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Mft to * right and top to bottom, aa oMny franMO aa raqubad. Tha foNowbig dlagrama ilhiatrata tha L'lAianiplaba filn«4 fut raproduH griao I to _^ g4nAroalt* do: Unlvarslty of Toronto, Sclanca ft Hodlctne Library Laa bnagaa sulvantaa ont At* raprodultaa avae la ^ pkM grand aoin. eompta tanu do la condition dt do to notlotd do I'oKomplairo fibnd. at an aonformltd avoe too eondMona dii eontrat da mi^. .7^ Laa anamptolraa originaua dont to oouvortura an papiar aat bnprlmda aont fHnida an common^ant par to ipMntor ptot at an tnrmlnam toit par to dMo to ta paga 9fiA eomporto uno ampralnta dlmpiaailaaaM dlNuatradon. aolt pir to aoeond plot, aaton l^eaa. Toua laa autraa axamptolroa, origlnain aoilt nbnoa an ooniii^on^ant par to pramtora paga gut eomporto uno ompralnta dlmpraaaian ou dUbaatratlon at an tarmlnant par to dar h lft r a paga qui eomporto uno Un daa eymbolo a aubfanta apparaltra aur to damtofo image da cheque mteroflche. telon lo cea: to aymboto -^^ signifto "A tUIVRt". to / aymboto ▼ algnHto "FIN". -77^: - ■'.. ~^^^' Lea eartee. ptonohae. tableaux, etc.. pouvont *tro fHmda A dee taux da rdduction dHfdrenta. Loraqua to document eet trop grand pour Atro reproduH en un aeul cNchd. H eet fHmd A partir da I'angto aupArtour geucho. do gauche A droite. et do haul ah bee. en prenant to nombre dlmagee hioeaeelro. Lea dtogrammaoautoenta Nbiatrant to mAthode. • ■ 2 * * -•^,t ^ ■r ^ "' ■■ f ■ ... '••V-Vx.i^,, loo Sin ten ,)co »rS,.s,.:». ■, lA-t^L*!:- "*^>*- ♦'*'.•.•**'■ ■■>».-'-»**u' .HitL,_...;_i 1™ *'••*' •^'' ■"Pi*. • . >4iv , ■*-*««- ■W«^^!«»^- «?.*■>«'. "f%i,v% ■'•0>«»-r«;j^_i,,,,..^,, ''■"-^^s*^^^^^^' ;,f-^w|^*#jit^^^-ri -frWSiov*;.,., •-*>trji-»"v>.'T--.,>...j.,^ X i T ■1 ^^^ ^B ^^^^. ;■ .HSHHI^' " ' ■ ■ \ " " , ^^ ■ I ■f , ^\ ' ■: '[ '-■ / :-:„-..;-.: 'v..-' :..:.;:.•;.'■,:_::,.,. •;;^:. ■',,■. _, A:.,:-^ .1: j^ » \i toi win rttulto lik« these for the ne«t ten yean, at the end of that time a very large majority of the medical practitionen in this province will be graduates of thia Univenity, a distinction nKich should have been hers during the past thirty years. Without looki^ •<> f" forward, however, *»e are justified in sUting that, through the Medical Faculty, the ProvincUl University now exercises an influence in medical education corresponding to that which she exerte through her Arts' Faculty upon the liberal educa- tion in the province. And when in the near future she may have to consider the ways and means in the matter of expansion, l^t us hope that the influence in a new quarter may be of tl^ greatest service to her. I must not forget to mention that the Faculty has not been unmindful of other matten in which the student is to a very great extent interested. During the last session, it recommended to the University Senate such a KvisiQn of the medical curriculum as would make it more in accord with that of the British Medical Council arid with the trend of opinion resulting from experience as to what medical education should be. The Senate adopted all the Faculty's recommendations. The changes affect only atudenu who begin their undergraduate course now and subsequently. StudenU will be required to undergo only one examination in subjects in which the former curriculum made two coiiq;Milsory. Honors under the pro- visions of the new curriculum are no longer to be given as heretofore, and are in future to be won only in groups of subjects. The examinations are ■implified,and in the first the Univershy now insists upon a competent knowledge of chemistry, biology, and physics before the student passes to the second xear. This enables the student to do good, solid work in anatomy without being worried with the task of reading for an examination in that subject, the limits of which could never hitherto be fully defined for a first-year examination. That the University has not given chemistry, biology, and physics undue imporUnce by making them alone the subjects of one examination is shown by the fact that the British Medical Council now requires all studenU to spend the first academic year in attendance upon instructbn in these subjects, and wHh this regulation all the medical faculties and licensing bodies in Oireat Briuin and Irehmd must now comply* 4" ■■ / / i now proceed to discuu the future of medical science, and the Ijear- ing that possible advances in medicine may have upon the student's present course of study. This topic is one on which