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Remarks on some proposed alterations in the course of medical education at the University of Edinburgh

REMARKS

ON SOME

PROPOSED ALTERATIONS IN THE COURSE OF MEDICAL EDUCATION

AT THE

UNIVERSITY OF EDINBURGH.

BY A

GRADUATE OF THE OLD SCHOOL.


EDINBURGH:
MACLACHLAN & STEWART, EDINBURGH; AND
SIMPKIN & MARSHALL, LONDON.
MDCCCXXX.


NEILL & CO. PRINTERS.

REMARKS, &c.



The spirit of innovation and reform has assailed the penetralia of our Scottish Universities, and the period may not be far distant, when these useful and popular institutions will furnish a splendid Auto-da-fe to illuminate the pageantry of learned and liberal legislators. Many an oration is pronounced lamenting the defectiveness or degeneracy of our indigenous systems of University education; and invoking, with dignified pomp and melting pathos, applause and imitation of continental systems. The decrees of Milan and Berlin were not more rigorous and exclusive, than those which some erudite Napoleons are wishing to enact, for the leading-strings of our Faculties.

The public seem to take comparatively little interest in the question, apparently considering it as one merely professional, and as best understood by the Faculties to which it respectively applies; and may passively allow the rash hands of speculative innovators to level the venerable fabrics of our Almae Matres.

It may be well, therefore, to expend a few moments in investigating the nature of those abuses which are assumed to exist, and to contemplate the consequences of the remedies by which it is proposed to remove them;—perhaps it may be found, that, as in some other points of certain professional practice, the indications of cure are accurately defined, while the nature of the disease is purely conjectural.

It would, of course, be unfair to impute personal or selfish bias to these innovators—to insinuate that some of them, having perhaps little interest in upholding existing establishments, or possibly the contrary, may be disposed to abet academical change and revolution—that others, having passed the ordeal of graduation, reposing on the velvet of comfortable practice, and enjoying a liferent lease of high places, may be desirous to diminish the facilities of future rivals, and anticipate a wealthy and sinecure old age, unruffled by collision with numerous, energetic, and able competitors—and that, hence, they insist on multiplying the penances of candidates for academical honours, roughening the sackcloth of professional study, of igniting the ploughshares of philosophical ordeal, and of developing the bump of language by a long probationary listening to harangues on the omnipotent powers of logic, the simple principles of metaphysics, and the sublime mysteries of philology. Nor would it be less unfair to whisper, that a Holy Alliance may be on the eve of commencing a crusade against the freedom of our Faculties, and of suffocating genius by the weight and lumber of its folios. No; we most sincerely and distinctly mean nothing that is personal. It is not to individuals, but to opinions, that we are hostile; and while we concede to our opponents, in the most ample degree, purity of intention, we claim from them the same fairness and liberality in judging of us.

The subject embraces a wide field of interesting and momentous inquiry, but that department of it to which we shall at present confine our attention, is the System of Medical Education at the College of Edinburgh. The question that ought to be discussed here is simply—What course of study is best adapted to form the best medical practitioner, and what are the most eligible and efficient means of ascertaining that he has made a proper use of his opportunities of education, before he be entrusted with the officinal talisman of a diploma?

By many individuals it is broadly asserted, that the present system of this University is totally inadequate for these purposes; and, on this gratuitous assumption, they immediately commence, with prodigal liberality, framing projets de loi of radical reform. Before, however, gliding by this royal railroad to such a conclusion, it might have been more logical to have demonstrated their premises; to have shewn clearly that the existing system was, both in theory and practice, erroneous and defective, and that the majority of medical practitioners educated under it were ignorant of their profession. But, at this stage of the case, we shall, for brevity's sake, wave the consideration of these hypothetical premises, and throw together some remarks on the nature of their conclusions and innovations.

In legislating for the course of education to be pursued by individuals aspiring to become practitioners in any of the Faculties, one would naturally anticipate that the primary attention would be directed to those branches of knowledge essentially connected with each, those which form its distinguishing badge, and especially constitute it as a distinct profession. But, will it be believed, hardly any such thing is hinted at? The burden of the song is to introduce laws into the College, obliging every candidate for a medical degree to go through a course of study of Arts, Literature and Science, without condescending to shew in what manner this is essential to forming a sound intelligent practitioner of medicine, and without venturing to undertake the proof of a deficiency in general knowledge amongst the physicians of the present day. Now, it is the compulsory nature of this course of study, and its trifling and remote utility, or rather its utter worthlessness, in relation to judicious and useful medical practice, that are the points on which we are mainly at variance with these reformers.

