At the fourth Quinquennial Session of the Homoeopathic Congress held at Atlantic City in 1891, I had the honor to present a paper on “The Duties and Responsibilities of Homoeopathic Colleges as Leaders in Medical Progress.” This easy met with the approval not only of the Congress but of the American Institute of Homoeopathy and of its Intercollegiate Committee and some of its suggestions have been adopted by those bodies. The four years’ course of required study has been made the rule for all our recognized colleges.
Without question, this single step was the most important one ever taken in the cause of medical education in this country. With mature age, a thorough preliminary training, a your spent in the study of the collateral branches of medical science, and three subsequent years of sold work in properly equipped medical colleges, there can be no doubt of the great elevation thereby of the students of medical education and of the rapid development of medical science in all its departments.
In considering at this time the subject of “Medical Education in the Homoeopathic Colleges and Hospitals of the United States,” I desire to refer to the paper mentioned as containing certain important matters on which the subject of future medical education properly rests, and without repeating what was then said, to consider our present position and the proper methods for future progress.
In the first place let us consider and acknowledge the debt we owe to our medical colleges which, established and sustained at great effort and expense, have done so much for the development and spread of Homoeopathy, and with it the advancement of medical science in this country.
From these schools within the last forty-five years, about ten thousand physicians have been graduated and are scattered in various parts of this and foreign countries. The great majority of these have become good practicing physicians with a knowledge of Homoeopathy which, but for these schools, they probably would never have attained, while many have become distinguished in science as well as medicine.
These medical schools and colleges have often labored under the greatest disadvantages. Not only have the instructors at times been unable to illustrate sufficiently their teachings by clinical results, but students have oftentimes been debarred from the chance of visiting hospitals in which they could practically study disease. With effort and energy these obstructions have been largely overcome, and the schools which from the first could find their counterparts in the greater number of other medical schools, have as a rule so utilized their possible opportunities that even their clinical instruction now equals the average amount, and in many cases far exceeds it.
At the present time there are sixteen Homoeopathic colleges recognized by the Institute, and three or four others which have been organized. While I shall not in this paper attempt to do justice to any college, those represented in the American institute of Homoeopathy will be briefly mentioned. Of these, three are connected with State Institutions, viz.: The Homoeopathic Departments of the Universities of Michigan, Iowa and Minnesota, and are supported by their several States. If those schools continue to be properly conducted and successfully managed, there is no doubt that the people of those states will feel sufficient pride in their support and proper equipment.
The Hahnemann Medical College and Hospital, of Philadelphia, is the successor of the Homoeopathic Medical College of Pennsylvania, established in 1848, and while it has done valuable work from the beginning, it has within the last ten years made its greatest advance. It has secured an eligible location, and erected thereon a fine building for a college, dispensary and hospital; and its successfully warrants the far-seeing policy which planned and executed these improvements. Of the work which is being done there, any college may well be proud, and its graduates are an honor to the medical profession.
In Cleveland, the second Homoeopathic college was established in 1849, and though it has labored under many disadvantages yet it has made much of its opportunities, and the greatest credit is due to the courageous, self-sacrificing founders and supporters of that in situation. Earnest and faithful work has been done therein and upon its roll of graduates are to be found some of the ablest physicians of our school.
Later a division of the school established a second college in that city, the Cleveland Medical College and though many regretted the division, yet we cannot say but what the stimulus of enthusiasm and determination which opposition sometimes engenders may take both of these schools in the future more efficient than either would be alone.
In 1858 the Homoeopathic medical College of Missouri was established, and though it has met with many changes and alterations in fortune, yet there can be no question that much work of real value to the profession has been accomplished there, and at present its prospects are perhaps brighter than ever.
In 1859 the Hahnemann Medical College of Chicago, chartered four years previously, opened its doors to students, and there are some here present who remember the severe struggles and sacrifices which were required to establish and support this school in its earliest years. The amount of energy displayed and that success which has attended it are only characteristic of the wonderful city in which it is located, and among its alumni are found many of the most influential men of the profession.
The experience of this school, like that of Cleveland, shows that difference of opinion may widely separate friends, and the establishment, in 1876, of the Chicago Homoeopathic Medical College caused much severe criticism, yet the success which has attended it and the amount of good work done may perhaps justify its founders.
In 1860 the Metropolitan City, New York, established the new York Homoeopathic Medical College, and from the large number of distinguished physicians in that city it has always secured an exceptionally able faculty. That it has had its struggles goes without saying, but in the establishing of hospitals which could be used for clinical teaching, New York exceeds in number any other city. The wealth and influence of that city should give advantages to the college which no other location in this country could excel.
