NATURE 
349 
THURSDAY, SEPTEMBER 1, 1870 
THE MEDICAL SCHOOLS OF ENGLAND 
AND GERMANY 
re 
N the region of scientific medicine the Germans enjoy 
at the present time an undisputed pre-eminence. 
Their medical books have taken possession of the markets 
of the world, and their larger schools are themselves like 
markets in which representatives of all countries appear, 
in order to exchange gold for the higher culture. Next 
to German books, those published in Great Britain have 
the best programme and apparently the widest geo- 
graphical distribution. But here the enormous territory 
of the English language plays a very prominent part. 
To professional men who do not speak the English 
tongue, English books are but little known and still less 
read. In like manner, the extent to which foreigners avail 
themselves of the English schools is exceedingly small. 
It is very significant that even Americans pass by their 
natural market, England namely, for the acquisition of 
higher medical education, and resort annually in troops to 
Germany, where they have to contend with the disadvan- 
tage of a foreign language. 
If we now attempt to ascertain the causes of this phe- 
nomenon, we must arrive at once at the conclusion that 
local conditions have nothing to do with it. Great Britain 
can number nearly as many medical schools as exist 
in Germany, and their local position is extremely favour- 
able for visits from foreigners. In this respect the larger 
cities enjoy an enormous advantage over smaller towns, for 
medical students do not, as a rule, despise good living, and 
therefore prefer to live in great cities. Hence the medical 
schools of Vienna and Berlin are rendezvous for travelling 
physicians, while many a small German town with no 
less distinguished a teaching power, is visited only by 
those |foreigners who prefer to taste the treasures of a 
teacher drop by drop, far from the battle of the metro- 
polis. London alone possesses eleven medical schools. 
Here are also offered to the travelling disciple of science 
the advantages of the metropolis, and something besides 
which can only be obtained on the Continent by an ex- 
penditure of time and money, and then not altogether, 
the opportunity, namely, of changing the school, and 
especially of discovering the one which it will best answer 
his purpose to visit. 
If, in spite of all this, the schools of London form no 
open market, the cause must be sought for in their quality. 
It.does not, in fact, require much criticism to discover 
that the construction of the medical schools here is so 
entirely different from that of the corresponding schools 
in Germany, that the defectiveness of our language is 
the only excuse for designating the two by the same 
name. In the majority of the medical schools of London 
instruction is only a subsidiary product of the general 
charity. The hospitals are supported by Voluntary con- 
tributions, and at one and the same time medical assis- 
tance is given to the sick and medical instruction to 
youths eager for knowledge. The subscribers elect officers 
for this purpose ; and both the electors and the elected 
are agreed in considering the treatment of the sick as the 
VOL, IT. 
primary office, instruction as a secondary office. Pro- 
fessional men on the Continent are obliged to bear this 
relationship constantly in mind, if they would understand 
how it comes to pass that a nation of such sound judg- 
ment in practical life as the English, can act in a manner 
which, to those who look at such hospitals from the 
stand-point of the development of science, appears so 
opposed to every modern theory of work. 
In these hospitals, founded and supported by voluntary 
contributions, the teachers, in the course of their lives, 
change several times the subject of their lectures. The 
teacher generally begins with botany, and abandons it 
after he has acquired a moderate knowledge by several 
years’ instruction, in order to take up another important 
branch of human -knowledge ; and perhaps again ex- 
changes this for something else, just at the time when 
he can say with Faust :— 
Und sehe dass wir nichts wissen konnen. 
The final object of such a course is the position of hos- 
pital physician or surgeon, with which, as a rule, a profit- 
able practice is also combined. The hospitals attain in 
this manner the best result which they can attain. They 
obtain physicians who for several years have given their 
attention more or less assiduously to reading scientific 
literature. In so far as these physicians are at the same 
time in a wider sense useful to the community, this sys- 
tem performs good service in educating a large number of 
well-read medical men. For the development of these offi- 
cers into distinguished original investigators, the mosaic- 
work of their course of study is altogether destructive. 
From the haste with which they rush through great de- 
partments of knowledge, they can give no time or leisure 
to assist in drawing up the endless chain of causes to the 
light of day. Such an undertaking, moreover, is entirely 
outside the aim for which the charitable contributions 
were given. 
Among the numerous London schools, some three or four 
stand out conspicuously, and one of these is so constituted, 
from its connection with other non-medical chairs, as well 
as from the history of its establishment, that one may con- 
clude the fostering of science is not in this case a secondary 
aim. Let us observe now what assistance is afforded by this 
school for this purpose ; and let us compare these means 
with those provided by a great German school, for in- 
stance, that of Vienna. The writer of this article has 
chosen this example, chiefly because he is familiar with 
the interior arrangements of the Vienna school. The con- 
sideration also that this is the oldest of the prominent 
German schools, and that its eventful history can exhibit 
many points of interest which stand prominently forward, 
has its influence. Other examples might be brought for- 
ward which would equally illustrate the contrast. 
It must, in the first place, be borne in mind that the 
London school just referred to, that of University Col- 
lege, is, like all her sisters, a private institution, while 
the Vienna Medical School is a State institution; the 
Government builds or rents the building, directs it, and 
provides it with officers. The means for this object flow 
trom the provisions of the budget of the Ministry for 
Public Instruction; and the Government therefore pos- 
sesses the power of granting the means of diminishing or 
enlarging them according to circumstances. Since many 
German schools, which are still State institutions, 
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