This necessity for making the most painstaking observation of facts, the foundation to be laid by the student in every branch of her studies, is well illustrated in the life of Darwin, who writes thus to a friend: ‘I have been hard at work for the last month in dissecting a little animal about the size of a pin’s head, from the Chronos Archipelago, and I could spend another month and daily see more beautiful structure.’ Of the value of this method of persistent labour, his friend gives this noteworthy testimony: ‘Your sagacious father never did a wiser thing than devote himself to these years of patient toil. It is a remarkable instance of his scientific insight and courage that he saw the necessity of proper training and did not shrink from the labour of acquiring it.’
In medicine, anatomy, physiology and chemistry are the primary studies where that foundation of conscientious exactitude must be laid on which the skill of the future physician so largely depends.
The first and indispensable basis of medicine is anatomy, with which physiology is inseparably blended; for human physiology can only be properly studied in connection with the human structure, whose condition in health and disease forms the direct object of our profession. No student should be satisfied until she has most carefully followed out the structure of every region of that human body with whose life we shall have to deal. Careful anatomical study is the sure and indispensable preparation for that next advanced range of clinical observation, where pathology and therapeutics bring us into the direct study of the sick.
The more thoroughly the human organization is investigated, the more wonderful will the unapproachable mechanism for the use of human life be seen to be. We shall never regret any amount of time and care spent in acquiring the most intimate knowledge of human anatomy. For even if we never perform a surgical operation, the thorough knowledge of the human framework with whose aberrations we have to deal, gives a firm foundation for practice that nothing else can supply.
The thoughtless slashing of the delicate and complicated structure of the body, of which untrained students are sometimes guilty, is indicative of a careless, unconscientious future physician. If carelessness similar to what is sometimes observed in the dissecting-room were carried on in the chemical laboratory, life or limb would soon be sacrificed. Yet a thorough grounding in the structure of every vital organ is more indispensable to us than chemistry, important as the study of chemistry is. Let me here note how the moral element on which I have so strongly insisted comes into play in this the first of our medical studies. Reverence for this physical structure of ours should always be shown in the use and arrangements of the anatomical rooms. Carelessness and irreverence in this department of study exercise a really deteriorating influence on students of medicine. Respect for the material used, care in its disposition, and a decent covering for each work-table in the intervals of work, may seem small observances, but they exercise a large influence over the moral training of the student when persistently carried out.
It does not enter into my present purpose to enlarge upon the right method of studying each branch of medicine, for that would require a series of discourses. But I must give an emphatic warning against the strange neglect of human physiology which I observe. This seems to proceed from the mistaken idea that necessary knowledge can be obtained from other organisms which bear a misleading resemblance to the human.
What I would insist upon is, that we should endeavour to make ourselves thoroughly acquainted with the nature and variations of healthy human physiology before we are perplexed with the changes of pathology.
Auscultation and percussion; observations of the healthy variations of the pulse, the tongue, the skin, and the various secretions, in as many healthy individuals, both adult and infant, as can be examined, compared, and recorded; the vital chemistry of the human tissues and secretions in health and disease; the modifying effects of temperament, heredity, idiosyncrasy, etc.—all this forms a department of human physiology, strangely neglected as a practical study, yet certainly of primary importance to the progress of medicine.
But I must pass on to what is my immediate purpose—viz., the relation of women to medicine. Having dwelt on the moral and intellectual advantages of medical study, I must refer to another aspect of the subject—viz., the dangers which meet our earnest students.
Dr. Carpenter has recorded the wide-spread recognition of this dangerous aspect of medical study when he says: ‘There seems to be something in the process of training students for the medical profession which encourages in them a laxity of thought and expression that too frequently ends in a laxity of principle and of action’; and he further condemns the tone of some works issued by the medical press. Now, this judgment of a very cautious teacher so many years ago, is worthy of the most serious consideration in the present day. The freedom of entrance now accorded to women into the medical profession, lays a very heavy responsibility upon us, to prove that this new and increasing movement will be a future blessing to society.