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'OX 14X 18X 12X 16X 20X 22X ?6X 30X J 24X 28X 32 X The copy filmed here has been reproduced thanks to the generosity of: (National Library of Canada L'exemplaire film6 fut reproduit grdce d la g^ndrositd de: Bibliothdque nationale du Canada The images appearing here are the best quality possible considering the condition and legibility of the original copy and in keepi.ig with the filming contract specifications. Original copies in printed paper covers are filmed beginning with the front cover and ending on the last p<)ge with a printed or illustrated impre!>- sion, or the back cover when appropriate. All other original copies are filmed beginning on the first page with a printed or illustrated impres- sion, and ending on the last page with a printed or illustrated impression. The last recorded frame on each microfiche shall contain the symbol — »> (meaning "CON- TINUED '). or the symbol V (meaning "END"), whichever applies. 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Un des symboles suivants apparaitra sur la dernidre image de cheque microfiche, selon te cas: le symbole — ► signifie "A SUIVRE", le symbole V signifie "FIN ". Les cartes, planches, tableaux, etc., peuvent dtre filmds d des taux de reduction diff6rents. Lorsque ie document est trop grand pour dtre reproduit en un seul clichd, il est filmd d partir de Tangle supdrieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images ndcessaire. Les diagrammes suivants illustrsnt la mdthode. 1 2 3 32 X 1 2 3 4 5 6 5 PRESIDENTIAL ADDRESS. BT R MACNEILL, M D., Stanley Bridge, P.Hl.I. Delivered before the Maritime Medical Association, C/utrlottetoivn, July mh, 1899. (Reprinted from he Montreal Medical Journal, October, 1S90 { PRESIDENTIAL ADDRESS. liY R. Macneiix, M.D., Stanley Bridge, P.E.I. Delivered before the Maritime Medical Association, Charlottetown, July 12th, 1809. UIGHliR MEDICAL EDUCATION. Gkntlemen : When, one year ago, in the historic city of Halifax, you placed me in tJio honourable position of President, I felt that after the eminent addresses which my predecessors in this chair had delivered there was nothing left for me to say. The choice of a subject is a matter of no little difficulty. Medical education, however, is one in which the pro- fession of Canada is greatly interested, and this Association representing the Maritime Provinces of Canada, may consider the time opportune to review it, not only as it may interest the profession but the people in general. The profession for a long time felt our anomalous position in being hemmed in by provincial boundaries so that a doctor who was legalized in one province could not follow his profession in another without passing a rigid examination. To-day we witness the realization of reciprocity in the practice of medicine in these provinces and what has been accomplished here can be accomplished in all Canada. I need not refer to the oft discussed enactment, "The British North America Act " by which Canada was federated, leaving the question of education with each province. That matter is generally well understood. Medi- cal education since the early days of the fathers of our profession has undergone many changes and no one will dispute the fact that the science of medicine has advanced notwithstanding the mighty opposi- tion it has met with in its various epochs. It is somewhat unfortimate til at when our profession will take a step in advance, many of the people view our actions with suspicion and particularly when we apply for legislative enactments. No other profession is looked upon by the people in the same way. Account for it as you will, the public look upon us When trying to raise the standard of education with suspicion and dis- trust that It IS a scheme to raise our fees. A little reflection would convince them that it is truly in their own interes.ts and to protect their nves and that mercenary motives are secondary with us while primary with the people themselves. Is it unreasonable that we should