首页 >出版文学> Medical Essays>第51章

第51章

  IamafraidthatitisagoodplantogetridofoldProfessors,andIamthankfultohearthatthereisamovementformakingprovisionforthosewhoareleftinneedwhentheylosetheirofficesandtheirsalaries。IrememberoneofourancientCambridgeDoctorsonceaskedmetogetintohisricketychaise,andsaidtome,halfhumorously,halfsadly,thathewaslikeanoldhorse,——theyhadtakenoffhissaddleandturnedhimouttopasture。Ifearthegrasswasprettyshortwherethatoldservantofthepublicfoundhimselfgrazing。IfImyselfneededanapologyforholdingmyofficesolong,IshouldfinditinthefactthathumananatomyismuchthesamestudythatitwasinthedaysofVesaliusandFallopius,andthatthegreaterpartofmyteachingwasofsuchanaturethatitcouldneverbecomeantiquated。
  Letmebeginwithmyfirstexperienceasamedicalstudent。IhadcomefromthelessonsofJudgeStoryandMr。AshmunintheLawSchoolatCambridge。Ihadbeenbusy,moreorless,withthepagesofBlackstoneandChitty,andothertext-booksofthefirstyearoflegalstudy。Moreorless,Isay,butIamafraiditwaslessratherthanmore。ForduringthatyearIfirsttastedtheintoxicatingpleasureofauthorship。Acollegeperiodical,conductedbyfriendsofmine,stillundergraduates,temptedmeintoprint,andthereisnoformoflead-poisoningwhichmorerapidlyandthoroughlypervadesthebloodandbonesandmarrowthanthatwhichreachestheyoungauthorthroughmentalcontactwithtype-metal。Quiabu,boira,——hewhohasoncebeenadrinkerwilldrinkagain,saystheFrenchproverb。Sothemanorwomanwhohastastedtypeissuretoreturntohisoldindulgencesoonerorlater。InthatfatalyearIhadmyfirstattackofauthors’lead-poisoning,andIhavenevergotquiteridofitfromthatdaytothis。ButforthatImighthaveappliedmyselfmorediligentlytomylegalstudies,andcarriedagreenbaginplaceofastethoscopeandathermometeruptothepresentday。
  WhatdeterminedmetogiveupLawandapplymyselftoMedicineIcanhardlysay,butIhadfromthefirstlookeduponthatyear’sstudyasanexperiment。Atanyrate,Imadethechange,andsoonfoundmyselfintroducedtonewscenesandnewcompanionships。
  IcanscarcelycreditmymemorywhenIrecallthefirstimpressionsproduceduponmebysightsafterwardsbecomesofamiliarthattheycouldnomoredisturbapulse-beatthanthecommonestofevery-dayexperiences。Theskeleton,hungaloftlikeagibbetedcriminal,lookedgrimlyatmeasIenteredtheroomdevotedtothestudentsoftheschoolIhadjoined,justasthefleshlessfigureofTime,withthehour-glassandscythe,usedtoglareuponmeinmychildhoodfromthe“NewEnglandPrimer。“ThewhitefacesinthebedsattheHospitalfoundtheirreflectioninmyowncheeks,whichlosttheircolorasIlookeduponthem。Allthishadtopassawayinalittletime;Ihadchosenmyprofession,andmustmeetitspainfulandrepulsiveaspectsuntiltheylosttheirpowerovermysensibilities。
  TheprivatemedicalschoolwhichIhadjoinedwasoneestablishedbyDr。JamesJackson,Dr。WalterChanning,Dr。JohnWare,Dr。WinslowLewis,andDr。GeorgeW。Otis。OfthefirstthreegentlemenIhaveeitherspokenelsewhereormayfindoccasiontospeakhereafter。ThetwoyoungermembersofthisassociationofteacherswerebothgraduatesofourUniversity,oneoftheyear1819,theotherof1818。
