ADDRESS TO STUDENTS.

273
dexterous mechanism of the operator has succumbed beneath
the triumphant skill of more remedial and less formidable
THE LANCET. measures-all these sciences and pursuits but add to his per-
plexity and assist his aversion. The truth is, a certain
aptitude is required for the successful study of both. Now,
LONDON: SATURDAY, SEPTEMBER 17, 1853. we cannot for a moment suppose that all who this week enter

at our hospitals and medical schools possess this essential

AGAIN the period has arrived for fulfilling the pleasant quality. It is necessarily confined to a few. But courage,
and gratifying task which we have now for several years industry, assiduous application, and patience, are habits to
undertaken with very satisfactory results. It has been our be acquired and persevered in by all. Without these, little
custom at the advent of each medical year, when the hospitals advance can be made.
and medical schools of the metropolis teem with youthful The day has long since gone by when, as the idol of a tap-
and fresh faces, to address to the young gentlemen who are room, or as the devotee of Terpsichore in some low haunt or
about to enter upon a long and arduous course of study a few vulgar casino, the medical student was in his wonted circle.
words of exhortation, encouragement, and advice. Indeed, Plunged in deep dissipation, and the associate of lewd and
for the first time in their lives so many leave a parental roof, degraded persons, he was accustomed to taiut and sully with
and are launched upon the world without rudder or compass, "rank breath" the very atmosphere of hospitals; and every
exposed to all the fascinating novelties and seductive allure- freak that came under public notice, every prank or row of an
ments of a London life, and cast amongst companions who unmeaning but disgraceful character, was pretty sure to be
are utter strangers, that we shall take especial pains upon
played by a medical student, to the applause of his vulgar
this, as on previous occasions, to warn them, as far as lies in fellows, but as frequently to the condign punishment of him-
our power, of the difficulties and dangers which will beset self. For years past, we rejoice to say, the education, tone,
their path. character, and feelings of medical students have been dia-
The blanks in the medical profession are many, and the metrically opposed to the conduct and proceedings of former
prizes few. It requires of its votaries lengthened and times. We without hesitation affirm that neither in the
earnest industry, active energies, and cheerful zeal. It Church nor Bar will there be found better-conducted or more
offers them little of public fame, honour, or emolument ; sensible young men than they who at present pursue their
but it recompenses them by the knowledge that if they studies in hospitals and medical schools. It is indeed with
gain but scanty thanks for the good deeds they achieve pride that we may watch their conduct and scrutinize their
towards their suffering fellow-creatures,-if they meet with behaviour.
ingratitude where they expected kindness, and are treated But the marked improvement that has of late taken place
with contumely where they anticipated esteem,-they have at in the class of young men who pursue our calling is equally
least the reward of an approving conscience, which is the apparent in every department of the profession. The sphere
emblem of a brighter and better world. We therefore wish of education has become greatly enlarged, and a more ample
our young friends to avoid being buoyed up by false and de-
range of knowledge is now required from all who wish to be
lusive expectations. In choosing the medical profession they considered well-educated persons. An intimate acquaintance
have selected a most arduous calling. They must prepare them- with the languages of antiquity-with the tongue of VIRGIL
selves for much severe mental labour, and many distasteful, and the voice of HOMER-is of increasing importance every
disagreeable duties. If, however, this profession be of their ’, year. We consider it therefore as an ascertained fact, that
own choice,-a choice resulting from thought and sincere con-
every student who in the present year enters into a hospital
viction,-then let them put their shoulders to the wheel, ’, or school, has a competent knowledge of Latin and Greek;
determined neither to look back, nor be faint-hearted, but and we strenuously urge all who have it in their power-and
hopefully to wrestle with every difficulty, and manfully com-!, who has not ?-to pay attention to this most important point.
