The Hunterian Oration for 1850
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THE HUNTERIAN ORATION
For 1850.
THE
HUNTERIAN ORATION
For 1850.
By FREDERIC C. SKEY, F.R.S.,
MEMBER OF THE COUNCIL OF THE ROYAL COLLEGE OF SURGEONS; PROFESSOR OF DESCRIPTIVE ANATOMY
IN THE MEDICAL COLLEGE OF ST. BARTHOLOMEW'S HOSPITAL; FORMERLY LECTURER ON THE
PRINCIPLES AND PRACTICE OF SURGERY AT THE ALDERSGATE SCHOOL OF MEDICINE;
CONSULTING SURGEON TO THE CHARTER HOUSE, MODEL PRISON, THE HOSPITAL
FOR WOMEN, AND TO VARIOUS DISPENSARIES; LATE VICE-PRESIDENT
OF THE MEDICO-CHIRURGICAL SOCIETY OF LONDON; ASSISTANT-
SURGEON OF 8T, BARTHOLOMEW’S HOSPITAL &c. &c. &c.
LONDON :
JOHN CHURCHILL, PRINCES STREET, SOHO.
1850.
LONDON:
BRADBURY AND EVANS, PRINTERS, WHITEFRIARS.
DEDICATION.
TO THE
RIGHT HONOURABLE LORD JOHN RUSSELL,
FIRST LORD OF THE TREASURY.
My Lord,
In requesting your permission to dedicate to you the following oration, I cannot but feel sensible how imperfectly I have done justice to the memory of that great man, in honour of whom it was delivered, and how unworthy it is of the high patronage of your Lordship’s name.
Amidst the multiplicity of important subjects that engage your Lordship’s attention, may I venture to hope that you will not exclude that of the profession of medicine, satisfied that no one can prove a more efficient physician than your Lordship in ministering to its diseases, and in raising its professors to a rank commensurate with their successful devotion to the cause both of science, and humanity.
It was the boast of one of the most eminent of our country-men, that physicians were among the best friends and companions of his life.
While 1 would gladly see the social services of my profession at, the command of your Lordship, I trust that a long period of years may elapse before our professional services may be personally required by you: and that you may be permitted to enjoy in health and happiness the paper and gratitude, which a long, and no less brilliant, career of statesmanship has won for you, is the fervent wish of your admiring countryman, and grateful servant,
FREDERIC C. SKEY.
- GROSVENOR STREET,
- February, 1850.
- GROSVENOR STREET,
PREFACE.
I do not flatter myself that the sentiments I have ventured to advocate in the following pages, will meet with universal approval throughout the profession. If much of what I have advanced, be prospective of the condition of those now entering on their career, I confess my persuasion, that it 1s reserved for the incoming generation to witness the complete redemption of our profession.
The way to a better state of things, lies through the demolition of habits and routine systems which established practitioners can change, but with difficulty. Their more youthful brethren have not this reasonable argument, for persistence in an established, but not less objectionable practice; and for them I also urge the adoption of an improved system of training, which, while perfecting students in the practical knowledge of their art, shall also aim to imbue them with those amenities of literature and a cultivated taste, which give grace and dignity to social life, and should be the distinguishing characteristic of a profession like ours.
Nor should they be regarded as mere elegant superfluities, for although not entering into the formation of the skilful physician or the dexterous surgeon, they are almost necessary to complete the measure of our preparation for enlightened intercourse with the world, to exalt the aim of life above that low and sordid level which limits our aspirations to the pursuit of gain, and presents no object of nobler attainment, than a name for professional skill.
A long and friendly intercourse with a large body of my professional brethren engaged in general practice, has convinced me of the all but universality of the sentiments I dared to promulgate in the theatre of the College of Surgeons; and I have reason to believe that an improved form of remuneration, and one more consonant with professional usage, if sanctioned by Parliament, would be generally acceptable to this large department of the profession of medicine. I quarrel not with the general practitioner, but I quarrel with the system, nor can I understand how any high- minded man, can fail to repudiate it. My object is to elevate the entire body in the professional scale, to a level commensurate with the value of its services.
The term “degenerate,” as applied to the profession of medicine, has been objected to. In justification of its employment, I would urge on the recollection of the reader, the condition of the profession at the latter end of the seventeenth century. At that time the physician monopolised the entire rank and name of the practitioner of medicine,—the surgeon was a mere operative, identified with a menial trade, and the apothecary, a drug vendor, having, like the surgeon, no claims to medical knowledge, quoad the treatment of disease, as may be inferred from the following lines from Dryden:—
- “Physicians from the tree have found the bark,
- They laboring for relief of human kind,
- With sharpened sight some remedies may find,
- The apothecary-train are wholly blind.”
13th Epistle.
While Pope, in a letter to his friend Allen, says, “Physicians” (that is, medical men) “are among the most agreeable companions, the best friends, and the most learned men I know.” Am I not justified in assuming, then, that, taking our profession as a whole, the entire body is degenerate from its former eminence?
It may be also objected that I have travelled out of my subject, by addressing myself to that of the profession of the law. My purpose was not to depreciate the law, but to contrast with it, the more useful, and, as I conceive, the higher calling of the profession of medicine. The profession of the law appeared to me a fair and legitimate subject of comparison with our own, and I took advantage of it in order to show that an artificial pursuit, which has proved destructive to the happiness as well as to the property of thousands, is less entitled than our own, to the esteem and sympathy of the world.[1]
In the latter pages, the reader may recognise in more than one passage quoted under his name, the sentiments, and probably even the language of that elegant writer.
THE HUNTERIAN ORATION.
Mr. President,
We are assembled in this place to do honour to the genius of Hunter, a name celebrated throughout the civilised world, and to record the merits of such recently deceased members of our profession, as, imitating his example, and possessed of a single spark of his genius, have claims on the respectful remembrance of their surviving brethren.
The period of Mr. Hunter has formed an epoch in the history of medical science. His wondrous and unceasing ardour, his genius for investigation, and no less his intellectual greatness, while they demand the homage of our veneration, leave competition far behind. In the race of modern physiological science, no one has approached his eminence, to participate in his exaltation, or to share his glory. His mind was the depository of the pure ore of true philosophy, in which neither bigotry nor selfishness could find a momentary resting place. No thoughts of private interest—no aspirations after posthumous fame—no ambition of personal distinction; neither the claims of anxiety, of sickness, nor of professional occupation, could divert his mind from the one great object of his life,—the pursuit of truth in the investigation of Nature and her laws.
Over the almost untrodden ground of his researches, replete with mental food, intensely interesting to the philosopher of science, his mind revelled in the luxuriance of his intellectual riches, and nobly did he redeem the pledge of industry, and of intellectual as well as moral pre-eminence, that Nature’s own hand had accorded to him. That his mind was imbued with the very spirit of earnest inquiry, his gigantic productions in his museum will amply testify: that his researches were conceived, and planned, and directed, by a superior intelligence, let me point to the philosophy of his written works. Crude they may be, and ill-digested, but they yet form the record of one who deservedly ranks among the highest orders of men.
It was said of Bacon, by Ben Jonson, that his words were so pregnant of meaning, that his hearers could not cough nor look aside from him, without loss. In like manner did Hunter’s reflecting mind teem with original conceptions. With rapid flight he winged his way from the infancy to the mature age of science, discovering, developing, and maturing every subject that engaged his fixed attention. The intellect of Mr. Hunter has been the theme of repeated eulogium in this theatre, and on which my numerous predecessors in this office have expatiated with force and eloquence.
Associated with his high intellect were certain moral qualities which in no less a degree demand our praise, while they fortify and confirm our convictions of his claims to the gratitude, as well as to the admiration, of posterity. The student of Hunter cannot fail to appreciate qualities which threw a charm over his character.
