UNIVERSITIES : ACTUAL AND IDEAL, 59 



I speak in the presence of those who know practically what medi- 

 cal education is ; for I may assume that a large proportion of my 

 hearers are more or less advanced students of medicine. I appeal to 

 the most industrious and conscientious among you, to those who are 

 most deeply penetrated with a sense of the extremely serious respon- 

 sibilities which attach to the calling of a medical practitioner, when I 

 ask whether, out of the four years which you devote to your studies, 

 you ought to spare even so much as an hour for any work which does 

 not tend directly to fit you for your duties ? 



Consider what that work is. Its foundation is a sound and practi- 

 cal acquaintance with the structure of the human organism, and with 

 the modes and conditions of its action in health. I say a sound and 

 practical acquaintance, to guard against the supposition that my in- 

 tention is to suggest that you ought all to be minute anatomists and 

 accomplished physiologists. The devotion of your whole four years 

 to anatomy and physiology alone would be totally insufiicient to attain 

 that end. What I mean is, the sort of practical, familiar, finger- 

 end knowledge which a watchmaker has of a watch, and which you 

 expect that craftsman, as an honest man, to have, when you intrust 

 a watch, that goes badly, to him. It is a kind of knowledge which is 

 to be acquired, not in the lecture-room, nor in the study, but in the 

 dissecting-room and the laboratory. It is to be had, not by sharing 

 your attention between these and sundry other subjects, but by con- 

 centrating your minds, week after week, and month after month, six 

 or seven hours a day, upon all the complexities of organ and func- 

 tion, until each of the greater truths of anatomy and physiology has 

 become an organic part of your minds — until you would know them 

 if you were roused and questioned in the middle of the night, as a 

 man knows the geography of his native place and the daily life of his 

 home. That is the sort of knowledge which, once obtained, is a life- 

 long possession. Other occupations may fill your minds — it may 

 grow dim, and seem to be forgotten — but there it is, like the inscrip- 

 tion on a battered and defaced coin, which comes out when you 

 warm it. 



If I had the power to remodel medical education, the first two 

 years of the medical curriculum should be devoted to nothing but 

 such thorough study of anatomy and physiology, with physiological 

 chemistry and physics ; the student should then pass a real, practical 

 examination in these subjects ; and, having gone through that ordeal 

 satisfactorily, he should be troubled no more with them. His whole 

 mind should then be given, with equal intentness, to therapeutics, in 

 its broadest sense, to practical medicine and to surgery, with instruc- 

 tion in hygiene and in medical jurisprudence ; and of these subjects 

 only — surely there are enough of them — should he be required to 

 show a knowledge in his final examination. 



I cannot claim any special property in this theory of what the 



