Imágenes de páginas
PDF
EPUB
[blocks in formation]

erudite of our profession, and was combined with other branches of the healing art by such men as William Hunter and William Dease. When the exclusive rule was being made in the London College of Physicians, Sir John Pringle proposed an exception in favour of the "man-midwife to the person of the Queen," William Hunter, but a large majority decided otherwise. There is no city which has reason to be more grateful to the philanthropy of obstetricians than Dublin, where the great Mosse has left so grand a monument of his benevolence and perseverance. Midwifery is an art easy of acquirement, at least as far as normal delivery is concerned; but as departures from the usual process are most common, it behoves the student to be acquainted with the details of many cases, so that at least six months' attendance should be enforced. Lectures can also teach its principles, and the anatomy and physiology of the reproductive organs. The diseases peculiar to women and children are generally joined to the subjects of the midwifery professor, and wisely; but there is no doubt that in many cities sufficient opportunities do not exist for illustrating these affections, especially the latter, and hence their diagnosis and pathology are somewhat imperfect. There are few schools which have contributed, however, more largely to the literature of this subject than that of this city. A special institution for their treatment exists in Pitt-street; and in St. Vincent's, the Meath, and Adelaide hospitals special wards are devoted to them. There are then, it is apparent, very many branches of human knowledge which the student must master; and their acquisition would be indeed difficult-aye, almost impossible, did they not possess a mutual correlation, so that the study of one leads to that of another, as its usefulness becomes apparent. It is to be lamented that the licensing bodies do not enforce, or at least strongly recommend some well-chosen order in which these sub

156

PROGRESSIVE ARRANGEMENT.

jects should be studied; but as the boards are so numerous, and their requirements so various, this is not done, and the student is indeed perplexed. In the French and German universities a regular progressive course is recommended, but is not obligatory. With us it would be most desirable that students should be advised in the same way; but indeed the only injurious mistake which is ever committed is the postponement of chemistry, the handmaid of all medical knowledge, to the second year. Anatomy, physiology, and surgery should be studied in all of the three years, but should be made progressively extensive.

The following three years' curriculum could not fail to train the student's mind advantageously. Curricula should be similar in every school, otherwise the student wishing to spend his second or third year in another school would be seriously inconvenienced:

[blocks in formation]

Tutorial instruction should be continued throughout the whole period, the last summer being devoted to a general resume of the business conducted by private teachers and to hospital practice.

[blocks in formation]

In the following cities and large towns of the United Kingdom there are medical schools and recognised hospitals-Birmingham, Bristol, Cambridge, Hull, Leeds, Liverpool, Manchester, Newcastle, Oxford, Sheffield, Belfast, Cork, Aberdeen, Edinburgh, Glasgow; and a multiplicity in London and Dublin which no disinterested observer could deny was injurious to the cause of medical education. So surely as a moderate number creates a wholesome amount of competition, an inordinate number produces a competition to undersell and otherwise degrade. Moreover, the vast number of schools cannot each attract a sufficient number of pupils to recompense the lecturer and make him independent of other resources. He cannot, therefore, be expected to throw much zeal into the employment, and just as he gets most efficient, he will desert it as soon as any more profitable one presents itself. There should be something to content an able teacher to devote his whole life to the pursuit. In the case of the chairs of medicine and surgery, some of the men in greatest practice retain them for a whole life. Sir W. Fergusson has now been lecturing on surgery for forty years. It may be objected that a large number of pupils cannot be instructed with the same care as a small number in class. The two Edinburgh schools show the falsity of this statement, as the professors, being adequately paid, can afford to give their entire time to the business of instruction. A wellbuilt lecture theatre will accommodate hundreds of pupils, microscopes and subjects can be provided in proportion, and demonstrators can be appointed in the ratio of one for every twenty-five dissectors. It may be here mentioned that demonstrators should be always appointed and removable by the anatomical lecturers, as they can best judge of fitness for the office and the manner in which the duties are carried on.

158

MULTIPLICITY OF SCHOOLS.

In London, owing to its vast extent, a large number of hospitals and medical schools are needed, and the eleven which exist, with the number of beds and new entries this session, are enumerated below:

[merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small]

Two or three of these which attract so unremunerative a class, and which are very close together, might readily amalgamate with larger ones. Edinburgh, with an average of 500 medical students yearly, has only 2 schools, while Dublin has 6 medical schools, and 9 separate recognised hospitals for some 600 students. Even in ratio to the population only, the like proportion for London would be 50 medical schools, and even the 11 are not all flourishing. The schools of Trinity College and the College of Physicians, of the College of Surgeons which was chartered for teaching purposes, of the Catholic University, and probably that of Stevens' hospital, which alone combines college and hospital-a very advantageous plan according to many-must needs remain distinct; but surely the two proprietary schools, the Ledwich and the Carmichael, should amalgamate with one of those previously named. These schools are under control of the

MULTIPLICITY OF SCHOOLS.

159

Council of the Royal College of Surgeons, and that body would surely suggest equitable terms on which some of the lecturers from these schools might be added to their own staff and division of fees arranged. Such is being just at present arranged between Queen's and Sydenham Colleges, Birmingham; the former, being equidistant from the two hospitals, is to be the future school, which will start with 100 pupils. The only chair which will be hard to decide is surgery, as between the two schools there are five teachers of that favourite subject, and two new candidates. Some of them should surely apply themselves to anatomy or other branches. The whole profession should then demand that no new schools should be established. The Dublin hospitals' commissioner, Mr. South, advised an impracticable combination of those on the north and on the south side, and specially urged the formation of a medical college at one of the hospitals. This plan was carried out without such success as would encourage the repetition of the experiment. The contrary plan holds in Paris, where medical teaching is most perfect, and there is some public antipathy in Dublin to the union of dissecting-rooms and hospitals.

It has been sometimes asserted that there should be no school in connexion with the College of Surgeons, but it seemed to be the original object of the early charter to found such, and thus provide surgical education for the country. It might as fairly be urged that the universities should give up their teaching faculties, and become mere examining boards; the only one, St. Andrew's, which has no regular school, is rapidly failing in the number of its medical graduates, and was not deemed worthy of a separate representative on the medical council. In the Scotch Reform Bill of last session only those graduates who had passed since residence was required for medical degrees, were to have a vote.

« AnteriorContinuar »