muelj may be said, and I Uke it up now because it is one of absorbing interest, and because, also, it is good for those of you who are preparing for a life of medical practice to be reminded that it is but a small part of your life's work to pass examinations, to acquire a degree and a license to practise, and that you may accomplish these things without, in the end, obtaining the <»-i % \ ■■ / object of rour life. The ttudent. k. . rule, doe. not, unlbrtur»tely. look more thui three or four yean $hk»d, and he is inclined to let the future bey«>nd take care of itself. It d<^ this, but without, however, paying much attention to hjm who doea not employ each year as it passes for that realisation of the ideal which is considered to constitute success. All courses of study and all examinations merely insure t))je lowest standard of atuinment that the necessities of the times permit, and beyond this they leave to the student the question of shaping his own career. His success in the future depends grei^ly on his capacity for foreseeing the wants of the future. Do not misunan that usually given the term. It includes, in addition to pathology in the narrower sense, the foundation sciences, biology phj-si- ology, bacteriology, and physiological chemistry; and whatever, therefore advances these will in a great measure ai Several reasons are to be urged in answer td this question, and for one of these we must examine the condition of medicine during the first half of this century, when it could not press any such claim*' to be considered' a science as it now presenu. While it consisted of much that was valuable, the greater part of it was pure empiricism. This was not all. There arose in the medicd world a discussion on questions of a purely dogmatic character ould never have be«n introduced into medicine at all. Whether like cures like, or whether a disease is cured by a drug which produces the very opposite symptoms, were the questions j^ the day. There were Others on which the very opposite answers were given. Is the therapeutical action of a drug increased the more if it is diluted or shaken, or the more finely it is divided ? This discuuion first arose in Germany, which gave, at the same time, origin to some other iantasiic and absurd creeds in medi^ cine^ like Rademacherism, Isopathy, Ideal Pathology, etc., and it spread to England, Franc#, and to this continent. Theiw questions were even taken up by the lay wqrid, and discussed, in some insUnces, with all the partisanship that characterises party politics. Then some strove to adopt a position between the two caibps, and this added to the confusion. What wonder is it that the public should, in the end, conclude that there was nothing scientific in medicine; that it was merely a mattlhr of taste in more waxs than one as to which school of medical practice you gave jour adhesion when you desired medical treatment ? Twenty-three centuries ago Hippocrates described a somewhat similar condition of medical practice which obuinedinhistime. Aft^rspeakingof somephysidanswhoconsUntlx adiqinister strained decoctions of barley, while others strain the Juice tMough a cloth in order to prevent harm to the patient resulting from swallowing a particle of it; while others, again, give neither the juice nor the thick decoction until after the s^enth day, or after the crisis, ht says : » Physi- cians are iiot in the habit of 'mooting such questions; nor, perhaps, if mooted, would a solution of them be found; although the whole art is thereby exposed to much censure from the vulgar, who fancy that there really is no such science as inedicine, since in acute diseases practitioncra differ so much amongst themselves that those things which one adminis- ' ters as thinking it the best that can be given another holds to be bad; and in this respect they might say that the art of tnedicine resembles augury, since atigurs hold that the same bird, if seen on the left hand, is good; bat, if on the right, bad " ("On Regimen in Acute Diseases "). In the^Uyp W (- N_ ^'3j*sjiiaL\i \ HippocnUM, lh« introduction of cttadt and dogOMW into inodkin* 'and Ih* ' conMqiMnt contempt of tb« vulgar did not mattar; but the attampt made within th« la«t ona hundrad jaan to introduca dofma and lancihil thaory haa raaultad in ratarding the davalopmant of madicina aa a Kianca of obaarvatiolr«nd cipaHnwnt; and avan ai» tha praaa n t day, whan w m not troubled ao much with denominationalitm in medicine, it haa halpRi