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by their followers, and carried down to this day in reality, although disguised in some of the stolen clothes of science, is the curse of our profession. When the public comes to form so low an estimate of an individual who should rank with the philosopher, as to believe that his knowledge is confined to one so-called disease, or to one organ, the beauty and the nobility of medicine, as a system, are for the moment gone, and the great philosophy which the ancient poets compared to the sun, and consigned symbolically to Apollo, is eclipsed. And when he, who should be the philosopher, is willing to bow to so mean an estimate, and to say, "Your servant, sir,” to the stupid who comes to him because he is considered the fountain head of knowledge on the kidney, the liver, the toe nail, the muscles and sinews as distinguished from the bones and the joints, then is the eclipse dense of dense. The darkness may be felt.
Nothing but a sense of an imperative duty could warrant these sayings. Nothing, except the deepest love for medicine, could embolden me to say them. But I am tired of seing physic sneered at as the least exact of all human knowledge. I am wearied with the everlasting sound of the earth bells tolling our frailties; and I am saddened to recognise that the profession, blind to its interests, allows an universal specialism to nourish and force an almost universal scepticism.
Unity of Education.
To sustain the principle of unity of research in medicine, a reform of the most sweeping character is required in the matter of medical education. The young mind, brought for the first time into connection with its older life, takes up at once the impressions by which it shall afterwards be mostly guided and ruled. What then sees the student as he enters
medicine? What does he hear? What does he grasp ? He sees a mirage, he hears a Babel, he grasps water.
What of the hundred things set before him to study shall he study first? Which one of all those debaters, for now there are no teachers, shall he believe To what tenet, to what current shall he trust his future ? Poor Student! thou hast many masters, but no master; and now thy masters, abusing with loud sounds, the scissor workers of physic out of the privileged house which thou walkest in, are far imitating the same as to snip up for thee, even in that privileged house, sundry similar patterns, which thou must also learn. I do not wish to over praise the old days of apprenticeship, and seven years' surgery. But, beshrew me, Student,-skipping about in that big asylum, now in this lecture room half asleep, and anon in that lecture room very much too wide awake; this hour pouring out thy broken ideas on that operation, criticising Peter thy master, at the expense of Paul thy master, and finishing up the day with a discussion at a society's meeting, on a subject, the alphabet of which is not thy possession,-beshrew me, Student, if perchance thou wert not better off in the seven years' surgery after all, and vastly better if there thou hadst over thee one good master, who would give thee all he has, except experience, and years, and ripeness of thought, and thine own soul.
Unity in medical teaching is a call urgent and unmistakable. As many schools as you may find teachers for them, as much rivalry as you please, but unity in the school, unity of thought, unity of word, unity of expectation and object, these are the urgent demands of the day and the hour.
Neither are the demands on the side, and in the interests, of the taught alone; they extend to the teacher. The art, the skill, the endurance, the fame of the teacher, are all in gal
loping decline. On the one hand, so keen is the competition for practice, so much richer are its rewards; on the other hand, so widely distributed are the responsibilities of the teacher, and so small is the return for skilled and profound teaching, that there is no practical competition whatever for professorial fame. Before he is himself schooled in schooling, your modern Lecturer is out of the chair and into the chariot; and thus we are accustomed to hear of the various schools that “the school is of no moment,” that “one school is as good as another,” and that everything in the way of success rests with the Student. The argument is irresistible, but is it good that it should be irresistible P Is there nothing for the student to learn in the patience, the impassion, the solidity, the labour, the zeal, the devotion of a great teacher ? Was Fabricius nothing to Harvey? Was Beddoes nothing to Davy? Was William Hunter nothing to Brother John ? Let the eloquence, the genius, the force of the great teachers of old pass into the grave, and the dead have buried their dead, and the living have no more life.
The Direction of Research. Presuming the centrifugal system of modern medicine be abandoned, or so modified as to lead us to some common understanding, what are the directions towards the unity of which I have spoken? The first step is to bring all minds to bear on the simple physical relations of animal force to animal matter. In animal bodies I find two different forms of matter, one I call fatty matter, the other I call albumi
I take the fat, which is a solid, I apply to it force, by the heat of a lamp or fire, and from the solid it becomes of fluid form. I take the albumen, which is before me liquid, in water; I apply to it the same force, and lo! the liquid becomes solid. I take a dead animal, and expose it, directly after death, to a temperature from five to six degrees above freezing point, and its fat solidifies, but its muscles remain flaccid. I take another animal recently dead, and place it on a sand bath at 110°, and its fatty matter remains fluid, but its muscles contract and fix in the firmest rigidity. I take blood, newly drawn and fluid; I place it below 44°, and it holds as a fluid; I raise the temperature only ten degrees, and it yields me a firm coagulum. I take gelatine, a solid, like dried and coagulated fibrine, treat it with heated water, and it dissolves, into what resembles water itself in tenuity, to solidify again as it cools. What mean these opposite effects of the same force ? How does the force bind one thing and loosen the other? Why in the organs of active locomotion have we only matter that is put into contraction by force, while in the nerve tissue we have compound matter, one part of which is solidified, the other fluidified, by force ? How is force laid up in nervous matter ? Why, in one case is it fatally poured out, and in another case fatally suppressed ? These, and many more questions of the same caste, lie at the root of the explanation of living phenomena healthy and diseased; nor can a step be made in scientific healing until they are answered.
With the relations of force to matter unknown, the morbid dissector, like the grave-stone carver, cuts merely to record, the pathologist is an abstraction, while the therapeutist is a sceptical believer, who fears to trust, dares not mistrust, and relies on an experience which varies like the deceitful sea.
The simple relations of force to matter understood, all that requires to be known by the physician, in every department, would proceed as light proceeds from the sun. He would see phenomena as natural and sequential, and what now appears to him out of the order of nature and as disease, so named in abhorrence or disgust, would be found to be in order and to be preventable, remediable, or removable, according to the
necessities of order. Then would he see and understand the limitations of his power, nor waste his time in what, for aught he knows now, may be vain efforts to resist the inevitable. Then would he understand the full extent of his influence, and gather, I predict, such marvels of knowledge that the crude beliefs of the wondering world should be shaken to their centre.
But towards this end the cry is again for the unity of research. As none but the God can love from “whole to parts,” as no service, nor labour, nor work of man hath ever descended from the whole to the parts, but hath always proceeded from the individual to the whole, when success hath attended it; so, in medicine, we must move from the primary facts of life to the whole manifestation.
And here will be the point of the conversion of medicine from dissolute and prodigal weakness into absolute and united strength, that her wandering children, ceasing, in sheer and useless weariness, from their isolated tasks, and called by the trumpet voice of some great leader, shall lend themselves manfully to the discovery of primary truth, and, from that discovery, march on in the consciousness that the accepted is the proved, and that what is not proved is not known.
In the midst of much confusion, and, as I have shown, of fearful centrifugal rending, there stand forth two facts of promise.
I notice, first, that there are one or two stranger voices whose words are reaching us. Amongst these the voice of Thomas Graham, Master of her Majesty's Mint, is specially attracting us. His language is strange to many, but there are single notes, and I had almost said harmonies, which come with power upon the mind. He will be listened to more.*
* Since this address was delivered the world of science has, alas ! had to deplore the loss of this illustrious master, His researches on osmosis, and on the division