30

YOUNG PRACTITIONERS.

training would become skilled. It is now being remembered that "mere opportunities of observation, without the aptitude to profit by them, are like light to a blind man," as was well observed by Bichat, who, although he was lost to science at the age of twenty-nine, was the most renowned of physiologists. The uneducated had witnessed the fall of entire orchards before Newton developed the first law in physics from having seen one apple drop. The student, though young in years, may be old in hours well spent; and I have generally found students of sixteen or seventeen more zealous, and, of course, less liable to succumb to temptations of a city life, than older ones. Besides, many distinguished teachers had begun before their legal majority, were famous in their next decennium; and Carmichael was president of his college when only thirty-four years of age. For such reasons I regard restrictions as to age occasionally oppressive and always unnecessary, if examinations be well organized.

It is a curious psychological fact that men's opinions undergo very great transitions throughout life, and in no profession is this more remarkable than in medicine. The newly-fledged physician, timid as yet in the use of his own powers, follows implicitly the doctrines of the teacher he most respects. This implicit obedience produces a reaction, and after a few years' practice nothing is believed in which is not new or startling. As years increase and have given time for more deliberate judgment, the practitioner relapses into the ways of those who have taught him, and is convinced that "there is nothing new under the sun." The rebuke which the famous Dr. Rush administered to an over-confident graduate is well known; he was just boasting that his studies had been now completed; Dr. Rush replied, “I am only beginning mine."

It is not given to every man that he shall occupy a high place in the medical and surgical professions. The

66

ELEMENTS OF SUCCESS.

31

competition in the race of life is now more close than ever, and it is only by very peculiar endowment and exceeding industry that one can reach the summit. It has often been averred that no practitioner who has risen to a greater degree of success than his fellows, can assign a cause for his elevation-an assertion in the main unfounded. Rare instances there may be of men having greatness thrust upon them" in this and every other walk of life, owing to such fortuitous circumstances as family connexions or wealth; but deceived is he who trusts to them, as there is no profession where such attributes have so seldom conferred distinctions; and, indeed, the patronage of the great is rarely bestowed until the deserving man can afford to despise it. Such eminence could not be sustained for any length of time without superior and peculiar fitness for the position. Apparent success, it must be admitted, is often attained by mere meretricious aids, and it is notorious that in medicine the credulous and unenlightened are apt to mistake that which they do not understand as most admirable. It is, however, on the determined, unremitting practice of industry the aspirant must look for success, and he is meanwhile cheered by the feeling that in his labour there is much intrinsic pleasure.

To make a great surgeon there is needed the gift of genius, developed by sound and comprehensive education and matured and rectified by experience. The exertions which well regulated ambition encourages, if opportunities are availed of, seldom fail to be crowned with success; yet instances occur where even persevering industry and brilliant talents do not succeed in obtaining wealth, but gain what is more valuable-the selfconsciousness of having done good and the acquisition of a good repute. Happiness is incomparably better worth striving for than fortune. But exclusive of fame and distinction (too scantily bestowed on medicine), and the less worthy desire for the acquisition of wealth,

32

ELEMENTS OF SUCCESS.

there are other promptings to stimulate.

"No motive is so strong as that founded on the sympathy of the good and wise, no reward so sweet as that of being held up to admiration as a benefactor of the species, no glory so pure, so calculated to awaken great minds as immortality." Such are the words of Sir Humphrey Davy, the noblest philosopher the present age has produced. Another stimulus for exertion is that

"which the clear spirit doth raise, That last infirmity of noble minds

To scorn delights and seek laborious days."

But higher still is the motive of exercising benevolence and charity towards fellow-creatures; and hopeful therefore were the reflections of that great surgeon, Percival Pott, who on his death-bed exclaimed, "My lamp is nearly extinguished-I trust it has burned for the benefit of others." Great acuteness of mind to form rapid, almost instantaneous, yet judicious decisions under emergency, and imperturbable coolness, are special endowments of the operative surgeon. Such qualities are not often combined in the same individual. "Although I have taught surgery for twenty-seven years," confesses the erudite Baron Haller, "and exhibited the most difficult operations on the dead body, yet I have never ventured to apply a cutting instrument to the living body for fear of giving too much pain." However, chloroform has now dissipated such fears. Cultivated judgment and accurate powers of observation are required in dealing with outward ills, and are still more necessary in the investigation of internal affections. It indeed requires patient and painstaking inquiry, profound knowledge of precedent, and great intuitive talent, to discover many of the more obscure maladies; and then, intimate acquaintance with and experience in the use of the remedies bountiful nature has furnished. No course of education can be too profound, no examination too rigorous, for those who undertake so grave and responsible a duty. It is there

fore reprehensible that any should engage in it without due aptitude or preparation, or merely as a means of subsistence. "The physician is to be regarded," exclaims Louis, "as holding a sacred office, which demands greater sacrifices than are to be made in any other profession." From him indeed is called for complete abandonnement de soi.

Many codes of what is termed medical ethics have been drawn up, but those honorable feelings which should ennoble the breasts of men in every walk of life, suggest beacons to those who would follow in the footsteps of Him who, the Saviour of Man, was likewise the Great Physician. Medico-ethical rules do not differ, therefore, from the moral or ethical rules which should guide Christian gentlemen in every pursuit of life. They are such as will suggest themselves to any man of good sense and good nature who practically does to others as he would wish others to do to him. No code of ethics could be more refined or more honorable than that which the "oath of Hippocrates' contains, and which in some American universities forms the declaration which every graduate on being admitted recites. Among other wise injunctions it declares, "Whatever in connexion with my professional practice, or not in connexion 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."

Lord Bacon has forcibly said, "I hold every man a debtor to his profession, from the which as men of course do seek to receive countenance and profit, so ought they of duty to endeavour themselves by way of amends to be a help and ornament thereunto. This is performed in some degree by the honest and liberal practice of a profession, where men shall carry a respect not to descend into any course that is corrupt or unworthy thereof, and preserve themselves free from the abuse therewith the same profession is noted to be in

fected; but much more is thus performed if a man be able to unite and strengthen the roots and foundations of the science itself, thereby not only gracing it in reputation and dignity, but also amplifying it in profession and substance." The right principles of practice are also expressed in the following declaration: "To act in the spirit of science where I can; by the mere light of experience, without scientific insight, where I must; but with the uniform avoidance and contempt of quackery in all cases."

A medical practitioner should always feel the immense responsibility of his position; the more so if junior, for he is liable to be called on to undertake the most important duty at a moment's notice, and without any possibility of aid from his seniors. Such feelings should stimulate continued study to improve the faculty of memory and judgment, so that he can be sure of doing as well for his patient as if the most eminent of his brethren were aiding him. Medicine cannot be said to be positve and exact, like mathematics, but all should endeavour to approach as near as possible to perfection. He should also be constantly impressed with a sense of moral obligation, which a remembrance of the great and sacred duty of his mission will inculcate. Trusted with confidence in the most intimate circumstances of families, there is no calling in which a breach of honour or morality meets with a more speedy or more just punishment. Again, elegance of manner and moderation of temper should distinguish the educated physician, who always makes allowance for the weakness, irritability, and caprices of the sick. Inasmuch as the public can only judge of the skill of a medical man by results, being, from want of information about the natural functions of the human body; quite unable to form a more just estimate, patients should therefore be treated with candour, the imperfections of medical science never being concealed, nor a cure magnified and