bat every obstacle. We purposely desire to point out the Now the University of London demands that every candidate

i
difficulties that are attendant upon moderate success in the should possess a thorough insight into the dead languages, and
profession, because many enter it with very vague ideas of a moderate acquaintance with the elementary details of mathe-
its responsibilities, and not the remotest notions of the matics. The Matriculation Examination, though a little
struggles and labour in which they will have to engage. stringent, requires no more than this; for history, ancient and
Unless a youth selects it of his own free will, it is an modern, and geography, surely all have studied, while a know-
absolute certainty that he will never attain in it either posi- ledge of the roots and origin of our native tongue is one of the
tion or emolument. Anatomy, with its complicated details first desiderata in modern education. The Apothecaries’
and intricate beauties, is lost upon him; Physiology, with following in the wake of the metropolitan Uni-
Company,
its prescient reasonings, deep reflections, and extended versity, have very wisely and judiciously instituted a similar
investigations, is beyond his comprehension; Chemistry, examination, though of a more simple nature, for all who
with its latent marvels, splendid discoveries, and increasing enter into indentures of apprenticeship with them; and though
influence, is too difficult a science for his puny conceptions. for the present the examination is a voluntary one, it will
- Medicine exerts her influence in vain, as with accurate very soon have to be passed by every pupil. A good rudi-
induction she successfully combats difficult and obscure mentary education is therefore absolutely indispensable; and
and complicated disorders; while Surgery, with its glorious it is discovered that the better a student possesses this
achievements in recent days, when the knife is no longer the advantage the easier is his path in medical study. His mind
ina qua non of the brilliant practitioner, and when the mere becomes more attuned to a close application, his thoughts
 274 ADDRESS TO STUDENTS.

more supple and pliant, while his feelings appear, as it were, life. The means either of success or failure are entirely in
purified and refined by a higher appreciation of the grand his own hands. His teachers can give him good advice; it
truths of science. The study of mathematics, too, is of ex- depends upon himself to follow it. This is true especially in
treme importance. The intellect accustomed to its rigid regard to his selection and choice of associates. It behoves
reasoning and severe logic is far better adapted to separate him to be very careful. Society is apt to judge of a man’s
the ‘° chaff and stubble"from the airy and captivating character by the company in which he mixes. And is it
hypotheses in which some eJoquent writers on physiology, not correct ? What so likely to throw light upon a student’s
medicine, and science, are wont to clothe their thoughts, and disposition as keenly watching the companions with whom he
thus sooner arrives at practical truth by its sagacious argu- mingles He chooses his friends either amongst the gay and
ment and sound deduction. But while we have been at some thoughtless, oramongst the diligent and hard-working; between
pains to impress the advantages that a thorough cognisance of the inane " fast" man and the stupid idler. Let him deliberate
the classics confers, it must ever be remembered that the re- well before lie makes his choice, and not be led away by those
quirements of the present age, in the way of education, are who, however cheerful and admirable as companions, are the
each day becoming wider and more extended. The writings very antitheses of steady working men. Let him recollect
of LIEBIG, and the eloquent and elaborate treatises of MuLLER, that he is sent to a hospital, not for pleasure, but for gaining
should be read in their native tongue; while the works of a knowledge of his profession.
Louis, RICORD, and a host of French writers of celebrity, are One of the first severe trials which the young student will
to a great extent wasted and spoiled, if not studied in their have to overcome will be in persuading himself to enter upon
original language. To all therefore who have the necessary a course of reading. He will read much, con and ponder over
opportunities, whatever of time and labour they bestow upon it, and yet understand but very little; so he becomes depressed
the acquisition of the German and French languages, they and anxious. He begins to doubt if he possesses equal abilities
will be rewarded a hundred-fold. Indeed, it is a fact now with other men; and unless he has some friend to cheer and
established beyond dispute, that the more elaborate the educa- incite him, he begins to neglect his studies, till, little by little,
tion is which a man possesses the greater are his chances of they appear to him distasteful and abhorrent. No one is so
success in mental competition. We earnestly urge this truth likely to fall into this frame of mind, or is so apt to err in his
upon the minds of the young. It is in the power of everyone notion of the best method of acquiring professional know-
to do much for himself. A thousand masters cannot make a ledge, as the medical student. The different subjects appear
man conversant with a language unless he uses the talents he multifarious, complicated, and perplexing. A little sound
naturally enjoys; yet with steady application and little severe advice from an older student, or, better still, from one of the
labour an excellent knowledge of modern languages may be teachers-a few practical suggestions as to the arrangement
easily attained. of his studies, will often protect a pupil from much superfluous
We now proceed to some more immediate remarks upon labour, and unprofitable study. He must, however, be
the career which young students are about to commence, and zealous and unremitting, and not work by fits and starts:
we bid them recollect that these observations are offered in Hope, Perseverance, and Courage are the loadstars to cheer
a spirit of sincere conviction of their value, and the aid it is him on. "If," says one of the most powerful and accom-
believed they may afford to all who are willing to profit by plished writers of the day,you had the abilities of all the
sound advice and ample experience. Of course no hints "great men, past and present, you could do nothing well
can here be tendered to guide pupils in their selection of a without sincerely meaning it and setting about it. If you
place of instruction. The present LANCET contains complete entertain the supposition that any real success in great
information concerning every recognised Hospital and School. °° things or in small ever was or could be-ever will or can be-
We would merely remark, that it is a grievous misapprehen- " wrested from fortune by fits and starts, leave that wrong
sion to suppose that the large Schools, like those of St. Bar- idea here."* But were the student to require additional
tholomew’s or Guy’s, are preferable because they are con- incitements to study, what is so powerful and irresistible a
sidered to afford more ample Instruction. The contrary is motive as the conviction of the awful position in which
rather more frequently the fact. The very crush of pupils, and ignorance of his profession may at any moment place him?
