medical essays-第55部分

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When　I　compare　this　direct　transfer　of　the　practical　experience　of　a　wise　man　into　the　mind　of　a　student；every　fact　one　that　he　can　use　in　the　battle　of　life　and　death；with　the　far　off；　unserviceable　〃scientific〃　truths　that　I　and　some　others　are　in　the　habit　of　teaching；　I　cannot　help　asking　myself　whether；　if　we　concede　that　our　forefathers　taught　too　little；　there　is　nota　possibility　that　we　may　sometimes　attempt　to　teach　too　much。　　I　almost　blush　when　I　think　of　myself　as　describing　the　eight　several　facets　on　two　slender　processes　of　the　palate　bone；　or　the　seven　little　twigs　that　branch　off　from　the　minute　tympanic　nerve；　and　I　wonder　whether　my　excellent　colleague　feels　in　the　same　way　when　he　pictures　himself　as　giving　the　constitution　of　neurin；　which　as　he　and　I　know　very　well　is　that　of　the　hydrate　of　trimethyle…oxethyle…ammonium；　or　the　formula　for　the　production　of　alloxan；　which；　though　none　but　the　Professors　and　older　students　can　be　expected　to　remember　it；　is　C10　H4　N4　O6＋　2HO；　NO5｝=C8　H4　N2　O10＋2CO2＋N2＋NH4　O；　NO5。

I　can　bear　the　voice　of　some　rough　iconoclast　addressing　the　Anatomist　and　the　Chemist　in　tones　of　contemptuous　indignation：　〃What　is　this　stuff　with　which　you　are　cramming　the　brains　of　young　men　who　are　to　hold　the　lives　of　the　community　in　their　hands？　　Here　is　a　man　fallen　in　a　fit；　you　can　tell　me　all　about　the　eight　surfaces　of　the　two　processes　of　the　palate　bone；　but　you　have　not　had　the　sense　to　loosen　that　man's　neck…cloth；　and　the　old　women　are　all　calling　you　a　fool？　　Here　is　a　fellow　that　has　just　swallowed　poison。　　I　want　something　to　turn　his　stomach　inside　out　at　the　shortest　notice。　　Oh；　you　have　forgotten　the　dose　of　the　sulphate　of　zinc；　but　you　remember　the　formula　for　the　production　of　alloxan！〃

〃Look　you；　Master　Doctor；if　I　go　to　a　carpenter　to　come　and　stop　a　leak　in　my　roof　that　is　flooding　the　house；　do　you　suppose　I　care　whether　he　is　a　botanist　or　not？　　Cannot　a　man　work　in　wood　without　knowing　all　about　endogens　and　exogens；　or　must　he　attend　Professor　Gray's　Lectures　before　he　can　be　trusted　to　make　a　box…trap？　　If　my　horse　casts　a　shoe；　do　you　think　I　will　not　trust　a　blacksmith　to　shoe　him　until　I　have　made　sure　that　he　is　sound　on　the　distinction　between　the　sesquioxide　and　the　protosesquioxide　of　iron？〃

But　my　scientific　labor　is　to　lead　to　useful　results　by　and　by；　in　the　next　generation；　or　in　some　possible　remote　future。

〃Diavolo！〃　as　your　Dr。　Rabelais　has　it；answers　the　iconoclast；　〃what　is　that　to　me　and　my　colic；　to　me　and　my　strangury？　　I　pay　the　Captain　of　the　Cunard　steamship　to　carry　me　quickly　and　safely　to　Liverpool；　not　to　make　a　chart　of　the　Atlantic　for　after　voyagers！　If　Professor　Peirce　undertakes　to　pilot　me　into　Boston　Harbor　and　runs　me　on　Cohasset　rocks；　what　answer　is　it　to　tell　me　that　he　is　Superintendent　of　the　Coast　Survey？　　No；　Sir！　　I　want　a　plain　man　in　a　pea…jacket　and　a　sou'wester；　who　knows　the　channel　of　Boston　Harbor；　and　the　rocks　of　Boston　Harbor；　and　the　distinguished　Professor　is　quite　of　my　mind　as　to　the　matter；　for　I　took　the　pains　to　ask　him　before　I　ventured　to　use　his　name　in　the　way　of　illustration。〃


