Science and Culture, and Other Essays. Thomas Henry Huxley
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is the difference between his knowledge of a structure which he has read about, and his knowledge of the same structure when he has seen it for himself; and he will tell you that the two things are not comparable—the difference is infinite. Thus I am very strongly inclined to agree with some learned school-masters who say that, in their experience, the teaching of science is all waste time. As they teach it, I have no doubt it is. But to teach it otherwise, requires an amount of personal labour and a development of means and appliances, which must strike horror and dismay into a man accustomed to mere book work; and who has been in the habit of teaching a class of fifty without much strain upon his energies. And this is one of the real difficulties in the way of the introduction of physical science into the ordinary University course, to which I have alluded. It is a difficulty which will not be overcome, until years of patient study have organised scientific teaching as well as, or I hope better than, classical teaching has been organised hitherto.
A little while ago, I ventured to hint a doubt as to the perfection of some of the arrangements in the ancient Universities of England; but, in their provision for giving instruction in Science as such, and without direct reference to any of its practical applications, they have set a brilliant example. Within the last twenty years, Oxford alone has sunk more than a hundred and twenty thousand pounds in building and furnishing Physical, Chemical, and Physiological Laboratories, and a magnificent Museum, arranged with an almost luxurious regard for the needs of the student. Cambridge, less rich, but aided by the munificence of her Chancellor, is taking the same course; and, in a few years, it will be for no lack of the means and appliances of sound teaching, if the mass of English University men remain in their present state of barbarous ignorance of even the rudiments of scientific culture.
Yet another step needs to be made before Science can be said to have taken its proper place in the Universities. That is its recognition as a Faculty, or branch of study demanding recognition and special organisation, on account of its bearing on the wants of mankind. The Faculties of Theology, Law, and Medicine, are technical schools, intended to equip men who have received general culture, with the special knowledge which is needed for the proper performance of the duties of clergymen, lawyers, and medical practitioners.
When the material well-being of the country depended upon rude pasture and agriculture, and still ruder mining; in the days when all the innumerable applications of the principles of physical science to practical purposes were non-existent even as dreams; days which men living may have heard their fathers speak of; what little physical science could be seen to bear directly upon human life, lay within the province of Medicine. Medicine was the foster-mother of Chemistry, because it has to do with the preparation of drugs and the detection of poisons; of Botany, because it enabled the physician to recognise medicinal herbs; of Comparative Anatomy and Physiology, because the man who studied Human Anatomy and Physiology for purely medical purposes was led to extend his studies to the rest of the animal world.
Within my recollection, the only way in which a student could obtain anything like a training in Physical Science, was by attending the lectures of the Professors of Physical and Natural Science attached to the Medical Schools. But, in the course of the last thirty years, both foster-mother and child have grown so big, that they threaten not only to crush one another, but to press the very life out of the unhappy student who enters the nursery; to the great detriment of all three.
I speak in the presence of those who know practically what medical education is; for I may assume that a large proportion of my hearers are more or less advanced students of medicine. I appeal to the most industrious and conscientious among you, to those who are most deeply penetrated with a sense of the extremely serious responsibilities which attach to the calling of a medical practitioner, when I ask whether, out of the four years which you devote to your studies, you ought to spare even so much as an hour for any work which does not tend directly to fit you for your duties?
Consider what that work is. Its foundation is a sound and practical acquaintance with the structure of the human organism, and with the modes and conditions of its action in health. I say a sound and practical acquaintance, to guard against the supposition that my intention is to suggest that you ought all to be minute anatomists and accomplished physiologists. The devotion of your whole four years to Anatomy and Physiology alone, would be totally insufficient to attain that end. What I mean is, the sort of practical, familiar, finger-end knowledge which a watchmaker has of a watch, and which you expect that craftsman, as an honest man, to have, when you entrust a watch that goes badly, to him. It is a kind of knowledge which is to be acquired, not in the lecture-room, nor in the library, but in the dissecting-room and the laboratory. It is to be had, not by sharing your attention between these and sundry other subjects, but by concentrating your minds, week after week, and month after month, six or seven hours a day, upon all the complexities of organ and function, until each of the greater truths of anatomy and physiology has become an organic part of your minds—until you would know them if you were roused and questioned in the middle of the night, as a man knows the geography of his native place and the daily life of his home. That is the sort of knowledge which, once obtained, is a life-long possession. Other occupations may fill your minds—it may grow dim, and seem to be forgotten—but there it is, like the inscription on a battered and defaced coin, which comes out when you warm it.
If I had the power to remodel Medical Education, the first two years of the medical curriculum should be devoted to nothing but such thorough study of Anatomy and Physiology, with Physiological Chemistry and Physics; the student should then pass a real, practical examination in these subjects; and, having gone through that ordeal satisfactorily, he should be troubled no more with them. His whole mind should then be given with equal intentness, to Therapeutics, in its broadest sense, to Practical Medicine and to Surgery, with instruction in Hygiene and in Medical Jurisprudence; and of these subjects only—surely there are enough of them—should he be required to show a knowledge in his final examination.
I cannot claim any special property in this theory of what the medical curriculum should be, for I find that views, more or less closely approximating these, are held by all who have seriously considered the very grave and pressing question of Medical Reform; and have, indeed, been carried into practice, to some extent, by the most enlightened Examining Boards. I have heard but two kinds of objections to them. There is, first, the objection of vested interests, which I will not deal with here, because I want to make myself as pleasant as I can, and no discussions are so unpleasant as those which turn on such points. And there is, secondly, the much more respectable objection, which takes the general form of the reproach that, in thus limiting the curriculum, we are seeking to narrow it. We are told that the medical man ought to be a person of good education and general information, if his profession is to hold its own among other professions; that he ought to know Botany, or else, if he goes abroad, he will not be able to tell poisonous fruits from edible ones; that he ought to know drugs, as a druggist knows them, or he will not be able to tell sham bark and senna from the real articles; that he ought to know Zoology, because—well, I really have never been able to learn exactly why he is to be expected to know zoology. There is, indeed, a popular superstition, that doctors know all about things that are queer or nasty to the general mind, and may, therefore, be reasonably expected to know the “barbarous binomials” applicable to snakes, snails, and slugs; an amount of information with which the general mind is usually completely satisfied. And there is a scientific superstition that Physiology is largely aided by Comparative Anatomy—a superstition which, like most superstitions, once had a grain of truth at bottom; but the grain has become homœopathic, since Physiology took its modern experimental development, and became what it is now, the application of the principles of Physics and Chemistry to the elucidation of the phenomena of life.
I hold as strongly as any one can do, that the medical practitioner ought to be a person of education and good general culture; but I also hold by the old theory of a Faculty, that a man should have his general culture before he devotes himself to the special studies of that Faculty; and I venture to maintain, that, if the general culture obtained in the Faculty of Arts were what it ought to be, the student would have quite as much knowledge of the fundamental principles of Physics, of Chemistry, and of Biology, as he needs, before he commenced his special medical studies.
Moreover, I would urge, that a thorough study of Human Physiology is, in itself, an