The party opposed to any reforms in medical education has, of course, a right to be heard, and Dr. Penrose is well entitled to represent it both by his position and by the evident heartiness with which he is prepared to defend the existing system at every point. In impugning the motives of those who have attacked it he lays himself open to an obvious retort; but it is sufficient to remark that the contest is not of a nature to call for or justify the use of personalities, which could serve only to divert attention from the real issues.
The arguments put forward by Dr. Penrose may be summarized as follows: 1st, that the proposed changes are not demanded either by the public or by the profession; 2d, that the present system is the best possible in a nation constituted like ours; 3d, that the preparatory education of our medical students is equal to that of law or divinity students, or of young men entering upon mercantile or manufacturing pursuits; 4th, that in certain cases obstacles in the way of a regular and thorough training have been overcome and success achieved in spite of them; and 5th, that it is unavoidable and proper that medical men, as well as members of other professions, should educate themselves after graduation.
It will be observed that none of these arguments except the last, which is based on a mere verbal ambiguity, touches the two subjects discussed in Dr. Wood's article—namely, the need of reform and the methods by which, if practicable, it is to be effected. Dr. Penrose does not venture to assert that the existing system is perfect, or to deny that the suggested changes are in the nature of improvements. What he wishes us to believe is that the system, whatever its defects, is as good a one as Americans have a right to demand, and that it is so closely interwoven with our political and social institutions as to admit of no separate handling. Similar arguments are frequently urged against the desire to raise the standard and widen the avenues of the "higher education." We are thus taught to regard ourselves as a poor and struggling nation with no claim to the possession of intellectual luxuries, or as having bound ourselves to forego any aspirations to an equality with other nations in respect of culture when we secured the advantages of popular government and its social concomitants. It would seem, however, to be a sounder, as it is certainly a more gratifying belief, that precisely because we have attained these advantages it will be easier for us to appropriate all the benefits which civilization has to offer—possible for us to make more rapid strides than have been made by other nations, impeded by a diversity of interests and conflicts between the government and the people. No doubt the comparative youthfulness of the nation will account for our backward condition in certain respects; but surely it is time to abandon this and every similar plea as an argument against any attempt at progress.
We have not space, and for the reasons indicated we see no necessity, to discuss Dr. Penrose's positions in detail. It will be sufficient to notice generally what seems to us their inherent weakness. His assertion that no changes are now demanded by the public or the profession is, he thinks, "clearly proved" by the fact that thirty years ago some that were introduced in the University of Pennsylvania at the suggestion of the American Medical Association ended in failure. But what this experience really proves is, that the defects of the system were even then admitted, while the remedies are still to be applied. At Harvard this has been done; and the question for other medical schools is whether they are to follow the example or to be deterred by a bugbear—whether, for example, the University of Pennsylvania, after raising her scientific and art departments to a higher level, shall be content to let her medical school remain stationary. It is the opinion of intelligent physicians who are not parties to this controversy that the experiment which failed in 1846 would succeed now. The new plan adopted at Harvard, which exacts three years of study, and embraces lectures, recitations, clinical conferences and written examinations of the most stringent character, has, we are informed, attracted a class of very superior men. Compared with the effort made here in 1846, this change may be described as a revolution, and it has proved a success.
We are at a loss to understand what Dr. Penrose wishes to prove by his citation of cases in which eminence has been reached—chiefly, it is to be noticed, in politics or the law—by persons who have had insufficient opportunities for study. If the disadvantage was imaginary, where was the merit of overcoming it? If it was real, as most people would admit, what is the objection to insisting on it as such? In the great majority of cases it is not overcome, and the result is, that the country is overstocked with men engaged in the practice of professions for which they are inadequately qualified. As to the skill that is gained by practice, the ripe knowledge that may result from experience, this cannot without a confusion of terms be described as "education." It will in general be most surely and rapidly acquired by those who have received the best training, and the great object of our higher educational institutions should be to provide such training—not, by maintaining a low standard, to facilitate the efforts of those who, from whatever cause, would find it difficult to meet the demands of a higher one. Such persons may have a claim to encouragement and assistance in their endeavors to reach the mark; but they have no right to expect that the distance shall be regulated to suit their convenience.
Dr. Wood's admissions in regard to the excellence of the army medical service during the war are seized upon with natural exultation by his opponent, who draws from them a legitimate inference in favor of the general status of medical skill and knowledge throughout the country. If Dr. Wood really intended to say—what his language, we confess, would seem to imply—that the service attained its high state of efficiency in a few months, we do not well see how he is to resist the conclusion thus pressed upon him. But we conceive the truth to be that either his phraseology or his recollection of the facts was at fault. It is well known that at the beginning of the war it was impossible to find competent surgeons in anything like the number that was needed, and that the examining boards were consequently forced to be ridiculously lenient. We know of an able surgeon who after a battle found that he had not a single assistant in his corps who could be trusted to perform an operation. This state of matters was the direct result of the imperfect education given in the schools. Not one man in ten who leaves them has ever been practically exercised in operations on the cadaver, and the proportion was still smaller before the war. It is easy therefore to understand, while it would be painful to recall, the circumstances under which the great bulk of our army surgeons acquired the requisite proficiency. The ultimate success of our medical service, like the final triumph of our armies, was preceded by many woeful blunders and mishaps, and, like that, was due in great measure to a lavish outlay which would scarcely have been possible in any European war, and to the general devotion and united efforts which drew out all the resources of the country, of whatever kind, and directed them to the furtherance of a single aim.
OUR EARLY NEWSPAPERS.
In looking over the contents of the old newspapers of this country, of which there was a considerable number as early as the year 1730, one is specially struck by the number of advertisements of slave sales and of runaway slaves, apprentices and servants. The following are common examples:
"To be sold, a very likely Negro woman about 30 years of Age, has been in this city about 10. She is a fine Cook, has been brought up to all sorts of House Work, and speaks very good English. She has had the small Pox, and has now a Young Child. Enquire further concerning her and the Conditions of Sale of Mary Kippen, or the Printer hereof."—New York Weekly Journal, May 9, 1735.
"Just arrived from Great Britain, and are to be Sold on board the Ship Alice and Elizabeth, Capt. Paine Commander several likely Welch and English Servant Men, most of them Tradesmen. Whoever inclines to purchase any of them may agree with said Commander, or Mr. Thomas Noble, Merchant, at Mr. Hazard's, in New York; where also is to be Sold several Negro Girls and a Negro Boy, and likewise good Cheshire Cheese."—New York Gazette, Sept. 11, 1732.