NOW.

HEN I recall affectionately my old medical professors, it is never with criticism of their limited knowledge and crude methods as compared with the present age. If any such unworthy thought arises in my mind, it is enough to remember how pitiful our boasted advances will appear to future generations.

I ask myself: "What if my methods of instruction are more scientific; can I ever impress upon the hearts, as well as the minds, of my students the respect and affection which I entertain for my teachers, whose influence is still strong and elevating, thirty years after their lips have been sealed and their kindly eyes closed in the long sleep?" What am I but a depository of facts, a purveyor of predigested mental pabulum, which I was taught to chew for myself, however tough and unpalatable it seemed at the time?

Our representative medical teachers were not simply lecturers, but vital moral forces. When we think of them it is not so much as didactic, or clinical lecturers, as of vivid personalities. Their enthusiasm, sincerity and love of truth could not fail to make an impression upon their hearers. Yet the audience was radically different from the one which we address-intellectually, if not morally. I sometimes think that the rough-and-ready type made stronger men and more practical and resourceful practitioners than the modern medical student, though, of course, it is natural for the older generation to believe that the former times were better than these.

The rough but tender-hearted Sayre-who does not recall his original and forceful sayings, which stuck in the mind when the elegant phrases of more polished lecturers made no impression! And in striking contrast to him was the elder Flint, that noble old man, whose wise and prophetic vision is just as true and helpful to us now as it was in the days when bacteriology was unknown, and the functions of the ductless glands were unsuspected.

It is impossible to state in intelligible terms to the present generation the boldness and manual dexterity of surgeons, to whom every operation was a doubtful experiment. We may smile in our fancied superiority, at their gallery-play as compared with our cold, business

away from the operating theatre-an appropriate term -not only the feeling that he had witnessed a brilliant. operation, but certain scraps of wisdom which he never forgot. It seems as if the old amphitheatre at Bellevue were filled with the ghosts of by-gone students and professors, who revisit the familiar scenes and view with wondering if not approving eyes the changes that time has wrought. Do they with the broader vision than that of mortal eyes see better men occupying their seats, or only better surgeons? Do you ever think of that, my colleagues, and so thinking, wonder if your name will last as long as theirs, or soon be forgotten, "As a dream dies at the dawn of day"? It is impossible to subject to cold analysis the characters of the men to whom we owe the most in the line of moral and intellectual development. Such were the college presidents of our time. A Yale man recalls reverently those beautiful old men, Woolsey, Porter, Dwight; a Harvard graduate, "Charley" Elliot; a Williams man, Mark Hopkins; and a Princeton. "Jimmy" McCosh.

Doubtless present medical students have favorites, but their attitude toward their professors (whose name is now legion) is rather critical, or purely intellectual. So and so is a clever diagnostician, another a clever surgeon, a third an eminent pathologist. One has written an epoch-making book, one has been often before the public and in the press as a reformer, medical or civic, or has been a power as a sanitarian. How many are recognized as real teachers, as imparting vital impulses to inquiring minds, or impressing upon the coming practitioner the fact that money is the least of his rewards, that the heart, as well as the intellect, is concerned in his life-work; that "success" is not an elusive phantom but the natural and inevitable result of faithful work, that the "code" is not engraved on tablets of stone, but is the essential element of a gentleman? Our predecessors needed not membership in any guild to keep them in the path of rectitude, nor did they require the reminder that the commercial instinct was essential to worldly success in the practice of medicine.

We have outgrown them in many of our methods and wisely so. The abolition of the didactic lecture, personal instruction in small classes, the importance assigned to laboratory work, as well as to clinical experience—all these are distinct advances.

But do we teach young

men to think for themselves, do we prepare the rank and file (the average man) for the responsibilities of life? These are questions which are being seriously considered by modern educators in our preparatory schools and colleges, and deserve the no less earnest attention of teachers in professional schools. We hear a good deal about "raising the standard of medical education," as if this were to be accomplished solely by requiring more advanced preliminary study, or by adding an extra year to the medical curriculum. Who thinks about clearing the spring at its source, of fixing the responsibility on the individual and not upon the system? There are too many theories of education. They are the shell with out the kernel. Read Henderson's suggestive book on "What Is It To Be Educated?" and you will agree with his conclusion that: "Education is the unfolding and perfecting of the human spirit." I fear that we are too much occupied in trying to cram our students with scientific facts, to bring them up to the standards required by state boards and commissions, to give much attention to the human side. This, I take it, is the essential difference between us and our old teachers. They were human, while we are human machines.

