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school has forty or fifty patients under his care, a house physician, a resident physician, a group of clinical clerks, and certain laboratory facilities. There are peculiar advantages in this British system, which has grown out of the old days when each physician and surgeon had his group of students, who walked the wards' with him, and paid him good round fees. Nowhere else have medical students facilities equal to those enjoyed in the hospitals of this country, into which they fit as part of the ward scheme, just as do the nurses; and the special merit lies in this fact that only in a day-by-day close personal contact with patients does the student gain a first-hand knowledge of disease. According to the character of the cases and the amount of time at his disposal he is able to look after six or eight patients; and in the London schools the proportion of patients to students is very high. In Edinburgh, on the other hand, where the practical ward teaching is excellent, it is not found so easy to assign to each man a sufficient number of beds. With a keen house physician, and a sympathetic resident physician, a clinical clerk in a London hospital has advantages enjoyed by very few of his colleagues elsewhere; and if fortunate enough to have as physician a man of the type of Murchison, accurate, painstaking and industrious, he gets an introduction into the art of medicine that may be unequalled. On the other hand, it is quite possible that the student may be assigned to a man who takes no interest in teaching, and does his work in a perfunctory manner; or to a popular consultant, who looks at his watch for quite another purpose than to count the pulse, and has to hurry away after a brief visit to keep unavoidable appointments. While it sometimes happens that the hospital visit is only an incident in the life of a very busy man who has to make his living, and the student suffers, we all know that a majority of the hospital physicians spend more time in the wards than they are under obligation to do. The scientific side of medicine has not flourished under the system; and that a change is needed was acknowledged by a majority of the men who gave evidence.

All are agreed that the present method of bed-side teaching and of clinical clerks should be maintained; but to meet modern requirements the Commissioners

propose to bring into the hospital the idea of University Departments. Just as the Professor of Chemistry, in charge of a large laboratory, has assistant professors and graded assistants, who work at different aspects of the subject, so it is proposed to organise on University lines departments of medicine, surgery, midwifery and gynæcology, and other specialties, each with a head and a subordinate. For example, the professor in charge of the medical clinique would control from eighty to a hundred beds and an out-patient department; he would have three or four resident senior assistants, permanent members of his staff, who would remain with him for two, three, or more years, with assistants in charge of the out-patient department, and others in that of the clinical laboratories, and of microscopy, bacteriology, chemistry, etc. The term 'hospital unit,' applied to such a clinical division, indicates no new thing, as this plan has prevailed for several generations in France, Italy and Germany, and has been adopted in some of the newly-built hospitals in Paris, even in those not utilised directly for University purposes. Unquestionably, for teaching and for work this is the ideal plan, and it is one which can be carried out in small University towns. At Groningen, for example-a town of not more than 30,000 inhabitants-there is a new combined University and civic hospital, admirably composed of a series of these units. Obviously, the man in charge of such a department must be something more than the ordinary hospital physician; he must be a professor whose work lies as much in investigation as in the cure of the sick and in the teaching of students. It is proposed to pay the clinical professor a good salary, to enable him to devote a large part of his time to the work. Whether he should be allowed consulting practice, or not, is much discussed, with a balance of opinion in favour of his taking a limited amount.*

To carry out such a plan demands complete re-arrangement of the existing methods of appointment and of service in the hospitals. Out-patient classes, clinical lectures, clinical demonstrations, and clinical laboratory

*In the recently opened Brigham Hospital, Boston, Mass. (in connexion with the Harvard Medical School), of which only the medical and surgical units have been built, private consulting rooms have been provided, in order to enable the professors in charge to concentrate their work.