their overwhelming numbers, are often made the excuse for Probably, when he quits his hospital studies, he may engage
giving much instruction to the mass, and but little to the individual. in country practice, and is situated many miles from any
A more limited number of beds, too, so far from being a loss, brother practitioner. A serious accident occurs in the neigh-
is rather a gain, to the young student, for he does not get so bourhood; an immediate operation is required. He has no
much bewildered and puzzled by the number and variety of the assistance on which he can place reliance. The patient is a
cases he visits, and he can more conveniently ascertain their man of rank and position; a weeping family crowd around

histories, and more readily comprehend the reasons for their him-wife, daughters, friends, all fearfully trusting in the
plans of treatment; and as the teachers have less arduous surgeon’s skill. Each moment his condition becomes more
duties to perform, he will probably obtain more clinical in- precarious. What, then, must be the practitioner’s feelings---
struction ; whereas in the half-thousand beds of a monster how damning his remorse-when, in taking up the knife to
hospital he wanders about dreary and dispirited, and often search amidst, perhaps, the most delicate and vital parts of
attempts in vain to gain an insight into the cases. But what- the body, he knows that he is utterly ignorant of the dan-
ever may be the School at which he enters as a pupil, we sin-
gerous structures he is about to divide, and yet all the while
cerely hope that he will commence his studies with a firm ’, feels convinced that his slightest error will imperil still more
determination to do his best, patiently and honestly. He must
recollect that the present is the most important period of his * Dickens.
 ADDRESS TO STUDENTS. 275
his patient’s existence, and his most trivial misconceptioni learn its beautiful designs, and unravel the marvellous com-
launch him to eternity ! We feel sure that a very littlet plexity of its peculiar textures. Dissect as much as possible,
consideration will satisfy students of the extreme horror offor in later days there will be small opportunities. And as
such a situation, but it is one to which they may be exposed by dissection you become intimate with the human fabric-as
any moment of their lives. So likely an occurrence will by physiology you trace and distinguish between cause and
prove to them what an imperious necessity exists that they effect, and strive to comprehend, as far as our limited know-
should thoroughly study their profession while they enjoy ledge permits, the various functions of its several organs-so
the ample opportunities that a hospital affords. by attendance in the " dead-house" you investigate those
But although we hope to impress upon their minds organs in a more or less healthy state, and learn to discern
the importance of perseverance in their studies, we by for yourself the different changes which disease produces
no means wish to urge them on to impossibilities. Many upon them, and the more or less probable causes which
are lured to a School on account of the large number wrought those deviations from the healthy condition. Your
of prizes that- may be offered, or for the sake of the investigations then carry you further. In the wards of the
scholarships that are vacant. This is a grievous error. What- hospital you study the living man, and you see him suffering
ever the inducements to honourable competition, but few under more or less of disease. Here is opened to you a wide
men are qualified to gain the rewards. If a student will work field for study. As Anatomy should be the basis of your
fairly at each subject required by the curriculum of the education, so is sound and good Clinical knowledge the
Examining Boards, and at the end of the Session feels himself greatest auxiliary to professional suocess. You must not,
justified in competing with others for public distinction, we however, begin it as a novice. You ought not to commence
most assuredly sanction his conduct. Unfortunately, however, attendance in the wards of a hospital until after a year’s
at most medical schools the injurious system of distributing good previous study. You have then to educate eye, ear, and
class prizes is still prevalent. The evils resulting from it may touch. Upon this subject we hope to offer many useful hints,
be easily explained. A young student desires to gain a prize. but for the present they must be deferred, as there are
I
He has not either the abilities, perseverance, or diligence to yet a few general suggestions to be made. Understand,
wrestle with his rivals in two or three subjects, so he selects however, that though Anatomy discovers to you the structure
one, and 11 crams" himself up in it. He attains the object of and design of man’s composition, and Physiology unfolds the
