THE

LONDON LANCET.

A JOURNAL OF

BRITISH AND FOREIGN MEDICAL,

SURGICAL AND CHEMICAL SCIENCE,

CRITICISM, LITERATURE AND NEWS.

FOR THE YEAR 1867.

EDITED BY

J. HENRY BENNET, M.D., and T. WAKLEY, Jr., M.R.C.S.E.

THE LANCET.

Journal of Medical, Surgical and Chemical Science and Practice, Criticism, Literature and News.

No. 1.

J. HENRY BENNET, M.D., T. WAKLEY, JR., M.R.C.S.E. EDITORS.

Address

PUBLISHED MONTHLY.

NEW YORK, JANUARY, 1867.

years of labor, with almost every ambitious hope of life fulfilled-and among these hopes I may mention one not the least, that of being a Professsor in King's College, London,-I am here, with an experience which time and occasion can alone bring in some degree to maturity, to offer you such an address as may seem most appropriate when men meet to begin a new year of labor and study. To those who, like myself, have spent a life time in such matters, addresses of this sort must be monotonous; but it should be kept in mind that they are not intended for reverend seniors. They are for those to whom the profession is new, or all but new; they are in

each year has its own fledging, the oft-told theme has a novelty to the beginner which it lacks with those who have already been years at our work.

Gentlemen, it is hardly possible for the youn mind to estimate or realize the magnitude of terest of the profession of Medicine. Its inhaene extends over the whole human race-over every animal subservient to man's use and pleasure and from the lowest grade of man in savage life to the sovereign ruler over millions in the highest state of civilization, it is held in the greatest respect. There is, perhaps, no single occupation or profession amongst our social arrangements which has such influence on individual man; and whilst it in some degree sways the daily action of every one, it is equally felt by the masses. It influences alike the inmates of a cottage and those of a palace. Although pre-eminently of a peaceful character, even the sinews of war may be paralysed without its healthful assistance.

MR. PRINCIPAL and GentleMEN,-Another ses-tended for the beginning of a generation; and as sional year dawns upon the Medical Schools of London, and we in this College hail its advent with our customary congratulations. We are delighted to see familiar faces and friends; we welcome those who appear among us for the first time; and we rejoice that we have been spared once again to begin that work of love and labor in which most of us have spent so many years of our lives. On the part of our much-loved Principal, and for my colleagues, I bid you all a hearty welcome. It has been my duty on more occasions than one to hail your predecessors on similar auspicious days, and I never did so more sincerely than I now address you. In early days, when thus engaged, whilst zealously advocating, to the best of my ability, the claims of Medicine as a profession, I felt that I was but a struggler in the great ocean on which I had embarked only a few years before those who were listening; yet, now that my battle in the fitful heaving struggle is drawing to an end, I can say, with all my heart and soul, that, with my experience of life and my profession, had I to begin the world again I should a second time select Medicine, and buckle to my task as cheerily as I did when a lad of eighteen, without special prospects, and without a hope but that engendered by a firm determination to do my duty, and a belief that straightforward industry would meet a fair reward. Now, after

To what, it may be asked, is all this to be attributed? The answer is simple. Medicine has charge of the health of the living frame. There is no gift which the Almighty has bestowed on man equal to that of health. .Without it the greatest intellects must be enfeebled, and it is in the mortal nature of man, even with his superior mental endowments over other animals, to place health as the

oremost blessing of life. When we reflect upon the meaning of health, we are more fully impressed with the magnitude and grandeur of the objects and aims of Medicine.

