singleperson,combininginmanycases,asinthatofMr。GilesFirmin,theofficesofphysicianandpreacher,taughtwhatheknewtoafewdiscipleswhomhegatheredabouthim。Ofthemakingofthat“Anatomy“onwhichmyfirstpredecessorinthebranchIteach“didreadverywell“wecanknownothing。Thebodyofsomepoorwretchwhohadswunguponthegallows,wasprobablyconveyedbynighttosomelonelydwellingattheoutskirtsofthevillage,andtherebythelightofflaringtorcheshastilydissectedbyhandsthattrembledovertheunwontedtask。Andeverandanonthemasterturnedtohisbook,ashelaidbarethemysteriesofthehiddenorgans;tohispreciousVesalius,itmightbe,orhisfiguresrepeatedinthemultifariousvolumeofAmbroisePare;totheAldineoctavoinwhichFallopiusrecordedhisfreshobservations;orthatgiantfolioofSpigeliusjustissuedfromthepressofAmsterdam,inwhichlovelyladiesdisplaytheirviscerawithacoquettishgraceimplyingthatitisratherapleasurethanotherwisetoshowthelace-likeomentum,andholduptheirappendicesepiploicaeasiftheyweresaying“theseareourjewels。“
Histeachingofmedicinewasnodoubtchieflyclinical,andreceivedwiththesamekindoffaithasthatwhichacceptedhiswordsfromthepulpit。Hisnotionsofdiseasewerebasedonwhathehadobserved,seenalwaysinthelightofthetraditionaldoctrinesinwhichhewasbred。HisdiscoursesavoredoftheweightydoctrinesofHippocrates,dilutedbythesubtlespeculationsofGalen,reinforcedbythecuriouscommentsoftheArabianschoolmenastheywereconveyedinthemellifluouslanguageofFernelius,blended,itmaybe,withsomethingoftheloftymysticismofVanHelmont,andperhapsstealingaflavorofthatearlierformofHomoeopathywhichhadlatelycometolightinSirKenelmDigby’s“DiscourseconcerningtheCureofWoundsbytheSympatheticPowder。“
HisPathologywasmythology。Amalformedfoetus,asthereadersofWinthrop’sJournalmayremember,wasenoughtoscarethecolonistsfromtheirpropriety,andsuggestthegravestfearsofportendeddisaster。ThestudentoftheseventeenthcenturyopenedhisLicetusandsawfiguresofalionwiththeheadofawoman,andamanwiththeheadofanelephant。Hehadofferedtohisgaze,asbornofahumanmother,theeffigyofawingedcherub,apterocephalousspecimen,whichourProfessorofPathologicalAnatomywouldhardlyknowwhethertotreatwiththereverenceduetoitscelestialaspect,ortoimprisoninoneofhisimmortalizingjarsofalcohol。
Hispharmacopoeiaconsistedmainlyofsimples,suchasthevenerable“Herball“ofGerarddescribesandfiguresinaboundingaffluence。
St。John’swortandClown’sAll-heal,withSpurgeandFennel,SaffronandParsley,ElderandSnake-root,withopiuminsomeform,androastedrhubarbandtheFourGreatColdSeeds,andthetwoResins,ofwhichitusedtobesaidthatwhatevertheTacamahacahasnotcured,theCarannawill,withthemorefamiliarScammonyandJalapandBlackHellebore,madeupagoodpartofhisprobablelistofremedies。HewouldhaveorderedIronnowandthen,andpossiblyanoccasionaldoseofAntimony。Hewouldperhapshavehadarheumaticpatientwrappedintheskinofawolforawildcat,andincaseofamalignantfeverwith“purples“orpetechiae,orofanobstinateking’sevil,hemighthaveprescribedacertainblackpowder,whichhadbeenmadebycalciningtoadsinanearthenpot;achoiceremedy,takeninternally,orappliedtoanyoutwardgrief。
Exceptforthetoad-powderandtheperemptorydrastics,onemighthaveborneupagainstthisherbdoctoringaswellasagainstsomemoremodernstylesofmedication。BarbeyracandhisscholarSydenhamhadnotyetcleansedthePharmacopoeiaofitsperilousstuff,butthereisnodoubtthatthemoresensiblephysiciansofthatdayknewwellenoughthatagoodhonestherb-teawhichamusedthepatientandhisnurseswasallthatwasrequiredtocarryhimthroughallcommondisorders。
Thestudentsoonlearnedthephysiognomyofdiseasebygoingaboutwithhismaster;fevers,pleurisies,asthmas,dropsies,fluxes,small-pox,sore-throats,measles,consumptions。Hesawwhatwasdoneforthem。Heputupthemedicines,gatheredtheherbs,andsolearnedsomethingofmateriamedicoandbotany。Helearnedthesefewthingseasilyandwell,forhecouldgivehiswholeattentiontothem。Chirurgerywasaseparatespecialty。Womeninchild-birthwerecaredforbymidwives。Therewasnochemistrydeservingthenametorequirehisstudy。Hedidnotlearnagreatdeal,perhaps,butwhathedidlearnwashisbusiness,namely,howtotakecareofsickpeople。