Ingenuous, disinterested, unreserved in his communication of knowledge, he exhibited many of the excellencies that mark the true philosopher. From his eminence above the world, he surveyed the great book of Nature. His thoughts expanded by a natural elasticity, in proportion as he was elevated above the grovelling passions and influences of the world. With a love of Nature was inseparably interwoven a still stronger love of truth. It is impossible to read the history of his laborious investigations, his personal sacrifice of time, of health, and of property, without believing that to the ardour and enthusiasm which incited him to toil over the great field of Nature, he added with equal force an undeviating adherence to truth.
A spirit of arrogance, of self-esteem,—a disposition to depreciate the works of a competitor or rival, is the characteristic of the pretender to science, and exposes the unsoundness of the motives which carry him on in the pursuit of knowledge. And the cause is obvious; for, if animated by a true love of science, as the primary motive of exertion, any contribution to his favourite study is hailed with gladness; whereas the same contribution would be received by the empiric, with coldness, if not with disapprobation.
How broad is this distinction! how unlike the men! how dissimilar the motives! How often does the desire of distinction, or of notoriety—the ambition of pre-eminence above others, dictate our efforts, and develope an envious and uncharitable interpretation of the exertions of those who venture to compete with us in the struggle for fame! In the great temple of knowledge, there are no contentions for place, or for personal distinctions, no strivings for pre-eminence. Among its true votaries, a spirit of genuine fraternity prevails, that harmonises the soul. He who would become its occupant must throw aside all sinister and indirect motive, every degrading thought, every selfish passion, as alike derogatory to himself, and injurious to his cause. Between two students of Nature, their common object, their identity of thought and pursuit, maintain an harmonious interchange of kindly intercourse. They have no motives for rivalship or ill-will. They are directed by one common, and by the same high motive; they have neither time nor tendency to step out of the direct path of inquiry, to indulge in angry passions, to deal in personalities, to question motives. On one distant object their eyes are fixed; to reach this goal is their common end; and applying to their journey onward the principle of a mathematical truth, they pursue their course in a straight direction, as the shortest given line between the two points.
The excellence of Mr. Hunter is to be sought in his unwearied efforts to advance the cause of physiological science; in his untiring industry; in his unselfish indifference to riches, which he coveted solely for the purpose of advancing his favourite studies; in the benevolence of his nature, which identified itself with moral and physical suffering; in his earnest desire to communicate knowledge; and in his possession of those homely qualities of the heart, that inspired love in the breasts of his pupils and of his friends.
I hold in my hand an autograph letter of Mr. Hunter’s, written in the year 1786, to the Master, Wardens, and Court of Assistants of the Corporation of Surgeons, which affords strong evidence, were any required, of his earnest desire to extend the advantages of medical literature and general knowledge to all who could avail themselves of them*.
One of the last, and perhaps the most interesting link that has connected the great man, whose name and whose labours we are met to-day to celebrate, and the present generation
of Surgeons of England, is broken by the death of Mr. Clift,
whose name, next to its great founder, is more fully iden-
ἃ (ΤῸ THE MASTER, WARDENS, AND COURT OF ASSISTANTS OF THE CORPORATION OF SURGEONS.
- ¢ GENTLEMEN,
“ At this period in which the Surgeons of Great Britain have deservedly acquired the highest reputation in Europe, both by their practice and publications, it appears to be a reflection upon them that the Corporation of Surgeons of London should not be possessed of a public surgical library ;— a circumstance so extraordinary that foreigners can hardly believe it.
“If a custom had been established at the time the Surgeons were incur- porated, that every member should send a copy of his publications to the Com- pany’s library, it would have at present contained the works of many of the best writers in Surgery, which might have proved a valuable collection of instructions for the improvement of the profession.
“ As the smallest beginnings may in the end lead to the greatest acquisitions, I have done myself the honour of presenting to the Company, through your hands, the few observations on Anatomy and Surgery which I have published; and should the other members of that body be induced to follow my example, and by presenting their works establish a library which shall hereafter become both a public benefit and an honour to the Corporation of Surgeons, I shall consider it as one of the happiest events of my life to have been at all instru- mental in such an establishment.
“ T have the honour to be, “ Gentlemen, “ Your most obedient humble Servant,
“JOHN HUNTER.” “ LEICESTER SQUARE,
“ August 14th, 1786.”
[From the collection of Autographs in the possession of Mr. Strong, Librarian of the College. ] tified with the Hunterian Museum than any other man, living or dead.
It is not intended in this brief memoir to place the name of Clift even in juxta-position with that of Hunter, although fellow-labourers in the same field of industry. I will, however, endeavour to do justice to him who was great, because he was good; who was faithful to a sacred trust, under circumstances of peculiar embarrassment and temptation; whose mind was fortified against betrayal by high principle, strengthened by lasting affection, and engendered by a term of brief companionship with him who first raised in his breast the ardour of a congenial occupation; who was uncontaminated by the world, and the world’s vices; who carried to the grave the same single-mindedness and simplicity of character, that stamped with truth, every act of his past life.
Such was William Clift, and such the bond of fidelity that fixed on his character its indelible stamp!
Mr. Clift was born at Burcombe, near Bodmin, in 1775; and he owed his connection with Mr. Hunter to the circumstance of an intimacy subsisting between a lady resident at Bodmin, and Miss Home, who had then become the wife of Mr. Hunter, by whom he was recommended on the ground of his promising abilities, and graphic powers.
He was received into Mr. Hunter’s house as an apprentice, in the year 1792, and devoted to him his services as an amanuensis, anatomist, and artist. Mr. Hunter died in 1793, from which date until 1800, when the Collection was purchased by the Government, it was placed under the exclusive care of Mr. Clift, who, with two gallons of spirit meted out occasionally, and seven shillings a week granted for his own support out of the limited funds at the disposal of Mr. Hunter’s executors, at a time when the quartern loaf was occasionally at two shillings, contrived to maintain the entire Museum, valued at that time by Sir Joseph Banks and others at £20,000, in a sound condition for seven years; his additional occupation being that of culling from the mass of manuscripts also placed under his charge, such knowledge as would enable him to class, and otherwise profitably arrange it. “His merit,” says one man who was especially well calculated to appreciate such services, “consisted in his single-minded fulfilment of arduous duties under peculiar difficulties, and his noble self-devotion to the achievements and memory of his great master.”
Sir Everard Home, the brother-in-law of Mr. Hunter, having undertaken the charge of preparing a catalogue of the Hunterian Collection, Mr. Clift was much occupied in promoting such investigations as appeared requisite for that purpose.
The results of most of these labours have been recorded in the Transactions of the Royal Society, and with few exceptions, the illustrations of the numerous papers on “Comparative Anatomy,” are from the accurate pencil of Mr. Clift.
In the year 1826, the proffered assistance of Sir Εἰ, Home having been withdrawn, consequent on the alienation between himself and Mr. Clift, arising out of the well-known destruction of the Hunterian MS., Mr. Clift applied to the Council for the aid of some person well versed in human anatomy; and Mr. Abernethy, then a member of the Board of Curators, proposed the appointment of Mr. Owen, with a view to render that assistance in the formation of the catalogue, the deficiency of which furnished a weekly topic of censure, in a newly-established weekly periodical.
The office was accepted by Mr. Owen, happily for the cause of science, happily for the reputation of the College of Surgeons of England, and not less happily for the reputation of the great founder of the Hunterian Museum, as well as for that of Hunter’s distinguished successor, on whom I may say that the mantle of Hunter, which had been held in charge for so many years by Mr. Clift, has so deservedly fallen. The result of the labours of Mr. Clift, in conjunction with his newly-appointed colleague, was the production of two volumes in 1830 on the “morbid series.” It was then considered that the catalogues would proceed more rapidly if each person took a different subject. Mr. William Home Clift completed the catalogue of the “dry vascular and miscellaneous preparations” in 1831, and the catalogue of the “osteology ” in 1832. Mr. Clift undertook that of the “monsters and malformations,” which was printed in 1831, after which he chiefly occupied himself in collecting cases and materials from all the medical publications contemporary with Hunter, that related in any way to the morbid specimens.