Most of the advocates for changing our present systems, or for assimilating them to those of the Continent, seem to have imbibed Utopian ideas of university legislation, and to have been led away by the visionary fallacy of legislating for men as they ought to be, not as experience proves they are. They have realized to themselves the beau-ideal of what an accomplished physician ought to be; and the regulations which they are endeavouring to introduce are accommodated to this abstraction. Now, nothing is more easy than to conjure up phantasms of this description, and to frame codes of laws for giving them theoretically "a local habitation and a name;" but to bring them down from the limbo of vanity, and apply them to real life, we find it, constituted as human nature is, to be impracticable. We may, in a speculative perfectibility mood, indulge our imaginations in conceiving what the accomplished Merchant, for instance, ought to be. We may invest him with all that is brilliant in theory and invention, all that is profound in philosophy, and all that is felicitous in practice and experience. We may decorate him with every intellectual, moral, and physical excellence, and all in harmonious novel keeping—all devoutly to be wished for, no doubt. But when, alas! is it our lot to see these commercial Grandisons realized, or how should we ever expect to frame laws to form them? In like manner, we may fancy a completely accomplished character adorning the Physician, Jurist, or Divine; but although sporadic instances of this may possibly occur, undoubtedly no general set of rules will fashion it. To be adepts in a profession, and at the same time well skilled in every branch of literature and science, presuppose a reach, a power, and a versatility, of intellect, that have hardly ever yet been exhibited, and which, independently of its being based on prodigious natural genius, it would require a lifetime of toilsome industry to perfect; at any rate, such cases must be considered as exceptions, and laws must be made for what is general. We must look long, I am afraid, even after the Utopian system has been in full operation, for such "admirable Crichtons" to arise; and I question much if that illustrious individual (whose name this genus of intellectual prodigies may be expected to assume) would now, in these latter days, be able to support his reputation, when to the attainments of his age he had to super-add the enormous stores of knowledge that have been accumulated since lie triumphantly disputed with the Doctors of the Sorbonne. The ignis fatuus by which our opponents appear to be led astray, consists in not separating and distinguishing between those branches of information which are essential to each separate profession, and general knowledge. That alone which is essential in each profession is that which should constitute the ground of his admission or rejection, when an individual stands candidate for its academical honours. A physician, as well as other men, is doubtless all the better for possessing general knowledge; so would he be perhaps all the better for being a good painter, or musician, or dancer: in fact, dancing and Chesterfieldian graces may be directly and eminently useful, inasmuch as we know that many an able and excellent physician has failed to have his merit popularly and extensively drawn forth for want of them. Yet, as Lord Chesterfield failed in his endeavours to stamp on the object of his solicitude the "homme poli," so will these contemplated regulations fail in making physicians Porsons or Newtons. Does it not comport with the dictates of common sense, and with the conviction of every man of experience and sagacity, that there are innumerable individuals of great figure and talent in their respective professions, who yet have a natural or early acquired inaptitude, and an invincible repugnance, to certain other branches of knowledge; for instance to languages and mathematics? Yet, would any man in the possession of sanity dream that any competent surgeon could not take up an artery, cut off a limb, or reduce a dislocation, and teach others to do so, without knowing the Alpha and Omega of the Greek? Do our innovators fancy that the doctrines of the Greek verbs, and the subtleties of the Greek prepositions, or that the complexities of the Aristotelian philosophy, are necessary to the elucidation and advancement even of Physiology a fortiori of the tactus or visits eruditus of the practitioner? Do they imagine that Belles Lettres and Euclid unravelled the difficulties which opposed themselves to John Hunter, or called into existence the beneficent boon of the illustrious Jenner? Do they suppose that Gregory, acute and elegant scholar as he was, tortured his brain with literary enigmas, when he was distinguishing and prescribing for incipient phthisis? Ask a patient racked with the agony of ischuria, whether he will select for his relief a discourse held in Greek on the unities, and on the stoical sophism of pain and pleasure, or will he prefer the skilful introduction of the catheter? Ask another, burning in the furnace of syphilis, whether he will choose a luminous exposition of the Solar System, and a profound disquisition on the laws of matter, rather than the resources of mercury and sarsaparilla? Will it not be granted, that any one profession demands all the energy and talent that one man can be supposed to possess, to confer a just and permanent, not a tinsel and temporary, title to excellence in it? Ask any respectable physician, even in ordinary practice, how much time he can spare for keeping pace with the progress of medical science, and for contributing to its advancement? Ask any Professor how much leisure he can afford, from the faithful and conscientious discharge of his duty in his own individual sphere? And is it considered disgraceful or disqualifying in them, not to be competently acquainted with every branch of literature and science? Why, then, should it be considered so in a candidate for graduation? Yet all this is imperiously demanded of the graduate. Tyro is required to be infinitely more wise and learned than Philo: these scavant revolutionists would have him to be nothing short of a very conjuror—a Dr Faustus—a Peripatetic Encyclopædia.

