NATURE 

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THURSDAY, MAY 25, 1871 


THE SMALLER LECTURESHIPS AT THE 
LONDON MEDICAL SCHOOLS 
Il.—THE TRUE FUNCTIONS OF THE SMALLER SCHOOLS 
i. a recent article* we pointed out the prodigious waste 
of time and energy that results from the existence of 
no less than eleven medical schools in the metropolis, 
with from thirteen to twenty-one lectureships attached to 
each, and called attention to a scheme by which it is pro- 
posed that an amalgamation should take place between 
several of them. 
It is maintained by those who have proposed this 
scheme that by its means a reduced number of central 
institutions would be created in which the preliminary 
subjects of medical education, such as natural philosophy, 
mechanics, rudimentary chemistry, and botany, could be 
taught in a much more satisfactory manner than at 
present, since the increased value of the lectureships 
would enable the lecturer to devote more time to their 
preparation, and to supply much greater wealth of illus- 
tration, whilst the larger number of students in attendance 
would correspondingly stimulate his zeal. At the same 
time the smaller hospitals and schools might still fulfil a 
very important 7é/e as supplying the means for the prac- 
tical or clinical study of disease—certain lectureships still 
remaining attached to them. 
The importance of good preliminary education in natural 
philosophy, taking it in its widest sense, for the medical 
practitioner, seems to us to be by no means sufficiently 
recognised. Up to a very recent time it has been almost 
entirely ignored. It is only within the last few years that 
any steps in the right direction have been taken by the 
great examining boards. Fifteen years ago the College of 
Surgeons required little more than a good knowledge of 
anatomy and the principles of surgery in those they 
admitted as members, and even now the acquaintance with 
preliminary subjects they demand is of a very rudimentary 
nature, as may be gathered from the fact that it includes 
only writing from dictation, arithmetic, algebra, geography, 
English history, the first two books of Euclid, and a little 
Latin translation, with one optional subject, which may 
be either Greek, French, German, mechanics, chemistry, 
botany, or zoology. We cannot but think that this pro- 
gramme might be advantageously extended. 
Does it not stand to reason that the lad who is about'to 
enter upon the study of Anatomy and Physiology ought 
to possess a competent knowledge of the principal facts 
of Natural Philosophy? How is he to comprehend the 
contraction of muscles, the action of the valves of the 
heart, the phenomena of respiration, the construction of 
the eye and ear, unless he is well grounded in Mechanics, 
already understands the lever and the pulley, and knows 
the principles of Hydraulics and Pneumatics, the laws of 
refraction of light, and the conduction of sound? Nor 
can it be said that such knowledge is of temporary value 
only. The surgeon and physician must daily and hourly 
see cases which can only be treated properly by reference 
to such knowledge. 
If we might venture to suggest a scheme for the 
* See NaTuRE, vol. iv. p. 1. 
VOL, IV, 

61 

education of the student intended for the medical pro- 
fession, we should recommend it to be commenced 
while he is still at school, at the age of sixteen, by 
passing the matriculation examination of the University 
of London. The following year should be devoted to 
the study of Natural Philosophy, rudimentary Chemistry, 
and Botany; and there could be no doubt that these 
subjects could be admirably taught at all the larger and 
better appointed schools through the country. But 
these are precisely the subjects that might be taught 
to large classes in a most superior manner in the four or 
five institutions with which it is proposed that the smaller 
schools should be amalgamated. The preliminary ex- 
amination, in which considerable knowledge should be 
demanded, might take place at the age of seventeen. In 
the following winter session the student, now thoroughly 
grounded, should begin the study of Anatomy and Phy- 
siology, and the following summer might be employed in 
pursuing Chemistry in its application to Medicine ; Botany 
in the same relations ; and the recently introduced subject 
of Practical Physiology ; the first embracing such subjects 
as the chemistry of the excretions and secretions, &c. ; the 
second, the orders containing medicinal plants, and the 
composition and formation of the vegetable alkaloids, &c. ; 
and the last, such points as the action of the valves of 
the heart, the processes of respiration and digestion, &c. 
The second winter session should be taken up in com- 
pleting the knowledge of Anatomy and Physiology ; and 
at the expiration of this session the first examination 
should take place, comprehending the subjects of Anatomy, 
Physiology, Chemistry, and Botany, the two latter points 
being at present almost wholly neglected. The second 
summer session might be occupied with the so-called 
Materia Medica, formerly merely consisting of the driest 
of all possible discourses on the composition and form 
of the various drugs, but with which our student is already 
perfectly familiar, and which might now be advantageously 
replaced by an account that could, in the hands of an 
efficient lecturer, be made deeply interesting, on the 
physiological action of drugs, and the effects of remedies 
on man and animals. 
Up to the present time the whole work of the stu- 
dent could be conducted at one of the central institu- 
tions. From henceforward he might with great advantage 
be allowed to elect whether he would remain at this 
central institution, or go to one of the amalgamated 
schools. These might be made most serviceable as 
means of instruction in chemical medicine, surgery, and 
midwifery ; and lectureships on these subjects, to avoid 
the loss of time to the students that would otherwise 
be involved in going to and fro, might be retained at the 
smaller schools. The instruction on these subjects 
would extend over the third and fourth winter sessions, at 
the end of which the final examination should take place. 
Thus it appears to us a vast improvement in the education 
of the medical student might be effected. He would enter 
the portals of his profession with a good general knowledge 
of the subjects he is about to study. The first years 
would be spent under circumstances in which he would 
obtain the best education on preliminary subjects the 
kingdom can afford, whilst the last two years would be 
spent under conditions in which the great field for clinical 
instruction possessed by the smaller hospitals could be 
E 