insist on a high standard of medical education ? I think not. The Church precepts and text of the sacred volume require such a standard of educa- and a curriculum of seven or eight years including an arts course, and he people appear quite satisfied that it should be so. The disciples of Blackstone also require a high standard of education. The candidates must pass a preliminary examination and a course of five years. If the precepts and text of the sacred volume require such a standard of educa- tion if the statutes of parliament and the common law require an equally high standard to interpret, what can be said against us requiring of our followers that they be educated men, when they have to deal with a constitution that is fearfully and wonderfully made ? Instead of repulsive epithets we should be hailed by the people as benefactors. There is no pursuit that calls for a larger display of the best qualities of human nature than the practice of medicine, and one of the most essential elements among medical men is a reputation for high qualifica- tions and accurate knowledge of their profession. The great Dr Pepper when Provost of the University of Pennsylvania ,aid " the vast improve- ments that have talcen place in medical science, the additions to the positive knowledge of disease and of the means for its prevention and cure, the widespread interest among the community concerning all physical science the prevailing sense of the supreme importance of pnvate and public hygiene, the constantly increasing wear and tear of our complicated social life-all of thes,e foretell the large part which our profession must play in the future and at the same time attest its power. This covers the whole ground and is sufl^cient to vindicate our course. IraZtZVTr *^' f'°P^' '""^ *^^ P^^^^^^^«^ *h«t ^« -^« ^ot travelling too fast, nor asking unreasonable things in our efforts to e evate the standard of medical education in Canada, let us briefly look at the state of medical education in other countries. Instead of being considered agressive, it will be seen that we are but humble followers in this movement Superstition and mystery are fast fading away and the feehng with which science and medical men are regarded has undergone an equal change in all countries. ® The German EMPiRE.-(Population forty-one millions.)-There are twenty-three universities which confer the doctorate. To matriculate. r$ •I ■• ■• the applicant must either present a certificate of a gymnasium or pass a prehnunary examination upon Latin, Ureek, Ut-rnmn, history, mathe- matics and the elements of natural science. The course extends over four years ol nine and a half months in each year. The right to prac- tise, however, can only be obtained by passing the State examination which IS conducted by a board composed of the profe^^sors of the ditfer'ent colleges appointed annually by the Ministry. The degree of Doctor has no special privileges attached to it, other than that it admits the pos- sessor to examination for ollicial position. AusTiio-HuNGAUiAN EMPiKE.-(Population about thirty-six millions.) Ihere are s.ix medical schools all supported by the government. To matriculate, the applicant must present a certificate from a gymnasium. Ihe course of study extends over a period of at least five years, of about nine months in each year. Examinations are held at the end of the second year upon the various subjects of the first two years ; and at tiio end of the fifth year upon the subjects of the preceding three ' years ; two or three months after the latter examination the candidate mus pass a third and final one, which secures the diploma of Doctor of Medicine, with the right to practise. liussiA.-(Population over eighty-five millions.)