In 1863 the New York Medical College and Hospital for Women was established under favorable auspices, and though colleges for women alone have met with strong opposition, even from their own sex, yet it has struggled on until it has obtained a success gratifying to its early friends.
In 1872 the Pulte Medical College, of Cincinnati, was established named for, and to a certain extent assisted by, our distinguished confrere, Dr. J.H. Pulte. That it has done much valuable work is certain, and many of its graduates are to be found holding prominent positions.
In 1873 Boston University established its School of Medicine. It was not an easy matter, but it has proved a success, and from the first has maintained a high grade of scholarship. An entrance – (?) which shall be in preliminary branches,-and during this first year students may be under special instruction of a physician,-after which three years must be spent, before graduation, in attendance upon the college courses.
When we consider the great advance in the methods of medical study which has been made in the last few years, and see the very decided changes from didactic to clinical instruction; when students who, not many years ago, were graduated simply in recompense for fees taken, while now examinations more or less stringent are required in every case, we can but feel that these changes in method are doing much for the improvement of medical instruction and the advance of medical science.
The change has indeed been very great, and while the tendency is still in the direction of improvement, and the whole sentiment of the stools, the profession, and the community requires more thorough instruction, is it not well for us to consider how far we may progress this direction to advantage, and not to hesitate or stop until we have reached the most useful limit?.
It has often been the case that the student who acquired his degree in the shortest possible time and knew the least of medical science was the most confident of his own superior knowledge, and was sure that he knew about all there was to be learned. On the other hand, the physician who has been thoroughly instructed finds open to hom so many sources of learning and so much of the unknown in the ever-varying forms of disease, that he is the more ready to devote himself to study until he has mastered at least a modicum of what science has revealed in medicine.
The ignorant “doctor,” if such a solecism may be allowed-in which to acquire all that is necessary for his purpose; how much time is essential for the student to spend in acquiring the necessary amount of knowledge to make him the learned physician-the one who is to give such character and tone to the profession as shall command the respect of the community and the confidence of his associates?
The four years’ course as marked out by the Intercollegiate Committee of the American Institute of Homoeopathy is certainly excellent, but does it go far enough? The first year is given to elementary medical study; there are then but three subsequent years given to the whole of that science and art, than which none is more comprehensive and varied. After the most careful study of this subject in its various phases, this time seems altogether too short to accomplish the needed work, and at least five years should be required from the time of leaving the ordinary literary studies to acquire essential knowledge of a subject so intricate as medicine.
The following presents a comprehensive schedule of the required work:.
General Chemistry (Laboratory Course and Recitations).
Physics (Laboratory Course and Recitations).
Zoology (Laboratory Course and Recitations).
Botany (Laboratory Course and Recitations).
Microscopy (Laboratory Course).
General Anatomy (Recitations and Dissections).
Physiology (Recitations and Laboratory Work).
Histology (Laboratory Course).
Pharmaceutics (Laboratory Course and Recitations).
Sanitary Science. Dietetics.
Anatomy of Nervous System and Special Organs (Dissections).
General Pathological Anatomy (Demonstrations and Recitations).
Pathology and Therapeutics.
Special Pathological Anatomy (Laboratory Work).
Operative Surgery (with Clinics and Laboratory Course).
Topographical Anatomy (Dissections).
Obstetrics (Clinical and Operative).
Diseases of the Chest and Throat.
Pathology and Therapeutics.
Diseases of the Nervous System.
Diseases of the Skin.
Diseases of Women.
Diseases of the Ear.
Diseases of the Eye.
Medical jurisprudence and Ethics of Medicine.
Clinics and Clinical Reports.
In addition to the subjects already enumerated, there are constantly arising many points of practical instruction suggested by the different forms of disease and the accompanying circumstances, which can be discussed by the various instructors with great value. Time becomes an elements of importance, and the student, however stupid, by continued contact with those well learned in the various subjects, will gain a large amount of knowledge.
But it can be readily seen that a medical school for the proper teaching of all these subjects requires the most extensive facilities, which are necessarily attended with great expense. The hospital should be large and commodious, the dispensaries sufficient to afford the greatest amount of clinical work, the numerous laboratories thoroughly equipped, with a sufficient number of competent instructors to properly direct the course of the student, and clinical material should be secured to illustrate as fully as possible all the essential points in medicine. The very detail of this work is startling, almost appalling, but the end to be gained-the physical advantage of the whole human race-makes the subject one well worthy of the greatest human effort.