Letmegiveyouapictureoftheold=fashionedwayofinstruction,bycarryingyouwithmeinimaginationinthecompanyofworthyMasterGilesFirminashemakeshisroundofvisitsamongthegoodfolkofIpswich,followedbyhisonestudent,whoshallanswertothescripturalnameofLuke。Itwillnotbeforentertainmentchiefly,buttoillustratetheonemodeofteachingwhichcanneverbesuperseded,andwhich,Iventuretosay,ismoreimportantthanalltherestputtogether。Thestudentisagreenhand,asyouwillperceive。
Inthefirstdwellingtheycometo,astoutfellowisbellowingwithcolic。
“Hewilldie,Master,ofasurety,methinks,“saysthetimidyouthinawhisper。
“Nay,Luke,“theMasteranswers,“’tisbutadrybelly-ache。DidstthounotmarkthathestayedhisroaringwhenIdidpresshardoverthelesserbowels?Notethathehathnotthepulseofthemwithfevers,andbywhatDorcastellethmetherehathbeennolongshuttingupofthevicenaturales。WewillsteepcertaincomfortingherbswhichIwillshewthee,andputtheminabagandlaythemonhisbelly。LikewiseheshallhavemycordialjulepwithaportionofthisconfectionwhichwedocallTheriacaAndromachi,whichhathjuiceofpoppyinit,andisagreatstayerofanguish。Thisfellowisathisprayersto-day,butIwarranttheeheshallbeswearingwiththebestofthemto-morrow。“
Theyjogalongthebridle-pathontheirhorsesuntiltheycometoanotherlowlydwelling。Theysitawhilewithadelicatelookinggirlinwhomtheingenuousyouthnaturallytakesaspecialinterest。
Thegoodphysiciantalkscheerfullywithher,asksherafewquestions。Thentohermother:“Good-wife,Margarethathsomewhatprofited,asshetelleth,bythegoat’smilkshehathtakennightandmorning。Dothoupluckamaniple——thatisanhandful——oftheplantcalledMaidenhair,andmakeasyruptherewithasIhaveshewedthee。
Lethertakeacupfullofthesame,fasting,beforeshesleepeth,alsobeforesherisethfromherbed。“Andsotheyleavethehouse。
“Whatthinkestthou,Luke,ofthemaidwehavebeenvisiting?““Sheseemethnotmuchailing,Master,accordingtomypoorjudgment。Forshedidsayshewasbetter。Andshehadaredcheekandabrighteye,andshespakeofbeingsoonabletowalkuntothemeeting,anddidseemgreatlyhopeful,butspareofflesh,methought,andhervoicesomethinghoarse,asofonethathathadefluxion,withsomesmallcoughingfromacold,asshedidsay。SpeakInottruly,Master,thatshewillbewellspeedily?“
“Yea,Luke,Idothinksheshallbewell,andmayhapspeedily。Butitisnotherewithussheshallbewell。Forthatrednessofthecheekisbutthesignofthefeverwhich,aftertheGrecians,wedocallthehectical;andthatshiningoftheeyesisbutasicklyglazing,andtheywhichdoeverydaygetbetterandlikewisethinnerandweakershallfindthatwayleadethtothechurch-yardgate。Thisisthemaladywhichtheancientsdidcalltubes,orthewastingdisease,andsomedonametheconsumption。Adiseasewhereofmostthatfallailingdoperish。ThisMargaretisnotlongforearth——butsheknowethitnot,andstillhopeth。“
“Why,then,Master,didstthougiveherofthymedicine,seeingthatherailisuntodeath?“
“Thoushaltlearn,boy,thattheywhicharesickmusthavesomewhatwherewithtobusytheirthoughts。Therebesomewhodogivethesetabidorconsumptivesacertainpossetmadewithlime-waterandaniseandliquoriceandraisinsofthesun,andtherebeothersomewhodogivethejuiceofcraw-fishesboiledinbarley-waterwithchicken-
broth,butthesebetoys,asIdothink,andyeshallfindasgoodvirtue,naybetter,inthissyrupofthesimplecalledMaidenhair。“
SomethingafterthismannermightMasterGilesFirminhavedeliveredhisclinicalinstructions。Somewhatinthisway,acenturyandahalflater,anotherNewEnglandphysician,Dr。EdwardAugustusHolyoke,taughtayoungmanwhocametostudywithhim,averydiligentandintelligentyouth,JamesJacksonbyname,thesamewhoseportraitinhisadvancedyearshangsuponthiswall,longthehonoredProfessorofTheoryandPracticeinthisInstitution,ofwhomIshallsaysomethinginthisLecture。OurveneratedTeacherstudiedassiduouslyafterwardsinthegreatLondonHospitals,butIthinkheusedtoquotehis“oldMaster“tentimeswherehequotedMr。ClineorDr。Woodvilleonce。