  Dr。Lewiswasagreatfavoritewithstudents。Hewasamanofverylivelytemperament,fondofoldbooksandyoungpeople,open-hearted,free-spoken,anenthusiastinteaching,andespeciallyathomeinthatapartmentofthetempleofsciencewherenatureisseeninundress,theanthropotomiclaboratory,knowntocommonspeechasthedissecting-room。Hehadthatqualitywhichisthespecialgiftofthemanbornforateacher,——thepowerofexcitinganinterestinthatwhichhetaught。WhilehewaspresenttheapartmentIspeakofwasthesunniestofstudiosinspiteofitsmortuaryspectacles。OfthestudentsImetthereIbestrememberJamesJackson,Junior,fullofzealandplayfulasaboy,ayoungmanwhoseearlydeathwasacalamitytotheprofessionofwhichhepromisedtobeachiefornament;thelateReverendJ。S。C。Greene,who,astheprefixtohisnamesignifies,afterwardschangedhisprofession,butoneofwhosedissectionsIrememberlookinguponwithadmiration;andmyfriendMr。CharlesAmory,aswecallhim,Dr。CharlesAmory,asheisentitledtobecalled,then,asnowandalways,afavoritewithallabouthim。HehadcometousfromtheschoolsofGermany,andbroughtwithhimrecollectionsoftheteachingsofBlumenbachandtheelderLangenbeck,fatherofhimwhoseportraithangsinourMuseum。
  Dr。Lewiswasourcompanionaswellasourteacher。Agooddemonstratoris,——IwillnotsayasimportantasagoodProfessorintheteachingofAnatomy,becauseIamnotsurethatheisnotmoreimportant。Hecomesintodirectpersonalrelationswiththestudents,——heisoneofthem,infact,astheProfessorcannotbefromthenatureofhisduties。TheProfessor’schairisaninsulatingstool,sotospeak;hisage,hisknowledge,realorsupposed,hisofficialstation,areliketheglasslegswhichsupporttheelectrician’spieceoffurniture,andcutitofffromthecommoncurrentsoftheflooruponwhichitstands。Dr。Lewisenjoyedteachingandmadehisstudentsenjoybeingtaught。Hedelightedinthoseanatomicalconundrumstoanswerwhichkeepsthestudent’seyesopenandhiswitsawake。Hewashappyashedexterouslyperformedthetourdemaitreoftheoldbarber-surgeons,orappliedthespicabandageandtaughthisscholarstodoit,soneatlyandsymmetricallythattheaestheticmissionaryfromtheoldercentreofcivilizationwouldbendoveritinblissfulcontemplation,asifitwereasunflower。Dr。Lewishadmanyothertastes,andwasafavorite,notonlywithstudents,butinawidecircle,professional,antiquarian,masonic,andsocial。
  Dr。Otiswaslesswidelyknown,butwasafluentandagreeablelecturer,andesteemedasagoodsurgeon。
  Imustcontentmyselfwiththisglimpseatmyselfandafewofmyfellow-studentsinBoston。AfterattendingtwocoursesofLecturesintheschooloftheUniversity,IwenttoEuropetocontinuemystudies。
  YoumayliketohearsomethingofthefamousProfessorsofParisinthedayswhenIwasastudentintheEcoledeMedicine,andfollowingthegreatHospitalteachers。
  IcanhardlybelievemyownmemorywhenIrecalltheoldpractitionersandProfessorswhowerestillgoingroundthehospitalswhenImingledwiththetrainofstudentsthatattendedthemorningvisits。SeethatbentoldmanwhoisgropinghiswaythroughthewardsofLaCharity。ThatisthefamousBaronBoyer,authorofthegreatworkonsurgeryinninevolumes,awriterwhoseclearnessofstylecommendshistreatisetogeneraladmiration,andmakesitakindofclassic。Heslashesawayataterriblerate,theysay,whenhegetsholdofthesubjectoffistulainitsmostfrequenthabitat,——butIneversawhimdomorethanlookasifhewantedtocutagooddollopoutofapatienthewasexamining。Theshort,square,substantialmanwithiron-grayhair,ruddyface,andwhiteapronisBaronLarrey,Napoleon’sfavoritesurgeon,themosthonestmanheeversaw,——itisreputedthathecalledhim。TogoroundtheHoteldesInvalideswithLarreywastoliveoverthecampaignsofNapoleon,tolookonthesunofAusterlitz,tohearthecannonsofMarengo,tostrugglethroughtheicywatersoftheBeresina,toshiverinthesnowsoftheRussianretreat,andtogazethroughthebattlesmokeuponthelastchargeoftheredlancersontheredderfieldofWaterloo。LarreywasstillstrongandsturdyasIsawhim,andfewportraitsremainprintedinliveliercolorsonthetabletofmymemory。
  LeavethelittlegroupofstudentswhichgathersaboutLarreybeneaththegildeddomeoftheInvalidesandfollowmetotheHotelDieu,whererulesandreignsthemaster-surgeonofhisday,atleastsofarasParisandFranceareconcerned,——theillustriousBaronDupuytren。
