Boston University - HUB Yearbook (Boston, MA)

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26 BOSTON UNIVERSITY YEAR BOOK. hended. In the language of a leading English journal, speaking of recent government proposals in Germany: ff The medical profession is to be lowered,-its emolu- ments are to be diminishedg the mode of life of its mem- bers rendered more abject, and nearer that of the peasant class,-and thus to become less worthy as an object of ambition by those who from birth are likely to ennoble a trade so miserable. On the other hand, the standard of preliminary education is to be lowered so that men of a lower stamp may find their way into the medical profes- siong for the authorities are too keen not to perceive that it is far easier to stop the entering than hinder the parting medical candidate, and that an easy entrance-examina- tion or abbreviated preliminary training is a far greater inducement than a lowering of the professional standard in another way .... We shall await the issue of this miserable business with great interestg and our German brethren may be assured of the sympathy of the p1'Of9S- sion in Great Britain. From these great evils the German sees no deliverance, save in a fuller organization of the whole body of the pro- fession, and in a discussion of them and of remedies in strong voluntary medical associations like those of Great Britain? 991 1 The Questions of the Day, in the German Medical World. Medi- cal Times and Gazette. London, April 12, 1879, p. 402. -In the face of both of these perils the German physicians pluckily respond, NVir wollen nicht abgedriingt werden aus der Reihe der ukademischeu Berufsarten. VVir wiinschen fiir unsern Stand die hiiohste allgemeine Bildung. -Berliner lclinische Woclaenaclzfift, 1879. CXVI., S. 113.J 2 This feeling is found also in France: Nulle profession n'a plus que la notre besoin de ces reunions perlodlques, oil chacun vieut apprendre ou communiquer quelque chose de cot art qui n'a pas de fln. En France le clroit de se rcunir est si nouveau que les medocins en usent a pelne, et doivent aller a 1'6tranger pour eveiller en eux-meme la valcur des mots 'As- sociations M6dicales,' 'Congrbs M6dicaux,' etc. -Le P7'0gTl?8 Medical, p. 560. Another lwriter complains of the same fact, saying, C'est plus qu'ennuy- eux, c'est humiliantf' p. 683. Paris, 1879. -Meantime the Germans say, Wir Dentschen haben keine Ursache, die franzosische Einrichtung im ganzen nachzuahmenf' Dr. R. Slalsmmn. Berliner klinische Wochen- schrift, 27 Jan., 1879.

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SYJIPTOMS IN MEDICAL EDUCATION. 25 medical colleges under a general law prescribing the num- ber and work of the chairs, the length of the curriculum, Ste. Here is despair of the State, and a coveting of the progressive and self-helpful influences which are insepa- rable from such powerful competing institutions as the great universities of Germany! The aspiration is a wise oneg but the profession seem to have small hope of its early realization? Is Germany, then, the paradise of this profession, the land in which the ideal has been made real, the country where the medical reformer finds his occupation gone? Here is the omnipotent State, here, furthermore, the fore- most seats of learning. The State demands more rigid training than the most enthusiastic representative of American medical colleges dares suggest. The Univer- sities are ready and able to give it. Can any thing be Wanting here ? Alas! even the German physician is not happy. By recent laws the new Empire has changed his occupation from a liberal ffprofession to a mere trade CGewerbejg has substituted for the old-fashioned free honorarium a legalized tariff of prices for medical serviceg and finally, while exacting the utmost possible in the way of training from all candidates for honorable and legitimate practice, has opened to all others - so, at least, it is alleged-the widest opportunities, if not the strongest invitations, to quackery. Moreover, still further humiliations are appre- 1 Aveo nos mceurs actuelles il n'y a. rien a esperer de nouvelles loisg trop sever-es,el1es ne seront pas appliquees, trop indulgentes elles ne seront qu'un encouragement a recommencerf' M. A. Lnroua. Le Progres Medical, p. 344. Paris, 1879. - Avec1a participation future des agregcs D. Penseignement, avec Padjonction des cours cliniques spcciaux et le con- cours de Penselgnement libre, on peut afiirmer que nos facultes de maide- cine offriront des sources d'enseignement aussi abondantes que les univer- sites allemandes, xuunies de leurs professeurs ordinaix-es et extraordinaires et de leurs privat-docenten. CHAUFFABD. Revue des Deux Mondea, 1878, p. 155. - 2 Etant dormees nos habitudes, nos moanrs et nos lois contraires ln. Pinitiative individuelle, il est peu probable que, de longtemps, on essaie de fonder de pureilles soci6t6s. Le Progres Medical, Nov. 8, 1879.

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SYIIIPTOMS IN MEDICAL EDUCATION. 27 Thus, while England has long looked to France as pos- sessed of the true theory and instrument of medical re- form, France has been looking to Germany as showing a better plan g while Germany, in turn, has looked with envy upon the power and commanding leadership of medical societies in the Anglo-Saxon realm. In this way the agitation for medical improvement completes a circuit, returning upon itself. In each of the leading countries of Europe the current sets one way only,- and that a hope- ful one 3 but, studied in international relations, it resembles a vortexlquite as capable of sucking down existing excel- lences as of casting up superior substitutes? Three years ago in these pages, in a paper entitled The Gateways to the Learned Professions, it was shown that the entire and exclusive committal of the custody of these gateways, either to the Profession itself, or to the Scholastic Authorities by which its recruits are trained, or to the State, is fraught with evil, and that only by the co-operation of all these forces can the best results be attained? Precisely this is the impressive lesson of the attempted medical reforms now undergoing discussion in Great Britain, France, and Germany. And one of the fundamentally hopeful things characterizing present move- ments for the improvement of the profession in this coun- 1 As to the system-if such it can be called--of the United States, none seem so poor as to do it reverence. Every one here seems dissat- isfied, and abroad, while English writers are pointing out the superiority of the French or German systems, and French writers are demanding less centralization on the English plan, we nowhere find the system of the United States held up as a model. fzimerican Journal of the Medi- cal Sciences, July, 1878, p. 175.5-But for the symptoms of improvement which we hope to bring out in this paper, we should fear lest our medical education soon cease to possess'the negative virtue of insignihcance, and come to be indicted in the forum of the world's opinion as a nuisance of international dimensions. Already some of the more philosophical stu- dents of civilization have discerned the dehauching influence of our ex- ample upon the ideals and methods of professional education in Europe. See, for example, La Critique Philosophiquc, Politique, Scientyique, Litte- raire. Paris, 1879, pp. 289, 290. Apropos of an article by Ch. Dollfus in Le Temps of Oct. 1, 1879. 2 Boston University Year Book, Vol. IV. pp. 17-28.