-There are eight medical schools m Russia. To matriculate, the applicant must have a certificate from a gymnasium. The course of study extends over five years with examinations at the end of each year. The arrangement of the course of study is similar to that of Germany. Upon pa^^ing the final examination upon all the subjects of the entire course the candi- date receives the right to practise with the title of " Physician " To obtam the degree of M. D., he must have the above title and must undergo a written examination, and also present a thesis. Ther-^ was formerly a third degree, M. D., C. M., obtained after an examina. ., in surgery, but it is now becoming obsolete. SwEDEN.-(Population four and one half millions.)-There are two universities and one academy all of which confer the license to practise. To matricu aie, the applicant must present a certificate from a gym- nasium^ Three years after matriculating the .student is required to pass the medico-philosophical examination which includes physics chemistry, mathematics, botany, zoology, and comparative anatomy! Three years later he must pass the examination for the academic degree of candidate in medicine which includes anatomy, physiology, physi- ological-chemistry, general pathology, pathological anatomy, and phar- macology. Four years later he must pass a final examination upon practical medicine and surgery, obstetrics, ophthalmology and medical jurisprudence. Upon passing the above examinations the candidate receives the right to p-actise. Attendance upon lectures is not obliga- ory but the student is obliged to attend elinicB for one and a half years 11^ course ot medical studies is thus not less than ten year! ^ NoBWAv.-(Population nearly two nnlHons.)-Th/on,y medieal 001 . ,n connection with the University of Christiana. To ma r eu late as a medical student the applicant must pass two pre m larv tion held two and a half years after niatrit:fatToitp: ^ ^tr^ ^oction, use ol the microscope, histology, chemistry (organic S„o game) .oology, and botany. Second examination held tlirc and a ears alter the first upon physics, pharmacology, toxicology nlic n ~^ ^"' ''''''''■ ^''''^ examinationthuG one year a ter the second, upon surgery and bandaging, topographical atomy, obstetrics and gynecology, diseases of children, forLricmd ? o;o 'f''"'' ;"1 " '''''''''' examination in medicine and urgery is isolr": "t^' "' ^"""^^'^'^ "'"^ "'« --"« hospital warT; lo , K r r^-, ^^°° P'^^^'"^ t^« examinations, which are con ducted by the faculty, the candidate receives the right to practise Z DrMAHK iP Tf '"'' '^ P""'°^ ' ''^y -^-« examination. I^ENMARK.-(Population nearly two millions.)-Has one medical chool ,n connection with the University of Copenhagen. To ma rtu iteVrt' ''rt .''' ^' r*^""^^ '' P^^^^'^^ ^ certificate from a reeognrd teraiy institute, and must then attend a course of' two years uDon oology, botany, physics and chemistry, including analysil After Z- " g the examination on these subjects, he is admitted to the course of medicine which extends over five years. The degree of M D wU the fBANCE.— (Population thirty-six millions.)— There are siy ^r«A.rr.- conferring degrees and sixteen preparatory medical llLZl To m aW hite at an academy, the candidate must have the degree of B. A Tnd In Imt r^""' ''''"'^' ''" '^"^ y^"^^ '' t^" "^-ths in each year In addition there are required practical laboratory work and clinicai work in connection with the hospital., for two years Th « Zl tT either the last two years of th^ cou'rse or theTst yea ^^t : 'Z following. There is a practical examination at the end of elbn/r three first years, and at the close the final examination for thBo.f \' consists of five parts, including all the subiel nf f^ Doctorate with the presentatioi^ of a thels ^ ^ '^' '''''''' ^'^'^^'^ HoLi.AND.-(l opulation one unci a half n,illi.,n«.)-llad ihico uiuvor- .e« Hupportod entirely l.y the State. To matriculate at a university the apj,|„,.ut ,nu>t pre-soMt a cortidcate from a gynu.asiu.n or underKO an e.ju,valent exan.iimtion. The course extends over six year.. The rght t„ p,a,t.s« ,« not conveyed with this degree, but can be obtained onl> by pa.s8.ng an exandnation before a special board consLsting of ei-dit professora appointed annually by the governn.ent l{KiG,u.v.-{r„j,ulation over live n,illions.)