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AbstractsOF

INTRODUCTORY ADDRESSESDELIVERED AT THE

PROVINCIAL SCHOOLS OF MEDICINEAT THE

Opening of the Session 1881-82.

UNIVERSITY OF DURHAM COLLEGE OFMEDICINE.

THE introductory address was delivered by Dr. JAMESMURPHY, Lecturer and Examiner on Botany in the College.The lecturer commenced with some words of advice to i

those about to enter upon medical studies, some of the pro- ’minent features of which he described. He then referred tothe social advantages and disadvantages connected with the 1 1profession of medicine, and proceeded as follows :—

"I trust, gentlemen, you all come here from other motivesthan those of mere money-making, and that you look uponit as secondary, though still no doubt of very great import-ance, that you have come to engage in a beneficent work,and look for your highest reward in relieving the sufferingsof your fellows, in prolonging life, and in advancing ourscience. You who thus draw near, I can congratulate uponyour choice, bid you welcome from my heart, and expressthe earnest hope that while your sojourn amongst us maybe mutually pleasant and agreeable, that you may so utiliseit that you may receive an education which will fit you foryour work, and which will stand you in good stead for thetrials and the difficulties which are inseparable from it; and,believe me, the way to knowledge is hy constant, steady,and devoted work; and knowledge, if it does not commandsuccess, at least deserves it, There is no other way to knowledge- there is no Roy alroad. More can bedone foran injured limbthan applying the charmed hand of a bone-setter-I use theword charmed, as I believe those eminent specialists disdainall study of the diseases they treat. The precious gift ofhealing is with them hereditary, in fact they are to themanner born. Not but that some have unbounded, thoughmisguided, faith in those people ; and as regards thehomoeopaths, it now appears that they may be divided intoat least two great classes : the one containing a set ofsimple-minded men honestly believing what they profess,the other professing the system of infinitesimal doses, butfinding it necessary to treat most of their cases according tothe teachings of legitimate medicine, by ordering remediesin ordinary doses; and this class surely contains within itsranks, if they exist at all, those men of " ability and educa-tion that we have recently been asked to recognise. Thesuccesses of the first class are founded on the method somany people have of arguing that post hoc, ergo propter hoc,and quietly ignore the natural tendency to recovery exhi-bited by most diseases ; while, as to the second class-notthe simple-minded men, the others-they, of course, bringsuch "ability and education" as they possess into use, andare as successful as we who profess no narrow system, buttreat our patients in whatever method seems most conduciveto their recovery....... You will not have advanced veryfar in your studies before you will realise that medicine is

not a perfect science, nor can it ever become one ; its scopeis so extensive that it will never be possible to fully masterall the facts that can be learned about it, and this is what we ewant-facts, as opinions are only admissible when facts areunattain,able, and then serve merely as substitutes to

compare numerous observations with, and thus beconfirmed into facts or shown to be erroneous..........

I would remind you that your object in coming here is toget as much knowledge of the science and art of medicine aspossible during the time you spend here, and not the merepassing of examinations, or the winning of prizes, howevercommendable and desirable these things may be. Thescience of medicine implies the knowledge of disease in allits forms, and the art of medicine is the manner of applyingthis knowledge to the best advantage ; and for its properstudy it is first necessary for yuu to be well acquaintedwith several collateral sciences on which the structure isfounded. You will commence with anatomy, physiology,

chemistry, and botany, and the most important of these areanatomy and physiology. Anatomy treats of the structureof the body, and physiology shows how the body carries onits life, and as disease is merely a vitiated organic or

functional change from wbatisfound in health, to properly un-derstand it you must first know what is usual. Our knowledgeof anatomy, for most practical purposes, may now be regardedas complete, but in physiology we have yet much to learn.Chemistry and botany you will also have to learn in theearly part of your career ; and at first you will meet withseveral words which you have never heard of before, and it willbe well to search the dictionary for their meaning, otherwiseyou are very liable to acquire erroneous ideas of the subject inhand. Furtheron in your course you will have to learn materiamedica and therapeutics, pathology, medical jurisprudence,and finally, medicine, surgery, and midwifery ; and all ofyou who purpose entering general practice should attendmost diligently to this latter subject, as your knowledge ofit will often be tested under the most trying circumstances,when you may not have time to call in assistance, and whereyou are liable to suffer materially both in reputation and inpeace of mind for any mistake. The various examiningboards, not realising the importance of this subject, requireattendance at too short a course of lectures, and butscanty proof of a man’s knowledge. When you commenceyour hospital work-which personally I consider should notbe undertaken till the second year, otherwise the preliminarywork is sure to be neglected-you should bear in mind thatall patients are to be treated with the greatest consideration,irrespective of rank, sex, or age, and, unromantic as it mayappear, the most worthless drunkard who gets his head cutin a street brawl is to be treated as kindly as the mostcharming maiden in her first attack of hysterics. Youshould be impartial, and treat everyone alike, as gently andas tenderly as if they were your own. I trust I have suffi-ciently impressed upon you the necessity of the proper studyof the scientific part of your career, but I must also impressupon you that, important as it is, more is required by youthan a sound knowledge of anatomy, physiology, chemistry,and botany. To those of you who intend to practise medi-cine more is required than being a mere scientist; howeverperfect you may be as an anatomist or as a physiologist, themere knowledge of these sciences alone will not make youa sound practitioner ; these are but the stepping-stones ;and it is in the hospital and at the bedside you mustlearn the real business of your calling, and it is herealso you will first experience the fascination which ourart possesses, in relieving the sufferings of a fellow-being.......To you, gentlemen, who have recently qualified, or are aboutto do 80, I would say, if possible become house-surgeon tosome large hospital for a couple of years before entering intoprivate practice, or, failing that, go as assistant to some

