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Romance Languages, Sanscrit, Political Economy and Philosophy. On the other hand it is rare to find the subject even mentioned in the curricula of the medical schools.
I have been at some pains to ascertain to what extent it is taught in this country, and, with this object in view, have written to the Deans of fourteen of our leading universities which have medical departments, for information. pend a table made up from the meagre replies received from the following: Harvard, Yale, Cornell, Buffalo, Columbia, New York, Pennsylvania, Johns Hopkins, Maryland, Virginia, Tulane, Chicago, Michigan and Minnesota. From this it appears that a full course of lectures, fourteen to sixteen in number, is attempted in but three, viz.: Universities of Pennsylvania, Maryland and Minnesota. There are four “lectureships;" one just established and still without an incumbent, and another held jointly with a “Clinical Professorship of Dermatology.” One of the "courses” consists of three lectures. There is but one professorship and that an "Honorary” one. In two institutions "some" instruction is given by the Professor of Therapeutics and the Assistants in Surgery, respectively, in the latter case only in surgery. In one, and that one strange to say, Harvard, lectures were attempted, but “no great interest was shown" and they were discontinued. There is no uniformity in those receiving instruction; sometimes it is the Sophomores, sometimes the Juniors or Seniors, and sometimes any that choose to attend. In but one is the claim made that the course is compulsory. In none is there any examination. One can readily imagine what the attendance must be under such circumstances, and the experience of Harvard is instructive. However, according to the table, in three cases it is "good," "one-half the class" and "poor," respectively. The table gives the size of the medical libraries attached to the universities, and, finally, I would call your attention to that very useful auxiliary, the MedicoHistorical Society. There are two of these, but as one is limited to a dozen graduates, is not attended by the students, and takes no part in their instruction, it does not concern us here. The other is the excellent Historical Club of the Johns Hopkins Hospital, founded in 1890, upon a very broad basis, and which has exercised a profound influence,
not only locally, but throughout the entire country. Many able papers have been read before it, and there are few who have any claims to distinction in this field in the United States, who have not been its guests.
Let me, in passing, point out the error of a statement by Prof. Roswell Park, of Buffalo, the author of a very interesting course of historical lectures delivered before the University of Buffalo and published in 1897, viz.: that his was "the first attempt in the medical schools of this country to give systematic instruction in the history of the science."'1 For, over three-quarters of a century ago, the far-seeing "Sage of Monticello” provided for the teaching of the history of medicine in his great university (Virginia), and the course of lectures there delivered by the late Prof. Robley Dunglison was published in 1872. As appears from the table there is no course on the subject at that institution at the present time.
Now, I do not believe that any one, who possesses a broad and genuine culture, and whose opinion is therefore worth considering, will hesitate for a moment to acknowledge that the facts above given indicate a shocking neglect, an inexcusable apathy on the part of our medical schools. Where is our boasted intelligence and superiority, that we do not perceive the folly and danger of such a course; folly in that we are willing to deprive our young graduates of the accumulated wisdom and experience of all the ages; danger in that we turn them loose without the salutary checks and restraints that such studies afford? “No man,” says Lord Macaulay, : "who is correctly informed as to the past, will be disposed to take a morose or desponding view of the present." The fact is, we of this age are too much carried away with the rage for novelty. Nothing is esteemed of consequence but that which contains something new. But in catching at the new, how often we risk losing that which is old, well-grounded and far better. Haste is stamped on everything, and this is particularly true of Americans. We scarcely attain to one point of vantage
Dedication of his : An Epitome of the History of Medicine. Phil., 1897.
2 History of Medicine from the Earliest Ages to the Commencement of the Nineteenth Century. By Robley Dunglison, M.D., LL.D. Arranged and edited by Richard J. Dunglison, M.D. Phil., 1872.
8History of England, Vol. 1, p. 2.
when, without rest, we rush to the next. We allow ourselves no enjoyment of anything, indeed, scarcely time for reflection. We seem to be drifting more and more into mere machines, mere worshippers of physical science. Yet hear the warning words of Prof. Du Bois-Reymond: “Where physical science reigns exclusively, the intellect becomes poor in ideas, the fancy in images, the soul in sensibility, and the result is a narrow, hard and dry disposition, forsaken of the muses and graces; and not only so, but physical science leads down by imperceptible gradations from the highest efforts of human intellect to mere mechanical work that looks at nothing beyond gain.” Without doubt, we need constant infusions of what the Germans call "the science of antiquity” as a corrective to this mechanical tendency. Here is an opportunity for some laudator temporis acti. We must not permit ourselves to be severed from the high ideals and the inspiration that come from a contemplation of the examples, the lives, the achievements of the great men of the past.
