Critiques and Addresses

by Thomas Henry Huxley

But it is of no use to grumble about this state of things unless one is prepared to indicate some sort of practical remedy. And I believe—and I venture to make the statement because I am wholly independent of all sorts of medical schools, and may, therefore, say what I believe without being supposed to be affected by any personal interest—but I say I believe that the remedy for this state of things, for that imperfection of our theoretical knowledge which keeps down the ability of England at the present time in medical matters, is a mere affair of mechanical arrangement; that so long as you have a dozen medical schools scattered about in different parts of the metropolis, and dividing the students among them, so long, in all the smaller schools at any rate, it is impossible that any other state of things than that which I have been depicting should obtain. Professors must live; to live they must occupy themselves with practice, and if they occupy themselves with practice, the pursuit of the abstract branches of science must go to the wall. All this is a plain and obvious matter of common-sense reasoning. I believe you will never alter this state of things until, either by consent or by force majeure—and I should be very sorry to see the latter applied—but until there is some new arrangement, and until all the theoretical branches of the profession, the institutes of medicine, are taught in London in not more than one or two, or at the outside three, central institutions, no good will be effected. If that large body of men, the medical students of London, were obliged in the first place to get a knowledge of the theoretical branches of their profession in two or three central schools, there would be abundant means for maintaining able professors—not, indeed, for enriching them, as they would be able to enrich themselves by practice—but for enabling them to make that choice which such men are so willing to make; namely, the choice between wealth and a modest competency, when that modest competency is to be combined with a scientific career, and the means of advancing knowledge. I do not believe that all the talking about, and tinkering of, medical education will do the slightest good until the fact is clearly recognized, that men must be thoroughly grounded in the theoretical branches of their profession, and that to this end the teaching of those theoretical branches must be confined to two or three centres.

Now let me add one other word, and that is, that if I were a despot, I would cut down these branches to a very considerable extent. The next thing to be done beyond that which I mentioned just now, is to go back to primary education. The great step towards a thorough medical education is to insist upon the teaching of the elements of the physical sciences in all schools, so that medical students shall not go up to the medical colleges utterly ignorant of that with which they have to deal; to insist on the elements of chemistry, the elements of botany, and the elements of physics being taught in our ordinary and common schools, so that there shall be some preparation for the discipline of medical colleges. And, if this reform were once effected, you might confine the "Institutes of Medicine" to physics as applied to physiology—to chemistry as applied to physiology—to physiology itself, and to anatomy. Afterwards, the student, thoroughly grounded in these matters, might go to any hospital he pleased for the purpose of studying the practical branches of his profession. The practical teaching might be made as local as you like; and you might use to advantage the opportunities afforded by all these local institutions for acquiring a knowledge of the practice of the profession. But you may say: "This is abolishing a great deal; you are getting rid of botany and zoology to begin with." I have not a doubt that they ought to be got rid of, as branches of special medical education; they ought to be put back to an earlier stage, and made branches of general education. Let me say, by way of self-denying ordinance, for which you will, I am sure, give me credit, that I believe that comparative anatomy ought to be absolutely abolished. I say so, not without a certain fear of the Vice-Chancellor of the University of London who sits upon my left. But I do not think the charter gives him very much power over me; moreover, I shall soon come to an end of my examinership, and therefore I am not afraid, but shall go on to say what I was going to say, and that is, that in my belief it is a downright cruelty—I have no other word for it—to require from gentlemen who are engaged in medical studies, the pretence—for it is nothing else, and can be nothing else, than a pretence—of a knowledge of comparative anatomy as part of their medical curriculum. Make it part of their Arts teaching if you like, make it part of their general education if you like, make it part of their qualification for the scientific degree by all means—that is its proper place; but to require that gentlemen whose whole faculties should be bent upon the acquirement of a real knowledge of human physiology should worry themselves with getting up hearsay about the alternation of generations in the Salpae is really monstrous. I cannot characterize it in any other way. And having sacrificed my own pursuit, I am sure I may sacrifice other people's; and I make this remark with all the more willingness because I discovered, on reading the name-of your Professors just now, that the Professor of Materia Medica is not present. I must confess, if I had my way I should abolish Materia Medica[1] altogether. I recollect, when I was first under examination at the University of London, Dr. Pereira was the examiner, and you know that "Pereira's Materia Medica" was a book de omnibus rebus. I recollect my struggles with that book late at night and early in the morning (I worked very hard in those days), and I do believe that I got that book into my head somehow or other, but then I will undertake to say that I forgot it all a week afterwards. Not one trace of a knowledge of drugs has remained in my memory from that time to this; and really, as a matter of common sense, I cannot understand the arguments for obliging a medical man to know all about drugs and where they come from. Why not make him belong to the Iron and Steel Institute, and learn something about cutlery, because he uses knives?