The shock which poor Clift’s nervous system had sustained after his rupture with Home, and the catastrophe of the Hunterian manuscripts, had produced an almost morbid apprehensiveness of putting any description into print. He never could assure himself of its accuracy and its conformity with Hunter’s opinions. This state of indecision, and the loss of his usual clear intellectual power, increased after the fatal accident that befel his only son; and his chief literary and scientific occupations, until he retired from the College, consisted in copying out from various periodicals and works, whatever he thought might elucidate such preparations as especially related to pathology.
Mr. Clift’s immediate contributions to science, at least those bearing his name, are but few. ‘Two only appear in the Transactions of the Royal Society. The first is entitled, “Experiments to ascertain the Influence of the Spinal Marrow on the action of the Heart in Fishes,” and is published in Vol. CV. of the Philosophical Transactions in the year 1815; and the second consists of a description of some fossil bones found in the caverns at Oreston, printed in the volume for the year 1843.
“By the judicious choice,” says his son-in-law, Mr. Owen, “and the care and skill with which these experiments were performed, Mr. Clift, in the first of these papers, established, in contravention to the conclusions to which M. Le Gallois had arrived, that the action of the heart continues long after the brain and spinal marrow are destroyed.”
Mr. Clift was elected a Fellow of the Royal Society in 1823, soon after the publication of the first of these memoirs, and served on the Council of the Society in the years 1838 and 1834, The Transactions of the Geological Society also con- tain some memoirs from the pen of Mr. Clift, “On the Fossil Remains from the Irawaddi,” and on the “Megatherium;” and undoubtedly most of the works on the fossil remains of the higher class of animals, which have appeared since the publication of Sir E. Home’s first paper on the “Protecsaurus,” in 1814, until a recent period, are more or less indebted to Mr. Clift.
Very unequivocal have been the acknowledgments of his services by Dr. Mantell and by Baron Cuvier, and by the public voice in the case of the publications of Sir E. Home. But the highest acknowledgment of the productive labours of Mr. Clift, are to be witnessed in the present efficient condition of the great museum itself, which is a lasting monument of the integrity, and of the activity, as well as the honesty of his stewardship.
It is in no vein of flattery that I advert to a remarkable resemblance both in person and in character between John Hunter and Mr. Clift. Both exhibited the same ardour and devotion to the cause of physiological science, employing however, the force of minds of different calibre; and both exhibited the same single-mindedness.
The personal resemblance between the two, has been the theme of frequent observation, and has elicited the most ill-founded suspicion of a real relationship. This observation having been on one occasion made to Mr. Clift, such was his veneration for Mr. Hunter, that he replied, “He should only be too happy were its truth confirmed.”
This day is also the anniversary of the birth of both Mr. Hunter, and Mr. Clift.
Mr. Clift retired from the College in the year 1842, on an increased salary of £400 per annum. He died on the 20th of last June, having survived his wife, to whom he had been united, and tenderly attached, more than fifty years, a period of six weeks only. His only daughter is married to his successor, in whose expressive words, inscribed on his tomb by his son-in-law, I shall conclude this hasty and imperfect sketch of Mr. Clift:—“He carried a child-like simplicity and single-mindedness to the close of a long, and honoured career.” Charles Aston Key, a name identified with the highest class of scientific surgery in this country, occupies a prominent position in the large obituary I am painfully compelled to place before you.
A biographical sketch having been published by one whose intimate knowledge of Mr. Key must have rendered him so competent to the task, it will be unnecessary for me to enlarge on the details of his early life, or of his deservedly eminent career as a leading surgeon of the metropolis.
Mr. Key was appointed one of the chief surgeons of Guy’s Hospital in the year 1824, which office he continued to hold till his death, in 1849, a period of twenty-five years. Possessed of a mind, of which a refined common sense was, perhaps, the most striking feature, that most practical and most valuable of all its individual qualities, he added, in a very high degree, that peculiar talent for observation, which has ever marked the eminent surgeon.
His knowledge was his own. Without undervaluing the services of written surgical authorities, he studied disease where alone it could be thoroughly learnt, viz., at the bedside. To the advantages arising from a field of observation, as ample as this large city could furnish, he added a deep interest in the cultivation of professional knowledge, great industry, and a most justifiable ambition of professional distinction.
On such conditions Mr. Key could scarcely fail in reaching the eminence which was the object of his aspiration. He possessed a remarkably cool judgment. He was not content with a general inquiry into the history of any case that interested him, but he pursued his investigation into every detail that could illuminate it. His reasoning on such a case, would often become mathematically inductive.
This habit became a prominent feature in his professional character. His knowledge of anatomy was cultivated just so far, as to fit him for all the exigencies of surgical duty, for without depreciating the labours of the microscopist, he grasped only at that level which he could render subservient to the treatment of disease. Without possessing an absolute claim to inventive power, he was happy in his improvements of the inventions of others, of which the employment of his strait staff in lithotomy is one example.
Mr. Aston Key is equally well known to the profession both as a teacher and asa writer. During nineteen years he addressed one of the largest assemblages of medical students in the metropolis on his favourite subject, viz., the principles and practice of surgery; and fully maintained the almost unequalled reputation of the great school of Sir Astley Cooper, by the correctness, the force, and the lucidity of his instruction.
As a writer, he has contributed some valuable papers to our surgical records. His first work, in 1824, introduced to the profession a new mode of operating for the stone, which has acquired a decided influence on the present operation of lithotomy. In 1827, he published an edition of Sir A. Cooper’s great work on Hernia; and, in 1828, a memoir “On the advantages of Dividing the Stricture in Strangulated Hernia without opening the Sac.”
In this recommendation, also, the practice of Mr. Key has obtained many proselytes in the profession.
His papers, communicated to the Guy’s Hospital reports, particularly one on lithotomy, are highly valued by the profession, and indicate both an independent and a reflecting mind.
A large portion of the success of Mr. Aston Key may be assigned to the interest he took in the cases consigned to his charge, whether in public or in private. Neither time nor trouble were spared in his endeavour to sift every case of difficulty to its root.
It cannot be denied, I fear, that he held somewhat eccentric opinions with respect to food and diet, and to which eccentricity his own untimely death may be in some measure attributed. I am informed that he leant much to the recommendation of a vegetable diet, and that he frequently denied his patients the indulgence in animal food. Whatever was his practice in reference to others, I believe there is little doubt that he adopted for himself a system of diet that was little likely to. afford him efficient protection against the horrible pestilence that pervaded the metropolis during the last summer.
An anecdote was mentioned to me by a common friend, which speaks loudly as to his condition at the date of his unfortunate attack. When asked as to the state of his health, only a few days prior to his last illness, his answer was, “I am as well as a man can be with most irritable bowels.” Within a week of this event, he was himself thrown prostrate by cholera in its most fearful form. One profuse action of his bowels was followed by almost immediate collapse, from which all the skill and experience of the eminent physicians who surrounded him, failed to extricate him, and he expired in nineteen hours from the period of his attack, in the fifty-seventh year of his age, regretted by the entire body of the medical profession.
In his relations of husband and father, Mr. Aston Key’s conduct was peculiarly exemplary, and affectionate.
The past year has terminated the career, at the age of sixty-five, of Mr. Joun Goldwyer Andrews, who was the Senior Surgeon of the London Hospital, and a Member of the Court of Examiners of this College.
Thomas Morton was born, at Newcastle-on-Tyne, in 1813. While a boy, he was distinguished by great quickness of apprehension, by his intelligence, and by that peculiar kindness of heart, that so endeared him to his friends in later life.