  Nomandisputedhisreign,someenviedhissupremacy。Lisfrancshruggedhisshouldersashespokeof“cegrandhommede1’autrecotsdelariviere,“thatgreatmanontheothersideoftheriver,butthegreatmanheremained,untilhebowedbeforethemandatewhichnonemaydisobey。“Threetimes,“saidBouillaud,“didtheapoplecticthunderboltfallonthatrobustbrain,“——ityieldedatlastastheoldbaldcliffthatisrivenandcrashesdownintothevalley。Isawhimbeforethefirstthunderbolthaddescended:asquare,solidman,withahighandfull-domedhead,oracularinhisutterances,indifferenttothosearoundhim,sometimes,itwassaid,veryroughwiththem。Hespokeinlow,eventones,withquietfluency,andwaslistenedtowiththathushofraptattentionwhichIhavehardlyseeninanycircleoflistenersunlesswhensuchmenasex-PresidentJohnQuincyAdamsorDanielWebsterwerethespeakers。IdonotthinkthatDupuytrenhasleftarecordwhichexplainshisinfluence,butinpointoffacthedominatedthosearoundhiminaremarkablemanner。
  Youmusthaveallwitnessedsomethingofthesamekind。Thepersonalpresenceofsomemencarriescommandwithit,andtheiraccentssilencethecrowdaroundthem,whenthesamewordsfromotherlipsmightfallcomparativelyunheeded。
  AsforLisfranc,Icansaylittlemoreofhimthanthathewasagreatdrawerofbloodandhewerofmembers。Irememberhisorderingawholesalebleedingofhispatients,rightandleft,whatevermightbethematterwiththem,onemorningwhenaphlebotomizingfitwasonhim。IrecollecthisregrettingthesplendidguardsmenoftheoldEmpire,——forwhat?becausetheyhadsuchmagnificentthighstoamputate。Igotalongaboutasfarasthatwithhim,whenIceasedtobeafollowerofM。Lisfranc。
  ThenameofVelpeaumusthavereachedmanyofyou,forhediedin1867,andhismanyworksmadehisnamewidelyknown。ComingtoParisinwoodenshoes,starving,almost,atfirst,heraisedhimselftogreateminenceasasurgeonandasanauthor,andatlastobtainedtheProfessorshiptowhichhistalentsandlearningentitledhim。
  Hisexamplemaybeanencouragementtosomeofmyyoungerhearerswhoareborn,notwiththesilverspoonintheirmouths,butwiththetwo-tinedironforkintheirhands。Itisapoorthingtotakeuptheirmilkporridgewithintheiryoungdays,butinafteryearsitwilloftentransfixthesoliddumplingsthatrolloutofthesilverspoon。SoVelpeaufoundit。Hehadnotwhatiscalledgenius,hewasfarfromprepossessinginaspect,lookingasifhemighthavewieldedthesledge-hammerasIthinkhehaddoneinearlylife
  ratherthanthelancet,buthehadindustry,determination,intelligence,character,andhemadehiswaytodistinctionandprosperity,assomeofyousittingonthesebenchesandwonderinganxiouslywhatistobecomeofyouinthestruggleforlifewillhavedonebeforethetwentiethcenturyhasgothalfwaythroughitsfirstquarter。Agoodsoundheadoverapairofwoodenshoesisagreatdealbetterthanawoodenheadbelongingtoanownerwhocaseshisfeetincalf-skin,butagoodbrainisnotenoughwithoutastouthearttofillthefourgreatconduitswhichcarryatoncefuelandfiretothatmightiestofengines。
  HowmanyofyouwhoarebeforemearefamiliarlyacquaintedwiththenameofBroussais,orevenwiththatofAndral?BothwerelecturingattheEcoledeMedicine,andIoftenheardthem。Broussaiswasinthosedayslikeanoldvolcano,whichhasprettynearlyusedupitsfireandbrimstone,butisstillboilingandbubblinginitsinterior,andnowandthensendsupaspirtoflavaandavolleyofpebbles。Histheoriesofgastro-enteritis,ofirritationandinflammationasthecauseofdisease,andthepracticewhichsprangfromthem,ranoverthefieldsofmedicineforatimelikeflameoverthegrassoftheprairies。Thewayinwhichthatknotty-featured,savageoldmanwouldbringoutthewordirritation——withrattlingandrollingreduplicationoftheresonantletterr——mighthavetaughtalessoninarticulationtoSalvini。ButBroussais’stheorywaslanguishingandwell-nighbecomeobsolete,andthis,nodoubt,addedvehemencetohisdefenceofhischerisheddogmas。