practitioner for a time. It seems to me that this is the timewhen an apprenticeship will really be of service, not whenyou are in complete ignorance of the nature of disease.......It is our great pride that all our discoveries are made knownto all ; there is nothing kept secret, nothing hid, and hencethe rapid advance we are making. Compare an amputationnow with what it was formerly, when the unhappy suffererwas put to the greatest torture, when the bleeding had to becontrolled with hot irons and boiling pitch, and when he hadto undergo months of suffering, being wasted with a purulentdischarge, whereas now, thanks to the labours of Simpson,Esniarvh, and Lister, the largest limb can be removed withthe loss of only a few teaspoonfuls of blood, without theslightest pain, and recovery rapidly goes on without theformation of a single drop of pus. Consider, then, that it isyour duty also to contribute to the general advance. Further,do not he perpetually prattling about medical etiquette ; thisis a subject about which we are being constantly twitted bythe-laity, and sometimes, I fear, not undeservedly. Finally,gentlemen, pursue your study for its own sake, and if youdo you will find it a labour of love.’’

LEEDS SCHOOL OF MEDICINE.

INTRODUCTORY ADDRESS BY MR. W. NICHOLSON PRICE.

On Oct. 4th the fifty-first session of the Leeds School ofMedicine was opened. The President-elect for the year(Mr. W. Nicholson Price) delivered the introductoryaddress.Mr. Price having traced the history of the Leeds School

and spoke of the chief characteristic of its founders, which he

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said was a love of " hard work," addressed himself more espe-cially to the consideration of the work of medical students.Believing that medical education meant something morethan attending lectures and examinations-dissecting, read-ing, and clinical instruction-he proposed to offer them a fewhomely hints, mainly based upon the experience of peoplehe had known, which might prove useful to them in theircourse. It was formerly the fashion to say that the studentwas over-lectured. With regard to the special work beforethem, the study of anatomy must hold the first place, andin its forefront stood that of osteology, confessedly a dry sub-ject, which appeared difficult to beginners, though not so inreality. It was the alphabet of their work. The study ofmedicine and surgery everyone, and particularly theirfriends of the laity, would tell them was intensely interest-ing, and that the power to relieve pain and suffering mustafford most genuine satisfaction to those who possessed it.Having pointed out the importance of husbanding theirresources and of cautiously training their powers in youth,Mr. Price said that amongst the qualities which they asstudents would require were courage, self-reliance, presenceof mind, energy, self-denial, a ready sympathy for thosearound them, and a steady application to the work beforethem. Without courage and self-reliance no man dare begin,and certainly could not successfully carry through, the greatand complicated operations in surgical and obstetric practice.It was entirely a mistake to suppose that the danger was allon the side of the patient, an instance of which was affordedbut a few days ago by an effort made by Dr. Lowson, ofHuddersfield, to save the life of a patient at the extremerisk of his own : an act for which he was awarded a medal.Ready, self-denying sympathy should be the daily practiceof their lives ; for they were ever surrounded by danger,distress, or pain. That quality should, indeed, be themoving impulse of their lives, not difficult to exercise, butbrought into play as an ordinary gift. The exercise of sym-pathy was not often wanting in their profession. Success intheir calling could only be achieved by steady, hard work.Having made up their minds to work hard, the best way todo so was quietly and steadily to follow out the curriculumlaid down by the authorities, and, if they could, they mightadopt the plan sketched in the prospectus. He was old-fashioned enough to have a sort of lingering preference forthe apprenticeship system, which was almost universal, atleast in the provinces, in his day. An old physician, whohad been twenty-six years attached to a large London hos-pital, told him when he joined that he found all their bestmen had been previously more or less trained in establishedpractices. The progress of science and the " march of intel-lect rendered that impossible now. If it could be adoptedit would enable the pupil to learn many practical points,and early to apply and test the fruit of his more scientifictraining in school and hospital, besides assisting him in theformation of methodical habits of work, which he would belong in teaching himself in after-life. Let students not allowpressure of social circumstance, or adventitious aids, toforce them into positions for which they had not fittedthemselves by study, early professional training, and sub-sequent habits of thought and action ; for the penalty waspretty sure to be increased anxiety and over-taxing of bothmental and physical power; and if that ended in failure, howsad the disappointment. Far be it from him to advise themnot to avail themselves of every honourable advantage, pro-fessional or otherwise, but they must take care to be fittedfor the posts they aspired to fill.

