I speak in the presence of those who know practically what medical education is; for I may assume that a large proportion of my hearers are more or less advanced students of medicine. I appeal to the most industrious and conscientious among you, to those who are most deeply penetrated with a sense of the extremely serious responsibilities which attach to the calling of a medical practitioner, when I ask whether, out of the four years which you devote to your studies, you ought to spare even so much as an hour for any work which does not tend directly to fit you for your duties?
Consider what that work is. Its foundation is a sound and practical acquaintance with the structure of the human organism, and with the modes and conditions of its action in health. I say a sound and practical acquaintance, to guard against the supposition that my intention is to suggest that you ought all to be minute anatomists and accomplished physiologists. The devotion of your whole four years to anatomy and physiology alone would be totally insufficient to attain that end. What I mean is, the sort of practical, familiar, finger-end knowledge which a watchmaker has of a watch, and which you expect that craftsman, as an honest man, to have, when you intrust a watch, that goes badly, to him. It is a kind of knowledge which is to be acquired, not in the lecture-room, nor in the study, but in the dissecting-room and the laboratory. It is to be had, not by sharing your attention between these and sundry other subjects, but by concentrating your minds, week after week, and month after month, six or seven hours a day, upon all the complexities of organ and function, until each of the greater truths of anatomy and physiology has become an organic part of your minds—until you would know them if you were roused and questioned in the middle of the night, as a man knows the geography of his native place and the daily life of his home. That is the sort of knowledge which, once obtained, is a lifelong possession. Other occupations may fill your minds—it may grow dim, and seem to be forgotten—but there it is, like the inscription on a battered and defaced coin, which comes out when you warm it.
If I had the power to remodel medical education, the first two years of the medical curriculum should be devoted to nothing but such thorough study of anatomy and physiology, with physiological chemistry and physics; the student should then pass a real, practical examination in these subjects; and, having gone through that ordeal satisfactorily, he should be troubled no more with them. His whole mind should then be given, with equal intentness, to therapeutics, in its broadest sense, to practical medicine and to surgery, with instruction in hygiene and in medical jurisprudence; and of these subjects only—surely there are enough of them—should he be required to show a knowledge in his final examination.
I cannot claim any special property in this theory of what the
