NATURE 



217 



THURSDAY, JULY 18, 1872 



MEDICAL EDUCATION 



A THOUGHTFUL address on "Medical Education 

 in America," read by Dr. Bigelow to the Massa- 

 chusetts Medical Society, has just been published in the 

 form of a pamphlet. It discusses the important subject 

 of the kind and degree of instruction in collateral sciences 

 that should be given to the student of medicine during 

 th; short period of four years now at his disposal, and in 

 the course of which he is supposed to have acquired the 

 knowledge that will enable him to practise with advan- 

 tage, or at least let us say with safety, to his patients, and 

 with credit to himself. The question is of a very com- 

 plex nature, and its difficulties can, perhaps, only be pro- 

 perly appreciated by those who have themselves been 

 teachers, and who are not, therefore, likely to be led away 

 by Utopian ideas of the amount of information that can 

 be acquired by a man of ordinary abilities in this space 

 ot time even under favourable circumstances. It is very 

 easy to say Educate to the highest point possible ; let the 

 student knoiv something, at least, of Chemistry, of Botany, 

 of Comparative Anatomy, of the origin, composition, and 

 mode of manufacture of the drugs he uses ; but the fact is 

 overlooked that almost all he learns of these subjects is 

 quickly cast aside when he begins to practise, because he 

 finds that it is of no earthly use to him, and he regrets 

 when too late the time he has spent in acquiring them, 

 because it has led him to neglect the far more important 

 matters of Pathological Anatomy, and the actual prac- 

 tice of Medicine and Surgery. "The Medical Student," 

 Dr. Bigelow observes, " does not need]to pick herbs from 

 the field, or treat horses and dogs, or consider his paralle- 

 logram of forces before putting in a dislocated shoulder ; 

 but he does need to know how to recognise and exactly 

 how to reduce a dislocated shoulder, how to recognise and 

 treat human disease, and what are the medical properties of 

 the drug which the farmer has grown, or the merchant 

 imported for the apothecary. This is but a fair division 

 of labour. He has enough to occupy him profitably and 

 exclusively in his own immediate field of study, without 

 wandering over the whole domain of knowledge — at least, 

 at the mistaken behest of those who have a confused notion 

 of a liberal education and large culture." " There is a 

 fallacy in the idea of culture. Talent and power of appli- 

 cation may, indeed, incidentally lead a man to eminence 

 in several directions. But a cultivated, a hterary, or even 

 a scientific man is not necessarily the best physician." 

 At the same time Dr. Bigelow concedes that there should 

 be a certain latitude in the study of medical science on 

 the ground that " no student or artisan is the worse for 

 an outlook upon kindred arts and sciences which will 

 help him to establish the true relations of his own, 

 which will supply him with additional facilities and light 

 for its pursuit, and with that training of his intellectual 

 powers afforded by a systematic variation in their exer- 

 cise." It must be remembered that all the sciences col- 

 lateral to medicine have undergone extraordinary deve- 

 lopment during the past few years ; and that to acquire 

 a very moderate knowledge of chemistry, for example — 

 such knowledge as would enable the student to analyse 



VOL. VI. 



a single animal fluid, or even a fragment of a calculus — 

 would be the undivided work of a year, and when accom- 

 plished he would scarcely be one step in advance of the 

 man who had learnt a few rules of general application to 

 the diagnosis of disease taught by an accomplished 

 chemist. 



Whilst agreeing with the general views expressed by 

 Dr. Bigelow upon the education of the medical student as 

 he now presents himself at the Hospital Schools at the 

 age of eighteen or nineteen, it yet appears to us that the 

 quality of the raw material, if we may call him so, might 

 be immensely improved by the general adoption of a well- 

 directed scheme of preliminary education. " One of the 

 enormous follies of the enormously foolish education of 

 England," said Sydney Smith, " is that all young men, 

 dukes, fox-hunters, and merchants, are educated as if they 

 were to keep a school or serve a curacy." Just so ; and it 

 is precisely in this respect that the education of the medical 

 student of this country requires revision and improve- 

 ment. The medical profession is not essentially a literary 

 one. What is really required is a seeing eye and an un- 

 derstanding heart ; the faculty of correct observation on 

 the one hand, and on the other the ability to single out 

 what is important amidst a multitude of unimportant 

 particulars — in a ward, judgment ; and as this is 

 capable of being immensely improved by exercise, it 

 should surely be the point to which the education of the 

 student should be directed. Bat, as a matter of fact, no 

 line of education can be better adapted for the purpose 

 in view than that of the medical student of the present 

 day. From the beginning to the end it is or might be 

 made a " questioning of nature." The grand defect of 

 the system is that insufficient time is at the disposal of 

 the student to master the details. He learns a little of 

 many things ; nothing well, unless it be his anatomy ; 

 but the advantage a knowledge of all would give him may 

 be estimated in some remote degree by the value that 

 teachers and students alike set upon this single acquisi- 

 tion. Seven years are not thought too long to make a 

 master workman in any of the humblest trades ; and yet 

 the student is expected to acquire a fair knowledge of all 

 the branches of a very wide, difficult, and profound intel- 

 lectual pursuit in four short years, or if we read Dr. 

 Bigelow aright, in three years in America. It is here we 

 think, then, that some alteration is requisite. A boy who 

 is going to enter the medical profession should be early 

 set apart for that ministry. We are bold to say that a 

 boy of fifteen knows or ought to know enough of Latin, 

 Greek, and Arithmetic for any subsequent use he is likely 

 to make of them. At this age he should be called upon to 

 select what his future career shall be, and his education 

 should be directed accordingly. From the inquiries of the 

 Committee of Convocation of the University of London, 

 d. propos of the proposal for rendering the examination in 

 Greek optional at Matriculation, it appears that there are 

 several large schools of good repute in this country, as those 

 of Cheltenham, Clifton, Haileybury, Marlborough,and Wel- 

 lington, in which a " modem side " has been established, 

 where attention is chiefly directed to the cultivation of 

 mathematics and modern languages, Latin and Greek 

 being considered as subsidiary branches of knowledge, 

 or even completely omitted, as in the case of Greek at 

 Cheltenham College. 



