and in close association with contiguous, contributory, or overlapping sciences. No one of them is sharply demarcated; at any moment a lucky stroke may transfer a problem from pathology to chemistry or biology. There are indeed no problems in pathology which are not simultaneously problems of chemistry and biology as well. So far the rigorously and disinterestedly scientific viewpoint is valid. These considerations, however, still omit one highly important fact: medical education is a technical or professional discipline; it calls for the possession of certain portions of many sciences arranged and organized with a distinct practical purpose in view. That is what makes it a "profession." Its point of view is not that of any one of the sciences as such. It is difficult to see how separate acquisitions in several fields can be organically combined, can be brought to play upon each other, in the realization of a controlling purpose, unless this purpose is consciously present in the selection and manipulation of the material. Pathology, for example, is a study of abnormal structure and function; the pathologist as such works intensively within a circumscribed field. For the time being, it pays him to ignore bearings and complications outside his immediate territory. Undoubtedly, the progressive pathologist will always be at work upon certain problems, thus temporarily, but only temporarily, isolated. But in the undergraduate class-room he is from time to time under necessity of escaping these limitations: there he is engaged in presenting things in their relations. The autopsy, the clinical history, will be utilized in presenting to the student, even if incidentally, the total picture of disease. Similarly, the anatomist can score many a point for the physiologist without actually forestalling him. He views the body not as a mosaic to be broken up, but as a machine to be taken to pieces, the more perfectly to comprehend how it works. The pharmacologist is in a similar relation to the clinician. The principles of bacteriology lose nothing in scientific exactitude because, taught as a part of the medical curriculum, they are enforced with illustrations from the bacterial diseases of man rather than from those of animals and plants; and histology is not the less histology because tissues from the human body are preferably employed.[1] In
- ↑ The following quotations from "An Outline of the Course in Normal Histology," by L. F. Barker and C. R. Bardeen (Johns Hopkins Hospital Bulletin, vol. vii., nos. 62, 63, p. 100, etc.), forcibly illustrate the above contention.
"In deciding as to the plan to be adopted we have been much influenced, too, by the fact that our students are students of medicine. Thus it will be noticed that in the selection of tissues, those from the human body make up a large part of the material used; and when animal tissues are employed, special care has been taken to point out how they differ from the human. Moreover, in deciding what to exclude from the course thought was given to the bearing of the specimens on the practical work in medicine which was to follow, and stress was laid upon those portions of human histology which previous experience has taught us are of the most importance in the appreciation and interpretation of the pathological alterations in disease. In the present status of pathological histology a knowledge of certain details is of much greater value than that of others; and for the student entering medicine, a judicious selection of what shall be given and what shall be left out should be made by some one who has had a more or less wide training in pathological histology.
"Further bearing in mind the life-work for which the student is preparing himself, we have not always chosen the method which would show the finest structural details of the tissues. While the most delicate methods have been introduced in places, we have endeavored to familiarize the students with a large number of different modes of preparation. The student who has been brought up entirely on 'gilt-edged' histological methods will find himself sadly at a loss in battling with the 'rough and ready' world in which the pathologist has to live." (Somewhat abridged.)
