as I may have to make upon the state of knowledge
of these gentlemen, if they be justified, in regard
to any faults I may have to find, cannot be held to
indicate defects in the capacity, or in the power of
application of those gentlemen, but must be laid,
more or less, to the account of the prevalent system
of medical education. I will tell you what has
struck me—but in speaking in this frank
way, as one always does about the defects of one’s
friends, I must beg you to disabuse your minds of
the notion that I am alluding to any particular school,
or to any particular college, or to any particular
person; and to believe that if I am silent when I
should be glad to speak with high praise, it is because
that praise would come too close to this locality.
What has struck me, then, in this long experience
of the men best instructed in physiology from the
medical schools of London, is (with the many and brilliant
exceptions to which I have referred), taking it as
a whole, and broadly, the singular unreality of their
knowledge of physiology. Now, I use that word
“unreality” advisedly: I do not say
“scanty;” on the contrary, there is plenty
of it—a great deal too much of it—but
it is the quality, the nature of the knowledge, which
I quarrel with. I know I used to have—I
don’t know whether I have now, but I had once
upon a time—a bad reputation among students
for setting up a very high standard of acquirement,
and I dare say you may think that the standard of
this old examiner, who happily is now very nearly an
extinct examiner, has been pitched too high. Nothing
of the kind, I assure you. The defects I have
noticed, and the faults I have to find, arise entirely
from the circumstance that my standard is pitched too
low. This is no paradox, gentlemen, but quite
simply the fact. The knowledge I have looked
for was a real, precise, thorough, and practical knowledge
of fundamentals; whereas that which the best of the
candidates, in a large proportion of cases, have had
to give me was a large, extensive, and inaccurate
knowledge of superstructure; and that is what I mean
by saying that my demands went too low, and not too
high. What I have had to complain of is, that
a large proportion of the gentlemen who come up for
physiology to the University of London do not know
it as they know their anatomy, and have not been taught
it as they have been taught their anatomy. Now,
I should not wonder at all if I heard a great many
“No, noes” here; but I am not talking
about University College; as I have told you before,
I am talking about the average education of medical
schools. What I have found, and found so much
reason to lament, is, that while anatomy has been
taught as a science ought to be taught, as a matter
of autopsy, and observation, and strict discipline;
in a very large number of cases, physiology has been
taught as if it were a mere matter of books and of
hearsay. I declare to you, gentlemen, that I
have often expected to be told, when I have been asked