-JIas four universities «o which are «uj,ported by the State. To matriculate, the applicant must bo a gra. nate ol a literary college or pass a thorough prel minary nnafon. The course extends over five years and indudes practical laboratory work, operative surgery, and attendance for three years upon tT 'f n 'f'"'; H^'^''^ ""^^ "^^^^*"^«- 'I'he exandnation for the deg ee of Doctor ol Medicine is held a few weeks after the close of tho ocurse, and includes the general subjects of the course, together with practical exannnat,on.« in clinical medicine, surgery, obstetrics and in opera ,ve surgery This degree is conferred by the universiUes. b tl d donia must be legalized by a (Jovernnu-nt Commission, ;hose crpiiLrw!;r""'"'" ' "' '"-' '""''^'""^ ^-^"^^^^ ^^ ^-^ '-- b- (JXHAT MiUTA.N.-There are nineteen medical schools, ten, namely the un,ver..ties confer the Doctorate. The remainder be tow tie applicant must either possess a degree in arts of some recognized col- legiate institution, or must pass the prescribed preliminary examination. an hoso Id T rT T'"''^ '' "^^ ^''''- ^"""^ the attendance at an hospi al the student must serve as clinical dresser for three months and as clinical clerk for three month.. The examinations are two in number partly written and partly oral. The examinations are quite rigid and are conducted by a board composed of professors and of oJh ' K)n he candidate receives th. ■ ,ht to practise, with the title (differing m dil eren .schools) of licenti.t., member, fellow, bachelor of medicine bachelor of medicine and master of surgery, or doctor of medicine. In Edinburgh the degree of M.D. is only to be obtained after flr.t havin.. taken a degree both of bachelor of medicine and master of su gery anS alter having devoted two years to actual practice. No special examina ion ,s required but the candidate must present a thesif The hl^he" titles such as F. 11. C. S., P. R. C. P., and M. D., have no privTeg tached to them outside of the college granting them, excepting tl hey are requisite for appointment on the staff of hospitals of any repu tation The medical j.rofession in Great Britain enjoys tha degree of estimation and credit which a science (conferring on Jankind the gCte of all comforts) justly deserves. We find that the physicians and su - an7o..l[ ^71 ^"'r'" "*■' "'"'"'^^ '"^'"••'•'^'^ '"«° «f »i»^«ral education ^uLTr' u " '"'^ ^''^ "'■* "*■ '"«^'«'"« '« ^'^''"'^'1 to u .singular nejgnt of oxcellenco. Au8:.j{AUA.-(l'oj)uluti..n about two n.iiiion8.)-There are two uni- tr'crii iT "' ^?'^"""'' ""'^ '"' "' ^"^^"^"y- ^^'"r*^ ".atriculation mati tc ',;' '"'" '; "*'"'"'" -^'""'-^t'"" i" language., matJ.e- mat.c, etc. 1 he course of .nedioai ntinly .xton.Js over five years of nine m 1 o.p,t«l wards. Ti.e examinations are both written and oral The ^nal exam.nat.on includes all the subjects of the fourth and fifth years licino r f' ;" """""•' "'""'"^'^^ ^"^«'-"'^' ^'•'"'-' --goryfand « ; 7r!r' ^T '"""""^ ^''' ^'"i^«r«iti«« and one academy. To matriculate, the applicant mu.t possess a certificate from a lyceum wJiich s a high grade of literary institute. The course of m'edical ItuSy extends over six years of nine and one-half months in each year There col "id 7"'";"°"^ ^t' " '"'^'""'^ -^^ *^^« y^^'-' 'y ^commission composed of professors with one of two associates having no connection whatever with the schools and nominated by the government. Excellence in one or more branches is not allowed to compensate for ilure .n others. Upon passing a second examination at the'end o tl tourth year the student receives the title of licentiate, which is merely an academic distinction. The final examination at the end of the sixth >ear includes not only all the subjects of the entire course of study but also the diagnosis and treatment of medical, surgical and obstetric c'ases Lpon passing this examination and presenting a thesis, the candidate ;r;:::;ise" '"' ''"'" °' ''^''^'"^ ^'"^^ '^"'-^^^^ -«^ «- -^^^ PoRTUGAL.-(Popu]ation four millions.)