to |N«vant that racogfiition to which tha.acianca ia entitled from th* •tatat. > Another reiuon for the indiflerenoe ahown by the iUta to medicine and medical research, eapecially on thia continent, ia the fact that inatruction in. medicine haa been very largely conflicted and controlled by proprietary inititutiona Ai theae were managed for flnanckl gain, it ia manifeat. that they would spend aa little as they could in equipping labmatorict which coat money. It waa to the.intereat of many of the teachen to leach the profeaaional tubjectt well, for (heir own reputaliona were enhanced; )>ut in inatruction in the aciences there waa very little of auch inducement, for tht - , air was' full of talk about " practical " things and against " new-fangled no- tions." Theseinstitutions-tumedout a large numberof medical practitioners, ^ among whom were undoubtedly good men"; but the ideas of maliy of these graduatea concerning medicine and medical science could not be higher than those of the institutions from which they received their education. -.The advocates of the endowment of medical research have had to' con- ^ "* tend, therefore, with a confused public opinion, backed by the inertia of at least thirty thousand practitioners, and also wi4h schools and collegea of medicine whose craft was endangered. According to a lecture recently delivered by Professor DaCosta, the number of medical schools and colleges iti the United States constitutes the greatest enemy of medical progress, for the weaker ones, in order to have students and live, keep the sundard down. A few years ago there were nearly three hundred of them, and they now number' about one hundred and forty-five. As there are but about twenty-five medical schools and faculties in Great' Britain and Ireland for a population of 38,000,000, it is obvjpus that if the same proportion obtained in the 65,000,000 population of the United Statea there would be about forty-five auch institutions. Professor DaCosu says that they die at the tate of three a year, according to which it would take over thirty years to get rid of the not only needless, but harmful exceas. The majority of them confer the degree of M.D., although they have no university connection whatever, and we owe to such a condition of affaira that the American medical degree receives so little respect the world' over. We may find in this condi- tion also the cause of the failure of American universities to mould profea- aional life, at least in medicine. Of lat^ears ^ ITorts have not been wanting ■/ '\ ■J / 4^ .-%-.■<■ V ■ y ^ ■ . J'V N - ^ \S- *? V>ii to bring medical education under the control of the itate and other univer titles, and when such a result is fully atuined no doubt the sundard of •■ dBcienqr in medical education will at once rise. We in Canada have all. but Mcceeded in that respect, but the present condition of things was' oppoied by some who, for various reasons, ot^ject to the university and sute control of medical education, nominally on the ground that the latter is •• professional." "I think nothing human foreign to me," said the Roman of old, and our present^lay culturists subscribe to the sentiment and urge the state to endow the study of language, of which but less than one per cent, of the population receive the benefit, while they are ready to oppose grant- ing sute aid to the study of pathology and sanitary science, by which every unit of the population would b^ benefited directly or indirectly. A third cause of the failure of the public, through constituted authority, to support medical research is the prevalence of a spirit very much like that of fatalism. It is a harsh term to employ, and I use it apologetically, .although I cannot find a milder one that befits the situation. In the east, where cholera and leprosy find a permanent home, there is an extraordinary ' apathy regarding them. No effmt^is made on the part of the natives to prevent the occurrence and spread of these diseases, or of any odgr. for that matter. Why should they, when they regard these as ordainEl by fate ? What is the use of fighting agiainst fate ? We wonder and are per- plexed at the phase of diaracter presented, without thinking that we of ■ the west, as a whole, exhibit the same. W^ have had with us from time immemorial that disease, tuberculosis, of which annually liiore people die in America alone than of cholera in the whole worid. It is indeed the scourge of the race. When choleia threatens to