154 SECTIONAL ADDRESSES. 



' physiology can only come to the aid of medicine with becoming modesty, 

 and without overweening dogmatism. There is no finality about either, 

 but they can co-operate usefully . . .' and I thoroughly agree with him, 

 not only because I recognise, as a physiologist, that my subject has been 

 nourished largely by the problems of the bedside, but also because I think 

 that modesty is the only attitude compatible with the ignorance of all of 

 us when we view the handiwork of nature however revealed. 



At this point I would like to digress a little to say a few words about 

 the training of medical students in physiology. This has two objects in 

 view, first to equip these students with a grasp of physiology such as will 

 enable them later on to build a proper rational knowledge of medicine 

 and surgery ; second, to encourage them further to advance medical and 

 surgical knowledge, and in special cases physiology itself. With certain 

 reservations, I do not think that these two objects are at all incompatible 

 at the present time. 



A hundred years ago the common portal of entry into the medical 

 profession was by a preliminary apprenticeship, begun at the age of 

 about fourteen, to a doctor or apothecary, as often as not in the country. 

 This lasted for five years, after which it was usual for the student to 

 ' walk the hospitals ' at some great centre, the chief in London being St. 

 Bartholomew's and Guy's Hospitals. Here he could also attend some 

 lectures on anatomy (including physiology), botany, medicine, surgery 

 and midwifery, and there were also courses of dissections. The require- 

 ments of licensing bodies were, however, fragmentary. The College 

 of Physicians had no definite curriculum of professional study before 

 1845. In Scotland physiology was incorporated, as the ' Institutes of 

 Medicine,' with some teaching of general pathology and elementary 

 clinical medicine. 



The medical students of Dickens — for example. Bob Sawyer, who 

 ' eschewed gloves, and looked upon the whole something like a dissipated 

 Robinson Crusoe ' — were caricatures of the students of this period. 



There were few medical students in England outside London a century 

 ago ; Oxford and Cambridge together averaged six medical graduates a 

 year. Edinburgh produced about 100-120. In England it was only the 

 handful of University men who received anything like a preliminary 

 education before entering hospital. 



A notable step was taken in London with the foundation of University 

 College, then called the University of London. In his introductory 

 address at the opening of the University in 1827, Sir Charles Bell said : 

 ' With respect to our students, the defects of their mode of education are 

 acknowledged on all hands. They are at once engaged in medical studies 

 without adequate preparation of the mind ; that is to say, without having 

 acquired the habit of attention to a course of reasoning ; nor are they 

 acquainted with those sciences which are really necessary to prepare for 

 comprehending the elements of their own profession. But in this place 

 this is probably the last time they will be unprepared, for example, for 

 such subjects as we must touch to-day. In future, they will come here 

 to apply the principles they have acquired in other class rooms to a new 

 and more useful science.' 



In the first year 165 students entered the new college, and classes were 



