medical essays-第52部分

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ie　was　seventy　years　old　before　he　left　his　physiological　and　surgical　studies　to　indulge　in　psychological　speculations。　　The　period　of　pupilage　will　be　busy　enough　in　acquiring　the　knowledge　needed；　and　the　season　of　active　practice　will　leave　little　leisure　for　any　but　professional　studies。

Dr。　Graves　of　Dublin；　one　of　the　first　clinical　teachers　of　our　time；　always　insisted　on　his　students'　beginning　at　once　to　visit　the　hospital。　　At　the　bedside　the　student　must　learn　to　treat　disease；　and　just　as　certainly　as　we　spin　out　and　multiply　our　academic　prelections　we　shall　work　in　more　and　more　stuffing；　more　and　more　rubbish；　more　and　more　irrelevant；　useless　detail　which　the　student　will　get　rid　of　just　as　soon　as　he　leaves　us。　　Then　the　next　thing　will　be　a　new　organization；　with　an　examining　board　of　first…rate　practical　men；　who　will　ask　the　candidate　questions　that　mean　business；who　will　make　him　operate　if　he　is　to　be　a　surgeon；　and　try　him　at　the　bedside　if　he　is　to　be　a　physician；and　not　puzzle　him　with　scientific　conundrums　which　not　more　than　one　of　the　questioners　could　answer　himself　or　ever　heard　of　since　he　graduated。

Or　these　women　who　are　hammering　at　the　gates　on　which　is　written　〃No　admittance　for　the　mothers　of　mankind；〃　will　by　and　by　organize　an　institution；　which　starting　from　that　skilful　kind　of　nursing　which　Florence　Nightingale　taught　so　well；　will　work　backwards　through　anodynes；　palliatives；　curatives；　preventives；　until　with　little　show　of　science　it　imparts　most　of　what　is　most　valuable　in　those　branches　of　the　healing　art　it　professes　to　teach。　　When　that　time　comes；　the　fitness　of　women　for　certain　medical　duties；　which　Hecquet　advocated　in　1708；　which　Douglas　maintained　in　1736；　which　Dr。　John　Ware；　long　the　honored　Professor　of　Theory　and　Practice　in　this　Institution；　upheld　within　our　own　recollection　in　the　face　of　his　own　recorded　opinion　to　the　contrary；　will　very　possibly　be　recognized。

My　advice　to　every　teacher　less　experienced　than　myself　would　be；　therefore：　Do　not　fret　over　the　details　you　have　to　omit；　you　probably　teach　altogether　too　many　as　it　is。　　Individuals　may　learn　a　thing　with　once　hearing　it；　but　the　only　way　of　teaching　a　whole　class　is　by　enormous　repetition；　representation；　and　illustration　in　all　possible　forms。　　Now　and　then　you　will　have　a　young　man　on　your　benches　like　the　late　Waldo　Burnett；not　very　often；　if　you　lecture　half　a　century。　　You　cannot　pretend　to　lecture　chiefly　for　men　like　that；a　Mississippi　raft　might　as　well　take　an　ocean…steamer　in　tow。　To　meet　his　wants　you　would　have　to　leave　the　rest　of　your　class　behind　and　that　you　must　not　do。　　President　Allen　of　Jefferson　College　says　that　his　instruction　has　been　successful　in　proportion　as　it　has　been　elementary。　　It　may　be　a　humiliating　statement；　but　it　is　one　which　I　have　found　true　in　my　own　experience。

