Thiswasthebeginning，asnearlyaswecanfixit，ofthatreformwhichhasintroducedplainwater-dressingsintheplaceofthefarragoofexternalapplicationswhichhadbeenasourceofprofittoapothecariesanddisgracetoartfrom，andbefore，thetimewhenPlinycomplainedofthem。AyoungsurgeonwhowasatSudleyChurch，laboringamongthewoundedofBullRun，tellsmetheyhadnothingbutwaterfordressing，andhebeingalsodouxdeselwasastonishedtoseehowwellthewoundsdidunderthatsimpletreatment。
　　Letmeherementionafactortwowhichmaybeofusetosomeofyouwhomeantoenterthepublicservice。Youwill，asitseems，havegun-shotwoundsalmostexclusivelytodealwith。Threedifferentsurgeons，theonejustmentionedandtwowhosawthewoundedofBigBethel，assuredmethattheyfoundnosabre-cutsorbayonetwounds。
　　Itistherifle-bulletfromasafedistancewhichpiercesthebreastsofoursoldiers，andnotthegallantchargeofbroadplatoonsandsweepingsquadrons，suchaswehavebeeninthehabitofconsideringthechosenmodeofwarfareofancientandmodernchivalry。[SirCharlesJamesNapierhadthesameexperienceinVirginiain1813。
　　“Potomac。Wehavenastysortoffightinghere，amongstcreeksandbushes，andlosemenwithoutshow。““Yankeenevershowshimself，hekeepsinthethickestwood，firesandrunsoff。“——Thesefivethousandintheopenfieldmightbeattacked，butbehindworksitwouldbethrowingawaylives。“Hecallsit“aningloriouswarfare，“——
　　saysoneoftheleadersis“alittledeficientingumption，“——but——stillmyopinionis，thatifwetuckupoursleevesandlayourearsbackwemightthrashthem；thatis，ifwecaughtthemoutoftheirtrees，soastoslapatthemwiththebayonet。“——Life，etc。
　　vol。i。p。218etseq。]
　　Anotherfactparallelsthestoryoftheoldcampaigner，andmayteachsomeofyoucautioninselectingyourassistants。Achaplaintoldittotwoofourofficerspersonallyknowntomyself。Heoverheardtheexaminationofamanwhowishedtodriveoneofthe“avalanche“
　　wagons，astheycallthem。Themanwasaskedifheknewhowtodealwithwoundedmen。“Ohyes，“heanswered；“ifthey’rehithere，“
　　pointingtotheabdomen，“knock’emonthehead，——theycan’tgetwell。“
　　InartandoutsideofityouwillmeetthesamebarbarismsthatAmbroiseParemetwith，——formendifferlessfromcenturytocenturythanweareapttosuppose；youwillencounterthesameopposition，ifyouattackanyprevailingopinion，thatSydenhamcomplainedof。
　　Sofaraspossible，letnotsuchexperiencesbreedinyouacontemptforthosewhoarethesubjectsoffollyorprejudice，orfosteranyloveofdisputeforitsownsake。Shouldyoubecomeauthors，expressyouropinionsfreely；defendthemrarely。Itisnotoftenthatanopinionisworthexpressing，whichcannottakecareofitself。
　　Oppositionisthebestmordanttofixthecolorofyourthoughtinthegeneralbelief。
　　Itistimetobringthesecrowdedremarkstoaclose。ThedayhasbeenwhenatthebeginningofacourseofLecturesIshouldhavethoughtitfittingtoexhortyoutodiligenceandentiredevotiontoyourtasksasstudents。Itisnotsonow。Theyoungmanwhohasnotheardtheclarion-voicesofhonorandofdutynowsoundingthroughouttheland，willheednowordofmine。Inthecamporthecity，inthefieldorthehospital，undershelteringroof，orhalf-protectingcanvas，oropensky，sheddingourownbloodorstanchingthatofourwoundeddefenders，studentsorteachers，whateverourcallingandourability，webelong，nottoourselves，buttoourimperilledcountry，whosedangerisourcalamity，whoseruinwouldbeourenslavement，whoserescueshallbeourearthlysalvation！
　　SCHOLASTICANDBEDSIDETEACHING。
　　AnIntroductoryLecturedeliveredbeforetheMedicalClassofHarvardUniversity，November6，1867。
　　Theideaisentertainedbysomeofourmostsincereprofessionalbrethren，thattolengthenandmultiplyourWinterLectureswillbeofnecessitytoadvancethecauseofmedicaleducation。Itisafairsubjectforconsiderationwhethertheydonotoverratetherelativeimportanceofthatparticularmodeofinstructionwhichformsthelargerpartofthesecourses。
　　AsthisSchoolcouldonlylengthenitslecturetermattheexpenseofits“SummerSession，“inwhichmoredirect，personal，andfamiliarteachingtakestheplaceofouracademicdiscourses，andinwhichmoretimecanbegiventohospitals，infirmaries，andpracticalinstructioninvariousimportantspecialties，whatevermightbegained，agooddealwouldcertainlybelostinourcasebytheexchange。