invade us we become vastly alarmed, and every agency em- ployable by th« sute for that purpose is utilized to prevent iu advent, while we ^rd with apathy the ravage! of tuberculosis, on the plea that nothing an be done. Although it is a disease that is on the increase, and altho agh iu causation was definitely determined over eleven years ago, no cfvilizW government has, so far as I am aware, directly encouraged any research jirith the object of finding a cure, preventing its spread, or stamp- ing it out altogether. Had scientific facts indicated it to be incurable, we -might have an excuse for our apathy ; but facU point in the contrary directton, ^d show that a number recover on hygienic treatment alone. When I say that no government has favored research in tuberculosis, I omitted to mention that the national government of the United Sutes has, through iu Bureau of Animal Industry. Uken up (he question of fuherculosw in cattle. That does not need any comment. Why should not tuberculosis, typhoid ftver, diphtheria, scarlet fever, •nd other zymotic diseases be the suhjecu of research carried on under I f r r i\ '»» ♦ I I I itote contiol and by .ute aid? Whan the state iutitutet hm^ ' ttoM into hog cholera and cattle plagues, surely it ought to do no less for «MMes of the human subject It is true that the state has attempted to attend «. functions in the direction of the pretention of disease through J?.!!^??°^*^' •*"* *° '°"« •■ *•" n«««ber of deaths per an^Him^^ wntabte by ordinary means is more than two thousand for every million or people, it is evident that the jt|te has not done iu duty fully «I.nd technical educaUon wiXthat gmnted. for the same purpose^© mediane. According to Dr. Gould, the editor of the Philadelphia iWWim/ Mws, there is. in the United Sutes, a sum of between seventeen and ^i^rn" r/ ° **?.!" ''"""^'^ '" theological education, while there tt less than half a million invested in medical education. In Ontario, according to the estimates I have in hand, the figures are, respectively. J!:'t?'.°!! t ^**^' '^^ •"**""* '»^t«» '" technical education m the United States it is difficult to estimate, but is undoubtedly a vast sum, .«.»!..i;ii''"*'"r.'?' "^"""^ '^"^ '""^ -gricultunil and mechanictf instruction and cml. engineering reaches the neighborhood ofljooiood. ^1?/^ '1T^' "^.^' '' "•' ^ "'«^ »»»» whateveTugiveifto h^ piUls should be considered under the bead of medical education ; but If it wuld be shown that they always serve that purpose, the contention would b !!Jr°!f ^^ ' "^^ °"*- ^" "^"^ "•» «>»»««» that this very . indirect aid, if it is that, is the •equivalent of that gmnted to instruction in mining, mechanical and civil engineering, and to agricultural education? ^^'"^K •'**^!*" volunurily by the people to the support of instruc- tion m the i«nou8 denominational theologies, the sute ought surely to presume to giyea fn«tiop of such a sum to aid that which is, in the language of the Marquis of Salisbury, -the most sober, the most ab«,hite, the mo« positive ofall the sciences." «='«!«■« _ Now, let us turn from the dark to the bright side of this picture. What Til!u T^l • I "^"'*^ ^^"^ °"* ^"^ •*' the sciences which lie' 1.L ^"1"?*'°" "L^r*'*^'"* have progressed during the last thirty y«rs,andIh.ve8Uted that the present abundance of publications con- taining original ob«»irations on subjects within the provinces of these sciences indicates that a host of enthusiastic workers are directing their energies to problems, the solution of some of which would be of inesti- mable nnporUnce to the welfcre of mankind. Just as it has been in the past thirty years, so in the coming generation will there be a sready increase in all our knowledge along this line. Indeed, within the next ten years some subjects, as, €^., bacteriology, as it is now understood, wiU be wOTk^ out-that is, we wfll know the substantially important facts con- nected with it-and there will remain questions of minor importance only to m i ■'n' w lO be wived. But becteriology in a tense other than that commonly received it dettined to be a lubject of vatt importance in the prevention of diaeMe. I mean the biology of bacteria in itt widett tense, embracing not onl^r, at it doet now, the determination of tpeciet,4heir external forms, their con- ditiont of occurrence, and the effect of their pretoice in organisms, but alto, and thit more eipecially, their phytiological chemittry. It it in phytiplogical chemittry, in all iu