At about fifteen years of age, he was articled to the house-surgeon of the Newcastle Infirmary, and during the period of his studentship he was frequently entrusted with the sole charge of the patients of the institution, consequent on the illness of his master, Mr. Church. He left Newcastle in the year 1832, with a well established reputation for superior acquirement, and entered University College as a student, where his talents and indefatigable industry obtained for him a renewed approbation, evidenced by his successful competition for various prizes awarded to his industry, by the College. The intervals of the sessions were devoted to anatomical and other pursuits, holding reference to his profession, in Paris; and each year contributed its quota to an increasing and well-earned reputation for professional acquirement; and throughout the whole of his career he was no less notorious in the circle of his friends and personal acquaintance, by the kindliness of his nature, and the simplicity of his mind and manners. In 1815, he became house-surgeon to University College Hospital, and in the following year demonstrator of anatomy in the College to which that Hospital is attached, imparting knowledge to others with the same success as he himself had acquired it. In 1841, Mr. Morton was elected assistant-surgeon to the Hospital, and subsequently surgeon to the Queen's Bench Prison. In addition to the practical duties of these offices, Mr. Morton appeared before the public as an author: besides many contributions to various medical periodicals, he published a series of works on the surgical anatomy of the most important regions of the body;—in 1838, that relating to the perineum; in 1839, that of the groin; in 1840, hernia; and, in 1845, the surgical anatomy of the head and neck. These works are admirably illustrated by the late Andrew Morton, an artist of very superior merit, and they bear testimony to the accuracy, and to the diligence of these two talented brothers. In 18438, he was appointed surgeon to University College Hospital, an office which he held for little. more than one year. As a surgeon, Mr. Morton was distinguished by an ardent love of his profession, and by the patience and accuracy of his observation; his treatment of disease was remarkable for its simplicity; and his operations were characterised by peculiar neatness, and dexterity. Simple in his habits, and equally earnest in his pursuits, he was remarkable for a modesty approaching to diffidence. He suffered at times from mental despondency, which was attributed by his friends to a too close application to his professional studies. Certain changes which occurred in the medical department of University College, which produced on his mind an impression that he was deprived the prospect of further advancement, were unfortunately superadded, and, in a moment of despair, he sought at his own hand, relief from his suffering, and his anxiety. He died in the thirty-seventh year of his age, leaving with his contemporaries the reputation of a talented surgeon, and with his friends the memory of a kind and estimable man.
I should do injustice to the memory of a highly respected member of our profession, were I to omit reference to the late Mr. Pennington, who played no unimportant part in the great medical drama of both the last, and the present century.
Unknown as a writer, and unconnected with public professional life, he pursued a career of almost unexampled activity, in the department of private practice. Warmly attached to the order to which he belonged, I believe it may be said of him, that by no one act did he ever tarnish the lustre of his own high character.
At the age of fifteen, Mr. Pennington left his native town of Alford, in Lincolnshire, in company with the late Archdeacon and Major Pott, the sons of the great surgeon of that name, and they repaired to his house, where Mr. Pennington took up his abode. Mr. Pott, appreciating at its true value the intelligence and earnest zeal of his young friend, took him as a private pupil. In Percival Pott, up to the period of the death of that justly emiment man, Mr. Pennington found a benefactor, an instructor, and a friend.
One is naturally disposed to inquire into the history and cause of the unusual success that marked the career of the late Mr. Pennington, and to consider how far his reputation was a just or a factitious one. His extensive practice, so far as I can ascertain, appears fairly deducible from a well-grounded confidence of the public in his professional skill, obtained by patient industry and an ardent love for his profession. Mr. Pennington ascribed his own early success to the great advantages he acquired from his daily intercourse with the person, and practice of his great benefactor, and to his possessing the intimate friendship and the benevolent assistance of the late Dr. Pitcairn, then Mr. Pott’s colleague at St. Bartholomew's Hospital.
To a thorough knowledge of the Therapeutic art, he added an indefatigable energy in its practice, from which all the attractions of society failed to entice him. The experience of his later years was derived entirely from observation, the most valuable school of medical proficiency; and, among his medical friends, his powers of diagnosis were considered of a very high order. He, early in life, took a high station in the profession as a family medical adviser, and it was his no inglorious boast that, at one time, he attended professionally every Cabinet Minister, and every Judge upon the bench.
In his private character, he was practically a most kind and benevolent man; his philanthropy was large and generous, his sympathies were readily enlisted, and his purse opened to distress and difficulty, more especially among his younger professional brethren. His mind revolted from an act of meanness or dishonour, and I believe it may be said of him, without flattery to his memory, that he never sullied his integrity by a single ungenerous or sordid act during a long life of unexampled professional activity. Mr. Pennington died, in the month of March last, in his 85th year.
From the earliest period of the world, the science of medicine has been esteemed among the noblest occupations of the mind. Amidst the varied pursuits of educated man, it would be difficult to find one more calculated to inspire the mind with intellectual ardour, or to kindle the energies of thought, and speculation.
The study of physiology, as it unfolds the machinery of life, whether applied to the revelation of the structure of the body, by investigating the microscopic details of the material framework which it habits, or to the attempt to fathom and explore the mysterious immaterial agent of life itself—the study of the scarcely less interesting phenomena which characterise the defects in its machinery, whether local or general—the study of psychology, applied to the mind in its healthy condition, while exercising a never-ceasing control over the physical actions of the body, or that of the phenomena of mental disease, demanding the highest order of intellect for their exposition and treatment—the ingenious discoveries of innumerable agents obtained from the vegetable, animal, and mineral kingdoms—the application of the resources of mechanical philosophy—the profound researches of the chemist, whose operations are so closely interwoven with the study of almost every branch of medical science—the necessary cultivation of a peculiar refinement of the external senses, of sight, of hearing, and of touch, that may well deserve the title of erudite. In fact we can hardly point to one department of philosophy, whether of mind or matter, that is not in a greater or less degree incidental to the service of medicine, and the records of which have not been enriched by the exertions of medical men.
These are among the intellectual occupations of the medical mind. Observe how readily our occupations blend into the wider circles both of philosophy and science, for there is no definite boundary to the scope of medical study. Plutarch says, "Of all the liberal sciences, physic is one which, as it gives place to no other in attractiveness, and in the pleasure it affords, so it makes a great return to those that love it, even as much as their life and health come to; and, therefore, philosophers who discourse and dispute of matters concerning the management of health, are not to be charged with passing beyond the legitimate bounds of their studies. We ought rather to blame them for avoiding subjects of that description, and for not removing those limit-marks of science, so as to labour in the common field between themselves and physicians, in the study of things good and becoming."
Nor are his moral requisites less indispensable to his utility and success in life. The practitioner of medicine in every rural district, is a member of each social circle into which the service of his profession calls him. Into his charge, the father resigns the health of his wife and children. Into the privacy of his dwelling, into the recesses of his very chambers, he is admitted at all hours, and at all seasons, where he may exercise even a more than parental authority. Nor are his functions limited to his direct professional duties. He becomes a familiar, an adviser, and a friend. His ear is the depository of private histories and family secrets; he has extensive rights and peculiar privileges. Add to these the fact, that the path to medical knowledge is steep and dangerous, and that its requirements are often of a nature repugnant to delicacy of feeling—that. it involves an intercourse with objects, from which the senses may well revolt, with disgust and loathing. Be it remembered, that his services are perilous from their outset, and that a large proportion of the profession pursue their anxious and laborious career, often unchequered by the recreation of a single day, throughout a life of daily companionship with sorrow, contagion, disease, and death. Of domestic joy, he knows nothing but in name. From the comforts of his home, his easy chair, his winter’s fireside, he is estranged by incessant toil, the slave of caprice, of ignorance, of groundless apprehension. While other members of his family seek that repose which nature calls for at the termination of the day, he is perhaps summoned to a distant village, to minister to the temporary relief of a disease he cannot cure; devoting to reflection while on horseback, amidst the sleet of a winter’s night, those hours that should be engaged in invigorating his mind and body for the pursuits of the morrow.