If the possession of this universal knowledge is considered essential, before passing under the yoke of a diploma, the same reason in a higher degree holds for retaining it afterwards, or it degenerates into a display of pernicious and deceptive pedantry: but is it not found that many even of the professional preparations for graduation are necessarily laid aside, after the degree has been conferred? Much more must those be abandoned which have no connexion whatever with the discharge of professional duty. These are not calculated to maintain themselves, as strictly professional attainments are, in order to preserve an honest title to the confidence of patients. If they are good for any thing, then some provision should be devised for keeping them during the period of the natural life of the graduate fresh in his recollection. For this purpose, I would beg leave to suggest an annual or triennial examination of all the physicians in the empire; and, in composing rules for its proceedings, many useful hints might be gathered from the economy of similar institutions,—such as the Wesleyan Conferences, and the periodical assemblages of Friends.

These irrelevant attainments must therefore rank, in as far as medicine is concerned, with the boarding-school accomplishments of dancing, music, and the French language, which every Missy is compelled to attempt before marriage, and which she almost as regularly forsakes after it.

It seems to be forgotten, that while, in every other department of knowledge and inquiry, of science and art, the principle of division of labour is duly appreciated and applied, in the business of professional education it is to be most strenuously denounced; the object seems to be, not to make good physicians, but jacks-of-all-trades, and speculative pedants. While the practice of medicine is so vast and extensive a field, that it has been found necessary to subdivide it amongst physicians, surgeons, accoucheurs, apothecaries, oculists, aurists, dentists, men for the gout and men for the gravel, one for the belly and another for the brain, these reformers seem to regard medical knowledge and medical practice as in a nutshell,—as already perfect and complete. Medicine with them is no longer ars conjecturalis,—its facts are all discovered, and its principles laid down; all that remains to be done is to polish and adorn its high priests by philosophy and the belles lettres, by criticism and by Greek.

A serious objection to compulsorily superadding to the acquisition of medical science a long catalogue of miscellaneous general and extraneous studies, appears entirely to be overlooked. By directing a candidate’s mind to these branches as essential to graduation, he must devote equal attention to them as to those strictly professional. When he commences practice, he either cherishes or forsakes them; if the former, he exercises his intellect on subjects of a speculative, as opposed to those of a practical nature; and he calls into action, and cultivates a class of faculties and habits of thought, very different from those most useful and efficient in medical practice. If, on the other hand, he abandon them, then, to say the least, his labour has been vain and unprofitable.

If the proposed regulations are carried into effect, one result is immediate and apparent,—the course of probationary study must be greatly prolonged, and the number of lectures to be attended increased. The gates of physic, in these remodelled universities, must be closed against the great bulk of the population; and a heavy purse and early age must be the prerequisite possessions of every aspirant to medical honours. What must be the effect of this? Either medicine must be deprived of a large proportion of the talent which otherwise would be attracted to it, or a great number of our youth destined to its profession will migrate to foreign schools, not for the sake of adding letters to their names, but skill to their practice: they will temporarily expatriate themselves for the sake of enjoying the advantages which these Universities possess in economy,—in their anatomical and surgical facilities,—in their greater opportunities of access to libraries, to museums, to hospitals, and to practice. These are the real causes of the celebrity of these schools, and not their appendages of A.M., S.B.[1], &c. &c., and these are the points in which, as far as we can, we should do well to imitate them. Then must our worthy and injured Professors expect to look with unavailing regret at empty benches, and learned graduates be assured to meet with energetic and triumphant, though untitled, rivals in practice; and let them reflect whether the power of wailing out their lamentations in pure Attic, and with the rigor of the higher geometry, will tend to administer consolation.

