science in boys' schools and medical education

1
315 leads to objection3 being raised t) the legitimate exercise of the authority of the master and matron in the arrangements connected with the sick wards. The Board consider that so long as these establishments are constituted as at present the nurses should ba responsible to the medical officer for the treatment of the patient, but should clearly understand that in other matters they must defer to the authority of the ma,ter and matron." From the views expressad by the recent Departmental Committee on Nursing it woutd appear that the Board is not now quite so sure of the advisability of leaving a free hand to the master and matron as regards nurses. Perhaps in course of time it may recognise that the medical officer, too, has feelings worthy of consideration. - SCIENCE IN BOYS’ SCHOOLS AND MEDICAL EDUCATION. AT no time probably since the introduction into this country of compulsor.v school attendance has more general interest been taken in the question of the subjects and methods of education than at the present moment. We have left behind us, we hope for ever, the controversy as to the practical utility and absolute necessity of some form of education for every one of our fellow subjects. We are now entering upon what bids to be even a more prolonged con- troversy as to the matter and manner of education which shall prove most efficacious in fitting our race to perform its allotted functions. Now that it is recognised that education is for all it is being questioned whether the methods of instruction in the past may not be im- proved upon. Doubt as to the perfection of our methods extends through every department of learning from the board school to th university. To our shame, but also perhaps to our advantage at the present time, other countries have recognised the need of reform before us and have made experiments in various directions from which if we are wise we may profit. As in medicine so in education, the empirical method is not always the best means of testing efficiency. It is not easy to estimate the influence of all the factors in the environment and because good men are turned out from our public schools it does not follow that the character of the education in those institutions does not need improvement. It is not only by watching the result of different forms of education that we can tell which is the most desirable. Thoughtful consideration of the objects to be attained by education and of the probable results of different measures may often lead to prac- tical reforms, just as researches in the laboratory and the contemplations of philosophical pathologists have often given the clue to effective methods of treating cases which have baflied practical physicians. In trying to ascertain the particular scheme of school education most suitable for an intending student of medicine it is not sufficient even if it were possible to contrast the respective merits of medical practitioners submitted to rival methods of scholastic treatment. Statistics could be put to no more futile use than to estimate the percentage of successes in final medical examinations achieved by candi- dates educated on the classical and modern sides respec- tively of our chief public schools. Nevertheless, those who are engaged in medical education must necessarily take the keenest interest in the preliminary instruction of their pupils and they are generally supposed to hold strong views upon the much-vexed qaestion of the role of science in school education. The belief that teachers of medicine would naturally desire that their pupils should have studied science at school arises from a false assump. tion as to the chief objects of a boy’s education against which a strong current of opinion is now setting. The tyranny of the examination system is causing a revolt against the view that the acquirement of knowledge is the main object of education. Systems of education dominated by examinations tend to become little else than methods of storing facts in students’ brains, since it is the success of this process which is most readily estimated by the examiner. If a teacher of medicine desired his pupil to be handed over to him with his brain well stored with facts upon which subsequent knowledge could be built there is no doubt preference would be given to one who had baen instructed in a school in which natural science was fully taught. But teachers of medicine, in common with all those whose duty it is to import instruction to youths who have completed their school curriculum, find that their best material is characterised not by knowledge but by brain power. The facts which a boy has acquired at school are of little importance compared with the effect that the school training has had upon his intellect and his morals. A boy of high moral sense, well trained to observe and capable of logical reasoning, will make a better medical student though he has never had the least smattering of so-called Ecientific education than an un- observant boy with an illogical brain stuffed with facts con- nected with elementary chemistry, physics, and biology. Recognising this fact the medical profession should use its influence to secure that the course of study in preparatory and public schools should be that bast suited to develop a boy’s senses and intellectual faculties regardless of the sub- sequent uses to which the facts acquired may be put. Schoolmasters are already too much harried by those, whose sole idea of education is that it shall provide useful knowledge. Science is more or less on its trial as a subject of education in schools and it is believed by some to be a very unsuitable subject. It would be unfortunate if the supposed needs of- the medical student led to the retention in the school curriculum of a subject which failed to promote intellectual development, inasmuch as the pure science which a medical student requires can easily be provided after school is over. There are some who are disposed to give great credit to the medical profession for such share as it has had in encouraging the establishment of science laboratories in secondary schools. It is a question requiring the most thoughtful and careful consideration whether such laboratories are of real value and in helping to solve this problem the medical profession must not regard , the matter from a selfish or utilitarian point of view. ALBUMINURIA IN THE NEWLY BORN. If is well known that the urine passed shortly after birth diffars in several details from that passed later, notably in being of low specific gravity, turbid from uric acid and epithelial cells, and of darker colour. Dr. Ssesenowski of St. Petersburg has investigated the urine of infants in the first few days after birth with especial reference to the presence of proteid substances and has recorded his observa- tions in the Wrasehebneia Gazette, No. 21, 1903. He- finds that in the first six days after birth traces of albumin can be detected in 22 per cent. of the cases and traces of mucin in nearly every case. On the first day after birth albu- min can be demonstrated in as many as 30 per cent. It i& found more frequently where labour has been protracted and is thus more common in first-born children. The less the absolute body-weight of the infant, and the greater the relative diminution of this in the first days of life, the more frequent is the presence of albumin ; moreover, its presence appears to depend to some extent upon the temperature of the infant. The presence of mucin is most constant on the first day after birth, when it can be demonstrated in 96 per cent. of the cases. It gradually lessens, so that on the sixth day it can only be found in 50 per cent. Tracer of uric acid are found in 60 per cent. and both this substance and