  Oldtheories,andoldmenwhoclingtothem,musttakethemselvesoutofthewayasthenewgenerationwithitsfreshthoughtsandalteredhabitsofmindcomesforwardtotaketheplaceofthatwhichisdyingout。Thiswasatruthwhichthefieryoldtheoristfounditveryhardtolearn,andhardertobear,asitwasforceduponhim。Forthehourofhislecturewassucceededbythatofayoungerandfarmorepopularprofessor。Ashislecturedrewtowardsitsclose,thebenches,thinlysprinkledwithstudents,begantofillup;thedoorscreakedopenandbangedbackoftenerandoftener,untilatlastthesoundgrewalmostcontinuous,andthevoiceofthelecturerbecamealeoninegrowlashestroveinvaintobeheardoverthenoiseofdoorsandfootsteps。
  Broussaiswasnowsixty-twoyearsold。Thenewgenerationhadoutgrownhisdoctrines,andtheProfessorforwhosehourthebencheshadfilledthemselvesbelongedtothatnewgeneration。GabrielAndralwaslittlemorethanhalftheageofBroussais,inthefullprimeandvigorofmanhoodatthirty-sevenyears。Hewasarapid,fluent,fervid,andimaginativespeaker,pleasinginaspectandmanner,——astrongcontrasttotheharsh,vituperativeoldmanwhohadjustprecededhim。HisCliniqueMedicaleisstillvaluableasacollectionofcases,andhisresearchesontheblood,conductedinassociationwithGavarret,contributednewandvaluablefactstoscience。ButIrememberhimchieflyasoneofthoseinstructorswhosenaturaleloquencemadeitdelightfultolistentohim。IdoubtifIormyfellow-studentsdidfulljusticeeithertohimortothefamousphysicianofHotelDieu,Chomel。Wehadaddictedourselvesalmosttoocloselytothewordsofanothermaster,bywhomwewerereadytoswearasagainstallteachersthateverwereoreverwouldbe。
  Thisobjectofourreverence,Imightalmostsayidolatry,wasonewhosenameiswellknowntomostoftheyoungmenbeforeme,eventothosewhomayknowcomparativelylittleofhisworksandteachings。
  PierreCharlesAlexandreLouis,attheageofforty-seven,asI
  recallhim,wasatall,ratherspare,dignifiedpersonage,ofsereneandgraveaspect,butwithapleasantsmileandkindlyvoiceforthestudentwithwhomhecameintopersonalrelations。IfIsummedupthelessonsofLouisintwoexpressions,theywouldbethese;Idonotholdhimanswerableforthewords,butIwillcondensethemaftermyownfashioninFrench,andthengivethemtoyou,expandedsomewhat,inEnglish:
  Formeztoujoursdesideesnettes。
  Fuyeztoujourslesapeupres。
  Alwaysmakesurethatyouformadistinctandclearideaofthematteryouareconsidering。
  Alwaysavoidvagueapproximationswhereexactestimatesarepossible;
  aboutsomany,——aboutsomuch,insteadoftheprecisenumberandquantity。
  Now,ifthereisanythingonwhichthebiologicalscienceshavepridedthemselvesintheselatteryearsitisthesubstitutionofquantitativeforqualitativeformulae。The“numericalsystem,“ofwhichLouiswasthegreatadvocate,ifnottheabsoluteoriginator,wasanattempttosubstituteseriesofcarefullyrecordedfacts,rigidlycountedandcloselycompared,forthosenever-endingrecordsofvague,unverifiableconclusionswithwhichtheclassicsofthehealingartwereoverloaded。ThehistoryofpracticalmedicinehadbeenlikethestoryoftheDanaides。“Experience“hadbeen,fromtimeimmemorial,pouringitsflowingtreasuresintobucketsfullofholes。Attheexistingrateofsupplyandleakagetheywouldneverbefilled;nothingwouldeverbesettledinmedicine。Butcasesthoroughlyrecordedandmathematicallyanalyzedwouldalwaysbeavailableforfutureuse,andwhenaccumulatedinsufficientnumberwouldleadtoresultswhichwouldbetrustworthy,andbelongtoscience。