To　the　student　I　would　say；　that　however　plain　and　simple　may　be　our　teaching；　he　must　expect　to　forget　much　which　he　follows　intelligently　in　the　lecture…room。　　But　it　is　not　the　same　as　if　he　had　never　learned　it。　　A　man　must　get　a　thing　before　he　can　forget　it。　　There　is　a　great　world　of　ideas　we　cannot　voluntarily　recall；　they　are　outside　the　limits　of　the　will。　　But　they　sway　our　conscious　thought　as　the　unseen　planets　influence　the　movements　of　those　within　the　sphere　of　vision。　　No　man　knows　how　much　he　knows；how　many　ideas　he　has；any　more　than　he　knows　how　many　blood…globules　roll　in　his　veins。　　Sometimes　accident　brings　back　here　and　there　one；　but　the　mind　is　full　of　irrevocable　remembrances　and　unthinkable　thoughts；　which　take　a　part　in　all　its　judgments　as　indestructible　forces。　　Some　of　you　must　feel　your　scientific　deficiencies　painfully　after　your　best　efforts。　　But　every　one　can　acquire　what　is　most　essential。　　A　man　of　very　moderate　ability　may　be　a　good　physician；　if　he　devotes　himself　faithfully　to　the　work。　　More　than　this；　a　positively　dull　man；　in　the　ordinary　acceptation　of　the　term；　sometimes　makes　a　safer　practitioner　than　one　who　has；　we　will　say；　five　per　cent。　more　brains　than　his　average　neighbor；　but　who　thinks　it　is　fifty　per　cent。　more。　　Skulls　belonging　to　this　last　variety　of　the　human　race　are　more　common；　I　may　remark；　than　specimens　like　the　Neanderthal　cranium；　a　cast　of　which　you　will　find　on　the　table　in　the　Museum。

Whether　the　average　talent　be　high　or　low；　the　Colleges　of　the　land　must　make　the　best　commodity　they　can　out　of　such　material　as　the　country　and　the　cities　furnish　them。　　The　community　must　have　Doctors　as　it　must　have　bread。　　It　uses　up　its　Doctors　just　as　it　wears　out　its　shoes；　and　requires　new　ones。　　All　the　bread　need　not　be　French　rolls；　all　the　shoes　need　not　be　patent　leather　ones；　but　the　bread　must　be　something　that　can　be　eaten；　and　the　shoes　must　be　something　that　can　be　worn。　　Life　must　somehow　find　food　for　the　two　forces　that　rub　everything　to　pieces；　or　burn　it　to　ashes；friction　and　oxygen。　　Doctors　are　oxydable　products；　and　the　schools　must　keep　furnishing　new　ones　as　the　old　ones　turn　into　oxyds；　some　of　first…　rate　quality　that　burn　with　a　great　light；　some　of　a　lower　grade　of　brilliancy；　some　honestly；　unmistakably；　by　the　grace　of　God；　of　moderate　gifts；　or　in　simpler　phrase；　dull。

The　public　will　give　every　honest　and　reasonably　competent　worker　in　the　healing　art　a　hearty　welcome。　　It　is　on　the　whole　very　loyal　to　the　Medical　Profession。　　Three　successive　years　have　borne　witness　to　the　feeling　with　which　this　Institution；　representing　it　in　its　educational　aspect；　is　regarded　by　those　who　are　themselves　most　honored　and　esteemed。　　The　great　Master　of　Natural　Science　bade　the　last　year's　class　farewell　in　our　behalf；　in　those　accents　which　delight　every　audience。　　The　Head　of　our　ancient　University　honored　us　in　the　same　way　in　the　preceding　season。　　And　how　can　we　forget　that　other　occasion　when　the　Chief　Magistrate　of　the　Commonwealth；　that　noble　citizen　whom　we　have　just　lost；　large…souled；　sweet…　natured；　always　ready　for　every　kind　office；　came　among　us　at　our　bidding；　and　talked　to　us　of　our　duties　in　words　as　full　of　wisdom　as　his　heart　was　of　goodness？

You　have　not　much　to　fear；　I　think；　from　the　fancy　practitioners。　The　vulgar　quackeries　drop　off；　atrophied；　one　after　another。　Homoeopathy　has　long　been　encysted；　and　is　carried　on　the　body　medical　as　quietly　as　an　old　wen。　　Every　year　gives　you　a　more　reasoning　and　reasonable　people　to　deal　with。　　See　how　it　is　in　Literature。　　The　dynasty　of　British　dogmatists；　after　lasting　a　hundred　years　and　more；　is　on　its　last　legs。　　Thomas　Carlyle；　third　in　the　line　of　descent；　finds　an　audience　very　different　from　those　which　listened　to　the　silver　speech　of　Samuel　Taylor　Coleridge　and　the　sonorous　phrases　of　Samuel　Johnson。　　We　read　him；　we　smile　at　his　clotted　English；　his　〃swarmery〃　and　other　picturesque　expressions；　but　we　lay　down　his　tirade　as　we　do　one　of　Dr。　Cumming's　interpretations　of　prophecy；　which　tells　us　that　the　world　is　coming　to　an　end　next　week　or　next　month；　if　the　weather　permits；not　otherwise；feeling　very　sure　that　the　weather　will　be　unfavorable。

