Various

Transplantation and Replantation.

Mercurial Amalgams.

Introductory Lecture to Course on Dental Mechanics.

Special General Meeting of the Midland Counties Branch of the British Dental Association.

Correspondence.

Birmingham Dental Hospital, Broad Street.

DENTAL HOSPITAL OF EXETER.

White Nickel Bronze.

TO CORRESPONDENTS.

TRANSCRIBER'S NOTES

Transcriber’s Note:

The cover image was created by the transcriber and is placed in the public domain.

The subjects rightly embraced in a Medical education, and the degree and manner in which those subjects should be respectively studied, have been freely discussed in many places during the last few weeks. Dr. Michael Foster in an “Address in Physiology,”^[1] of unsurpassed interest, contends without contradiction that no medical subject—now that the entrance upon medical studies is preceded by a tested preliminary education—need be studied as heretofore as a mere mental training, and proposes that topographical anatomy, which has hitherto been so studied, should, to a certain extent, give way in favour of a more complete knowledge of physiology. The address must, and no doubt will, be read by all interested in medical education, whether general or special. The following quotation will answer our present purpose:—

“I think I am not overstating the case when I say that, in the two years (or less than two years) which the medical student devotes to studies other than clinical, 60 or 70 per cent. of his time—in some cases even more—is spent on the study of topographical anatomy. That study may be regarded in two lights—as a discipline, and as practical useful knowledge. The late Dr. Parkes, in a remarkable introductory address which he delivered at University College, London, many years ago, insisted most strongly that its value as a discipline was far higher and more precious than its direct utility; and I imagine that the more one reflects on the matter, the more clearly this will appear. The details of topographical anatomy have this peculiar feature, that, though they can only be learnt with infinite pains and labour, unlike other things hard to learn, they vanish and flee away with the greatest ease. I would confidently appeal to my audience of practical men, how much of the huge mass of minute facts, which in their youth they gathered with so much toil, remained fresh in their minds two years after they passed the portals of the College; and how much now remains to them beyond a general view of the parts of the human frame, and a somewhat more special knowledge of particular regions, their acquaintance with which has been maintained by more or less frequent operations. I would confidently ask them what is the ratio, in terms of money or any other value, which the time spent in those early anatomical struggles—say over the details of the forearm—bears to the amount of that knowledge remaining after twenty, or ten, or even five years of active practice, or to the actual use to which that knowledge has been put.

“No, it is as a discipline, and not for its practical utility, that anatomy has been so useful; and this, indeed, may frequently be recognised in the questions set at examinations. When the candidate is expected to describe, within the error of a few Professor Burdon-Sanderson in his introductory lecture, says,—

“The precious years which immediately precede a man’s entry on professional duty, are far too valuable to be wasted in learning anything he does not intend to retain.”—British Medical Journal, October 9th, 1880.

The observations of these most distinguishing physiologists and teachers, support the view which has been taken respecting the education of the Dental Surgeon, from the time the College of Surgeons was in 1857 asked to establish a Dental department, up to the determination of the Dental curriculum by the Medical Council in 1879.

An education equal in degree, but different in kind to that of the General Surgeon—an education which embraces a knowledge of the general principles of Medicine and Surgery, and a special, precise, and practical knowledge of Dental Surgery, was asked and given, the degree of education progressing as the attendant circumstances allowed, up to its present advanced condition.

The place assigned by Dr. Michael Foster to topographical Anatomy in Medical education, will certainly hold good in the education of the Dental Surgeon. Physiology and Chemistry, subjects now inseparable and of surpassing interest, are equally necessary to the Special and General Surgeon.

The position of Medicine and Surgery is not quite parallel. The general principles of each must be thoroughly known, but it is not necessary that the Dental Surgeon should be practically acquainted with all the details that pertain to any other branch of either than that which he selects to practice. It is not needful that he should become a skilful midwife or oculist, or that he should be skilled in the treatment in any other class of diseases than those to the treatment of which he proposes to devote his life. For if he does acquire such detailed knowledge, it will, when no longer used, “fade like a raindrop upon a porous stone,” and the time devoted to the acquisition will have been wasted, and, perhaps, worse even than wasted, for the subject may have been studied at the cost of neglect of the practical study of his speciality. It does not admit of doubt that the high degree of manual skill, without which the professed dentist is but a shameless pretender, can be acquired best, perhaps can be fully acquired only during youth; that if the acquisition be put off till a medical education is completed, the golden opportunity will have been lost. Mr. Fawcett tells us that the blind may acquire manual skill sufficient to secure independence, but that it can be gained only during youth. The adult blind, he says, have a greatly diminished power of learning.

The time may come when the principles of Medicine and Surgery will be taught before their special application to any particular class of disease, and their modification resulting therefrom is entered upon. Till that time arrive, it will be in the interest of the Dental Surgeon to study with the utmost care the general principles and their application to his own speciality, and to acquire, while he can, a very full and perfect knowledge, practical, as well as scientific, of Dental Surgery, before he enters upon a detailed study of their application to any other branch or subject of Medicine or Surgery, the practice of which he does not propose to follow, and a trustworthy knowledge of which can not be retained or extended in the absence of continuous general practice.

The qualified surgeon who has devoted himself to the practice of dentistry, may be legally qualified to treat any and every kind of case, but would he be morally right in undertaking the treatment of a case, say of fever or of stone? all his knowledge of which diseases lies in a misty memory of facts brought before his notice, and studied for a pass examination in long past student days. As a matter of fact, the dental surgeon of necessity limits his practice to his speciality, and the general surgeon as a further fact, where selection is possible, declines to take Dental cases, though legally entitled so to do. In the absence of special training, he cannot be expected to possess the special knowledge requisite to successful treatment, and to add the Dental to the over loaded Medical curriculum, would be to greatly increase the rejections which, in the case of the College of Surgeons, have already risen to the formidable amount of upwards of thirty per cent. of the candidates for diplomas. Hence it is that Dr. Michael Foster, in asking for more physiology, asks for less topographical anatomy.

The Dental curriculum requires for its honest fulfilment, the whole of the assigned four years, and more must not be attempted in the same four years, for to repeat the words of Professor Burdon-Sanderson,—“The precious years which immediately precede a man’s entry on professional duty, are far too valuable to be wasted in learning anything he does not intend to retain,” to which may be added, or which his subsequent occupation will not allow him to retain. If then more medical knowledge is required of the student than is embraced in the dental curriculum, more time must be given for its acquisition.