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Page 1: SCIENCE IN BOYS' SCHOOLS AND MEDICAL EDUCATION

315

leads to objection3 being raised t) the legitimate exercise ofthe authority of the master and matron in the arrangementsconnected with the sick wards. The Board consider that

so long as these establishments are constituted as at

present the nurses should ba responsible to the medical

officer for the treatment of the patient, but should clearlyunderstand that in other matters they must defer to theauthority of the ma,ter and matron." From the views

expressad by the recent Departmental Committee on Nursingit woutd appear that the Board is not now quite so sure ofthe advisability of leaving a free hand to the master and

matron as regards nurses. Perhaps in course of time it

may recognise that the medical officer, too, has feelingsworthy of consideration.

-

SCIENCE IN BOYS’ SCHOOLS AND MEDICAL

EDUCATION.

AT no time probably since the introduction into this

country of compulsor.v school attendance has more generalinterest been taken in the question of the subjects andmethods of education than at the present moment. Wehave left behind us, we hope for ever, the controversy as tothe practical utility and absolute necessity of some form ofeducation for every one of our fellow subjects. We are now

entering upon what bids to be even a more prolonged con-troversy as to the matter and manner of education whichshall prove most efficacious in fitting our race to performits allotted functions. Now that it is recognised thateducation is for all it is being questioned whetherthe methods of instruction in the past may not be im-

proved upon. Doubt as to the perfection of our methodsextends through every department of learning from theboard school to th university. To our shame, but also

perhaps to our advantage at the present time, other countrieshave recognised the need of reform before us and havemade experiments in various directions from which if we arewise we may profit. As in medicine so in education, theempirical method is not always the best means of testingefficiency. It is not easy to estimate the influence of all thefactors in the environment and because good men are turnedout from our public schools it does not follow that the

character of the education in those institutions does not need

improvement. It is not only by watching the result ofdifferent forms of education that we can tell which is

the most desirable. Thoughtful consideration of the

objects to be attained by education and of the probableresults of different measures may often lead to prac-tical reforms, just as researches in the laboratory andthe contemplations of philosophical pathologists have oftengiven the clue to effective methods of treating cases