Another consequence is, that a number of unchartered Universities will arise; a much greater latitude and importance will be attached to the system of private lecturers; and, while individuals can gain from them every essential of their profession, they will give themselves little trouble about what may then be termed the musty pedantry of scholastic titles; the signatures of lecturers of ability will, in point of fact, be as valid a passport to respect and practice, as the most massive signet of the College; and the sentence of the public is, after all, that of the highest tribunal.

The enactment of these rules, moreover, will imply an imputation on all the former, and all the existing non-conformist Professors, who, either not having sense to appreciate, or not willing to employ, this panacea,—this recipe for compounding a physician, left its merit to be unfolded and taken advantage of by the sapient reformers of the present day. They, good worthy simpletons! (forgive me, oh Patres Conscripti!) the Blacks, the Monros, the Cullens, the Gregories, and the host of other Professors, whom we doubtless in our folly believe to have enlarged so much the boundaries of our knowledge, and exalted their school to the high rank which it has so long occupied, were only demonstrating, it now appears, their ignorance and illiberality, when they annually and authoritatively maintained, that a candidate found to be duly acquainted with anatomy, chemistry, physiology, materia medica, practice of medicine, &c. &c. was qualified to practise medicine. If these new regulations are essential to medical practice, then have these illustrious professors been yearly deluging the kingdom with incompetent physicians, and, what is perhaps a more serious fault in the estimation of some individuals, have been palming upon the public M. D. clowns, men who, ex officio et cathedra, were not ascertained to be competent to dance gracefully a quadrille, hand a lady of quality to her carriage, and quibble away with a blue stocking on the eloquence of Demosthenes and the powers of the steam-engine. Although it may be questioned, whether, in a large proportion of genteel (nervous) diseases, the honest bluntness of a Radcliffe might not be more effectual than the greasy smoothness of some courtly Hippocrates. But even admitting that graduate dunces and clowns occasionally occur, because such excrescences are sometimes thrown forth on the surface of a vigorous and healthy system, is that whole system to be broken down? is a merely local-accidental cutaneous affection, not implicating the general health, to demand a destructive mercurial course, sapping the foundations, and demolishing the fabric of the constitution? I hope, for the safety of the lieges, that these reformers, if they are of the medical profession, reason and practise more logically and soundly in real than in metaphorical pathology. To expect that any system of regulations is, in every case, to exclude fools and clowns, is to expect an institution to be perfect, and this expectation is itself synonymous with folly. Such lusus naturæ will find their way into every profession, but they will also find their level, and will mope away their time in that obscurity and practical solitude, to which their indolence or incapacity has justly condemned them; and even some pert, prattling, prancing, parsing, precocious graduate of the new system may be found wofully at fault, when, in actual practice, and in contrast with less scholastic and assuming rivals, the awful responsibility of a human life comes to devolve on the promptitude and sagacity of his diagnostics and decision.

On the abstract question of the different excellencies and defects of any particular system of education, much of course may be said on both sides, and the dispute, as happens in most theoretical controversies, may terminate further from the goal of agreement than when it commenced; but, so long as these discussions are matters of mere abstract opinion, it is of little consequence how they are conducted or ended. When plans, however, are attempted to be executed, which would altogether subvert the genius and constitution of a College of the first respectability and eminence, some very serious practical evil and inherent vice in it to be removed, or some obvious and important good to be obtained, ought of necessity to be demonstrated. The question might be brought, in the present instance, to issue at once, by the simple and undeniable position, that physicians educated at Edinburgh are fully equal in every respect to those of any other school, and the plain inference from this would seem to be, that their opportunities of education, and their use of them, are also equal.

