[17] “Treatment of the Insane without Mechanical Restraints,” 1856.
[18] For details of the exposure of 1813 and 1814, see “A History of the York Asylum,” York, 1815.
[19] For a description of the state of Bethlem Hospital in 1815, see Conolly’s work above cited, pp. [26-29]. In making this record Conolly says, “Nothing can more forcibly illustrate the hardening effect of being habitual witnesses of cruelty, and the process which the heart of man undergoes when allowed to exercise irresponsible power. Partly from custom, and partly from indifference, and partly from fear, even physicians not particularly chargeable with inhumanity used formerly to see patients in every form of irritating restraint, and leave them as they found them. Such facts justify the extremest jealousy of admitting the slightest occasional appliance of mechanical restraints in any asylum. Once admitted, under whatever pretext, and every abuse will follow in time.”
[20] Memoir of John Conolly, M.D., D.C.L., by Sir James Clark, Bart., 1869; very ill-arranged.
[CHAPTER XXV.]
EMINENT SPECIALISTS.
SIR ERASMUS WILSON AND SKIN DISEASES; MORELL MACKENZIE AND THROAT DISEASES; COBBOLD AND INTERNAL PARASITES.
Specialisation is decreed by the will of the public as much as by that of the practitioner. This is true of many professions besides those of medicine. Although the general discernment has always recognised the ability of men with powers of the universal type, these men are rare, and there is a strong tendency to believe that a man cannot be master of the whole field of a science, but may more probably be master of a portion of it. Again, with hawk eye the people who want to be cured of disease mark and then swoop down upon men who appear to them specially capable in one department of medical practice, and no denunciation of specialism, no drawing back on the part of the physician, will avail against this natural selection. The man to whom crowds of patients of one kind flock naturally becomes specially skilled in dealing with them: and it is impossible to stem the tide by saying that such ought not to be the case.
Specialism has been carried to a surprising extent in America, when Dr. Morell Mackenzie informs us, in his article on “Specialism in Medicine,”[21] it would be almost impossible to find a city with ten thousand inhabitants in which there are not three or four specialists; whilst in a city of one hundred and thirty thousand inhabitants, thirteen specialists were found exclusively engaged in treating throat diseases.
The days of encyclopædic knowledge may be past, but the need of a broad, general, scientific, and professional education for the medical man, even a specialist, will never cease. If, as Dr. Mackenzie says, the leviathans of omniscience loom dim and gigantic, like the megatherium and mastodon of remote geological periods, and if the type is as utterly extinct as he believes, it is all the more incumbent on the guides of medical instruction to see that their pupils pass through a broad course of study which shall fairly represent the achievements of the past and the main features of the knowledge of the present. Erasmus Wilson was a man who undoubtedly gained a good record in general professional knowledge, and knew well the anatomy and physiology of his student days.
William James Erasmus Wilson, son of William Wilson, surgeon, a native of Aberdeen, in early life a naval surgeon, who later settled at Dartford and Greenhithe in Kent, was born on November 25, 1809, in High Street, Marylebone, where his maternal grandfather, Erasmus Bronsdorph, a Norwegian by birth, resided. He was educated at Dartford Grammar School and at Swanscombe, but very soon commenced practical medical work under his father in the parish infirmary. At the early age of sixteen he was sent to London to enter John Abernethy’s anatomical class, and there is no doubt that his teacher’s individuality powerfully impressed him. But among his friends were some who led his tastes also somewhat deeply into botany and zoology, entomological facts then learnt being destined to bear fruit in his Commentary on Diseases of the Skin.
Wilson was enabled to extend his studies to Paris in 1828 and in 1830, where he attended Cuvier’s and Geoffroy St. Hilaire’s lectures, and among others saw the practice of Dupuytren, Orfila, and Lisfranc. He became noted for his neat dissections, insomuch that he was nicknamed the “piocheur,” or “sap” in English slang. To his excellence in dissection young Wilson joined an equal faculty for drawing, derived from his mother.