1 64 



SCIENTIFIC NEWS. 



[Aug. 17, 1888. 



could get no one into trouble. And when we come down 

 more than a century and a half to Rabelais, two centuries 

 to Montaigne, three centuries to Moliere and Guy Patin, 

 we find the position still much the same, or rather, in all 

 probability, worse as respects the physician, although 

 surgery and anatomy may have been making some 

 steps in advance. I apprehend that the doctor of medi- 

 cine in the middle of the seventeenth century in France, 

 unless he has been caricatured out of all recognition 

 by Moliere, must have been altogether the most stupid, 

 pompous, brainless formalist that ever in any age of the 

 world practised the art under a learned title. The 

 satirical portrait of Thomas Diafoirus, and the magnificent 

 installation of Aigan in the" Malade Imaginaire," remain 

 for us and for our remotest successors, to show how the art 

 of healing may degenerate under the influence of scholas- 

 ticism, and how base a creature it was at least possible 

 to represent a " physician " as having become in the 

 days of Louis XIV., in the midst of a most brilliant 

 outburst of literature and art, at the very time when 

 Harvey's great discovery was slowly making its way 

 against prejudices derived from the darkest of the middle 

 ages, and the still overpowering authority of Aristotle 

 and of Galen. 



But at this time the Faculty of Medicine in Paris was 

 probably the last retreat of obscurantism in all Europe, 

 at least within the domain of the physician. In Italy, in 

 England, in Switzerland, in Germany, and in the Low 

 Countries, the spirit of observation and experiment was 

 awakening from a long sleep ; and in many departments 

 — anatomy, botany, physiology, surgery — things were 

 moving on apace ; but the physician was almost every- 

 where belated in the race. Even down to the last 

 century, the man of learning (of the type of Linacre and 

 Caius) in the Royal College of Physicians of London 

 greatly predominated over the man of science, as exem- 

 plified in William Harvey ; while Oxford and Cambridge, 

 which alone could open the portals of the College, were 

 absolutely nowhere as schools either of science or of 

 medicine; and neither taught, nor professed to teach, 

 anything but a mostly mediaeval curriculum. And thus 

 it came about, so late even as the year 1815, that the 

 curious anomaly of the "double qualification" obtained 

 a legislative sanction in English medical education. For, 

 while in most European countries, the State and the 

 universities co-operated in arranging and controlling 

 the issue of a single qualifying diploma for the general 

 practitioner, the Royal College of Physicians of Lon- 

 don was still too much the college of a learned 

 caste to allow of their exclusive privileges being 

 shared by any but university graduates ; while the 

 two great English universities were altogether too 

 helpless, as regards the necessary discipline of a medical 

 career, to make it even possible for them to afford the 

 slightest assistance. The Roy?l College of Surgeons, on 

 the other hand, which had for ages concerned itself only 

 with anatomy and surgery, to the exclusion of physic, 

 continued on the even tenour of its way, including in its 

 membership men ignorant of Latin, but instructed as 

 regards fractures, dislocations, and surgical procedures 

 ger.erally; while the Worshipful Company of Apothecaries, 

 cleverly perceiving and taking advantage of the enormous 

 gap which was at once apparent between the technical 

 discipline of the pure surgeon and that required for the 

 all-round practice of the medical profession, marched into 

 a position of legal independence through this gap, and, 

 from being the humble servants of the physician, obtained 



for their licentiates not only the exclusive right to dispense f 

 medicines, but the status of prescribing them also, and 

 thus a perfectly just and well-earned rivalry with the 1 

 physician all over England. 



What I am chiefly concerned to bring under your 

 attention, however, in this connexion is that, according 

 to the historical development, or evolution, of medical 

 education in this country, and especially in England, 

 the physician, in the sense of Natural studiosus, the 

 devotee of (fivois, as aforesaid, stood a very fair chance 

 of being altogether, and finally, suppressed and wiped 

 out of existence. 



From the earliest days of my experience as a teacher 

 it has been customary with me to use expressions and 

 to act in a spirit, of which you may readily judge for 

 yourselves from the following brief paragraph, taken 

 from an address to students of medicine, delivered more 

 than twenty years ago : " The first lesson to be learned 

 in order to make all other lessons possible is, in my 

 opinion, this — to deal very largely with things and not 

 with mere words ; to realise as much as you can all your 

 instruction by making it your own through personal 

 observation ; to suffer nothing, if it can possibly be 

 avoided, to lie in the mind as a dead weight of vocables, 

 oppressing the memory and dwarfing the intellect ; but 

 to bring everything into the living light of fact and of 

 nature, and thereby at once to assure to yourself the 

 truth and exactness of your knowledge, while at the 

 same time you are stamping it down upon the memory 

 by the most sure and lasting of all technical methods." * 



No one can be more ready than I am to admit th?.t 

 there are — nay, that there must be — limitations in the 

 very nature of the case to the too absolute recognition of 

 this ideal. It is said by some that the spirit of modern 

 science is ungenial and hard, even pitiless, and therefore 

 not at all fitted for the ministrations of humanity; that 

 it tends to make the suffering man, the patient (as we call 

 him), into a mere case — -a thing to be observed and noted 

 rather than a man of like passions with ourselves, and 

 therefore to be treated with consideration and sympathy. 

 There may be just a grain of truth in this ; and to what- 

 ever extent it is true, we of this medical school claim to 

 be aware of the fact, and to be ever on our guard against 

 the tendency. But none the less it may be affirmed with 

 entire trulh, and with cumulative evidence if need be, 

 that all the evils inflicted on poor suffering humanity by 

 the physician as scientist have been but a drop in the 

 bucket as compared with those which have sprung from 

 the too slavish adoption of traditions, in which there 

 never was any trace of the se'entific spirit at all. 



I shall venture to anticipate — because I am well assured 

 that anything I can say here will only give expression 

 to what will still more clearly emerge from the forthcoming 

 address in physiology by my esteemed colleague Professor 

 McKendrick — some of the discouragements to which I 

 referred a moment ago, the difficulties we experience in 

 training our students adequately on the lines we have 

 laid down from them. These difficulties are manifold, and 

 they are not of our making, nor are they peculiar to 

 Scotland. I have only time now to refer to two of them. 



The first of these difficulties belongs to the medical 

 curriculum, in which, although chemistry, botany, and 

 natural history have long been with us a necessary part, 

 and, so far as they go, a well-conceived and valuable 

 scientific basis for the more technical part of our teach- 

 ing, nevertheless physics proper— or, as we call it 



* "Medical Education, Character and Conduct," etc., p. 70. 



