"The chief objection to our present mode of teaching is that, however well inclined the student may be, he is never obliged to exercise his own judgment in distinguishing diseases and has no opportunity of trying his skill in their cure, and consequently at the end of his studies he is perhaps well grounded in the accessory sciences--is a perfect medical logician--able to arrange the names of diseases in their classes, orders and different subdivisions; he may be master of the most difficult theories of modern physiologists; he may have heard, seen and, if a member of the medical society, he may also have talked a great deal; but at the end of all this preparation what is he when he becomes a full doctor?--a practitioner who has never practised!"
These words have quite as suggestive applications to most phases of our modern education as they had to that of Graves' time. There are other passages that bear so significant a meaning in this regard that one can scarcely refrain from quoting:
"Our present method of instruction is indeed very useful and nothing better can be devised for a beginner; but for [{183}] the more advanced student it is by no means sufficient, nor is it calculated to give him practical experience, without which all other acquirements are of no avail. I say it does not give him experience, because he has at no time been charged with the responsibility of investigating a case for himself, and by himself; because at no time has he been called on to make a diagnosis, unassisted by others; and above all because he has never been obliged to act upon that diagnosis and prescribe the method of treatment. If those who had been thus educated, and who had been made doctors upon so slender a foundation, were to confess the truth, we should be presented with a picture calculated to excite dismay if not a stronger feeling. How many doubts and distracting anxieties attend such a man at his first patient's bedside. If the disease be acute and life in imminent danger, and if he shrink under this sudden and unusual load of responsibility, he gains little credit for professional ability. If, on the contrary, inexperienced as he is, he assumes that decision of judgment, that energy of practice which experience alone can confer, is it not probable that the result will be still more disastrous?"
Graves' last days and the circumstances of his death and burial are given by Professor Stokes, his great personal friend, and himself one of the most distinguished physicians of his time. We quote the concluding paragraph of Professor Stokes' biographical notice:
"It was in the autumn of 1852, he being then in his fifty-seventh year, that the symptoms of the malady which was to prove fatal first showed themselves. In the following February he began to succumb to the disease. Although at times his sufferings were great, yet he had many intervals of freedom from pain. And he then showed all his old cheerfulness and energy. To the very last he continued to [{184}] take pleasure in hearing of any advance of knowledge that tended to ameliorate the condition of man, or to throw light on his relations to a future state. In this latter point of view, the discoveries of Layard greatly interested him, as illustrative of the Sacred History; and thus he was permitted to fill up the intervals of his sufferings, even to the last; for his mental faculties never failed or flagged,--a mercy for which he often expressed a fervent gratitude; and so he was providentially enabled to review the past, and to form a calm and deliberate judgment on the religious convictions of his earlier years. And once the truthfulness of these were ascertained, he adhered to them with that earnestness which characterized all his decisions.
"It was after the attainment of this state of patient expectation that one who was dear to him expressed a prayerful wish for his recovery. 'Do not ask for that,' he replied; 'it might prove a fatal trial.'
"His mind having become thus satisfied he made few remarks on these subjects, except in reply to the inquiries of others. Thus, when referred to the prophetic illustration of purifying and redeeming love, 'A fountain shall be opened for sin and for uncleanness,' 'No,' he said, 'not a fountain, but an ocean.'
"On the day before his death he desired (a second time) to partake of the Holy Communion, with his family. When some explanations were commenced, he answered, 'I know all that; I do not regard this as a charm, but I wish to die under the banner of Christ.' Feeling himself sinking, he asked for prayer, and a petition was offered suitable to his condition; but he seemed to long for something more and, when questioned, replied, 'I want some prayer that I know, some of the prayers of my youth, some of my father's prayers.' The Litany was commenced, he immediately took up the [{185}] well-known words, and when the speaker's voice faltered he continued them alone, and distinctly, to the end of the strain, 'Whom thou hast redeemed with thy most precious blood.'
"On the twentieth day of March, 1853, and without renewed suffering, he ceased to breathe.
"His tomb is in the cemetery of Mount Jerome. It bears the following inscription dictated by himself:
"ROBERT JAMES GRAVES,
Son of Richard Graves, Prof. of Divinity,
Who,
After a Protracted and Painful Disease,
Died in the Love of God, and
In the
Faith of Jesus Christ."
William Stokes.
Very closely associated with the name of Robert Graves in all that made the Irish School of Medicine influential for good, about the beginning of the second quarter of the nineteenth century, is that of William Stokes. Stokes' work on Diseases of the Chest and, later in life, his treatise on Diseases of the Heart and Aorta stamp him as one of the great physicians of all time. His name is assured of immortality in medicine, because with that of the well-known Scotch physician, Cheyne, who came to Dublin late in the second decade of the nineteenth century, it is associated in the term most commonly used for a form of breathing, having special diagnostic and prognostic significance in certain serious diseases, and which is known as Cheyne-Stokes respiration. Even more interesting, however, than Stokes the physician, is, as we shall see, Stokes the man, and all that he stood for in his generation in Dublin, during a long life.