Much confusion can be avoided, I think, by classifying laboratories into two categories, those that inculcate principles of medical science and those which subserve clinical diagnosis. In the latter, clinical medicine or medical practise seeks to lay hold of the acquisitions of experimental science and to utilize them in the interpretation of symptoms. The clinical or hospital laboratory approaches medical problems from the professional side and is thus an extension of medical practise into a territory where science and practise meet and shade into one another. Here the future physician should receive most careful training when he begins to direct his studies toward some branch of medicine. For this important stage the Harvard Medical School has left the fourth year open. In this year the student should utilize all possible means of combining his practical training with the more analytic methods of the laboratory and exploit whatever it may offer in more accurate methods of making and recording observations. At the same time, we must not make the mistake of calling this research. It may later on shade into research, but it is at first simply increasing and perfecting the means of identifying already well-known disease processes.
We are just now passing through a period of reaction against so-called book learning which is likely to lead us too far in the other direction. So much weight has been placed upon the training of the senses that we are in danger of neglecting the mind behind them. It is vaguely assumed by some that laboratory work is per se research. This is far from the truth. We might with profit carry on researches in the published work of others without entering the laboratory. We might, on the other hand, spend our whole life in a laboratory without acquiring more than a little manual and optical dexterity. We are in danger of forgetting that the training of the observational powers is simply developing another language made necessary by the expansion of medicine as a biological science. The true investigator may have but imperfectly trained senses, but he may still succeed in discovering and opening up a new country to us. With his intellectual power to grasp and arrange data, largely worked out by others perhaps, he finds his way through the unknown.
In our zeal to further the educational methods of the day, there is just as much danger that we overload the mind with too many sense impressions, as with too many facts gathered through the medium of books. Have we not heard of the absurd waste of time in some laboratories over work employing laboratory technique which is as empty as the written page to many a student? Have we not seen many a laboratory servant whose senses were sharper than ours on occasion; many a butcher who detected abnormalities of the tissues more quickly than we? Yet they were not 'doing research.' Let us not deceive our-