No imaginable limits can be assigned to these speculative innovations, if once the simple principle be departed from, of confining the education and examination of a candidate for a degree, within its own distinct and proper province; and constitutions of education will become as rife, and the art of concocting them as notorious, as the political constitutions of the French Jacobins. By-and-by it will be maintained, that medical gentlemen, in addition to this general knowledge, must be well skilled in other professions; in jurisprudence, for instance, it will be said that they cannot acquit themselves, in courts of justice, like scholars and gentlemen, without being juris-consults, even after having mastered all the respectable writers on Forensic Medicine. Nor will the catalogue of languages stop with Greek: it will perhaps be necessary to read the works of certain physicians in Arabic. In a little while, possibly, the graduate will be required to parse a Paternoster in Sclavonic; and oh! what hidden stores of mind may be slumbering under the manacles of Sanscrit? What a sealed book is Chinese Medicine to European Doctors! The Coptic may be speedily introduced, unless a little delay can be obtained from the circumstances of Dr Young’s death, and Champollion still burrowing among the pyramids; at length the darkness of Babel will be rendered visible, and the career of the Medecin assimilated to that of the Mandarin. Not to speak of Religion, for that, it is presumed, some innovators may consider as a vulgar and pitiful accomplishment, whatever others may think to the contrary, who, in this age of academical refinement and innovation, may choose to enter the field, and entertain the public with their propositions; such as, for example, that no physician be passed without possessing an unblemished moral character, and producing proofs and testimonials of sound orthodox theological knowledge. Indeed, when we call to mind the necessarily unguarded and unsuspecting intercourse and domestic privacy into which the medical attendant must, in many instances, be admitted,—the distressing scenes of dangerous disease,—of deathbeds,—of mental alienation,—in which he is imperatively called on to invoke the resources of mental and moral discipline, and of religious firmness and consolation; and, in situations where no clergyman may be at hand, may be competent, or, what is worse, may be inclined to assist, we shall perceive some practical good, different from that of axioms and propositions, in superadding the ghostly attributes of the divine, to the catholicons and recipes of the physician.

If these changes are effected, then every physician who has received his diploma previous to their completion, must either perfect himself in these supplementary branches of knowledge, or he must rank, if not de facto, at least de jure, as a member of an inferior class of practitioners, and degenerate into a simple "Officier de Santé." All those, therefore, who have not the good fortune to possess the talismanic initials of A. M., S. B. must just make up their minds to study over again. What a beautiful and picturesque view would be afforded by a group of these venerable Eleves, hobbling and skipping across a College court to overtake the lecture hour of some "hoch edel gebohrner hoch gelehrter herr Doctor, A. M., S. B.," lately imported with Holstein horses and Hainault scythes! What a robust nimble scramble there would be among the "lads" for a favourite seat, where the dorsal and lumbar muscles might receive adequate support, where a sufficient supply of artificial caloric might be furnished for the wants of the cutaneous circulation, and where the demands would not be urgent on the auditory and optic nerves? What havoc these veterans would work amongst lamps and shop windows! What rows among the guardians of the night! What ruthless pelting of snowballs! What revelry and romping! Then comes the interesting sequela of the distribution of prizes,—gold-headed canes and silver snuff-boxes,—ear-trumpets and eye-glasses,—chamois waist-coats, caoutchouc cloaks, and cork soles! How degraded do the names of the old physicians appear, who had not the academical honours to boast of A. M., S. B.! How much more illustrious would that master of Medicine, though not of Arts, Celsus, have been, could he have been termed "Dr Celsus, A. M., S. B.!"

The period which our innovators have selected for arraigning existing systems, is peculiarly unhappy,—a period remarkable in the annals of British medicine, when the public is delighted with the ingenuity and originality of thought and elegance of diction of medical works. Let us contrast these with our medical literature forty or fifty years ago, in which there was no lack of Greek quotations and mathematics, and we shall at once be satisfied of our superiority. Look at the flourishing state of the College,—at the number of its students, greater than that of any other University in the world,—at its high reputation in other countries (though a prophet has little honour in his own),—at the circumstance of its being frequented by students from every quarter of the globe, even from those countries which boast the possession of the exclusive system,—and say, Whether it is prudent to tamper with the economy of such a school? Some men do not know when they are well; and, like the dog in the fable crossing the river, lose the substance when grasping at the shadow.

Assuming that these new laws were in operation, is there any security that they will be better enforced than those more simple and less numerous regulations already in existence? If dunces in medicine pass through the porch of graduation as it is, will they not continue to do so? Is it not perfectly easy also to believe that an individual may pass even with eclat, who may yet totally want that sound sense, and patient observation, and sagacity, which are essential to his success in practice? And how can the Examinators help this? Has any gauge—any hydrometric bead—any goniometer—been invented, by which they can unerringly ascertain the legitimate strength and purity of the spirit,—the angles and cleavage of the faculties. And must not, after all, much be left to the discretion of the Examinators, and, by increasing their number, do we not increase the sphere of favouritism and caprice? May not an intelligent and kind-hearted Professor be disposed to pass a candidate well skilled in his profession, but indifferently so in the commune vinculum, while some cavilling, malicious, pedantic petit-maitre colleague may delight in rejecting him, and thus kindle "wars and rumours of wars" within the sacred vestibule of physic, and at length reduce the analysis of merit (as occurs in certain other move numerous assemblies) to the profound method of the nasal calculus?

