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 may be 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 this is no reason for our requiring much more than we do. Such a notion can be entertained only through a confusion of duty on the part of those who direct medicine. Their business is the public safety; and the position of their profession is their business only so far as it affects this. Trusts are intended for the benefit of any one rather than the trustee.
Two objections lie against the recommendation of extraneous branches of learning in medicine: in the first place, by insisting upon them as elements of a special course of instruction, they are, by implication, excluded from a general one; in the second place, they are no part of a three years' training.
Concentrate your attention on the essentials. I am quite satisfied that as far as the merits or demerits of an education contribute to the position of a profession, we may take ours as we find it, and yet hold our own. Nevertheless, lest the position given to medicine by its pre-eminent prominence, in conjunction with the church and bar, as one of the so-called learned professions, should encourage the idea that a multiplicity of accomplishments should be the character of a full and perfect medical practitioner, one or two important realities in respect to our position should be indicated. We are at a disadvantage as compared with both the church and the bar. We have nothing to set against such great political prizes as chancellorships and archbishoprics. We are at this disadvantage; and, in a country like England, it is a great one: so that what we gain by the connection, in the eyes of the public, is more than what we give; and the connection is itself artificial, and, as such, dissoluble. It is best to look the truth in the face—we must stand or fall by our own utility.
Proud to be useful—scorning to be more
—must be the motto of him whose integrity should be on a level with his skill, who should win a double confidence, and who, if he do his duty well, is as sure of his proper influence in society, and on society—and that influence a noble one—as if he were the member of a profession ensured to respectability by all the favours that influence can extort, and all the prerogatives that time can accumulate. As compared with that of the church and bar, our hold upon the public is by a thread—but it is the thread of life.
Such are the responsibilities, the opportunities, and the prospects, of those who are now about to prepare themselves for their future career. We who teach have our responsibilities also; we know them; we are teaching where Bell taught before us; we are teaching where ground has been lost; yet we are also teaching with good hopes, founded upon improved auguries.