I　do　not　know　how　the　remarks　of　the　image…breaker　may　strike　others；　but　I　feel　that　they　put　me　on　my　defence　with　regard　to　much　of　my　teaching。　　Some　years　ago　I　ventured　to　show　in　an　introductory　Lecture　how　very　small　a　proportion　of　the　anatomical　facts　taught　in　a　regular　course；　as　delivered　by　myself　and　others；　had　any　practical　bearing　whatever　on　the　treatment　of　disease。　　How　can　I；　how　can　any　medical　teacher　justify　himself　in　teaching　anything　that　is　not　like　to　be　of　practical　use　to　a　class　of　young　men　who　are　to　hold　in　their　hands　the　balance　in　which　life　and　death；　ease　and　anguish；　happiness　and　wretchedness　are　to　be　daily　weighed？

I　hope　we　are　not　all　wrong。　　Oftentimes　in　finding　how　sadly　ignorant　of　really　essential　and　vital　facts　and　rules　were　some　of　those　whom　we　had　been　larding　with　the　choicest　scraps　of　science；　I　have　doubted　whether　the　old　one…man　system　of　teaching；　when　the　one　man　was　of　the　right　sort；　did　not　turn　out　better　working　physicians　than　our　more　elaborate　method。　　The　best　practitioner　I　ever　knew　was　mainly　shaped　to　excellence　in　that　way。　　I　can　understand　perfectly　the　regrets　of　my　friend　Dr。　John　Brown　of　Edinburgh；　for　the　good　that　was　lost　with　the　old　apprenticeship　system。　　I　understand　as　well　Dr。　Latham's　fear　〃that　many　men　of　the　best　abilities　and　good　education　will　be　deterred　from　prosecuting　physic　as　a　profession；　in　consequence　of　the　necessity　indiscriminately　laid　upon　all　for　impossible　attainments。〃

I　feel　therefore　impelled　to　say　a　very　few　words　in　defence　of　that　system　of　teaching　adopted　in　our　Colleges；　by　which　we　wish　to　supplement　and　complete　the　instruction　given　by　private　individuals　or　by　what　are　often　called　Summer　Schools。

The　reason　why　we　teach　so　much　that　is　not　practical　and　in　itself　useful；　is　because　we　find　that　the　easiest　way　of　teaching　what　is　practical　and　useful。　　If　we　could　in　any　way　eliminate　all　that　would　help　a　man　to　deal　successfully　with　disease；　and　teach　it　by　itself　so　that　it　should　be　as　tenaciously　rooted　in　the　memory；　as　easily　summoned　when　wanted；　as　fertile　in　suggestion　of　related　facts；　as　satisfactory　to　the　peremptory　demands　of　the　intelligence　as　if　taught　in　its　scientific　connections；　I　think　it　would　be　our　duty　so　to　teach　the　momentous　truths　of　medicine；　and　to　regard　all　useless　additions　as　an　intrusion　on　the　time　which　should　be　otherwise　occupied。

But　we　cannot　successfully　eliminate　and　teach　by　itself　that　which　is　purely　practical。　　The　easiest　and　surest　why　of　acquiring　facts　is　to　learn　them　in　groups；　in　systems；　and　systematized　knowledge　is　science。　　You　can　very　often　carry　two　facts　fastened　together　more　easily　than　one　by　itself；　as　a　housemaid　can　carry　two　pails　of　water　with　a　hoop　more　easily　than　one　without　it。　　You　can　remember　a　man's　face；　made　up　of　many　features；　better　than　you　can　his　nose　or　his　mouth　or　his　eye…brow。　　Scores　of　proverbs　show　you　that　you　can　remember　two　lines　that　rhyme　better　than　one　without　the　jingle。　The　ancients；　who　knew　the　laws　of　memory；　grouped　the　seven　cities　that　contended　for　the　honor　of　being　Homer's　birthplace　in　a　line　thus　given　by　Aulus　Gellius　：