For the influence of these occupations on the physical health of the members of our profession, let me point to the bills of mortality, which teach us, that they sink too often unrewarded into an early grave.
Such are the intellectual, and such the moral requisites of our profession—such the qualifications, and such the duties of him who, beyond any competitor, ministers to the physical and moral sufferings of humanity.
Nor is this condition, altogether unmerited by the practitioner of medicine. With largely increased resources, the profession of medicine is at the present day a degenerate pursuit. Even its indispensability to the wants of society, has failed to wrest it from the influence of neglect, if not of obloquy. The rank of individuals, the rank of a select few may yet remain; but as a profession, it has ceased to be sustained to the level of its intrinsic value by the applause of the public voice; and there must exist, in the very nature of things, some deteriorating influence in operation, which overbalances that esteem which the conviction of our utility to the world would naturally engender.
It is not, I presume, a subject of consideration inappropriate to this annual address, to inquire into the cause of the low elevation of that profession which, considered in the abstract, appears to possess such high claims on the respect and esteem of society; for I know not in what manner I can more efficiently do honour to the memory of Mr. Hunter than by commenting on the present condition of that profession, of which he was so bright an ornament. These causes are, I conceive, various; but by far the greatest of all the difficulties under which the profession of medicine labours, may be referred to the want of education. The object of education is two-fold:—First, to develope the powers of the mind,—to teach it to think, to reason, and to remember; and secondly, to apply the powers thus obtained to the acquisition of knowledge. The unfolding and developing mental power, in the endeavour to comprehend the resources of the great world around us, and ally those powers with the highest purposes, this is to realise the great end of life itself. “It is mind that does the work of the world.”[2] Mind is the great leveller that blends all the arbitrary distinctions of social life. He who would study the history of man in his moral and physical condition—he who proposes to himself to investigate the sources of the thoughts and opinions of the world,—or he who would render himself familiar with the capabilities of his own language, must cultivate an acquaintance with the writers of antiquity; he must take up his abode in the nursery of time. An inquisitive and ardent mind will take nothing upon trust; he will trace the streams of knowledge to their source; he will investigate its springs before he avails himself of the force of the current. “If there be,” says Godwin, “in the present age, any powers of reasoning, any acquaintance with the secrets of Nature, any refinement of language, any elegance of composition, any love of all that can adorn or elevate the human race, this is the source from which they ultimately flowed.” That of ancient Rome is the adopted language of the great congress of medicine and science throughout the world. The common university of medicine has employed it in the individual nations composing it. It is the language of Celsus, the adopted language of Haller, of Boerhaave, of Morgagni. Its cultivation is more directly indispensable to the practitioner of medicine, than to any other member of society. It is the accomplishment of all refined and educated society. But classical study should have no monopoly of the early mind, since, however valuable, it forms but the substratum of acquirement. Its excessive cultivation generates a learned folly, which in a remarkable degree disqualifies its possessor for the acquisition of that working knowledge demanded in our intercourse with the world. And I may take the liberty to remark, that no greater wrong is inflicted on the cause of education, than that indiscriminate, and almost exclusive devotion to classical reading which prevails in our public schools. No man is competent to the task of education, whose mind is not well stored with general, as well as with particular knowledge, philosophy, history, and elementary science.
The application of the knowledge acquired by classical study, is in an inverse relation to the benefit conferred on the retentive powers of the mind; for by its early cultivation, of all the faculties, the memory is its greatest benefactor. The actual knowledge acquired by classical study will therefore greatly depend on the age of the student.
A no less important branch of study, rather than of knowledge, most pertinent to our profession, is that of the exact sciences; and here again, we are largely indebted to antiquity. By mathematical study, we acquire the principles of inductive, and other forms of reasoning; we learn to compare and analyse. We acquire habits of close thought, the power of detecting the sources of error, and of “exposing the fallacies under which false reasoning is disposed to lurk.”[3] Logic also, is an important source of mental discipline, which invigorates the faculties by its application either to the precise interpretation of words, or to the higher purposes of abstract reasoning on things.
I conceive that the almost universal neglect of these pursuits in early life, and the want of cultivation both of philosophy and general science, are among the chief causes by which medicine is degraded at the present day; and that unless by a general Act of the Colleges which preside over each department of the profession, rendering some form of preliminary education in these branches of study, compulsory on those, destined to become members of our body, the entire removal of all the other causes combined, will fail to extricate it from the degenerate position it now occupies.
I cannot persuade myself to pass without comment, the still prevalent system of, so called, education, by means of apprenticeship, which appears little more or less than an ingenious device by which to exhaust or render nugatory, four or more invaluable years of the early life of the student.
Yet there are few pursuits without their advantages. During these four or more years the so-called student is compelled to practise the art of manipulation, which consists in the wielding the important instruments placed at his command; while he holds converse with the languages of the philosophers and orators of the past world, in a refined latinity obtained from his master’s day-book; and amidst the varied occupations of each eventful day, happily some small portion is allowed him for that most profound study,—the study of himself.
To this disgraceful system of officinal drudgery the medical profession has lent itself, in direct contravention of the laws of moral right, of reason, and of common sense; and glancing for a moment at the necessities of the future practitioner, I ask you, whether the rooted injury thus perpetrated by four or more long years of personal servitude, at this most critical period of a student’s life, in which the only distinction discoverable between his lot and that of an ordinary servant, consists in the fact, that he is made the purchaser of his own degradation, does not inflict a wrong on the mind and habits of a youth, which in avery large majority of cases, no future opportunities of study, no future discipline can redress or justify. This is the spring of his existence; this is the season, and the only season, in which the mind takes the impression for a whole life. The child is said to be "father to the man.” I have sketched his education, look at the result!
The construction of society demands a distinction in the grades of the medical profession; the rewards of exertion must be necessarily unequal in value; his physical relations must regulate in some measure the nature and extent of his occupations, the value of his time, and the rank he holds in society, but the giant evil of the day is want of education. The quantity or degree may be regulated by the future position and means of the student, but all should be educated in mind and manners up to the level of good society.
I conceive that education is required by all, whether rural, provincial, or metropolitan; but in every grade his general acquirements as to his competency for this high pursuit should be tested by actual examination; and I rejoice to think that the Council of this College, under the superintendence of its distinguished President, who have at heart the earnest desire to promote the highest interests of that department of the profession over which they preside, have acknowledged the necessity, by taking the initiative on this subject, and instituting examinations in classical and mathematical knowledge, for all future junior candidates for the rank of Fellow of this College, and on this head T have only to express my regret, that this important requisition is not made referable to the first, rather than to the last, stage in the career of the student. The second cause of inferiority in rank of the medical profession is founded on the degenerate standard of medical ethics; and if I dwell but briefly on this ungrateful topic, it is because we have in education alone, its legitimate, and only corrective. If we take the body corporate of the profession, as the field of comment, do we not find the want of that high tone that characterises the other professions? ‘There is a moral elevation that should distinguish the cultivator of natural science, from that resulting from conventional laws. Do I wrong our profession when I say that there is a want of tone, a jealousy of the exertions as well as the success of others; a tendency to misconstrue good, or to suggest evil motives ; the absence of that enlightened spirit, that marks the gentleman of education ?
Liberal and generous habits of thought and action, are the indisputable growth of a high degree of civilisation and refinement. What better evidence need be adduced of the want of that cultivation of mind, so indispensable to all ?
There is no profession the conventional refinements of which are more stringent than the higher departments of law. This fact is explained, perhaps, when we consider law to be a purely artificial pursuit.
In a conversation I once had with a notorious burglar, but obviously a man of good education, who had broken into and robbed my house, he told me that the laws of the society he moved in, were also stringent ; that inasmuch as his pro- fession was not altogether indispensable to the well-being of society, so the world was their common enemy, and that no calling or pursuit, exacted a more rigid observance of the authority of conventional regulations. It is the same necessity, possibly, that renders the conventionalism of law so imperative. This man had been educated to the law, and he added that he found his professional knowledge of remarkable service.