Have our reformers produced any satisfactory evidence of defect in the existing course of medical education, or in the examinations at the close of it? Do they wish, by adding literature and science to this course, to convert their proteges into more finished pedants, or more accomplished gentlemen? Is it absolutely essential to the character of a gentleman to be a proficient in Art and Science? Are not men found without any knowledge of Greek and Geometry, whom yet every one that can appreciate them, proclaims at once to be gentlemen? What becomes of the adage, that "nature and society must make the gentleman?" If gentlemanly attributes are now, for the first time, to be an essential condition in obtaining a medical degree, then must there be created a Beau Nash Examinator,—then must there be a Gentleman Professorship, and whether this is to be a Regius or a Town Council Professorship—whether this original and interesting branch of education is to be considered as a Science or an Art, will constitute one of the most knotty points for discussion with which our adversaries can occupy themselves. But if this is to be the tribunal which stamps men to be Gentlemen, then must other men, as well as physicians, place themselves under its control, or submit to the imputation of not being Gentlemen; though, indeed, I should not much envy the situation of Professor Nash, when he was announcing to a pupil of Professor Mars, that he was not a gentleman!

What is the object of all this hollowing about gentlemen and polite learning? Is it, that genteel learned physicians are so scarce, or that a patent has been found for forming them? Is it presumed that every graduate who shall pass, bound round with this commune vinculum, these stays of the Sciences, and stampt with the signet of the drawing-room, will be more successful than all the physicians of the old regime, or will supplant them in the confidence and respect of their royal, noble, and gentlemanly patients? And then, what is to become of plebeian practice? Oh! that may be left to the old Doctors, now sunk to the rank of Officiers de Santé!

What is it to us that Continental Universities are hermetically sealed against all who are not A. M., S. B.? Is Britain now to follow in the wake of those she has been accustomed to lead in the business of useful and enlightened education? Because they choose to have their corporation and exclusive laws,—their royal tribunals,—their A. M., S. B.—and all the other monastic mummeries of their College Jesuitism,—therefore, forsooth, we must have them, or something like them. Where are the departments of medicine to which we have not contributed our full share, as compared with them? Contrast the medical practitioners and press of Great Britain with those of any other country, and in what will they shrink from the comparison? Where is the evidence of a lack of medical industry and talent,—of gentlemanlike accomplishment,—of elegant and useful knowledge? What, then, is the use of all this hue and cry about Homer and Aristotle,—Euclid and Euler,—Wedgewood and Watt? Austria, too, that patroness of all that is liberal and enlightened,—all that facilitates the march of mind,—all that can disentangle it from the slavish trammels of ignorant authority,—exhibits, as might be expected, an "exquisite" form of this restrictive system; and to know that this Minerva of nations practises and patronizes any thing, is, of course, an amply sufficient reason for us enthusiastically to adopt it. She has taken her Medical Faculty, as she has all other Faculties in her empire, under the wings of her tender motherly protection; and, in the plenitude of her power, the sublimity of her wisdom, and the exuberance of her beneficence, has determined that none but Greek scholars, profound geometers, and accomplished gentlemen, shall prescribe even a cathartic for a Bohemian serf, or an Italian cook, tortured with the pains and penalties of repletion. No doubt all this may do very well for those countries where the medical profession is under the especial patronage and protection of the state, and we wish them joy of their prohibitions and monopolies; but away with the experiments of constitution-mongers on our Universities, until they prove in what we require reform, and the fitness and adequacy of their means of effecting it. If they are so unpatriotically and parracidically partial to every thing exotic, let them turn their eyes to America, and look at the flourishing and active Colleges in the United States, where, it cannot be denied, Medicine is cultivated both with ardour and success; how little do we find that sagacious and intelligent people clogging themselves with the chlorotic fastidious fantasies of A. M., S. B., and the rest of the long dire catalogue of the University Neuroses.