Smurna；　Rodos；　Colophon；　Salamin；　Ios；　Argos；　Athenai。

I　remember；　in　the　earlier　political　days　of　Martin　Van　Buren；　that　Colonel　Stone；　of　the　〃New　York　Commercial；〃　or　one　of　his　correspondents；　said　that　six　towns　of　New　York　would　claim　in　the　same　way　to　have　been　the　birth…place　of　the　〃Little　Magician；〃　as　he　was　then　called；　and　thus　he　gave　their　names；　any　one　of　which　I　should　long　ago　have　forgotten；　but　which　as　a　group　have　stuck　tight　in　my　memory　from　that　day　to　this；

Catskill；　Saugerties；　Redhook；　Kinderhook；　Scaghticoke；　Schodac。

If　the　memory　gains　so　much　by　mere　rhythmical　association；　how　much　more　will　it　gain　when　isolated　facts　are　brought　together　under　laws　and　principles；　when　organs　are　examined　in　their　natural　connections；　when　structure　is　coupled　with　function；　and　healthy　and　diseased　action　are　studied　as　they　pass　one　into　the　other！　Systematic；　or　scientific　study　is　invaluable　as　supplying　a　natural　kind　of　mnemonics；　if　for　nothing　else。　　You　cannot　properly　learn　the　facts　you　want　from　Anatomy　and　Chemistry　in　any　way　so　easily　as　by　taking　them　in　their　regular　order；　with　other　allied　facts；　only　there　must　be　common　sense　exercised　in　leaving　out　a　great　deal　which　belongs　to　each　of　the　two　branches　as　pure　science。　　The　dullest　of　teachers　is　the　one　who　does　not　know　what　to　omit。

The　larger　aim　of　scientific　training　is　to　furnish　you　with　principles　to　which　you　will　be　able　to　refer　isolated　facts；　and　so　bring　these　within　the　range　of　recorded　experience。　　See　what　the　〃London　Times〃　said　about　the　three　Germans　who　cracked　open　John　Bull　Chatwood's　strong…box　at　the　Fair　the　other　day；　while　the　three　Englishmen　hammered　away　in　vain　at　Brother　Jonathan　Herring's。　　The　Englishmen　represented　brute　force。　　The　Germans　had　been　trained　to　appreciate　principle。　　The　Englishman　〃knows　his　business　by　rote　and　rule　of　thumb〃science；　which　would　〃teach　him　to　do　in　an　hour　what　has　hitherto　occupied　him　two　hours；〃　〃is　in　a　manner　forbidden　to　him。〃　　To　this　cause　the　〃Times〃　attributes　the　falling　off　of　English　workmen　in　comparison　with　those　of　the　Continent。

Granting　all　this；　we　must　not　expect　too　much　from　〃science〃　as　distinguished　from　common　experience。　　There　are　ten　thousand　experimenters　without　special　apparatus　for　every　one　in　the　laboratory。　　Accident　is　the　great　chemist　and　toxicologist。　　Battle　is　the　great　vivisector。　　Hunger　has　instituted　researches　on　food　such　as　no　Liebig；　no　Academic　Commission　has　ever　recorded。

Medicine；　sometimes　impertinently；　often　ignorantly；　often　carelessly　called　〃allopathy；〃　appropriates　everything　from　every　source　that　can　be　of　the　slightest　use　to　anybody　who　is　ailing　in　any　way；　or　like　to　be　ailing　from　any　cause。　　It　learned　from　a　monk　how　to　use　antimony；　from　a　Jesuit　how　to　cure　agues；　from　a　friar　how　to　cut