extent, that we are to find the ttudy of the future. In thit tubject phytiology, pathology, and bacteriology, at it . will b^ will be one. Phytiology, in iU departmentt of digettion, abiorp- tion, tecretioh, and nutrition, it now timply physiological chemittry ; and when we analyse the functiont of the tpecialised organt of the body, and find how these depend on nutsition as well as on specialization of struc- ture, we can determine how great a part in physiology the chemistry of the cell and tissue plays. Pathology, in the sense in which we now use it, it quite at much interetted, if not more so, in the advances made in physio- logical chemistry, for not only are a hrge number of diseases merely .derangemente of nutrition, but the phenomena of zymotic diseases are referable to the products of decomposition caused by bacteria Jn the organism. This study of physiological chemistry in its broader aspect has already begun. Bacteriologists are now engaged in the investigation, on the one hand, of the chemical producu of the growth of bacteria, and, on the othe^ of the proteid compounds in the animal body which annihilate microoiganisms or prevent their growth. Pathologists have commenced the study of the chemittry of the tittuet in disease. But most busy of all hat been the physiological chemist himself. The researches on the pro- teids alone during the put. three years might be considered as epoch- making, showing, as Jhey do, how crude wa» our knowledge on many points connected wim th^se. There is, indeed, a life's work in these for many an investigator in the future. Ttiat the phenomena of life occur in a complexity of proteids shows how far-reaching any imporUnt addition to our knowledge of theminay be. To physiological chemittry, then, belongt the future. Closely related at it it to phytiology, pathology, bacteriology, and general biology, it will tend to overthadow these, and the number of its students will be greatly reinforced from the ranks of those endowed with scientific curiosity, for, in one of itt branches, that of the physiology and chemistry of the cell, a subject now developing into prominence, the investigator stands face to face with the mother of mysteries, and there is no student who would not give a , lifetime of work to be able to lift a comer of the veil to behold her featuf therapeutics, physiological chemistry will be a modifying factor. At sent we search the whole earth through for drugs to add to our list, and A^-\ * Bpaja ~ ■s^jl's^^^^BSKBK*^ I'l r we ditcovier new one* in our laboratory. Those that we take ready-made . from nature, as, for example, quinin, digitalin, etc., are, for the mofet part, excreted products of vegetable metabolism, whose presence and retention in the vegetable cell, like thaf of the nitrogenous products in the animal Irady, are injurious to life. In other words, we use the excreu or by-products of one kingdom to trritate or stimulate the organism in the other. Unless we believe that Providence ordained that vegetable organisms should produce such compounds to touch with exactness the springs of life within us, we may be excused from considering many of them as permanently placed in our jpij^rmacopeia. Were all the therapeutists of the present day to search fotm drug which would benefit cases of pancreatic diabetes, would they e^r find one which would replace exactly that physiological compound ^hbse absence in disease of tne pancreas is the cause of the appearance of sugar in the blood? Is it possible to find a by-product of vegetable ' metabolism which will replace, when the thyroid gland is diseased or atrophied, that physiological compound whose formation and presence in the^'normal thyroid glan^ prevents that deposition of muctn in the body lirhich characterizes the disease myxedema ? These facts and the possible ^vances in our knowledge of physiological chemistry isuggest how transient /is the present character of our pharmacopeia. At the present day we indiil- / gently smile when an old wife gives a child a dose of castor oil or calomel I for toothache, knowing how very indirectly the toothache is alleviated, if at all ; but what a laige number of drugs must we employ whose action, contrary to what we suppose, may be as indirect as that of calomel in •toothache ! Apart from this, and from the crudities at present exhibited in the administration of the so-called animal extracts, physiological chemistry is destined tabe a very important factor in the treatment of bacterial dis- eases. It is now known that some animals do not take certain dis^ises because of the presence in their blood of proteids which destroy or pre- vent the growth of- the bacteria causing those diseases.