　　Themostessentialpartofastudent’sinstructionisobtained，asI
　　believe，notinthelecture-room，butatthebedside。Nothingseenthereislost；therhythmsofdiseasearelearnedbyfrequentrepetition；itsunforeseenoccurrencesstampthemselvesindeliblyinthememory。Beforethestudentisawareofwhathehasacquired，hehaslearnedtheaspectsandcourseandprobableissueofthediseaseshehasseenwithhisteacher，andthepropermodeofdealingwiththem，sofarashismasterknowsit。Ontheotherhand，ourexcathedraprelectionshaveastrongtendencytorunintodetailswhich，howeverinterestingtheymaybetoourselvesandafewofourmorecuriouslisteners，havenothinginthemwhichwilleverbeofusetothestudentasapractitioner。ItisaperfectlyfairquestionwhetherIandsomeotherAmericanProfessorsdonotteachquiteenoughthatisuselessalready。Isitnotwelltoremindthestudentfromtimetotimethataphysician’sbusinessistoavertdisease，tohealthesick，toprolonglife，andtodiminishsuffering？Isitnottruethattheyoungmanofaverageabilitywillfinditasmuchashecandotofithimselfforthesesimpleduties？
　　Isitnotbesttobegin，atanyrate，bymakingsureofsuchknowledgeashewillrequireinhisdailywalk，bynomeansdiscouraginghimfromanystudyforwhichhisgeniusfitshimwhenheoncefeelsthathehasbecomemasterofhischosenart。
　　Iknowthatmanybranchesofscienceareofthegreatestvalueasfeedersofourmedicalreservoirs。Butthepractisingphysician’sofficeistodrawthehealingwaters，andwhilehegiveshistimetothislaborhecanhardlybeexpectedtoexploreallthesourcesthatspreadthemselvesoverthewidedomainofscience。ThetravellerwhowouldnotdrinkoftheNileuntilhehadtrackedittoitsparentlakes，wouldbeliketodieofthirst；andthemedicalpractitionerwhowouldnotusetheresultsofmanylaborersinotherdepartmentswithoutsharingtheirspecialtoils，wouldfindlifefartooshortandartimmeasurablytoolong。
　　WeowemuchtoChemistry，oneofthemostcaptivatingaswellasimportantofstudies；butthemedicalmanmustasageneralrulecontenthimselfwithaclearviewofitsprinciplesandalimitedacquaintancewithitsfacts；suchespeciallyasarepertinenttohispursuits。IaminlittledangerofunderratingAnatomyorPhysiology；butaseachofthesebranchessplitsupintospecialties，anyoneofwhichmaytakeupascientificlife-time，Iwouldhavethemtaughtwithacertainjudgmentandreserve，sothattheyshallnotcrowdthemoreimmediatelypracticalbranches。Soofalltheotherancillaryandauxiliarykindsofknowledge，Iwouldhavethemstrictlysubordinatedtothatparticularkindofknowledgeforwhichthecommunitylookstoitsmedicaladvisers。
　　Amedicalschoolisnotascientificschool，exceptjustsofarasmedicineitselfisascience。Onthenaturalhistoryside，medicineisascience；onthecurativeside，chieflyanart。ThisisimpliedinHufeland’saphorism：“Thephysicianmustgeneralizethediseaseandindividualizethepatient。“
　　Thecoordinatedandclassifiedresultsofempiricalobservation，indistinctionfromscientificexperiment，havefurnishedalmostallweknowaboutfood，themedicineofhealth，andmedicine，thefoodofsickness。WeeattherootoftheSolanumtuberosumandthrowawayitsfruit；weeatthefruitoftheSolanumLycopersicumandthrowawayitsroot。Nothingbutvulgarexperiencehastaughtustorejectthepotatoballandcookthetomato。Soofmostofourremedies。
　　Thesubchlorideofmercury，calomel，isthegreatBritishspecific；
　　theprotochlorideofmercury，corrosivesublimate，killslikearsenic，butnochemistcouldhavetoldusitwouldbeso。
　　>Fromobservationslikethesewecanobtaincertainprinciplesfromwhichwecanarguedeductivelytofactsofalikenature，buttheprocessislimited，andwearesuspiciousofallreasoninginthatdirectionappliedtotheprocessesofhealthyanddiseasedlife。Wearecontinuallyappealingtospecialfacts。WearewillingtogiveLiebig’sartificialmilkwhenwecannotdobetter，butwewatchthechildanxiouslywhosewet-nurseisachemist’spipkin。ApairofsubstantialmammaryglandshastheadvantageoverthetwohemispheresofthemostlearnedProfessor’sbrain，intheartofcompoundinganutritiousfluidforinfants。