which have baflied practical physicians. In tryingto ascertain the particular scheme of school education

most suitable for an intending student of medicine it

is not sufficient even if it were possible to contrast the

respective merits of medical practitioners submitted to rivalmethods of scholastic treatment. Statistics could be put tono more futile use than to estimate the percentage ofsuccesses in final medical examinations achieved by candi-dates educated on the classical and modern sides respec-tively of our chief public schools. Nevertheless, those whoare engaged in medical education must necessarily take thekeenest interest in the preliminary instruction of their

pupils and they are generally supposed to hold strong viewsupon the much-vexed qaestion of the role of science in

school education. The belief that teachers of medicinewould naturally desire that their pupils should havestudied science at school arises from a false assump.tion as to the chief objects of a boy’s education againstwhich a strong current of opinion is now setting. The

tyranny of the examination system is causing a revolt

against the view that the acquirement of knowledge isthe main object of education. Systems of educationdominated by examinations tend to become little else thanmethods of storing facts in students’ brains, since it is thesuccess of this process which is most readily estimatedby the examiner. If a teacher of medicine desired his

pupil to be handed over to him with his brain well storedwith facts upon which subsequent knowledge could be builtthere is no doubt preference would be given to one who hadbaen instructed in a school in which natural science wasfully taught. But teachers of medicine, in common withall those whose duty it is to import instruction to

youths who have completed their school curriculum, findthat their best material is characterised not by knowledgebut by brain power. The facts which a boy has acquiredat school are of little importance compared with the

effect that the school training has had upon his intellectand his morals. A boy of high moral sense, well trainedto observe and capable of logical reasoning, will make a

better medical student though he has never had the leastsmattering of so-called Ecientific education than an un-

observant boy with an illogical brain stuffed with facts con-nected with elementary chemistry, physics, and biology.Recognising this fact the medical profession should use itsinfluence to secure that the course of study in preparatoryand public schools should be that bast suited to develop aboy’s senses and intellectual faculties regardless of the sub-sequent uses to which the facts acquired may be put.Schoolmasters are already too much harried by those,whose sole idea of education is that it shall provideuseful knowledge. Science is more or less on its

trial as a subject of education in schools and it is believedby some to be a very unsuitable subject. It would beunfortunate if the supposed needs of- the medical student ledto the retention in the school curriculum of a subject whichfailed to promote intellectual development, inasmuch as thepure science which a medical student requires can easily beprovided after school is over. There are some who are

disposed to give great credit to the medical profession forsuch share as it has had in encouraging the establishment ofscience laboratories in secondary schools. It is a questionrequiring the most thoughtful and careful considerationwhether such laboratories are of real value and in helping tosolve this problem the medical profession must not regard

, the matter from a selfish or utilitarian point of view.

ALBUMINURIA IN THE NEWLY BORN.

If is well known that the urine passed shortly after birthdiffars in several details from that passed later, notablyin being of low specific gravity, turbid from uric acid andepithelial cells, and of darker colour. Dr. Ssesenowski of

St. Petersburg has investigated the urine of infants in thefirst few days after birth with especial reference to the

presence of proteid substances and has recorded his observa-tions in the Wrasehebneia Gazette, No. 21, 1903. He-finds that in the first six days after birth traces of albumin

can be detected in 22 per cent. of the cases and traces ofmucin in nearly every case. On the first day after birth albu-min can be demonstrated in as many as 30 per cent. It i&

found more frequently where labour has been protractedand is thus more common in first-born children. The less

the absolute body-weight of the infant, and the greater therelative diminution of this in the first days of life, the morefrequent is the presence of albumin ; moreover, its presenceappears to depend to some extent upon the temperature ofthe infant. The presence of mucin is most constant on thefirst day after birth, when it can be demonstrated in 96 percent. of the cases. It gradually lessens, so that on the sixthday it can only be found in 50 per cent. Tracer of uric acidare found in 60 per cent. and both this substance and