WhenIcomparethisdirecttransferofthepracticalexperienceofawisemanintothemindofastudent,——everyfactonethathecanuseinthebattleoflifeanddeath,——withthefaroff,unserviceable“scientific“truthsthatIandsomeothersareinthehabitofteaching,Icannothelpaskingmyselfwhether,ifweconcedethatourforefatherstaughttoolittle,thereisnot——apossibilitythatwemaysometimesattempttoteachtoomuch。IalmostblushwhenIthinkofmyselfasdescribingtheeightseveralfacetsontwoslenderprocessesofthepalatebone,orthesevenlittletwigsthatbranchofffromtheminutetympanicnerve,andIwonderwhethermyexcellentcolleaguefeelsinthesamewaywhenhepictureshimselfasgivingtheconstitutionofneurin,whichasheandIknowverywellisthatofthehydrateoftrimethyle-oxethyle-ammonium,ortheformulafortheproductionofalloxan,which,thoughnonebuttheProfessorsandolderstudentscanbeexpectedtorememberit,isC10H4N4O62HO,NO5}=C8H4N2O102CO2N2NH4O,NO5。
IcanbearthevoiceofsomeroughiconoclastaddressingtheAnatomistandtheChemistintonesofcontemptuousindignation:“Whatisthisstuffwithwhichyouarecrammingthebrainsofyoungmenwhoaretoholdthelivesofthecommunityintheirhands?Hereisamanfalleninafit;youcantellmeallabouttheeightsurfacesofthetwoprocessesofthepalatebone,butyouhavenothadthesensetoloosenthatman’sneck-cloth,andtheoldwomenareallcallingyouafool?Hereisafellowthathasjustswallowedpoison。Iwantsomethingtoturnhisstomachinsideoutattheshortestnotice。Oh,youhaveforgottenthedoseofthesulphateofzinc,butyouremembertheformulafortheproductionofalloxan!“
“Lookyou,MasterDoctor,——ifIgotoacarpentertocomeandstopaleakinmyroofthatisfloodingthehouse,doyousupposeIcarewhetherheisabotanistornot?Cannotamanworkinwoodwithoutknowingallaboutendogensandexogens,ormustheattendProfessorGray’sLecturesbeforehecanbetrustedtomakeabox-trap?Ifmyhorsecastsashoe,doyouthinkIwillnottrustablacksmithtoshoehimuntilIhavemadesurethatheissoundonthedistinctionbetweenthesesquioxideandtheprotosesquioxideofiron?“——
Butmyscientificlaboristoleadtousefulresultsbyandby,inthenextgeneration,orinsomepossibleremotefuture——
“Diavolo!“asyourDr。Rabelaishasit,——answerstheiconoclast,——
“whatisthattomeandmycolic,tomeandmystrangury?IpaytheCaptainoftheCunardsteamshiptocarrymequicklyandsafelytoLiverpool,nottomakeachartoftheAtlanticforaftervoyagers!
IfProfessorPeirceundertakestopilotmeintoBostonHarborandrunsmeonCohassetrocks,whatanswerisittotellmethatheisSuperintendentoftheCoastSurvey?No,Sir!Iwantaplainmaninapea-jacketandasou’wester,whoknowsthechannelofBostonHarbor,andtherocksofBostonHarbor,andthedistinguishedProfessorisquiteofmymindastothematter,forItookthepainstoaskhimbeforeIventuredtousehisnameinthewayofillustration。“
Idonotknowhowtheremarksoftheimage-breakermaystrikeothers,butIfeelthattheyputmeonmydefencewithregardtomuchofmyteaching。SomeyearsagoIventuredtoshowinanintroductoryLecturehowverysmallaproportionoftheanatomicalfactstaughtinaregularcourse,asdeliveredbymyselfandothers,hadanypracticalbearingwhateveronthetreatmentofdisease。HowcanI,howcananymedicalteacherjustifyhimselfinteachinganythingthatisnotliketobeofpracticalusetoaclassofyoungmenwhoaretoholdintheirhandsthebalanceinwhichlifeanddeath,easeandanguish,happinessandwretchednessaretobedailyweighed?
Ihopewearenotallwrong。Oftentimesinfindinghowsadlyignorantofreallyessentialandvitalfactsandrulesweresomeofthosewhomwehadbeenlardingwiththechoicestscrapsofscience,I
havedoubtedwhethertheoldone-mansystemofteaching,whentheonemanwasoftherightsort,didnotturnoutbetterworkingphysiciansthanourmoreelaboratemethod。ThebestpractitionerIeverknewwasmainlyshapedtoexcellenceinthatway。IcanunderstandperfectlytheregretsofmyfriendDr。JohnBrownofEdinburgh,forthegoodthatwaslostwiththeoldapprenticeshipsystem。I
understandaswellDr。Latham’sfear“thatmanymenofthebestabilitiesandgoodeducationwillbedeterredfromprosecutingphysicasaprofession,inconsequenceofthenecessityindiscriminatelylaiduponallforimpossibleattainments。“
IfeelthereforeimpelledtosayaveryfewwordsindefenceofthatsystemofteachingadoptedinourColleges,bywhichwewishtosupplementandcompletetheinstructiongivenbyprivateindividualsorbywhatareoftencalledSummerSchools。
第35章