sensible limits of disease. No single subject thus taught is the direct and primary object of your learning. The art of healing is so. You learn other things that you may understand this; and in hospitals at least you learn them with that view exclusively. If you wish to be a physiologist, chemist, or botanist, irrespectively of the medical application of the sciences of physiology, chemistry, and botany, there are better schools than the Middlesex Hospital, or, indeed, than any hospital whatever. There they may be studied as mathematics are studied at Cambridge, or as classics at Eton—simply for their own great and inherent values. But here you study them differently, that is, as mathematics are taught at a military college, or as classics are taught at the College of Preceptors, for a specific purpose, and with a limited view—with a view limited to the illustration of disease, and with the specific purpose of rendering them indirect agents in therapeutics. If you could contrive the cure of disease without a knowledge of morbid processes, it would be a waste of time to trouble yourself with pathology; or if you could bottom the phenomena of diseased action without a knowledge of the actions of health, physiology would be but a noble science for philosophers; or if you could build up a system of physiology, determining the functions of organs, and the susceptibilities of tissues, independent of the anatomy of those organs and those tissues, scalpels would be as irrelevant to you as telescopes; and if these three sciences received no elucidation from chemistry, and botany, and physics, then would chemistry, and botany, and physics, have the value—neither more nor less—of the art of criticism or of the binomial theorem. What you are taught in the schools is taught to you, not because it is worth knowing—for Latin, and Greek, and Mathematics, are worth knowing—but because, before patients can be cured, they are necessary to be learned.
And, in order to be taught at all, they must be taught systematically. It is an easy matter to ask for a certain amount of these two collateral sciences—to pick and choose just the part wanted for use, to require just that modicum of botany which illustrates the Pharmacopoeia, and just those fragments of chemistry that make prescriptions safe, and urine intelligible. It is easy, I say, to ask for all this; but the art of thus teaching per saltum has yet to be discovered. The whole is more manageable than the half. What it may be with others is more than I can tell; but, for my own particular teaching, I would sooner take the dullest boy from the worst school, and start him in a subject at the right end, than begin at the wrong end with the cleverest prizeman that ever flattered parent or gratified instructor. Bits of botany and crumbs of chemistry are less digestible than whole courses.
Thus much for those studies that make your therapeutics rational. Some few have spoken slightly of them—as Sydenham, in the fulness of his knowledge of symptoms, spoke slightingly of anatomy, or as a Greek sculptor, familiar with the naked figure, might dispense with dissection. They are necessary, nevertheless, for the groundwork of your practice. They must serve to underpin your observations.
And now we may ask, whether, when a medical education has been gone through, you have collected from it, over and above your professional sufficiency, any secondary advantages of that kind which are attributed to education itself taken in the abstract? Whether your knowledge is of the sort that elevates, and whether your training is of the kind that strengthens?
Upon the whole, you maybe satisfied with the reflex action of your professional on your general education—that is, if you take a practical and not an ideal standard. It will do for you, in this way, as much as legal studies do for the barrister, and as much as theological reading does for the clergyman; and perhaps in those points not common to the three professions medicine has the advantage. Its chemistry, which I would willingly see more mixed with physics, carries you to the threshold of the exact sciences. Its botany is pre-eminently disciplinal to the faculty of classification; indeed, for the natural-history sciences altogether, a medical education is almost necessary. Clear ideas in physiology are got at only through an exercised power of abstraction and generalization. The phenomena of insanity can be appreciated only when the general phenomena of healthy mental function are understood, and when the normal actions of the mind are logically analyzed. Such is medical education as an instrument of self-culture: and as education stands at present, a man who has made the most of them may walk among the learned men of the world with a bold and confiding front.
I insist upon thus much justice being done to the intellectual character of my profession—viz. that it be measured by a practical, and not an ideal, standard. Too much of the spirit of exaggeration is abroad—of that sort of exaggeration which makes men see in the requisites for their own profession the requisites for half-a-dozen others—of that sort of exaggeration which made Vitruvius, himself an architect, prove elaborately that before a man could take a trowel in his hand he must have a knowledge of all the sciences, and a habit of all the virtues. Undoubtedly it would elevate medicine for every member in the profession to know much more than is required of him—yet