^ kankin has investigated some of these proteids, and found that they belong to the class called nucleo-albumins. Vaughan and McCUntock have determined that they are nucleins. The nucleins and nucleo-albumins have been but little studied, but that they are a very important class of compounds is rendered apparent also by the extreme probability that the digestive and other ferments befong ^o that class. Kossel advance the view that the animal organizati(vi deftttds itself against the poisonous proteids formed or secreted by bacterj^hiough the nucleinic acid of the organism uniting with the toxic compoura and ttofreby rendering it insoluble. If, as some physiological chen|ists maintain, Uie nucleins can be formed out of simpler elements in the laboratory, and if, further, a very large number of them IS '' ..^.t exift, their employment in (he future at therapeutical rea^fenu may serve to prevent or alleviate many diseaaet due to micro-orKanismi. One may not hope for the extinction of disease. It will be present as long as life exists on this earth. Medicine has prolonged the average length of life by over three years, but it has llso succeeded in bringing to maturity very many of the less robust, who, under the severer conditions which onc;p obtained, would have succumbed. These are an easy prey, not only to bacterial, but also to functional diseases. The latter will always be with us, whether we have the other or not. The more medicine is perfected, the more of the less robust are saved to swell more and more the list of those who 'constantly require medical aid. The phjnically strong will not require it less than they do now, for, so long^ss human I nature is what it is, it will sin as readily against physiologicar ai f gainst moral law.' It is in the prevention of disease that progress ougJl)t to be made. I have already stated that there are over two thousand preventable deaths per annum in every million of inhabitants. To stop this waste of life— and stopped it ought to be— entails the prevention of a much greater amount of disease, because for ^every preventable death there are several cases of preventable disease. If the public could be convinced that tuber- culosis could be made less prevalent, it would so act that probably another two thousand deaths would* be prevented. To accomplish this, the state must teach sanitary science, not only to medical students, but to the whole people. , In the next thirty-five years, then, we will have a thorough knowledges of bacteria, of the compounds which they secrete or form during their growth, of the substances formed by, them which are injurious to animal life, and of the compounds formed by the animal organism for self-defence. H^vVrill probably be able to assist nature, in some instances, at least, by adding to the supply of defensive niaterial. We will have solved many of the problems of nutrition, while knowing more about others than we do now, and, as a consequence, our knowledge and treatment of disease will bekfar in advance of what it' is at present. Of all this progress we can be certain, as it depends on forces now operating and increasing in strength as the years go by. It may be precipitated in th^ scientific world by any , important increase in number of scientific investigators in medical science, in which case (he rate of progress will be greater, than I have attempted to outline. ' What is the bearing of all this on the student's career? It is quite evident that if he rests content with the minimum of attainments demandedL^by a curriculum he will fail to achieve solid success in the future, when the physician miist be more scientific than he is now ; and, if he is intelligently ambitious, he will exercise his foresight by giving to . <>■ "' ^ N.^ :• ■ ■:•;:■■■.■ ■", ■.