On the reform of the out-patient department of our hospitals / by Edward H. Sieveking.

  • Sieveking, Edward H. (Edward Henry), 1816-1904.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On the reform of the out-patient department of our hospitals / by Edward H. Sieveking. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    later period of their career. But it is perfectly possible that, if the poli-clinical system of teaching were duly carried out, the present system of rotation would be altered; and that the Se- nior Physicians and Surgeons might wish to take their turn in the out-patient department, in order to see that the students did their work well, and to give the other teachers the opportunities of studying the severe forms of disease admitted into the hos- pital. That, however, by the way. The subjects to which the teachers would be able specially to attend (I now speak only as a physician) would be, among others, the various forms and the physical diagnosis of thoracic disease, the varieties of dyspepsia, skin-diseases, the slighter forms of rheumatism, catarrhal affec- tions, the early stages of fevers, and the exanthemata. What do students see of early phthisis in the hospital ? what of the many forms of gastric disturbance ? what of cutaneous erup- tions ? To put all other considerations aside, is it allowable to permit a whole class of students, or even a majority of them, to percuss and auscultate a severe case of pneumonia or peri- carditis ? to worry a patient suffering from recent hemiplegia, with typhoid fever, or with peritonitis, by close examinations and questionings ? And yet the teacher, whose heart is in his work, tries to give every one an equal opportunity, if he will avail himself of it, of acquiring the knowledge of his profession; but how much less anxiety on this score will he feel, if he knows that the student will go through a fair field of observation be- fore he quits the school, and that he will there perfect himself in all the technical details of examination, diagnosis, and pre- scribing ? To sum up, I wish to make the Assistant-Physician and Assistant-Surgeon essentially Teachers. They are to guide the student into independent practice; to see that he makes the proper examinations of the patients put before him, takes proper notes of their cases and prescribes for them, and follows them up until a cure is effected or they pass from observation. Let me conclude this lengthy, and, I fear, somewhat tire- some, letter by a few remarks about the Patients.—Their cases would receive an amount of attention which it is impossible for one man to bestow upon them now. Those requiring home treatment would be visited, and the changes