ROYAL INFIRMARY SCHOOL OF MEDICINE,LIVERPOOL.

ADDRESS BY PROFESSOR O. J. LODGE.

The opening meeting and distribution of prizes of the

Royal Infirmary School of Medicine, the medical faculty ofUniversity College, Liverpool, was held on Oct. 3rd.

Professor OLIVER J. LODGE, Lyon Jones Professor of Ex-perimental Physics, delivered the introductory address.After some remarks on the nature and value of preliminaryeducation, Professor Lodge passed on to consider the im-provement which has taken place in secondary education.The desire of the great towns of England for a wider cui.ture and a higher training for the more eminent of theiryouth, and their recognition of its importance by the estab.lishment of centres of such culture and such training intheir midst, has led to a movement which, though carriedout at present with various amount of enlightenment and

with correspondingly various shades of success, must ex-ercise a potent influence on the future of English history.In Germany such institutions were long ago established bymeans of State aid. In America they have recently begunto flourish, also with large grants from the State; but in ourown land, although we start a little later, we start on thesolid basis of public spirit and enlightenment, and of high.minded private generosity. " I feel," said the lecturer,that the basis on which this Liverpool college is beingstarted is the broadest, wisest, and in every respect the mostsatisfactory of all the similar undertakings which havebeen recently set on foot. I have, indeed, been astonishedat the widespread, and I may say universal, conviction ofthe certain success of this centre of higher education whichthe people of Liverpool have determined to create, and whichI believe is intended to be as complete and as thorough asit can possibly be made. It will be a great advantage to thenew college to form itself round this firmly-estauhshed andwell-known Medical School as a nucleus; while the reciprocalbenefits which must accrue to the School of Medicine, frombeing associated with, and becoming one of the faculties of,a university college aiming at the highest culture in allbranches of knowledge, are absolutely incapable of over-

estimation......I have spoken of the gain which must accrueto the students of the School of Medicine from its becomingassociated with, and possibly absorbed in, a great universitycollege, by reason of the opportunities thereby afforded for awider and more general culture ; but, besides all this, thegreatly increased facilities for a high scientific training willbe perhaps even more important. For we know perfectlywell that modern medicine is no empirical body of rules, butthat it is an applied science : its whole spirit and its methodsare now intensely scientific, and it is the influence exertedby the introduction of such scientific methods into medicalpractice that has raised it from the low estate in which itexisted for so many centuries, and has made it what it nowis. The tone and habit of mind engendered by the study ofany pure science, therefore, whether it bear directlyupon medical practice or not, is of intense importanceto all who aim at the higher ranks of the profession......Examinations are a nuisance and a stumbling-block just inso far as the student thinks too much about them, and workstoo exclusively for them. As an indication of the right pathof study they are very valuable : as an ultimate end theyare absurd and mischievous. The passing of the examina-tion is one thing, the training necessary to a real understand-ing of the subjects is another and far higher thing. Workat the subjects for their own sake, and leave the examina-tion to take care of itself. He that works only for hisexamination shall fail to pass it ; to him who works earnestlyand loves his subject, the passing of the examination will bechild’s play. There is scarcely a pure science which doesnot bear, and bear very directly, upon a subject so largeand so all-embracing as modern medicine has become.Take, for instance, my own subject of physics. I sup’pose it is a mere platitude to say that the science mostintimately connected with medicine-its root-science, so to

speak-is physiology, and it is undeniable that modernphysiology is more than half of it applied physics andchemistry. The study of the eye and of the ear involvesthe most intimate acquaintance with the principles of opticsand of acoustics. On these two organs Helmholtz has ex-pended the whole of his unique combination of physiological,physical, and mathematical knowledge. His treatises onthe ear and on the eye are models of patient study and in-vestigation, combined with the most portentous knowledgeof the subject matters of which he treats. Nevertheless,many are the problems he is compelled to leave unsolved,and it remains to us of the coming generation to continue thework. The science of heat, again, lies at the very root ofanimal mechanics and muscular exertion. Then there is thegorgeous, the fascinating, the gigantic science of electricity,and magnetism. Time would altogether fail me if I wereto permit myself to enlarge upon this theme. A phvsiolo-gical laboratory of to-day bristles with electrical appliancesalmost as if it were a central telegraph station. From allpoints of view, electricity is to-day perhaps the most pro-minent feature in the whole of science."

AT the quarterly meeting of the Directors of theNaval Medical Supplemental Fund, Dr. H. J. Domville,C.B., Inspector-General, in the chair, the sum of £75 wasdistributed among the several applicants.