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The limits of this article compel me to stop with the story very imperfectly told, but yet, perhaps, it has been sufficient in detail to show somewhat of the astonishing progress of surgery within the century, but especially within the last quarter of the century.
About two decades ago one of the foremost surgeons of London, Mr. Erichsen, said in a public address that "surgery had reached its limits." How short was his vision is shown by the fact that surgery at that very time was just at the beginning of its most brilliant modern chapter.
We have reached in many respects, apparently, the limits of our success, but just as anesthesia and antisepsis and the Roentgen rays have opened new fields to us wholly unsuspected until they were proclaimed, so I have no doubt that the twentieth century will see means and methods devised which will put to shame the surgery of to-day as much as the surgery of to-day puts to shame that of thirty years ago, and still more of a century ago. The methods by which this will be attained will be by the more thorough and systematic study of disease and injury, so as to better our means of diagnosis, and so prepare us for immediate surgical interference, instead of delaying it, as we now do in many cases for want of certain knowledge; by the use of new chemical and pharmaceutical means to perfect our antisepsis and possibly to introduce other methods of treatment; but above all, we shall obtain progress by the exact experimental methods of the laboratory. We can never make progress except by trying new methods. New methods must be tried either on man or on animals, and as the former is not allowable, the only way remaining to us is to test all new methods, drugs, and applications first upon animals. He who restricts and, still more, he who would abolish our present experiments upon animals is, in my opinion, the worst foe to the human race, and to animals as well, for they, as well as human beings, obtain the benefit derived from the methods. He may prate of his humanity, but he is the most cruel man alive.
THE MISSION OF A MEDICAL COLLEGE.*
WELVE years ago I had the honor of delivering the introductory address at the opening of the session of the Jefferson Medical College. I took as my topic "The New Era in Medicine, and its Demands upon the Profession and the College." In it I pointed out the demands which this new era in medicine made on our medical colleges. To-day I purpose supplementing that address by considering an allied topic, "The Mission of a Medical College."
A mission is defined as "that with which a messenger or agent is charged," and I find in Webster an apt illustrative quotation from Milton:
"How to begin, how to accomplish best,
His end of being on earth and mission high."
There are missions for individuals, as for Columbus, Washington, and Lincoln, and in medicine for a Vesalius, a Jenner, and a Lister. There are missions for nations, as for the Hebrews in religion, the Greeks in art, the Romans in law, England and America in civil and religious liberty. But there are also missions for institutions, especially for institutions of learning, such as the Universities of Bologna, Oxford, Edinburgh, Harvard, etc. Has not the Medical College a mission? If so, what is its nature and how is it being accomplished? The mission of institutions of learning, among which may be classed the medical school, is
* Address delivered at the Seventy-sixth Commencement of the Jefferson Medical College of Philadelphia, May 15, 1901. Reprinted from American Medicine, May 25, 1901.
threefold: First and foremost the development of the character of its students; secondly, the education of its students; and, thirdly, the encouragement of original research.
First, the development of character; that is "the sum of the moral and mental qualities which distinguish an individual viewed as a homogeneous whole." The school which instructs the intellect, but does not develop the moral character of its students, fails in its most important duty. "Intellect alone is cold, heartless, and selfish; it must be lighted up by moral and spiritual principles to reveal its beauty or fulfill its high mission."
Character is partly the result of heredity and of environment. Those who are so fortunate as to possess parents to whom they can look up with reverence, even after they have passed away, are most happy. They have had a training which nothing else can replace. The environment which they have had at home and the subtle influences of the family life will influence their whole subsequent career. The preliminary education which they have had, the physical health with which they have been endowed, the mental stimulus that they have received from their parents, all these count for much. Then there are undoubtedly individual differences; for example, the slothful, the vicious, the brave, intelligent, hard-working, and virtuous. It would be a trite saying to assert that the last are those who will win the prizes in the struggle of life.
But when a young man has left his home and enters the medical school, he comes under a different set of influences, partly from his fellow-students, but chiefly from his teachers. He is moved by their example, observes their industry, acknowledges their ability, and recognizes their success in life as due to a sturdy character which in turn develops the character of the student. The College is a center for those projectile moral forces which, once set in action, prolong their effects for many years afterward in well-nigh every student.
We can point for example in this school to the splendid and forceful lives of a McClellan, a Dunglison, a Gross, a Pancoast, and a Da Costa, whose influence on the character of hundreds and even thousands of men all over the world tells for the best and the highest ideals in medicine.
Not the information which one acquires in a medical school or in any other educational institution is of the most value. The methods he learns rather than the facts which he acquires; the high ideals which are instilled into him rather than the low cravings for a mere sordid success-these are the things which are of value and develop most the character. To do one's level best every day with every patient and in many cases without hope of fee or reward save the sense of duty done, the inspiring influence of success in the constant and irrepressible conflict between good and evil, life and death,-this is what is of more value to the student of this and every other college than the mere information which he has acquired. It is not given to everyone to occupy a conspicuous place, but every one of you in your sphere, humble though it may be, can do your daily duty faithfully and truly, and if you do this, if you develop a high and noble character, even though your sphere be humble, when you lay down life's burdens the Great Master may well say to you, "Well done, good and faithful servant." Character depends not on the sphere, but on the person, not on the greatness of the opportunity, but on how the opportunity is met. Let me quote a portion of the justly-celebrated oath of Hippocrates to show you, away back in the fifth century before the Christian era, how well the Father of Medicine met his opportunity and set us an example we well may follow:
I will "reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring on the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of in
struction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to anyone if asked, nor suggest any such counsel. With purity and with holiness I will pass my life and practise my Art. Into whatever house I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption. Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted to me to enjoy life and the practice of the Art, respected by all men in all times! But should I trespass and violate this oath, may the reverse be my lot!"
The second mission of a medical school is education. In the address already alluded to, I pointed out in considerable detail the enormous and rapid strides which had been made in medical education in the last thirty years. It is especially gratifying that the progress made has not been only in medicine proper, but largely in the preliminary education which is required of medical students of to-day. The better educated men you are at starting, the better educated men you will be at the finish, and, as a rule, the greater your success. But along with this better preliminary education in order to meet the enormously increased demands of a modern medical education, a college must furnish facilities which were not in existence thirty years ago, but are absolutely indispensable Let us see how the demand has been met: The former methods were limited to lectures and text-books.