These plans seem as if they originated in the myopic view of some mere citizen, accustomed only to the bickerings and skirmishings of duxes and monitors of seminaries and establishments for some gilt-book prize, or some bursary or mortification. They look like the suggestions of men whose brains are so crammed with the imagery of satchels and ushers, of problems and prepositions, so accustomed to see around them every facility for construing acquisition, that their intellectual vision cannot extend itself to other districts of the empire, where minds may be forming that are one day to shed lustre and renown on the art of healing, but who, from the want of classical schools, and from pecuniary inability to pension tutors, are denied the opportunity of "making nonsense verses in Greek to improve themselves in prosody." Does the scholastic notion still prevail, that we can have no idea of the doctrines of mind but in the poetical hallucinations of Plato,—that we can look for Natural History and Physics only in the pages of Pliny and Aristotle,—that we can have no examples of eloquence, patriotism, or courage, but in the Grecian and Roman models. Is it impossible that a modern historian could have arisen if Tacitus and Livy, Herodotus and Thucydides had not existed? Could there have been no military commanders without the Alexanders and Caesars for their prototypes? And then, is it impossible for an Englishman to write his mother tongue, without having dived into the tangled depths of Greek philology? Can he not think and speak in it, without ever having troubled himself with its various revolutions? Who cares not whether this word is borrowed from the Greek or that from the Teutonic? Who has never heard of the Hermes of Harris—the gigantic and laborious ingenuities of Adelung and Jones, and who hardly ever reflects on the connexion of the philosophy of language with the science of thought? But have our energetic reformers taken the trouble to consider that sometimes much more is lost than gained by these classical studies? Are they attended with no dangerous consequences to the youthful mind? Is there to be found in the Grecian and Roman histories no ferocity—no contempt of natural affection garnished over by the subtle casuistry of heathen Ethics? Were there no abominations in their eternal civil broils, no foreign wars of ambition, of conquest, of murder, of plunder, and aggression? Have we forgotten the practice of the monsters of the French revolution, who always quoted these classical models to justify every breach of social order, and every outrage on human nature?

Yet while we reprobate these studies as forming essential constituents of medical education, we by no means are hostile to physicians devoting their leisure to the pursuits of general literature and science;—it must be borne always in mind, that it is compulsory attention to them, and rendering them necessary preliminaries to a degree in this profession to which we are resolutely opposed. Leave them to the voluntary selection of each individual as a matter of individual taste and prudence, and then we are certain they will retain their due place. Innovators have no right obtrusively to dictate to a practitioner what they conceive to be the best mode of squeezing himself into genteel patrician practice, an object which must be effected by many other means than the mere possession of literary and scientific attainments, and which each physician will or will not follow out under any imaginable system of regulations, as his taste or his interest prescribes to him.

If these reformers had directed their attention to the discipline and course of education in our medical schools in those points exclusively professional, they could hardly have gone wrong. Much might have been superfluous in their exertions, but they could scarcely have been injurious; for no one can reasonably object to the most complete and comprehensive study, and the most accurate and rigid, but not verbal and captious, sifting in medical matters, of candidates for the honour of M. D. before they mount the summum gradum.

Let our innovators try to invent some salutary antidote to the continued fever of Quackery; let them endeavour to introduce, as far as may be practicable and judicious, the mode of teaching by examination; let them especially look to the improvement of the school of Anatomy, that important and fundamental element of medical excellence, by procuring for it a competent and legitimate supply of subjects for dissection; let the students be provided with every facility of practical as well as theoretical Chemistry; let the doors of hospitals, libraries, and museums, be as open as possible to them; let reformers, if they will, be even indulged in subdividing or increasing medical and surgical professorships. All this may do some good, can hardly produce much evil; and if there are defects in these points, the candour, activity, and ability of the Professors will be at once exerted to remove them as far as the official powers with which these honourable individuals are invested will permit; for their zeal, fidelity, and talent, reformers have yet hardly ventured to impugn. Let no vacant professorships be filled up but by individuals of merit, of acknowledged celebrity, and of conscientious and teaching habits, no matter what their claims of country, or kindred, of politics, or pecunia may be, and we may unhesitatingly predict, that the Medical School of Edinburgh will maintain its high reputation, and may become, or continue, in spite of its rejection of A. M., S. B., the first School of Medicine in the world.

FINIS.


  1. Master of Arts and Bachelor of Sciences.

This work was published before January 1, 1924, and is in the public domain worldwide because the author died at least 100 years ago.