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