Is there any class of physicians to whom we could appeal for this with better reason than to those of our own school? From the time of Hahnemann to the present, those who believe in his principles have, as a class, been independent, earnest, progressive men, not accustomed to shrink from sacrifice or personal effort; are they not equally ready now? It is not a matter of a few months, or even years; but it is for us to set our standard of what should be done as high as possible, and then bend our efforts to its accomplishment, whatever time it may require.
We are now nearly at the close of the close of the nineteenth century, environed by mental activity and a rapidity of progress before unknown in the world’s history. Here in the City of Chicago, which stands pre-eminent for its energy and powers for great success, may we not take on some of the qualities of our surroundings, and determine that at the beginning of the twentieth century in all the Homoeopathic colleges of this country we will aim to reach the high standard of medical education which five years of close study can alone give to the physician.
THE CHAIRMAN: The address will first be discussed by O.S. Runnels, of Indianapolis.
DR. RUNNELS: Homoeopathy to-day holds pre-eminence in matters educational, and we want to do nothing here that shall in any way take her down from that proud position. We must keep our forces well to the front and be leaders in all educational matters, for it is a fact that the American Institute of Homoeopathy is the only national body that requires the high standard that she does. There is no college there recognized that does not requires a four years’ course from her students.
That is a great advance. And for several years students matriculating have been informed that they are to have a thorough education first, and that they can get their degree in no other way. I am sure that Dr. Talbot has taken the right stand here to-day in looking forward to a time when greater requirements must be had, when the student shall have to pass five years in preliminary work before he can go forth to practice. A great deal depends upon the stand the laity takes in this matter.
Medical colleges can will to do certain things, but unless they are supported by the profession at large they will be powerless to accomplish that work. I think the medical profession should patronize no college which does not require the highest of their students. From the earliest times in Homoeopathy we have been friends of education. We look back to a founder who was not a mountebank, but who stool at the very top of medical requirement, and so all along down the line, our leaders have been men who have shone in the firmament of knowledge.
THE CHAIRMAN: The address will be further discussed by Dr. A.P. Hanchett, of Council Bluffs, Iowa.
DR. HANCHETT: I feel illy prepared to discuss this question, for I have only heard the paper as you have heard it. I have a feeling of pride and of great satisfaction at all times to know that the representatives of our school of medicine could feel that their position was on firm ground, that we had taken the lead in the matter of a higher education.
A few years ago when one of our Western States organized its board of examiners, and the question of schools and colleges came up, the diplomas from which should be accepted as credentials, the whole field of the medical colleges was thoroughly and carefully canvassed. Something like 150schools that issued diplomas were found to be in existence in thus country; of that number but fifteen were Homoeopathic. Ten per cent. of the Allopathic schools were ruled as unworthy to have their diplomas recognized, whereas 100 percent of the Homoeopathic colleges were pronounced by this non partisan board as thoroughly reliable, and whose diplomas should pass current.
The strikes me there was one point in this paper which was overhead, and that was the requirement for preliminary education. Before a student approaches us we should say, are you ready young man, or young woman, to commence the study of medicine? have you, had the mental training that must precede it? And then if we should positively demand such preparation we would bring a better class of men and women into our colleges. I contend that the medical profession must make the same requirement made by some of our religious denominations.
I understand that in some of them they are not admitted to the theological schools until they bring a diploma showing a classical education and through mental training. It is this preparation that I am laboring for, and I have many times expressed the conviction that I should accept no student who has not had a through training or a college course. In that way only I believe are we to bring the standard of our medical men up to where it should be.
THE CHAIRMAN: The paper will be further discussed by Dr. T.G. Comstock, of St. Louis, Mo.
DR. COMSTOCK: I was very much pleased with Dr. Talbot’s paper, and I thought the Congress might be proud to know that the Boston University was the first to insist upon a four years’ course of study, and if you will look over the catalogue of the Boston University you will find for several years that one third of the students are A.B. ‘s. Now one year ago at Philadelphia I had the honor of being the President of the Alumni of the Hahnemann Medical College, and made and address there in which I insisted that hereafter none should enter a medical college unless they had the degree of A.B., and moreover. I made the prediction that within ten years from now every medical college would require a course of five years instead of three as at present.
THE CHAIRMAN: As there is no further discussion on this address the paper of Dr. Alexander Villers, of Dresden, Germany, on “Historical Development of Homoeopathy in Germany,” will be read by the Secretary.