• ■(■ • ■ ■■ , the Mienoei of hi* course that full attention which they require of him in order to prepare him for all the poaaibilitiei of a medical career. He muat lay the foundation! well and surely in his work in the laboratories, and he roust be constantly, year by year, building on the foundation with toch material as the times give. It is true that to know all the sciences / thoroughly is impossible to any one, ho^rever brilliant he may be, and , that, with the time at'the disposal of the student, a complete familiarity : with the sciences may not be expected of him. | He may, however, by concentrated industry, acquire a 4cnowlcdge of y • general biology, physiology, chemistry, pathology, and bacteriology, which I will be of immense service to him. It' is often stated that the student I .' cannot gain a competent knowledge of these subjects in the four or five ■ -^ years of the course. Does he get a competent knowledge of medicine ' ^ and surgery before he graduates, and is his development in these subjects arrested when he receives his license to practise ? If not, why should it be different in the case of the sciences? Should he not carry on the study of these sciences in post-graduate years ? When the scientific • specialist or the medical man urges that there is no opportunity for get- ting more than a smattering of the sciences, he forgets that the student of the present day travels a much less rugged road than Ae did. If _ : you ask any old practitioner about the facilities for anatomy in hit student days, he will describe a condition of aflairs that will, per- haps, be unintelligible to you who are aware of our splendid ana^ tomical equipment and methods for teaching anatomy. In my time, as a stddent, and that was not long ago the arrangements, for Jeam- ing anatomy, good as they 'were then, were far behind what they are. / now. In' inWruction in physiology ten years ago, no experiments were / performed, and /there were no demonstrations for the student In path<- ology and bacteriology, in former years, it was seldom t|iat a student had an opportunity for practical work. All that is 'changed. We have less of the fearful grinding out of lectures, and we make the student control all he reads by work in the laboratory. It appears to me that he is in a much better position to acquire the knowledge demanded by the curri- culum than he was ten years ago. He does, indeed, what he did not do to any great extent in *his undergraduate course then.. The laboratory work compels him to observe and note, a feature of his training that was formerly: developed at the bedside— a good (Hace, indeed, for observation, but a bad one for commencing the training of it. Dr. Billings says that <^ the vast literature on medicine much of it is wort.hless, much of it is suggestive, and only one per cent., perhaps, of it js valuable. That, it correct, can be explained in only one way — and that is, that the con- •^' tribuiors to this literaturejjjio are amongst the best and jnost progressive •£ Vi - «4 of the profcMion, are fearfully deficient in capacity for ohcervation. What is responsible for this but the old-time methods under which the student was trained ? The student of the present day has, indeed, everything in his favor, and he oUght to cultivate to the fi|ll every opportunity which our modem methods of teaching ofier him. He ought U> study the sciences not simply for ^he purpose of passing examuiations in them, but to avoid being an empiric in after years. The latter II one who relies on his own experience, or on that of others, without having therefor a scienti- fiq^explanation. Empirics are no| at all rare at the present day, and they usually style themselves " practical " men. As such, they are related, per- haps distantly, to the old "yarb"* woman who relies on her Umited experience, and on nothing else. It is the fashion of this .class to exalt the professional and deride the scientific subjects as if they were distinct «nd opposed. A physician whose training in the sciences may be very limited mayi indeed, avoid empiricism by constantly examining and proving the phenomena of disease which present themselves; but how laborio^s such a proc^ must be to him, and how much more practical is he who recognizes that the scientific and professional subjects of medicine are inseparable. . ^ It is maintained that the medical profession is overcrowded. It if claimed by some that twenty thousand practitioners in the United Slates could be very well replaced by a thousand well-educated and well-trained ones. It is certainly not wanting in numbers in Great Britain, France, and Germany, and we are familiar with the statement that there are quite enough in Canada. Those who are already in it must have a greater pro- fessional experience than the student can get by close attention to profes- sioiul requirements alone, valuable as these are ; and if he neglects the sciences on which they are