In large cities the good old family physician, whom President Cleveland described so affectionately in his address before the New York Academy of Medicine at its fiftieth anniversary, has become almost extinct, or he exists only as a purveyor for the specialist. The oldtime loyalty of patients is rare, and the intimate personal relation between physician and patient an exception. The human side has disappeared. It is "business"—and poor business, too.

Try a few moral sentiments in your class-room and, by your intuition as an experienced lecturer, you will read in the eyes of your youthful hearers the bored look so familiar to us when we strike an unresponsive chord. The coarse expressions, doubtful stories and occasional cuss-words of our old teachers are happily eliminated from the modern lecture-room, but with them seem to have disappeared too, the virility, the personal touch which held the most careless listener who felt that he was in the presence of a live man.

THE OLD HARVARD MEDICAL SCHOOL.

There is literally a flavor of antiquity about old medical colleges. No layman could pass through the gloomy portals of the College of Physicians and Surgeons on Twenty-third street and Fourth Avenue whose olfactory nerves did not convey to him a distinct impression that he was in the proximity of things of the remote past.

The atmosphere was redolent of mortality. In a lesser degree the same characteristic odor pervaded the obscure little corner of Boston, known as North Grove Street, where the old college nestled in a corner of the wall that separated it from the Massachusetts General Hospital. I made a pilgrimage to the ancient shrine when on a recent visit to the Hub. Alas! how many changes time has brought. Twice since I left it, thirty odd years ago, the college has expanded from its narrow limits into more spacious quarters. It is a far cry from the rickety old building, rich in memories of Holmes and Bigelow and those other Immortals, to the splendid group of structures, the pride of the country! But to the older alumni there remains a deep and abiding affection for the place in which they were grounded by dear old Calvin Ellis in the principles of "diagnosis by elimination," which subsequent experience has only developed, not improved upon. Non omnis moriar-who does not recall that impressive motto on the door of the closet in which hung the school (not family) skeleton, a sacred relic which is still preserved? It was in one sense prophetic of the illustrious teachers, whose names will never be forgotten by those who still recall vividly their striking personalities. Can we ever forget the lecture-room in anatomy, with its rough, uncomfortable benches, bad air and worse light, transfigured by the wonderful smile and gentle voice of Holmes, as he sat on the table with his black skull-cap on the back of his head, his eyes twinkling with humor, and every muscle in his mobile face twitching as they heralded the coming joke? There were no dull ears when he uttered the familiar introductory phrase: "There are no ladies present, I hope." We all knew that some racy anecdote or droll allusion was imminent.

And with what awe we gazed upon the stately form of Bigelow, as he sat with one leg crossed over the other and elucidated some favorite topic in surgery in a few crisp, well-chosen phrases, usually dismissing the subject with a wave of his eye-glasses: "That's all there is to it!" It may be apochryphal, that story of his description of the excision of a certain organ, but it is characteristic. "The only way to amputate is to cut off." His horror of a "medical incision" in opening an abscess was profoundly impressed on his hearers when they witnessed his own slashing style. The tall, ministerial Cheever, an inimitable clinical teacher, the portly, fatherly Reynolds, the classic style of Bowditch-shall we ever forget them?

The coming (now the past) generation of bright young teachers-Warren, Porter, Maurice Richardson, big in mind and heart—“a great cloud of witnesses," whose

influence is ever with us! We may well feel proud and thankful that it was our privilege (how little we appreciated it then!) to be in daily contact with such men, who gave freely of themselves to the work of higher medical education that has borne such a rich fruitage.

But it was not merely the teachers who diffused a peculiar atmosphere around the old school. The building itself was rich in traditions. The ancient dissecting room, the chemical laboratory with its gruesome associations with the Webster tragedy of half a century before, the museum over which brooded the spirit of the great pathologist Jackson, (to whom the microscope was an unknown factor in research,) the old Massachusetts General in which we administered ether with the same form of conical sponge that Morton used-all these things served to impress upon the student's imagination, not only the antiquity, but the solid conservatism of the

institution. It requires but a slight effort of the imagination now to picture the Saturday matinées in the amphitheatre, when each surgeon in turn, arrayed in a frock coat and immaculate cuffs, displayed his skill for the benefit of the admiring audience, with all the strict formalities of Listerism. Whatever suspicions the critical observer may have had with regard to the question of "gallery-play," there could be no doubt as to the skill and dash of the work and the technique, which was unequaled for those times.

By the modern medical student great names and greater deeds are held in slight remembrance, overshadowed as they are by present achievements, but we, who compare the past with the present, can never forget that "there were giants in those days." HENRY C. COE, M. D.

New York, N. Y.