We often admire, and not without good reason, the composition, the mechanism of a door-lock, of a Babbage's calculator, of a watch, of a sewing machine, of a steam-engine, of the numberless contrivances of man's ingenuity; yet how these fall short of the mechanism of man's body itself! A beautiful treatise on the human hand was written by one of England's greatest physiologists, Sir Charles Bell. Very recently a course of six lectures was delivered at the College of Surgeons by one of our most distinguished anatomists and surgeons, Mr. Hancock, on the human foot, in which he says: "In the whole range of mechanics, architecture, or engineering, where can we meet with such a structure as this ?"* Volumes have been written on the mechanism of the heart, of the eye, of the ear, of bones, muscles, and tendons; and when we think that all these surpassing perfections are united in one frame, our admiration is blended with awe that such things can be and actually are. In the watch and the steam-engine we can appreciate the design and mechanism developed by the head and hands of man; we can recognise and appreciate the physical power of a beam, of a lever, of a spring, of water, of steam; even the mysterious electric current can be controlled, guided, and brought to marvellous use; we know the agencies that can originate and cause this current to encircle the globe; we know that all these wondrous developments of man's ingenuity are the gift of the Divine Creator, and that of all His creatures man alone has been endowed with intellect sufficient to develop and appreciate such marvels; and when we consider that these marvels come from the intelligence of man; that that intelligence is associated with life, and particularly with the vigor of life; that "vigor of life," intellectual and physical, means health, we may well be awe-stricken at the marvellous mechanism of the human frame, and more particularly at the motor element which inhabits it-which prompts and sways its diversified movements, aye, even sways thought itself; and in our awe we may feel gratified that the profession of Medicine has chiefly to deal with the health of this marvel of God's creation!

The precious things in this world are usually guarded most carefully by the highest intelligence. The soul of man we deem imperishable, and most precious. Such a thought is the highest mark of civilization; it is the grand distinction betwixt heathen and Christian, and we delight to cultivate that intelligence which, by fostering health, guards our soul and tells us how we can best during life provide for this immortal part of man.

Success in Medicine implies efficiency; efficiency is, perhaps, the surest guarantee of success. Let me explain what I mean by these terms. We delight to pay homage to men in our profession who

* THE LANCET September number, 1866.

distinguish themselves in special departments: the great chemist, the great anatomist, the great pathologist, the great histologist. But it is not specially needful that any professional man must be preeminently accomplished in one or all of these departments of science; and, to say the truth, there is no demand either among ourselves or on the part of the public for great numbers of such men. A reasonable and comparatively moderate amount of such knowledge is all that may be required for both efficiency and success. As a round yet rough statement, it may be said that there are 20,000 professional men in England to 20,000,000 of population. The people do not expect these 20,000 men to be high-class philosophers; but they expect them to be well-educated gentlemen, and that that education should be such as best suits them to their calling. If it is too refined the mind may be incapacitated for commonplace work; if it be not up to a certain standard, it will be unfit even for such work. This term "commonplace" may possibly surprise some of my younger listeners; but it is purposely selected. There is a vast amount of what I call by this name required in our profession and occupation, just as there is in all the occupations of life; and it is in the due fulfilment of that commonplace work that the daily wheel of business is con

ducted.

Now it is for the purpose of learning how to enact daily business that most, perhaps all, of you have been sent here; and assuredly it is much more the purpose of medical schools to educate to this work than to bring men out as philosophers. There is nothing in such education to prevent a man aspiring to the heights or depths of philosophy but; depend upon it that accomplishment in the ordinary business of life is the true philosophy for the masses, both as regards the masses in our profession and the masses in the public.

The conduct of the youth foreshadows that of the man, and it usually happens that teachers can fortell the probable course and success in life which shall befall most of their pupils. In a well-conducted school, there is always such notice taken of each pupil that all become more or less marked men; and if the indications be good, a youth can carry with him from the school in which he has been educated such marks of approbation and esteem as shall give him an onward impulse in his start in life, and act as a vis a tergo to the end of his career.

But, gentlemen, besides the incitement to duty and the prospect of worldly success, there are in the study of medicine attractions which are scarcely excelled, if at all equalled, in the study of any other profession. The subjects embraced in such a course of study are certainly more extensive than in any other profession or occupation whatever. Besides a preliminary education equivalent to that of other gentlemen, the student in medicine must be proficient in Human Anatomy, in Physiology, in Chemistry, in Materia Medica, in Botany; he must possess a good knowledge of Natural Phil

gentlemen, will have your education under such gradually increasing advantages. You will have greater opportunities than ever your immediate predecessors enjoyed, and in reality you ought to excel in knowledge all who have gone before you.