based when he gets a license to practise medi* cine, he is one more in the struggling mass, with no more moral right to . succeed than the average man. The profession' is'' not overcrowded bo^ those who patiently and steadily train themselves in dl the parts that dis- tinguish a scientific practitioner of medicine. There cannot readily be too many of such, and if the student determines to be one of these, and carries out hiS' determination, his future is assured. A few years ago, a physician considered himself -equipped for clinical work if he had a stethoscope, a few test tubes, with a spirit lamp, and per* haps an ophthalmoscope. At the. present day, to be prepared for all cases, he must have a variety of instruments, the proper use of which requires a careful training in the laboratory, and also a very fair knowledge IwaoUn, I *"ForiaalllinMf,iii tb* opinion of lhaiDtdUtiid«,w!t^ei, and old wwiUn, and lapoMon hav* bad a oompetilioo with phyiician*. And what lollowMh T Ev«n ibis : that physician* lajr to thiMiiiln]i; a* ■SolooMn M pw i m h it npoo an biahar oocaaoo : ' If it bcfidlath to ma as bafcllatb to tba ToaU. arbr •honldlUbortobamqrawiieT'"— Akmi, "^Awwm(ra/«/i^«an(Av." : T :i ■ i ; f ■ ■ : ^ ■■.■.■■■■ , i$/v ■■. " of ph^ology, phyaiological chemistry, and bwrteriJMogy. Some dli may be and are diagnoMd by the use of theie Urttrumentt alone, or by methods uught in the taboratory, w^ile in the/Iiagnoais of other diseases these instriimenu and these methods furnish a very great assistance. Those who have examined the history of the past in medicine will agree with me when I say that the oiethods of diagnosis in the future will lequire a greater scientific knowl^ge than is even now the case. To the student himself I wo^ld say. Cultivate the sciences which lie at the foundation of medicine, fbr they are to be the key to you that will unlock the treasure-house of the future. They will .givf to you that sense of satisfaction that arises out of ybur knowing that you are in the van with progress. Not any th* less thereby, but rither the more fitted wiU you be for profeuional work when you enter upon it For this cultiva- tion there is abundance of opportunities in your undergraduate course ; and, indeed, the Medical Council has, with a wise foresight, provided that you n»ay pass the fifth year of your course in laboratory work wholly. If, on the other hand, you neglect the sciences, you will be hampered in the appreciation of your work, and the exigencies of a practice will prevent you from overUkipg the arrears of knowledge due to that neglect You niay then fully realiie your.mistake, when regret is of no avail to repair it / No one, I beUeye, esteems more highly than I do professional attain- ments and skill. Nor do I deride experience, for it is not that which makes you satisfied with what has been done, but rather that which stimulates your desire to know more. Perhaps the best view of experience is that given by Tennyson in his poem, "Ulysses."' The old hero, who had gone unwillingly with the Greek host, has, afker ten long years.tefore Troy and ten years of peril and adventure on the sea, returned to liiaca, and he is represented as resolving to take up once more the life of change and discovery. 1 quote^e familiar passage because it describes my ideal of the scientific spirit, whether it is to be found in the laboratory or at the bedside, and ^usfc it gives to the student of toniay a glimpse of the life that may be his in after years : ••I»in»pMtofj»llth«tIhavemet; ». Yet all experience u ut wch «het£tI»r(Mq* ^ Gleam* that untrmvelled world whose margin fade* Forever and forever when I move. ' How dull it were to pauae, to make an end. To rust unbumiihed, not to iblpe in lue t • A« tho* to breathe were life I Life pUed on life . Were all too little, and of one to me , Little renuunt ; but every hoiir i» laved Froqi that eternal ulence, something more, A bringer of new-things; and vUe it were. For some three suns to store and hoard myself, And this gray spirit yearning in desire To follow knowledge, like a sinking star, ^ Beyond the utmost bound of human thought. ~ ;i l"m .>■ \ l#' (^ '•^" r -4' .-» "^^ I * ■'-^^■^ - •- — — •*■ - — -' ■--..- -^.i. - -^ "^'■■'-- ■'- ■■ " ^ i'l* J«^.>,j5£>^ <^ T-.l I #^ ■* f m\ i M # I .* kif:,, ■• l-::^-. . , ■ '* ■«■' ■ '.IK^ :c^ ---_• '^^^s.. :■ ■• ... f \V. ^ ■-. ■ ^ • s r ' / I) ^^^* ^i_ _ . , , i..._j ( ^.>, ■ ... .' ^ ■» m Ul» ' ■ V "* I'- i // .) '\, ^ ( •< 5«1^