“Law in the abstract is an inflexible and impartial prin- ciple, holding out one standard of moral right, and moral wrong to all the world. It has been devised by sages in the privacy of retirement, to protect society against the encroach- ments of selfishness and power, and to be an accessible instrument in the hands of all.” *
As an abstract principle, none is more sublime or more deserving the veneration of the world. While, by the pro- gress of knowledge and civilisation, the profession of medicine, having enlarged the circle of its utility, has become degene- rate in rank; that of law, has gamed an ascendancy, in the same proportion as it has lost sight of its early simplicity. That which was an instrument, has become a machine, ponderous, complicated, and unwieldy ; and in the same degree as it has ceased to be the tribunal of impartial justice between man and man, have the conventional laws of its professors, their learning and education, obtained an ascendancy in the world, before which the claims of medicine sink immeasur- ably. It would appear that the estimate of truth recedes in value, in proportion as the world advances in civilisation. No man had a juster perception of the moral evils, insepara- ble from the practice of an advocate, than the late excellent Dr. Arnold, who, in a letter to an old pupil on the choice of a profession, says :—“'To see any man delivered from the snare of the law as a profession, 1s with me a matter of
- Godwin. earnest rejoicmg. I rejoice in your escaping while it is yet
time, and following the right hand path to any pure and Christian calling, which to my mind that of an advocate, according to the common practice of the bar, cannot be. For advocacy does seem to me inconsistent with a strony perception of truth, and to be absolutely intolerable, unless where the mind sits loose, as it were, from any conclusions, and merely loves the exercise of making any thing wear the semblance of truth which it chooses for the time being to patronise.”
It is impossible for a mind imbued with a love of truth to witness the contentions for victory, exhibited in our courts of justice, without acknowledging with painful regret, that the highest intellectual powers are too often enlisted in the cause of the lowest moral degradation ; and if we remove ourselves to a distance of time, and divest our minds of the influence of daily observation, which has reconciled us in some measure, to the growth and maturity of a system which pays homage to precedent, at the expense of reason, and which distorts the line of truth by the interposition of unprofitable subtleties, employed with the force of one of the mechanical powers to wrest the whole machine of justice from its centre, we cannot but deeply lament that this sacred cause, which is the only true cement of society, and the aspiration of all good men, should be rendered the object of secondary worship only—the first being devoted to the cause of victory.
For one, I rejoice to think that the mind and the habits of the medical man, are differently constituted. Truth is his field of action, good his aim, the world his study. With all our differences and contention, we have one common end and object ; one appeal to nature, from one common enemy, disease.
In a remarkable degree have the duties of our profession a tendency to keep alive the best emotions of our nature, and to engender a warm sympathy with the sufferings of humanity; towards the mitigation of which, a considerable portion of our time and knowledge, is devoted. Yet, with all its attendant evils, the practice of the law is regulated by a sense of decorum, of propriety, and even of refinement, which in a far less positive degree, are practised by the sister profession.
“I hold every man,” says Lord Bacon, “a debtor to his profession, from the which, as men do receive countenance and profit, so ought they of duty to render themselves, by way of amends, to be a help and ornament thereunto. This is performed in some degree, by the honest and liberal practice of a profession, when men shall carry a respect not to descend into any course that is corrupt and unworthy thereof, and preserve themselves from the abuses wherewith the same profession is noted to be infected. But much more is this performed, if a man be able to visit and strengthen the roots and foundations of the science itself, thereby not only gracing it in reputation and dignity, but also amplifying it, in profession and substance.”
Thirdly,—The state of the law exerts an important influ- ence in depressing the rank of the profession of medicine.
It is general practice that gives the stamp to the whole, and it is to this department that my remarks are intended specifically to apply.
The general practitioner is an amphibious link between a profession and a trade. For the exercise of his intellect, the law yet awards him a tardy, if not a questionable, remunera- tion. He is permitted aremunerative profit on the materials of his druggist,—on the mechanical agents of treatment, not on the exercise of the judgment that selects them. For his loss of time, or his knowledge, however superior to others, he obtains no certain compensation.
This system is fraught with the greatest evils, not only to the profession of medicine, but to society, who are its greatest sufferers. It is an injustice to the profession, by depriving it of the legitimate recompence due to years of study, by assimilating us to the tradesmen who supply our daily wants.
If the law awards payment for physic only, of necessity the medical attendant disposes of as large a quantity as is compatible with the digestive capabilities of his patient; and as this quantity demands some skill and judgment, in this sense, confessedly, his intellect is remunerated. It is nota question how little physic such a person requires, but how much will he take,—how much will repay his daily loss of time, for so many days, weeks, or months. His object is “to buy in the cheapest market, and sell in the dearest.”
I do not hesitate to assert that it is impossible in many cases for the medical attendant to be remunerated, but by the resort to means, which high principle must proclaim in his own breast, to be indirect, and even disingenuous. Is it to be expected that a medical man should ride to a distance from home, to devote his talents and knowledge to the immediate relief of a person in great bodily suffering from accident, such as a dislocation of a finger, or of the jaw,—to pass a probang, to remove a piece of dead bone, or to employ a catheter,—without compensation to be in some degree guaged by the nature and extent of the service he has rendered ? If the law does not award him legitimate compensation, he is necessarily driven to an indirect excuse for subjecting his patient to a course of physic, with a view to prevent the recurrence of the malady.
The objections to this system cannot be overcharged. It is mseparably interwoven with the rank of our profession, with the respectability of our characters, and with the well- being of every station of society.
It upholds the most pernicious doctrine, that medicine is the sole, or at least the primary, antidote against disease. It invites empiricism. It engenders erroncous principles of pathology, and it weakens the allegiance of our profession to nature, as the great author of disease, and the beneficent worker of its treatment. The true principles of the art of healing, consist in the endeavour to develope and awaken the influence of nature, in the cure of disease. By the adoption of the present system, we forget the operation of first causes, in our false reliance on second; we largely circumscribe our curative powers, and we strike a fatal blow at the just rank and respectability of our profession.
If there exist one feature more injurious than another to the rank of the general practitioner of England, and the persistance in which, presents a more fatal obstacle to the success of any attempt to ameliorate his condition, it is that which places a pecuniary value on the drugs he dispenses.
With quite as much reason, might the surgeon claim compensation, in the name of the instruments he employs, for their services, after an operation. I conceive that so long as the general practitioner consents to subject his professional practice to such degrading conditions, he is unworthy the rank and estimate of a professional man. Medicines should be dispensed at their real, not their adventitious value. With one voice, this depart- ment of the whole profession should cry aloud, and claim their indisputable right to repudiate a practice so vicious, both as regards their own high claims, and their utility to others ; and obtain from parliament the title to a remuneration, more consistent with the real services they have rendered, and less derogatory to the repute of the high profession to which they belong.
Fourthly,—One of the highest incentives to superiority that can animate the human mind, is ambition of distinction above the rank of our fellow-men.
I do not stop to inquire how far this sentiment 1s identified with the excellence, or the weakness of our nature, but it is undeniable that its exercise in every age has led to great deeds, by which the world has profited.
It affords, however, a stimulus to exertion, far less avail- able to the professor of medicine, than to any other of the so-called professions. We have in England no public honours or distinctions.
Inasmuch as our duties are limited to the bedsides of our patients, so are our claims to public gratitude, unacknowledged by the world. For, the mere privacy of our duties should not disqualify us for public reward; and I look forward to the time, when the profession of medicine will stand forth in higher relief; when the award of the public voice, shall grant to it some public memorial or acknowledgment ; when its high services, shall no longer pass unnoticed and unrewarded. I would claim for eminent superiority in either department, some “order of merit,’ to be granted by the Government, to such men as have distinguished them- selves, either in the cause of medical science, or in that of humanity.
