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JAMA 100 Years Ago
March 22/29, 2000


Author Affiliations

JenniferReiling, Editorial Assistant

JAMA. 2000;283(12):1540. doi:10.1001/jama.283.12.1540

In an address on the "Progress and Drift in Pathology," J. Mitchell Prudden,1 of New York, points out that the "general practical result of this busy quarter of a century in pathology is the getting together into useful form of a series of tests and methods by which the practitioner can secure greater accuracy in diagnosis and greater precision in treatment than was possible in the earlier days. These new methods in diagnosis, requiring considerable facility and some experience, now form a compact discipline which has been called clinical microscopy. . . . although strictly a practical adjunct to the work of the practitioner, clinical pathology still largely remains in the hands of the pathologist. This condition of affairs may be wise, and certainly must be convenient—for the practitioner." Prudden shows that the time-consuming tasks of clinical pathology divert the pathologist from lines of work in which lie his most cherished outlooks. Although this is a decidedly useful work, it often debars the pathologist from pursuing the lines of research that it is the privilege and duty of hospitals to encourage and maintain. Prudden urges, and properly too, that the medical boards of hospitals should create interneships in clinical pathology, the incumbents of which could be made responsible for much of the routine work in laboratory diagnosis. . . . There is no chance for young men to work under the benign influences that foster the studious and scientific spirit by which medical science is advanced; hence the small amount of thorough work of a high qualitative value turned out from our numerous hospitals, most of which are known chiefly as the scene of action of able surgeons who often fail to utilize the splendid opportunities at hand to train young men who are able and willing to earn promotion by thorough work. There is large room for improvement in everything relating to scientific work and scientific spirit in our hospitals. This is especially true of those situated in the large inland cities. And this improvement might well begin with placing the pathologist upon proper footing as regards both salary and facilities for laboratory and post-mortem work. It is a hopeful sign that so many hospitals for the insane are taking steps in this direction, and it may be expected that general hospitals will give this aspect of their work the needful attention. In many instances the reform must begin in the attending staffs.