　　Thebedsideisalwaysthetruecentreofmedicalteaching。Certainbranchesmustbetaughtinthelecture-room，andwillnecessarilyinvolveagooddealthatisnotdirectlyusefultothefuturepractitioner。Buttheoverambitiousandactivestudentmustnotbeledawaybytheseductionofknowledgeforitsownsakefromhisprincipalpursuit。Thehumblebeginner，whoisalarmedatthevastfieldsofknowledgeopenedtohim，maybeencouragedbytheassurancethatwithaveryslenderprovisionofscience，indistinctionfrompracticalskill，hemaybeausefulandacceptablememberoftheprofessiontowhichthehealthofthecommunityisintrusted。
　　Tothosewhoarenottoengageinpractice，thevariouspursuitsofsciencehardlyrequiretobecommended。Onlytheymustnotbedisappointediftheyfindmanysubjectstreatedinourcoursesasamedicalclassrequires，ratherthanasascientificclasswouldexpect，thatis，withspeciallimitationsandconstantreferencetopracticalends。Fortunatelytheyarewithineasyreachofthehighestscientificinstruction。Thebusinessofaschoollikethisistomakeusefulworkingphysicians，andtosucceedinthisitisalmostasimportantnottoovercrowdthemindofthepupilwithmerelycuriousknowledgeasitistostoreitwithusefulinformation。
　　InthisdirectionIhavewrittenmylecture，nottoundervalueanyformofscientificlaborinitsplace，anunworthythoughtfromwhichIhopeIneednotdefendmyself，——buttodiscourageanyundueinflationofthescholasticprogramme，whichevennowasksmoreofthestudentthantheteacherisabletoobtainfromthegreatmajorityofthosewhopresentthemselvesforexamination。IwishtotakeahintineducationfromtheSecretaryoftheMassachusettsBoardofAgriculture，whoregardsthecultivationoftoomuchlandasagreatdefectinourNewEnglandfarming。IhopethatourMedicalInstitutionsmayneverlaythemselvesopentothekindofaccusationMr。LowebringsagainsttheEnglishUniversities，whenhesaysthattheireducationismadeup“ofwordsthatfewunderstandandmostwillshortlyforget；ofartsthatcanneverbeused，ifindeedtheycanevenbelearnt；ofhistoriesinapplicabletoourtimes；oflanguagesdeadandevenmouldy；ofgrammaticalrulesthatneverhadlivinguseandareonlypostmortemexaminations；andofstatementsfagotedwithutterdisregardoftheircomparativevalue。“
　　Thisgeneralthoughtwillbekeptinviewthroughoutmysomewhatdiscursiveaddress，whichwillbeginwithanimaginaryclinicallessonfromthelipsofanhistoricalpersonage，andclosewiththeportraitfromreallifeofonewho，bothasteacherandpractitioner，waslonglovedandhonoredamongus。IfIsomewhatoverrunmyhour，youmustpardonme，forIcansaywithPascalthatIhavenothadthetimetomakemylectureshorter。
　　Intheyear1647，thatgoodmanJohnEliot，commonlycalledtheApostleEliot，writingtoMr。ThomasShepherd，thepiousministerofCambridge，referringtothegreatneedofmedicalinstructionfortheIndians，usedthesewords：
　　“Ihavethoughtinmyheartthatitwereasingulargoodwork，iftheLordwouldstirreuptheheartsofsomeorotherofhispeopleinEnglandtogivesomemaintenancetowardsomeSchooleorCollegiateexercisethisway，whereinthereshouldbeAnatomiesandotherinstructionsthatway，andwheretheremightbesomerecompencegiventoanythatshouldbringinanyvegetableorotherthingthatisvertuousinthewayofPhysick。
　　“Thereisanotherreasonwhichmovesmythoughtanddesiresthisway，namelythatouryoungstudentsinPhysickmaybetrainedupbetterthentheyyetbee，whohaveonelytheoreticallknowledge，andareforcedtofalltopractisebeforeevertheysawanAnatomymade，orduelytrainedupinmakingexperiments，forweneverhadbutoneAnatomyinthecountrey，whichMr。GilesFirman[Firmin]nowinEngland，didmakeandreaduponverywell，butnomoreofthatnow。“
　　SincethetimeoftheApostleEliottheLordhasstirreduptheheartsofourpeopletothebuildingofmanySchoolsandCollegeswheremedicineistaughtinallitsbranches。Mr。GilesFirmin’s“Anatomy“maybeconsideredthefirstancestorofalonglineofskeletonswhichhavebeendanglingandrattlinginourlecture-roomsformorethanacentury。
　　TeachinginNewEnglandin1647wasagravebutsimplematter。A