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CHAPTER IV.

ON MEDICAL EDUCATION.

A PHYSICIAN in a great city seems to be the mere play"thing of fortune," says Dr. Johnson:" his degree of re"putation is for the most part totally casual; they that em

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ploy him know not his excellence; they that reject him "know not his deficience. By any acute observer, who had "looked on the transactions of the medical world for the last “half century, a very curious book might be written on the "Fortune of Physicians."

Were parents and preceptors to believe with Dr. Johnson, that the reputation of physicians is totally casual, and that they are the mere play-things of fortune, it would discourage from all attempts to form children by peculiar care and instruction for this profession. But the fact is not as Dr. Johnson represents it. The measure of a physician's talents may be frequently mistaken; but all the world is competent to decide on this one simple, essential point, whether his patients die or recover under his care. Success is the ultimate standard, by which medical skill and learning, like all other species of merit, are appreciated by mankind; for though ignorant persons are not able to judge of the enlarged and remote views, which may lead to great discoveries, yet they are ready to reward most

liberally any practical application of ingenuity, that becomes useful to their health or conducive to their convenience; this is all that can reasonably be expected. Before they receive the benefit, why should they bestow the reward? Repeated u ccess implies superior sagacity; we can have no better proof of the excellence of a physician's theories, than the happy result of his practice: and when the end is attained, mankind are apt to rest satisfied about the means. It is true, that there may be exceptions to the rule, that success is the test of merit. Men of mere address have succeeded, while some philosophical physicians of great talents have failed; but perhaps, if all the circumstances could be investigated, their disappointments might be traced to want of prudence, instead of want of good fortune. Even, in the case of Dr. Akenside, whose fate suggested Johnson's observations, it would not perhaps be difficult to point out the causes, which prevented his attaining medical eminence. He was both a poet and a politician. "The patriot passion" and "The pleasures of "imagination" were probably indulged at the expense of his reputation as a physician.-Without stopping, however, to examine this example more minutely, the general truth will be admitted, that in medicine as in all other affairs, "men's judgments are a parcel of their fortunes:" under the word judgment, we include, in speaking of physicians, not only medical sagacity, but discretion in all that concerns their conduct in life, in the management of the humours and opinions of patients, as well as in the treatment of diseases.

Impressed with this belief, parents will take courage, and will commence the education of a son for a physician with

reasonable hopes of success. Two objects, which we hope are not incompatible, should therefore be kept constantly in view in the education of a physician; the attainment of such manners, knowledge, skill, and medical tact as may secure his success in the practice of his art, and the cultivation of those powers of reasoning and invention, by which he may extend the boundaries of medical science. Unless he succeed in practice, he cannot support himself by his profession; unless he be something more than a mere man of routine, he will never attain to eminence. In determining which of their sons to select, parents will observe, that bodily strength is less requisite for a physician than for a soldier or a lawyer; therefore in a family where there are boys of different constitutions, those who appear to be the least robust should be destined for the medical profession in preference to the military life or to the bar. The first thing to be attended to, even from the pupil's infancy, is the cultivation of his senses; acuteness, and accuracy of smell, of taste, of feeling, are peculiarly necessary to a physician, both in the practice of his art, and in the pursuit of the sciences by which medicine can be improved. As Dr. Hook, in his excellent treatise on the Improvement of Natural Philosophy remarks, men should pay more attention than they do to the education of their senses, which are in fact the instruments by which experiments of all sorts are to be observed, and by which discoveries are to be made. Mankind have by their ingenuity wonderfully assisted the sense of sight and hearing, and have prolonged to age the advantages of youth; but it yet remains for them to bring the senses to their highest state of perfection and activity by judicious cultivation. It is

worth remarking, that even common artisans, who are not distinguished by any superiority of intellect, have, by exercise and practice, brought some of their senses to a degree of perfection which might be highly useful to a natural philosopher in the pursuit of experimental science. The exercise of the senses is naturally pleasurable to children, and therefore it may easily be promoted, and improved: in distinguishing smells, colours, tastes, and the touch of various things, the pupil will soon become expert, if he have a sufficient supply of visible and tangible objects on which to exert his attention. These should be presented in succession, so that his mind may never be puzzled by having more than one thing at a time to examine. Care should also be taken not to fatigue his attention by long exertions. Trials of the acuteness and accuracy of his senses may be rendered amusing; and emulation may be excited by playful comparisons with those of his own age, and with the elder individuals of a family. He should be early accustomed to see some of the various articles of the materia medica. This will prepare him for the future study of pharmacy, which, though indispensably necessary, is too much neglected in medical education. It will not be sufficient merely to show the different substances once or twice, and to repeat their English and Latin names; the pupils must be perfectly familiarized both with the substances and the names. They should have possession or free access to the samples, which should all be labelled. Their nature and properties should be explained. Many useful facts. may thus be pleasurably impressed on the memory. These early lessons have been tried upon a young medical student; and even

the gall-nut, the flowers of benzoin, camphor, and such simple materials, have afforded many entertaining hours' amusement joined with profitable instruction.

From the simple exercise of the senses the pupil may be led to more complex observations, to notice and describe the general appearance of objects as they affect all the senses. He should be encouraged to mark characteristic differences and resemblances; his mind should, indeed, be urged to observe differences, more than to be pleased with resemblances; because a physician has more occasion for judgment than for wit. From observing effects, the pupil will naturally proceed to search for causes; in the most trifling instances this habit may be practised. If a child notice the shadow of any person or piece of furniture, if a reflection of light dancing upon the wall catch his infant attention, he may at that moment be excited to discover the immediate cause of what he sees. By removing different objects, he may determine the fact which he wishes to ascertain. However trivial this may sound, such are the ways by which preceptors may lead him to try experiments, and to take pleasure in discovering the causes of external effects. On the most common occasions he may find subject for experiment and reflection; if he see smoke from the candle and steam from the tea-urn*, he can compare the different properties of smoke and vapour, and he may be taught the causes and effects of each. The melting of butter, of ice, of sealing-wax, the most ordinary operations of nature or art, may be made amusing lessons. Even ignoble

*Practical Education.