第35章
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  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。

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