It　is　the　same　common…sense　public　you　will　appeal　to。　　The　less　pretension　you　make；　the　better　they　will　like　you　in　the　long　run。　I　hope　we　shall　make　everything　as　plain　and　as　simple　to　you　as　we　can。　　I　would　never　use　a　long　word；　even；　where　a　short　one　would　answer　the　purpose。　　I　know　there　are　professors　in　this　country　who　〃ligate〃　arteries。　　Other　surgeons　only　tie　them；　and　it　stops　the　bleeding　just　as　well。　　It　is　the　familiarity　and　simplicity　of　bedside　instruction　which　makes　it　so　pleasant　as　well　as　so　profitable。　　A　good　clinical　teacher　is　himself　a　Medical　School。　　We　need　not　wonder　that　our　young　men　are　beginning　to　announce　themselves　not　only　as　graduates　of　this　or　that　College；　but　also　as　pupils　of　some　one　distinguished　master。

I　wish　to　close　this　Lecture；　if　you　will　allow　me　a　few　moments　longer；　with　a　brief　sketch　of　an　instructor　and　practitioner　whose　character　was　as　nearly　a　model　one　in　both　capacities　as　I　can　find　anywhere　recorded。

Dr。　JAMES　JACKSON；　Professor　of　the　Theory　and　Practice　of　Medicine　in　this　University　from　1812　to　1846；　and　whose　name　has　been　since　retained　on　our　rolls　as　Professor　Emeritus；　died　on　the　27th　of　August　last；　in　the　ninetieth　year　of　his　age。　　He　studied　his　profession；　as　I　have　already　mentioned；　with　Dr。　Holyoke　of　Salem；　one　of　the　few　physicians　who　have　borne　witness　to　their　knowledge　of　the　laws　of　life　by　living　to　complete　their　hundredth　year。　　I　think　the　student　took　his　Old　Master；　as　he　always　loved　to　call　him；　as　his　model；　each　was　worthy　of　the　other；　and　both　were　bright　examples　to　all　who　come　after　them。

I　remember　that　in　the　sermon　preached　by　Dr。　Grazer　after　Dr。　Holyoke's　death；　one　of　the　points　most　insisted　upon　as　characteristic　of　that　wise　and　good　old　man　was　the　perfect　balance　of　all　his　faculties。　　The　same　harmonious　adjustment　of　powers；　the　same　symmetrical　arrangement　of　life；　the　same　complete　fulfilment　of　every　day's　duties；　without　haste　and　without　needless　delay；　which　characterized　the　master；　equally　distinguished　the　scholar。　　A　glance　at　the　life　of　our　own　Old　Master；　if　I　can　do　any　justice　at　all　to　his　excellences；　will　give　you　something　to　carry　away　from　this　hour's　meeting　not　unworthy　to　be　remembered。

》From　December；　1797；　to　October；　1799；　he　remained　with　Dr。　Holyoke　as　a　student；　a　period　which　he　has　spoken　of　as　a　most　interesting　and　most　gratifying　part　of　his　life。　　After　this　he　passed　eight　months　in　London；　and　on　his　return；　in　October；　1800；　he　began　business　in　Boston。

He　had　followed　Mr。　Cline；　as　I　have　mentioned；　and　was　competent　to　practise　Surgery。　　But　he　found　Dr。　John　Collins　Warren　had　already　occupied　the　ground　which　at　that　day　hardly　called　for　more　than　one　leading　practitioner；　and　wisely　chose　the　Medical　branch　of　the　profession。　　He　had　only　himself　to　rely　upon；　but　he　had　confidence　in　his　prospects；　conscious；　doubtless；　of　his　own　powers；　knowing　his　own　industry　and　determination；　and　being　of　an　eminently　cheerful　and　hopeful　disposition。　　No　better　proof　of　his　spirit　can　be　given　than　that；　just　a　year　from　the　ti