I may be told, perhaps, by such as are content “to stand upon the ancient ways,” that the purposed distinctions will be invidious, and I will point in reply, to the jealousies of our profession ; or, I may be told that however plausible the scheme, it cannot work practically, without great difficulty. I will reply that difficulty is no argument. If the profession be resolved to possess such a boon, they have but to demand it with one voice. Divinity, arms, law,—each has its public rewards, in the dispensation of which, if the voice of society does not exercise an immediate control, at least its sym- pathies are enlisted in their award, and most jealous is the public mind of their misappropriation.
These causes exercise a most pernicious influence on the public estimate of the profession of medicine, and for the removal of which, so indispensable are our duties, we may fearlessly call on society to co-operate with us in our endea- vour to remove them, nor should we call in vain.
Among these four causes of depression, viz.—l. The want of high classed education: II. The low standard of medical ethics: III. The present imperfect state of the law: IV. The absence of public and national honours—it is obvious that the first and greatest, 1s irremediable as regards the present generation; but there is no other reason why the remaining causes should not undergo consideration with a view to their removal, beyond the difficulty of rousing attention, the diffi- culty of bringing into action a distracted power, and directing it towards one focus.
We waste our energies in a fruitless struggle to raise ourselves in individual classes, by a sort of mternecine contention, instead of making one general effort to elevate our pursuit. Every class has its grievances, real or supposed. In one department, fretting under the imdignities imposed on it by law, we find contention for the honours of collegiate government. A second has sought emancipation from the contact of pharmaceutics, in the assumption of a title. The third has claimed superiority in the exclusive right to treat disease, within a certain locality; and on these lesser objects of contention, we fritter away on comparative trifles, that influence that might be profitably exerted in the far higher aim, of obtaining for ourselves as a profession, the estimate and the respect of the world.
It cannot be expected that society will aid us, unless we aid ourselves, unless we root out those evils that we alone can deal with; that we purge ourselves of the imputations of littleness, and throw ourselves on the highest resources of our profession.
We may point to the grandest discoveries in general science, or to the practical deductions of the profoundest philosophers and mathematicians without envy, we may marvel at the triumphs of human intellect, manifested in the recent discovery by Le Verrier and Adams of the planet Neptune, the nature and existence of which, was deduced from its recognised obedience to the Newtonian law of gravi- tation, and constituting one of the most sublime examples of induction the world has ever seen—to the knowledge of the remotest stars of the solar system—to the discovery of Voltaic electricity—to that of the atomic theory of Dr. Dalton —to the wondrous inventions in the mechanical arts that have in recent times all but realised the fervent appeal of the lover in Martinus Scriblerus, “ Ye Gods, annihilate both space and time ”—to the names of Ferguson, of Hallé, of Priestley, of Herschell, and of Davy, and feel that in the limited circle of our own profession, we may boast names and discoveries, not inferior in greatness or utility, and which, if they display themselves in a less degree as the result of the highest order of inductive reasoning, than on that of experimental science, greatly exceed them in their intrinsic value, if guaged by their subserviency to the well-bemg and happiness of mankind.
Famiharised by daily imtimacy with any recognised fact or phenomena, however grand its discovery, the mind ceases to wonder. We lose the power, or rather the habit of appre- ciating it in its early grandeur, forgetful of the mtellect that has been employed in developing it, and it takes its place in a prominent position in the great temple of science, to support the superstructure of yet more recent discoveries.
In our own profession, I may allude not unworthily to Mr. Hunter’s inductive reasoning on the subject of arterial disease,—to the yet older discovery of the circulation—to that of the recent investigations of Dr. Marshall Hall, which have established the important doctrine of the independence of the true spinal cord,—to the introduction of the vaccine virus as an antidote to smallpox, a disease more destructive than the plague ;—to the identity of the cellular formation of animal and vegable life; and finally, to the discovery of a property possessed by certain physical agents, of suspending unimpaired, the powers of sensation and consciousness.
These are indeed discoveries worthy of any age, or any science, discoveries of universal application, benefitting every class of society, from the peasant to the king.
If we could persuade ourselves occasionally to turn aside from the daily path of practical observation, to retrace the chain of thought on which our principles are based, and to recall to our recollection the names of Harvey and of Hunter, of Desault, of Cuvier, of Jenner, of Bichat, of Abernethy, of Cooper, and of Laennec, as the link that connects their great works with the occupations of our daily life, our souls would expand with the real greatness of our pursuit, and we might be induced to combine in one united effort to elevate our honoured profession to a higher rank, than it now occupies in the esteem of the world !
In considering the subject of the remunerations of our profession at the present day, so palpably below the level of our responsibilities, I do not lose sight of the fact, and a painful fact it is, that the necessities of society increase in proportion to its inability to afford us compensation,—that poverty is the very nursery and focus of disease, and that whether under the form of Hospital, Dispensary, or Union practice, a large portion of our time is devoted to the relief of human suffermg. Doubtless the motives that dictate these high services rendered to the world, are composite in their nature. If to motives of philanthropy, a love of professional knowledge, an honourable ambition of distinction, and a not unworthy desire of future independence, meet in combination, the world is yet our debtor, and it is because society cannot afford us pecuniary compensation, that we have an especial claim on it for an honorary distinction. The award of the sovereign encircles the soldier’s brow with victorious wreaths, his bruised arms are hung up for monuments of his glory— distinguishing orders of pre-eminent rank await him on his re- tirement from public life ; and while these and other honours, open to his ambition, operate as the reward of his past ser- vices, and stimulate the younger members of the same profession to high achievements; it is perhaps a natural sequence, that the professor of medicine, whose life is equally at the expense of his own, devoted to the purpose of extending the term of human existence, should pass unnoticed and unrewarded.
It is almost singular that this significant fact, should have escaped the inventor of the Malthusian doctrine.
I have alluded to the impracticability of extending the advantages of education to the practitioners of the present generation. Thus far the evil is irremediable, but there is no reason why much good may not be effected by the active agency of a refining spirit, employed for the purpose of root- ing out the vulgarisms in conduct, that unhappily prevail in our profession, to an injurious extent, and prey upon the - vitals of our reputation.
I desire to see a better spirit infused into our vocation, a spirit that will tend to avert those evils of conduct between man and man, that savour of the mercantile transactions of barter, and that are founded on questions of mere profit and loss. As an antidote against this spirit, I would venture to suggest the endeavour to cultivate a more refined taste than now pervades the profession, the accomplishment of which would, I apprehend, be a less difficult task than many would suppose.
By taste, I mean simply the power of appreciating beauty in any form, whether in nature or in art, and the cultivation of which, forms, I conceive, an important and a valuable substitute for more profound pursuits, but to which it may be superadded, with still greater advantage to its possessor. Good taste and good feeling are found in daily companion- ship with each other, and without its development in some shape or other, a blank is left in the circle of man’s most refined enjoyments, while even his intellectual frame-work is incomplete, and mutilated. For men are differently gifted, both as regards their sensibility and their taste. One man delights in the simple beauty of a flower, and expatiates with earnestness on its form and colours, a source of beauty quite distinct from that of its organisation; while another observes the same object with indifference.
I do not presume to enter into any definition of the nature of the beautiful, its essence or its source; but I will venture to assert, that its study forms one of the most elegant resources of our minds, by enlarging the number of our intellectual pleasures ; and in no direction can the mind, pre- occupied by the responsible and active duties of our profes- sion, expand more pleasingly or more profitably for the happiness of its possessor, than in that, which opens to its sense of admiration, the beauty of nature and of art.