Especially do we need to take deep and frequent draughts from the writings of the great Father, to whose genius we owe an everlasting debt. What a sublime figure he offers to our view! In an age of theory, how free from theorizing! Though one of the priestly caste, how untainted by superstition! Familiar with the natural course of diseases, he was in a position to gauge the true value of remedies and acquired a wonderful prevision of results. Not content with general impressions, he closely observed and carefully recorded individual diseases at the bedside and relied only on such experience to direct him to the proper management of his cases. Conscious of the limitations of his knowledge, and of the tendency of the human mind to err, he wisely confined himself to the guidance of each case and to the relief of symptoms. Above all things he was cautious to do no harm. And scarcely less inspiring are the work and lives of his successors. What an anachronism and an oasis in the anatomical desert seems the story of those old Alex-andrians, Herophilus and Erasistratus, with their human dissections and vivisections! With what fine judgment and choice language Celsus sums up the knowledge of his day,
*Quoted in : Essays and Studies. By Basil L. Gildersleeve. Baltimore, 1890.
and what a concise and admirable enumeration he gives of the qualifications demanded of the surgeon! How we linger over his descriptions of lithotomy (the "Celsian operation"), alopecia ("area" and "kerion Celsi"), and ligation of the arteries! What learning and literary fecundity are exhibited by Galen, “the first experimental physiologist, and what a high conception of professional morals he possessed! What graphic and inimitable pictures of disease Aretaeus, the Cappadocian, has drawn! What surprises await us in the work of the first gynecologist, Soranus of Ephesus! What a strange work that is of the great Byzantine surgeon and obstetrician, Paul of Aegina, in the seventh century, when his genius alone lit up the darkness of his age! What romance there is about the days of the Arabian cithern player of Bagdad, Abú Becr Mohammed Ibn Zacaríyá Ar-Rází, commonly known among us as Rhazes,
, who gave that famous description of small-pox! What a fine delineation of the surgeon is that given by old Guy de Chauliac, “the earliest herald of the modern surgery," in 1363, and with what surprise we learn that so high an ideal could be upheld in an age which we are accustomed to look upon as so barbarous! I cannot refrain from giving it to you: “Let the surgeon,” he says, "be well educated, skilfull, ready and courteous. Let him be bold in those things that are safe, fearful in those things that are dangerous ; avoiding all evil methods and practices. Let him be tender with the sick, honorable to men of his profession, wise in his predictions, chaste, sober, pitiful, merciful, not covetous or extortionate; but rather let him take his wages in moderation, according to his work, and the wealth of his patient, and the issue of the disease and his own worth.' How few realize that picture even in our own far more enlightened day! What an interesting story that is of the great barber surgeon, Ambrose Paré, of how in 1552 he was led to substitute the ligature for the cautery in amputation, and of the glorious fight he made against the pouring of that horrible boiling oil into the poor soldiers' wounds! And who does not shudder to recall Michael Servetus, the discoverer of the pulmonary circulation, burning at the stake, and
Paget (S.) Life of Paré. 1897 ; p. 2.
strangely by the hands of a fellow protestant? And what a grand role is that of Vesalius who, while Francis and Charles were turning the world upside down with their wars, was quietly turning anatomy upside down with his scalpel! And how familiar to every student are the names of Eustachius, Fallopius, Arantius, Varolius, Sylvius, Fabricius ab Aquapendente and Caesalpinus! And how many of us are aware that the great astronomer Copernicus, and Rabelais, the greatest wit of that most witty nation, the French, were practicing physicians ?
And not long after these there came the greatest of them all, Harvey, whose name is imperishably connected with the discovery of the circulation. It is not so well known, perhaps, that he established also the truth of the doctrine of the origin of all animals from the egg—“Ovum esse primordium commune omnibus animalibus."1 I shall have something further to say of the first of these presently. Listen to some well-known names of the seventeenth century, Havers, Naboth, Pacchioni, Cowper, Bartholin, de Graaff, Malpighi, Meibomius, Wirsung, Aselli, Highmore, Steno, Glisson, Nuck, Spigelius, Brunner, Wharton, Peyer, Willis and Vieussens, all incorporated into our anatomical nomenclature. Then there were: Borelli, who explained all physiology on mechanical principles; Sanctorius, who weighed himself in a balance for thirty years and thus determined the amount of the insensible perspiration; Mauriceau, the first great obstetrician; Morel, the discoverer of the tourniquet; Baglivi, the author of the celebrated saying, "he who diagnosticates well, cures well;" Sydenham, the "English Hippocrates," who refused to be bound by the theories of his day; Locke, the philosopher; and the sublime writer, Sir Thomas Browne.
Boerhaave is preeminent in the next century, the creator of no school, but selecting from all sources those things that appealed most to his reason and intelligence; a man of tireless industry, who held his priority as much, perhaps, though his high character as his exalted talents. We must single out also the name of Jenner, at the close of the century, as that of one of the world's greatest benefactors. And
1Exercitationes de Generatione Animalium.