classes would supplement, not replace, the systematic ward work of the clinical clerks. The atmosphere of a great clinique of this type, presided over by an enthusiastic teacher and active investigator, is something quite different from that in which the average hospital physician lives and moves; the teaching is systematised, is better done, and is done by men trained for the purpose. Judged by the results of the final examinations of the Conjoint Board, the present teaching of London medical students is singularly ineffective. A system under which thirty-five to forty-five per cent. of the men who have been studying for five years, or more, fail to pass so fair an examination surely demands revision. The Commissioners speak of establishing special cliniques in three of the main divisions; but in every one of the specialties there should be cliniques of the same type, presided over by men who will devote a large part of their time to teaching and to the investigation of special diseases. The amount of clinical material available in London for

this purpose is enormous. The best school of neurology in the country, that at the Queen's Square Hospital, could be made the rival of the Salpêtrière. There is room at the Great Ormond Street Hospital for two large cliniques for children's diseases, which would attract postgraduate students from all over the world. Psychiatry, Syphilis, Skin Diseases, Ophthalmology, Laryngology, etc., should all be represented by university departments at special hospitals. Post-graduate teaching will receive proper recognition. Colonial and home students wishing special instruction in any subjects, from Eugenics to Cardiac Physics, will be assigned to teachers with modern methods and equipment. At the smaller hospitals, not directly under the Faculty, physicians and surgeons of special merit will be accepted as extra-mural teachers and encouraged to come into competition with the official staff. The men are available, the clinical material is ample; but money and a strong central organisation are needed to carry the scheme into effect.

It is not only in London that the University must force its way into the hospitals. In the provinces, in Scotland and in Ireland modern cliniques are needed; in-breeding should be discouraged; and the teaching posts in the final subjects should be open to all. The

Universities should be able to seek the best men in an open market, which they cannot do until the hospital authorities and the Universities come together under new conditions. What happened a few years ago at Manchester in the Chair of Medicine is a hopeful sign; and the clinical schools should everywhere be as keen to seek out the best men as are the departments of anatomy, physiology or pathology. A new medical faculty in London, with the clinical chairs thrown open to competition, would set the pace and help to break down a system that has done much to retard the progress of medicine and surgery in this country.

It is hard to put new wine into old bottles; it is hard to organise an up-to-date Medical Faculty with the conditions at present prevailing in London; but it is not impossible. Wedded to the old order, some men are as oblivious of the changes going on about them as to the alterations they see daily in their glass but do not recognise. There is a new outlook in Medicine, and a new science is moulding both thought and practice. Vested interests are powerful, old associations and ways are strong, but stronger still, we hope, will be the public and professional opinion in favour of the changes suggested by the Commissioners. London should be the most important medical centre in the world. That it is not this, is due to lack of organisation and cohesion. To unite into a great Faculty its scattered forces is one aim of this able and far-reaching report, which will have the active support of all but those whom fear of change not only perplexes but appals.

Art. 12.-THE POETRY OF ROBERT BRIDGES.

1. Poetical Works of Robert Bridges, excluding the eight dramas. London: Henry Frowde, 1912.

2. Poetical Works of Robert Bridges. Vols. I to VI. London: Smith, Elder, & Co., 1898-1905.

ONE of the pleasantest features in the intellectual landscape of the moment is unquestionably the revival of poetry. Not that anyone who knew anything at all about poetry could suppose it would really die. It has had too many deaths, followed by too many resurrections, for that. We are now grown older and wiser than the people who, in the age of Spenser and the Elizabethan drama, declared poetry to be useless and provoked Sidney to write the 'Apology,' without which their very existence would be forgotten; or than Peacock, who, in the age of Wordsworth, Keats and Shelley, asserted that poetry was obsolete and absurd, and had the same good fortune as his obscurer predecessors by provoking a reply from Shelley which has saved his attack from total oblivion. All such fears have now passed away for ever from the minds of intelligent people. Criticism, which has often injured poetry, has now done for it the supreme service of showing the essential eternity of its nature. It has taught us to see in poetry the highest and most permanently satisfying of all interpretations of life, a thing which has the potentiality of being as many-coloured, as transcendental, as infinite and therefore as immortal as life itself. So long as man lives he will have an ear, a mind, an imagination and a spirit; and all four, especially if, as we may hope, they gradually develope in power, will more and more claim poetry as the only food which they can partake in common, and in the strength of which they realise their unity in themselves and their hold on ultimate and immutable truth.

This being so, believers in poetry were not likely to be led away by the voices which, after the deaths of Browning, Tennyson and Swinburne, proclaimed that English poetry was dead in their graves. Nor are they likely to be taken by surprise by the present revival. This, like everything else in a democratic age, seems at

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