This interesting study embraces a wide range of human knowledge, from its primitive form, exhibited in the sensa- tions of pleasure that reach the heart from the perception of the beauty of form or colour, or from a succession of harmonious sounds, equally grateful to the ear, to the highest manifestations of refined and cultivated taste, possessed by the poet or the painter. Such objects, in some form or other, are brought home within the range of every man’s observation, but im an especial degree, does a country life furnish materials for the development of untutored thought and admiration of such objects of beauty and refinement, which are calculated to take a man out of the sphere of his personal occupations, and to direct his thoughts to the contemplation of objects that tend to calm, and at the same time to elevate his mind.
The sources of this knowledge, and the pleasure that it produces, are infinite; the whole universe is charged with the office of mstruction to the hitherto untaught mind— innumerable voices reach it from earth and heaven! It takes lessons from every object within the sphere of its senses, from the form of a rosebud to the profoundest beauty of ancient or modern art.
Who can behold the exquisite colours of the tulip, or the gorgeous drapery of a golden sunset, or even the variegated colours decomposed by the common prism, without a sensa- tion of pleasure? Whose eye is so dead to the beauty of form or outline as to betray indifference to the delicate tracery of mosses, of ferns, of heaths, or to the grandeur and no less varied outlines of the sturdy oak, the graceful sweep of the weeping willow, or the lighter pencilling of the ash— the beautiful undulations of distant hills, or the yet more sublime form of gigantic and ponderous-looking clouds, when viewed against the blue sky, or fringed with light reflected from the sun ?—or more sublime than the boiling thunder of a cataract, or the broad expanse of the boundless ocean,—
“ That glorious mirror, where the Almighty’s form Glasses itself in tempests, in all time Calm or convulsed, in breeze, or gale, or storm, Icing the pole, or in the torrid clime Dark heaving, boundless, endless, and sublime, The image of Eternity,—the throne Of the Invisible.” *
The relish for such enjoyments has a tendency to adorn the solid acquisitions of the student. His mind awakening as from a trance to new existence, becomes conscious of infinite sources of delightful speculations, and objects around that have met his daily gaze for years, start into existence and disclose charms, hitherto unknown, and he may be said to breathe a new existence in the novel associations of every day, and hour.
The transition of the beauty of nature to that of art, is easy ; and here the painter, and the sculptor, and the archi- tect, exhibit all that is beautiful to the eye in composition, and elaborate in artistic skill. |
But nature is still the prototype from which are reflected the efforts of the artist, and from her simplicity we dare not stray.
Doubtless, the aptitude for these studies—I mean for the perception of the beauty of art—is possessed in various degrees of perfection by different individuals, but probably the germ is dormant in all; and in many, or in most, by early develop- ment and early cultivation, it may be rendered competent to perceive and to enjoy the highest perceptions of artistic
- Lord Byron. power, from the simple beauty delineated in the form of an
arabesque, to the highest sublimity of genius exhibited in the majestic beauty of the Theseus, or the other Greek adorn- ments of the great temple of Athens, which British taste and enterprise, have safely deposited within the walls of our National Museum.
It cannot be denied that the full appreciation of the highest sublimity of art, requires a specific development, but its study must always exercise a refining influence over the character; and I pity the man who could see unmoved the sublime exhibitions displayed in the marbles of Nineveh, and who, quite irrespectively of their intrinsic beauty, in which they far exceed the later productions of Egyptian art, does not attach to them a sacred character, as he enters the chamber allotted to them, with an emotion of awe, forming the great link in the chain of evidence, of the biblical history of a former. world.
If I appear to enlarge unnecessarily on the subject of taste, it is because I believe, by its more general cultivation, we may eradicate much of the human dross that pervades our profession ; for taste is not more a matter of perception and feeling than of conduct, and forms a regulating principle of our lives. It associates itself with our every action, as well as with the motive that animates them.
“Where taste exists in the highest perfection,” says Dugald Stewart, “we may expect to find an understanding discriminating, comprehensive, and unprejudiced, united with a love of truth and nature, and with a temper superior to the irritation of the little passions, while it implies a spirit of accurate observation, and of patient induction, applied to the most fugitive and evanescent class of our mental phenomena, it evinces that power of separating universal associations, from such as are local or personal, which more than any other quality of the mind is the foundation of good sense, both in scientific pursuits, and in the conduct of life. The intellec- tual efforts by which such a taste is formed, are in reality much more nearly allied than is commonly suspected, to those, which are employed in prosecuting the most important and difficult branches of the philosophy of the human mind.”
In truth, a man’s just taste for what is elegant, whether in art or in nature, and his delicacy in moral conduct, are but one and the same sense, exerting itself on the same subject,— viz., a love of beauty, of order, of propriety, extended to all their various intellectual exhibitions. ‘ We observe in such a man, the same elegance, pointing towards the simplicity of nature; the same refined, correct, and judicious mode of thought expressed in all his relations to the world, whether in his step, in his attire, his furniture, his equipage, his garden, or his actions.”
“The dignity of every occupation,” says Burke, “ wholly depends on the quantity and the kind of virtue that may be exerted in it.” What are the requisitions of our profession ? Test it by the claims of the other professions, or test it by its own. Can it be said that our duties demand a lower standard of moral excellence? Are we content with mediocrity of intellectual power? On the contrary, does any pursuit demand for its full efficiency a higher order of intellect, a deeper fund of moral courage, more quickness of perception, a greater boldness in action? Truly, the soldier is the occasional arbiter of the fate of thousands, but there are few who reach the standard of superior excellence. The law is sup- posed to be the arbiter of character and of property.
The medical man is, under Providence, the arbiter of human life, more precious im a ten-fold degree, in the esteem of that very world, whose favourable verdict is awarded to us with a niggard generosity, than the highest stake which calls forth in a court of law, the exercise of the most brilliant forensic talent of the advocate. “Ars corporis curandi tuendique, atque utilitas, Deorum immortalium, inventioni est con- secrata.”* A pursuit which, although in its infancy, and incomplete in its development, was yet so great as to claim a descent from the Gods, which is so interwoven with the phy- sical and moral welfare of every individual member of society, and on the cultivation of which, even something of our national character depends, and no less our scientific rank in the world, demands for its perfect condition of utility, first, the most vigilant observance and exposition of its defects, and secondly, the active co-operation of all who profess to study our national happiness, or desire to promote the welfare of this great nation throughout the globe.
We justly boast in this glorious country, our noble hospi- tals and infirmaries, erected and endowed by private benevo- lence, and dedicated to the relief of the diseased, and the necessitous. To what region of this globe can you point, and say, “ Here are equal examples of private munificence to those of Britain?” Is not the practice of charity stamped upon the national character? In the various hospitals of this metropolis alone, about 300,000 persons obtain annual relief from suffering. What are the endowments of a hos-
- Cicero, Tuse. Dise. pital, however noble, what is the value of its concentrated wealth and power, and all its complicated machinery of good, if we withhold from it, the active agency of our profession? The medical mind is to a hospital, what life is to the body—the spirit of religion, to the mere edifice in which its practice and its doctrines are enforced! It gives to it all its utility, and all its rank. It stamps it with its high name. It infuses a spirit of life into the inanimate and otherwise all but worthless body; and in vitalising the vast machine, it becomes in an instant, the instrument of incalculable good to thousands, the pride of virtue, the boast of the world!
THE END.
LONDON:
BRADBURY AND EVANS, PRINTERS, WHITEFRIARS.
- ↑ There is no other real source of greatness than that arising either from intellectual or moral pre-eminence. Dignity of noble birth, or the possession of wealth as sources of greatness, are the mere conventionalisms of the world. Their nature is extrinsic—not inherent, They may be said to be rather the representatives of greatness, than the possessors of it. Great and good deeds infer either intellectual or moral superiority. The professors of medicine, estimated by their unpaid services rendered to the world, are among the greatest benefactors to mankind.
- ↑ Channing.
- ↑ Herschell.
This work was published before January 1, 1929, and is in the public domain worldwide because the author died at least 100 years ago.
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