-There are three medical schools all supported by the government. The course extends o^er five years of nine months each. To matriculate, the applicant must r^il an exammation m Latin Portuguese, French, English, mathematics, d" geog!;;V " ''' "''""^ ''^*°^^' '"'''' ^-tory'and Bbazil.— (Population about twelve millions.)— There are two uni- ,1 t III vcr OH, re.,„,rm« a rigid prelinnnary t.xan.inati,.n. The course v' c en.l;-L" '"n"n "'' "I' ^''''- '^^"" P'^'''"*'' "'^" "«'»' exununalio., witn tlie riglit to practise. vel^;ir''nfr I''"'';''f "? "''""' *"" "'"'-^^O-There are two uni- lor Jhil ''"'■;''' "" '""'"^"'^ '"""^ ''"^^' *^'« degree of bache- lor ot philos..phy. 'li.e courne exlonds over sfx years u r uhi T " '""'''. 'T " ''''"""^ ''^ '^ ^^"^'^•'^te institute to matriculate. Ihe course extends ..ver .dx years nadicTs;:);!!,]'"'',!''''" :'""^«-r"^-" nullio„..)-Thore are three Tot r . n . " ""; nculate, the candidate n,u.t have the degree of ( m o ;' •■■ '" 7"''" "'■ "'""'•"' '^^"^^ '^ f«"r years. Cm,A.--(lopuh,hun «-ns alm„t one n.ilIion.)-Has one university lo matr.cnla e, the candi.laie n^iunc. to have a degree in ar" The course extends over six years. Unitko STATi.:8.-(l>oj,uh,tion about seventy millions )-Has one etate. Ihe leading States of Pennsylvania, xVew York, Massachusetts s Z; "of 'me ''VT r'''''''''''' "^ '''' ^ dip,:.n:rve: y the r- d to n lc7' r'" ' ""' '^^ ''''''' ''''' *''^^ '-'^^ thereof he r.ghl to practise. Too many .choojs have lowered the standard in CANADA.-Our belove.1 Canada, with a pop„Iation of about five mil- lions, has eleven n.edical schools. I need not refer tn flw. . n / course in this country. The colleges Cve been d nV^od wt ^^ always tollowed in the wake of improvements. For years pt' 't e for a 11 C Lda Tt "T". " "^ """"*^ ^' ''^^^'"^^ «"^ quaiificaLn or all Canada. At the last meeting at Quebec, the basis of uniformity of curriculum was agreed upon, and the matter entrusted oD Rod dick to perfect and complete. We look to him as the C .^n f ? across the provincial Rubicon, and l.ve estrbTisredt cln.l -^^^^^^^^^^^ the University of Canada, or the College of Physicians and SurgeJns of ^, I r "p xt; St: , - :— A-^^ bo to regiKtcr nil persons who have complied with certain requirements and all apjdicauts who shall have complied would receive what might be teriiiod Dominion registration by the Council." A^ we are aiming at making the profession iu Canada one body, with one legal qualification to practise, thus placing it as high as any other countiy, it behoves us to commence with a high standard of pre- liminary education. Men entering the profession with a low standard will be equally low iu the estimation of the profession and of the public. They arc the class who sell patent nostrums and show cleverness, not commercial but professional. Some of these are so clever that they do not require to see their patients. Wo have at least one on our register who protends by the signs of the zodiac and the date of birth to tell the disjiositions of his patients and in this way impress his great skill on the easily impressed minds of his patients. In the face of the bold and unblusliiiig quackoiy which we witness there is great need of higher medical education as being truly in the interest of the common people, as they are the ones who will suUer most by ignorant pretenders in medical science. The profession of medicine in Canada will be what it^ followers aim to make it. Tlio duty of maintaining its sanctions, and its higher standard must devolve upon those who practise it. The Government of the country has done nothing for the cure of the diseased, although thousands and millions of dollars are expended on other objects. True they establish quarantine hospitals. Good government has for its object the happiness of its subjects, and while we find laws regulating education and morals, etc., it i^ a sad reflection oa the vvisdom of our legislatures that no endowment or appropriation is made for training men for curing diseases. Let every obstacle arising from ignorance of the human organism and the diseases to which