I can see no more reason for making a group of students, designed to be practitioners, make bungling experiments with a kronecker – Bowditch heart apparatus than I can for their performing amputations and visceral operations on dogs or cats with the idea that they will become good surgeons; indeed, there is less reason. One cannot make a man who has no music in his soul a violinist in a six weeks course, and probably it is safe to say that the majority of excellent physicians have not the qualities which produce original contributions to medical knowledge.
My point is not that there should not be teachers of pharmacology. On the contrary, there should be, because it is only by the efforts of these men that the scientific or investigative side of therapeutics can be advanced and the errors of empiricism corrected. Their existence develops those who have the talent, initiative, the power of proper deduction and the love of investigation, and their methods of thought and mode of study are examples of the highest type of medical man; but in their enthusiasm they should not forget that 999 of their pupils want to know how to make the sick well and do not want to know by personal experiments on dogs the effect, for example, of cutting the animals sympathetic or the action of cocain on the eye. If this is to be taught, let the pharmacologist make the experiment and demonstrate the result.
It may be said that I do not know where of I speak; but I do, for I was once a pharmacologist myself. In the eighties I worked in laboratory pharmacology, and taught it, too, as a somewhat long list of titles in the Index Catalogue will show. I am not an iconoclast, and no one rejoices more than I do that the only pharmacologic laboratory in the United States in 1886 has been followed by two score of such laboratories from which a wealth of wonderful work has originated; but it is post – graduate work. I am pleading that hours now used otherwise may be employed to teach not only the theory, but also the practice of therapeutics.
When this is done, the work of the Council on Pharmacy and Chemistry will be helped to its completion; for when the practitioner knows how to prescribe, he will not tolerate the commercial concern that poses as his teacher. At present an attempt is made to make pharmacologists out of men who are going to practice medicine. A real pharmacologist is a highly educated man in physiology and chemistry, an investigator, a discoverer, and by rights a leader in the higher realms of therapeutics – one who should teach medical students how drugs can be studied and should be studied in the laboratory, and to determine fundamental facts about remedies.
But to try to train the general run of students, who will never have a laboratory, to be pharmacologists without first teaching elementary practical therapeutics is somewhat like a great opera singer trying to make every one a great singer, or as if one should attempt to make his infant son sing before he tried to teach him to walk. The use of instruments of precision necessary for the study of drugs, if taught at all, should be at the bedside. I repeat what I said above:
The lack of training as to what to do, what not to do, and when to do, as to remedies, is one of the weak spots in medicine to-day. I firmly believe that if the present generation of students is properly taught practical therapeutics, the chief labor of the Council on Pharmacy and Chemistry will be an accomplished fact, for the right way will be the easiest way. Let us first make good physicians and from these may be sifted out those who can and want to become laboratory pharmacologists. J.A.M.A.