I have alluded to the grandeur and dignity of our profession; but it is perhaps better in accorddance with my present duties that I should draw attention to its commonplace, every-day aspect, and to your commonplace, every-day objects.

osophy, Natural History, and of Comparative An- to our profession which will admirably illustrate atomy; and, without referring to certain subdivi- the cumulative influence of "continuation." You sions of these departments in which proficiency will also be expected, he has, over and above, to acquire a knowledge of Medicine and of Surgery, properly so called, as, also, of Midwifery and of various other specialties. Here is a volume on Human Anatomy, one on Physiology, one on Chemistry, one on Materia Medica, and one on Botany; every page of each the pupil is expected to have well-nigh by heart. Here are two modern and much esteemed volumes on the Practice of Physic, here is one on Surgery, and here one on Midwifery. I might show others on the Brain, the Eye, the Ear, the Throat, the Lungs, the Heart, the Stomach, the Liver, the Kidneys, the Bladder, the Prostate, the Rectum, the Bones, the Joints,-even more; and with these also the acquaintance must be, if not so precise, at least well-nigh as familiar. All such knowledge must be acquired before a youth can present himself for examination for a diploma; and without professing to be familiar with the special requirements from candidates for the Church or for the Bar, I think I may safely affirm that no such tax is put upon the aspirants to these professions, particularly in the short space of between three and five years, when the pupil is at his studies.

Even these form but a portion of the field of study, for the student is expected to spend a large portion of time in the museum of materia medica, in the dissecting-room, in the post-mortem theatre in the hospital, in the museum of natural history, and in that of pathology; and, moreover, is presumed to be in daily attendance on the hospital from first to last, besides the various courses of lectures demanded by the licensing boards, for all of which certificates are positively required!

Here is enough, gentlemen to exercise the mental powers of the cleverest men, and truly the task is great indeed. Well might a youth pause on beginning such an eventful way of life-a way to which the barriers appear so formidable that they might be held as altogether insurmountable. Yet do not fear! All, and more than all, that I have referred to has been accomplished by your predecessors in recent years, and the word "impossible" must have no place in your aspirations. You must hold yourselves as good as those who have gone before you. Men often refer to "the good old times," as if the world were in decadence. The old song has it that "we shall never see the like again;" but my impression is that even better times than ever are in store for the future. At least such I think to be the case in the medical profession; for as with certain other departments, Mr. Grove's theory of "continuation" applies in a remarkable manner to our profession. It may be doubted if single heads or intellects will ever arise which shall surpass those of bygone times. Another Harvey, Jenner, or John Hunter may perhaps never be seen; but the accumulation of knowledge, always sure to be well tended whilst civilization lasts, will give in after-times a power and force of character

In civilized life—and the higher the civilization so much the more conspicuous does it become-men suit themselves to each other's wants and to the wants of the community at large. Our professions, our trades, our occupations of all sorts, from the tiller of the soil to the cunning-handed mechanician, from the grammarian to the rhetorician, from the clerk to the statesman ruling the destinies of millions, are all the products of civilization. As we trace the social history of man from his savage condition upwards, variety of occupation seems a remarkable feature. From the simple trapper of fish and animals for the sake of food, from the savage warrior who may kill his opponent for the sake of his scalp, we can trace the gradual development of separate occupation and labor, that each may serve another-a reciprocity of work whereby each can best enact that for which his mind and frame seem to have been designed; whilst all are bound together by one great tie, each assisting in the way he best can-aiding in that great social compact to which men, the most intellectually endowed of God's creatures, give the name of civilization.

It is needless here to attempt to trace the rise and progressive development of occupations and professions-of "arts and sciences;" it is sufficient to point out that you are about to take your parts in the great whole of which it is our privilege to be individual members, in this the much-favored nineteenth century-favored by God and man, by the development and diffusion of marvels of knowledge and power such as the mightiest intellects in former years neither anticipated nor dreamt of.

Of the usually recognised professions in this country, those of the divine, the lawyer, the soldier or sailor, the engineer or the medical man, you have chosen the latter; and now you must so do your work as best to reciprocate those good offices which others do to you.

It is usual on these occasions to refer specially to the scientific character of your chosen occupation, and right, too, that such should be; but I must remind you that unless or until science be rendered in some way subservient to the use of man, it may be likened to a sort of plaything of little value to anyone. Some say that even here it is probably our ignorance which prevents us applying the socalled science to man's use. But not to detain you with such abstract views, let me state plainly that your friends have sent you here, not so much to make men of science of you, as that you shall ac