it is subject be removed by a thorough medical education, and let no one be permitted to treat the human frame who is not well gromided in everything pertaining to its anatomy, physiology, and the nature and properties of the medicines for the cure of its diseases, in addition to a full knowledge of all the sciences bearing upon this wonderful organism. There is no profession which should embrace a wider domain of science. When we consider the jealous eye witli which life and property is regarded in all civilized countries, and witness the precautions that are taken on steamships and railways, we wonder that any obstacles should be placed in our way by the very people we are trying to serve when we appear before them advocating higher medical education. To attain this object to-day the Federal Govern- ment must be approached. Whether we form the Dominion Medical Council or the University, of Canada, the Federal Parliament should appropriate an annuai sum to support and carry it through. The united ; D 9 voice of the profession behind Dr. Roddick in Parliament will do much h. !"'^r r.r' ""''^ ^^^ -"--n^ation of our desires. In ordT to b worthy of the name of Canada it should be a State University or a State Council created and supported by the Federal Parliam nt A diploma from such a body whether for a degree carrying wi h rthe ri.dft practise, or for membership, would be respected the lortd over ^u c uld gam admission with it to the Bntish Register, and the existence of such would serve as an object lesson to our cousin^ across thetc^X" Brethren, we must be united as one man, and it is a dutv incuKihlf" upon us to lay a good-a lasting foundation, and thl leave aTe"-Vo lLToTT' 7'"\t" '' '' P^""^"-^ - the eve last inT 'l s Like globules oi quicksilver dispersed over a polished surface 1 iZ as we have been separate we have been easily agitated and Cu ^ 2 just as tose globules, so soon as they eome^fthinlrspire :f\ad others attraction, however varying their size, are fused together into a common mass, so let us fuse and coi.«oIidate ourselves. On el" Ini hJirave^r rr'^rr ""'^ ■''™ ^ ^^"^-^ orgamzaS n w ■ shall have the status and distinction of a legislature Th^ fir.f • , dictated ., political Wisdom i. tl,i, th/lSlH J^^eS ^Je? : oWcd which natural justice inculcates as the proper groundwort o ^^rZ.'^IT- " t^ "° ™'** or'nellcctToppr^to:' moral duty and the general welfare demand It is thus Zl »=nt3 have been made in the const.tution. of nati st celZZi" nad^.t .. thu,, we trust, they will continue to bo made for ceZicTto inent for matriculation. ' '""'''^'"^ "^^^ ^' "^^ ^^q'^ire- The basis of agreement last year at Quebec reauirpd tl,. r a ^ or an academic first class teacher's licence th/Srt fu ^'^''' an honour Diploma of the third v! ' '., J ' ^'^°^ ^^' '^'""^ ^' Our Prince ^Lrd's ^d w^^^^^^^^^ ''L^'^^ 1 f '" '''"^^^• .e, reacted that provision and Z::l:^^:^Z:::Z:i:Z 10 of the first class, a qualificatiou deficient in Latin, Greek, English Very hkely the whole question will have to be considered again and the th?^P E Mini M f1 r "P"^ *'^ "°^^^ " ^-^ ^^- ^---^^^^^^^ I. «;l fT '^'"'^ ^'^- ^""^g^ ^«^«^« «^ 0% be accepted as rof^ro::^^^^^^^^ 1 ^^^^^ ^^^^^^^^^ ^^^^^^-^^^ ■> «-^ -un- professional r gilts to-day m any of the Provinces of Canada, and at the Prolle' ™-^y;^d-tion a state examination is requikd In e ch province Ihe practitioners of medicine in Canada should be free and iflttL t%r1"-f'"^ P"'^"^^^ '^^"^ *^^ -^g-g billows th m t ed o 1 ?%f rVT'^ '' ''^ ^^^•«^' ^^'l - ««d's chosen, per- mitted to go forth to do battle with disease and death. Let our a nf he to consolidate the profession under one head by Dominion RegTstrlt on el!" if ""' ' 'T '° ^^ *'^* '"^ ^«°^ - *^^ foundation fuf; Id ma J .-7.?^' rl^''^* ^^'"^ ^^*^ *^^* «^ *h^ f-«-^««t country f1 Tve fl r;f .: f ' '^ *'' P"'"^^°" ^"-^ *b^ P-P^« «f Canada' til snread h 'f, r ^°*"'^* '' *^^ *^^^"«' ^ «^^ ^^^ -* that you men Tthll T '' ^'"^ ''""^^ ''''' "^^ imperfections. Gende- men, I thank you for your kind and courteous attention.