collegiate basis,—a graduate institution, in other words. They will be simultaneously teachers and investigators. Non-progressive clinical teaching involves a contradiction in terms. The very cases which are exhibited to beginners have their unique features. New problems thus spring up. Every accepted line of treatment leaves something to be desired. Who is to improve matters, if not your university professor, with the hospital in which he controls conditions, with a dozen laboratories at his service for such aid as he summons, with a staff who will be eyes and ears and hands for him in his absence? These conditions exist in Germany, and clinical science has there thriven; they are lacking here, and clinical medicine droops in consequence. Undoubtedly, outright research institutions for clinical medicine are also necessary: the routine of the clinical teacher cuts into his time, to some extent limits the tasks he may essay, for the knotty problems of clinical medicine are excessively complicated and difficult. But the field abounds in questions for which the university hospital with its laboratories is the right place. Nor will the young doctor, for all his admirable technique, prove a progressive practitioner, even to the extent of keeping up his reading, unless his teachers have been so before him.
By the laboratories connected with the university hospital we do not mean merely the fundamental laboratories, described in a previous chapter, or the clinical laboratory, just mentioned: the former as such deal with the subject-matter of their
