MAKING A DOCTOR.

Hawke's Bay Tribune, Volume X, Issue 139, 27 May 1920, Page 2

MAKING A DOCTOR.

LEAKING THE BODY’S SECRETS AT THE MEpICAL SCHOOL. One hears much of those denizens of.tho Medical School whose feats in commemoratipp processions delight .the public, and whose witticisms pass into the general corpus (medically speaking) of profane humour. But. of their other activities, between which escapades are but pleasant interludes, the general, public’s conceptions are either fantastic or non-existent. And yet even to the layman the history and theories of medicine may be of fascinating interest. After preliminary Studies in physics, chemistry, and biology, the first year concludes with human embryology, to which the dissection of frogs aha other animals naturally leads. Though, the practising doctor may never use it, a training in pure science and its methods is necessary either for. independent research bir 'for an intelligent'understanding of-the work of others. In the 'second year, when he starts work in the dissecting-room, the student’s real initiation begins. The’cura- I tive art depends entirely on. an intimate knowledge of the human body, and this can be gained only by laying bare its all but infinite variety of structures. j STUDIES IN ANATOMY. 1 The layman is often puzzled as to the means by which the endless maze of minute structures is explained and identified. The task is. simplifieed by the method of preparation. A solution of red lead, injected into the arterial system, follows the course of the blood and reaches even thosp tiny capillary vessels ‘ whose visability on nose or ear excites disgust in the aesthetic. Tlie dissector, discovering (or, more usually, stumbling on) one of j those whitish cords which ramify. over . .> body, may nick it. Then,if he detects the red lead, he recognises an I artery, and refers to his chart; if the ■, vessel is shallow,' but collapsed and de- 1 void of lead, he tries to identify a branch of the venous system; while if | it is. like a white thread, apd solid, he knows that the forceps hold , a nerve, which he may trace back to its origin through the vertebrae from the spinal cord. The thought of such a thread, hooked on the foreceps of an inquisitive examiner, haunts the student at exam- j ination times- ' I

The study of normal tissues leads on to pathology, that .of their changes through disease.. Under the .microscope the thinnest flake of the simplest tissue Will show as complicated cellsystem complete as a honeycomb ; and greatly as the cells of muscle-or fat, of nerve or bone, differ under magnification among themselves, the differences between the same cells in health find in disease are usually ; no less obvious. MICROSCOPE AND DISEASE

The value of the, microscope in medi- I cal science can scarcely be . exagger- f a red. On its detection of those elusive! creatures, tne germs, is based' the whole fabric ot fact and theory of vaccines, inoculation, blood tests, and all those methods of diagnosis, treatment, and prevention, which tend to make medicine more exact and less empirical. As alchemy led in a sense to chemistry, so the student’s chemical, training prepares him for ‘-‘materia medica,” in which he, learns the details of the thousand and one substances with which the term “medicine” is most usually associated. It is not sufficient to know each drug and its effects. Its “incompatibles' ' must be noted, for the effect of a compound may not be the'sum of the effects of its ingredients. Medicine, in this sense pi the term, has not made an advance commensurable wijffi tnat achieved in recent times by surgery. For complete knowledge of the body anatomy, and histology must be supplemented by physiology, which investigates the functions or those organs and structures that the scapel has .'aid bare. It is a field whicn needs much more exploration. The functions of organs such as lungs and kidneys are easy to discover; out in recent years physiologists have attacked subtler problems, such as the action of those mysterious bodies known as the ductless glands. It has been found, for example. that the thyroid gland, which can be‘ felt in the throat below the “Adam’s apple,” controls the body’s growth, and that thyroid extract will improve remarkably the mentality of feeble-minded children. . CLINICAL WORK. Having acquired the foundation knowledge thus briefly described, the student is prepared, to spend his two last years in tne study and treatment of the il-’s that flesh is heir’ to. For tnis, of course, a hospital is necessary, whence the practice of walking the wards. With clinical (i.e-, bedside) experience, the student begins to put theory into practice, and nis time is occupied by the study of symptoms, diagnosis and treatment, and the uses of instruments, from' the familiar' stethoscope and thermometer to the more mysterious X and violet rays. Towards the end of the long five years he will attempt elementary operavioiis, such as lancing. Surgery is taugnt on the dead subject, and will be first practised in minor operations in a hospital appointment after gradual tion.

Those cases in which medicine comes into contact with law are dealt with in medical jurisprudence, which defines the doctor's responsibilities it) inquests and the like, and lays down how far he may practise his art, forbidding certain things. Medical etiquette is not forgotten, though it is learned by inference rather than by precept. - The whole of the exhaustive training is, however, merely a preparation, ana the knowledge acquired becomes practice 1 . only as experience increases. It is usual, threfore, to spend a year or more after graduation in one of the large hospitals, where, under the. eyes of the visiting “honoraries,” proficiency is attained. The one invaluable asset not in the gift of the medical school is that “bedside manner” which brings its sor to success. It has been the talisman of every famous physician from the days of William Bulleyn, who about 1550 exhorted the surgeon to “have a gladsome countenance,” because “thq paciente should not ba, greatly troubled.”