[Footnote 1: It will, I hope, be understood that I do not include
Therapeutics under this head.]

But do not suppose that, after all these deductions, there would not be ample room for your activity. Let us count up what we have left. I suppose all the time for medical education that can be hoped for is, at the outside, about four years. Well, what have you to master in those four years upon my supposition? Physics applied to physiology; chemistry applied to physiology; physiology; anatomy; surgery; medicine (including therapeutics); obstetrics; hygiene; and medical jurisprudence—nine subjects for four years! And when you consider what those subjects are, and that the acquisition of anything beyond the rudiments of any one of them may tax the energies of a lifetime, I think that even those energies which you young gentlemen have been displaying for the last hour or two might be taxed to keep you thoroughly up to what is wanted for your medical career.

I entertain a very strong conviction that any one who adds to medical education one iota or tittle beyond what is absolutely necessary, is guilty of a very grave offence. Gentlemen, it will depend upon the knowledge that you happen to possess,—upon your means of applying it within your own field of action,—whether the bills of mortality of your district are increased or diminished; and that, gentlemen, is a very serious consideration indeed. And, under those circumstances, the subjects with which you have to deal being so difficult, their extent so enormous, and the time at your disposal so limited, I could not feel my conscience easy if I did not, on such an occasion as this, raise a protest against employing your energies upon the acquisition of any knowledge which may not be absolutely needed in your future career.

IV.

YEAST.

IT has been known, from time immemorial, that the sweet liquids which may be obtained by expressing the juices of the fruits and stems of various plants, or by steeping malted barley in hot water, or by mixing honey with water—are liable to undergo a series of very singular changes, if freely exposed to the air and left to themselves, in warm weather. However clear and pellucid the liquid may have been when first prepared, however carefully it may have been freed, by straining and filtration, from even the finest visible impurities, it will not remain clear. After a time it will become cloudy and turbid; little bubbles will be seen rising to the surface, and their abundance will increase until the liquid hisses as if it were simmering on the fire. By degrees, some of the solid particles which produce the turbidity of the liquid collect at its surface into a scum, which is blown up by the emerging air-bubbles into a thick, foamy froth. Another moiety sinks to the bottom, and accumulates as a muddy sediment, or "lees."

When this action has continued, with more or less violence, for a certain time, it gradually moderates. The evolution of bubbles slackens, and finally comes to an end; scum and lees alike settle at the bottom, and the fluid is once more clear and transparent. But it has acquired properties of which no trace existed in the original liquid. Instead of being a mere sweet fluid, mainly composed of sugar and water, the sugar has more or less completely disappeared, and it has acquired that peculiar smell and taste which we call "spirituous." Instead of being devoid of any obvious effect upon the animal economy, it has become possessed of a very wonderful influence on the nervous system; so that in small doses it exhilarates, while in larger it stupefies, and may even destroy life.

Moreover, if the original fluid is put into a still, and heated for a while, the first and last product of its distillation is simple water; while, when the altered fluid is subjected to the same process, the matter which is first condensed in the receiver is found to be a clear, volatile substance, which is lighter than water, has a pungent taste and smell, possesses the intoxicating powers of the fluid in an eminent degree, and takes fire the moment it is brought in contact with a flame. The alchemists called this volatile liquid, which they obtained from wine, "spirits of wine," just as they called hydrochloric acid "spirits of salt," and as we, to this day, call refined turpentine "spirits of turpentine." As the "spiritus," or breath, of a man was thought to be the most refined and subtle part of him, the intelligent essence of man was also conceived as a sort of breath, or spirit; and, by analogy, the most refined essence of anything was called its "spirit." And thus it has come about that we use the same word for the soul of man and for a glass of gin.