his ambition. But what is the consequence1 Why he has phenomena of his existence, and the physical laws which keep
neg.kcted his otlte1’ branches of study ; and though he may be him in a condition of health,-though Medicine ascertains his
well enough informed upon a single subject, he has thrown deviations from that condition, restores and invigorates and
aside all opportunities of acquiring more extended knowledge. renovates his frame, while Surgery relieves him from loath-
He continues this ill-advised conduct, and at the end of his some growths, and enables him to palliate the consequences
education, he is able to leave his Alma Mater, joyful in the of severe injuries, and thus render his life happy, where it
acquisition of a prize or two. But it will be found that his would otherwise have been insupportable,-these sciences
range of professional knowledge is most probably--except alone are not sufficient for a thorough and complete educa-
upon one or two subjects-far less than that possessed by tion. There are collateral subjects. You have to make your-
many whom he may heedlessly have stigmatized as drones selves acquainted with Chemistry. It explains the intimate
and dullards. We would not be misunderstood. We compositions of the tissues and structures of the body; the
advise students to compete for prizes if they feel themselves purposes and uses and elements of metals, and the various
competent to the task. But let the prizes be gained by those ways in which the laws of Natureact upon them. Then
who exhibit the most competent knowledge in each branch Materia Medica marshals before you her teeming treasurer
of study required by the current year’s curriculum. If, how- expatiating upon the action of her drugs, showing you the
ever, at one trial the tyro should be unsuccessful, do not let countries and regions in which they first appeared, and
him be dispirited. The average of men are gifted merely describing the rules to be observed in their composition.
with very moderate powers. Talent, in the strict sense of the i And Therapeutics, again, demonstrates the larger or smaller
word, belongs to a very few. It is diligence and hard study- proportions in which they should be exhibited in different
courage and steady labour-that are the qualities which raise constitutions, and enunciates the variety of diseases in which
so many men to honourable positions. But the ambition that these remedies are efficacious. Botany, too, in her vast range
leads a man to look forward to high professional repute must of the vegetable kingdom, enables you, by her beautiful and
be displayed in his early days. It is seldom that he who has still-improving classifications, to distinguish the plant or herb,
neglected the struggle in his youth, has the opportunity whence the drug is derived whose medicinal properties you
afforded him to redeem lost time. " Those men who distin- will so often witness. While the numerous criminal and
"guish themselves most in academical competition when they medico-legal cases that daily come under public observation,
"are young, are the men who in after life distinguish them- in which the evidence given by the medical man is of vital
" selves most in the competition of the world."* Still, let not importance, makes Forensic Medicine a branch of study of
the student sacrifice his health merely to gain a few rewards, great interest and importance.
which, however tempting and praiseworthy in the acqui- At the commencement of your education confine yourselves
sition, are frequently purchased at far too dear a rate. to practical and simple elemental works, which as companions
Make anatomy the basis of education. Work at it earnestly to your lectures will furnish you with all the information you
and patiently. Search the structures of the human frame, and will either require or understand. Avoid, altogether, reading
elaborate and abstruse treatises. You will not be able to
* J. B. Macaulay. comprehend them, and they will waste your time, and exhaust
 276 THE THREATENED RETURN OF CHOLERA.
your patience. Do not be led into
boyish comments upon the
proceedings of your teachers, hastily decide that a thing
nor
is badly done, merely because performed in a different manner
from that in which you have been accustomed to witness it.
That you will treat your teachers with courtesy, deference,
and respectful attention, we do not doubt; that you will not
set your opinions against their
own better knowledge
ampler experience is equally certain. Above all, do not,
too often the case with many around you, go to an operation
for the sake of excitement, or enter the apartment as if it
were a playhouse. Reflect for a moment upon the scene that
you will probably witness. A young female, perhaps, is the victim
of malignant disease. Chloroform has lulled her into a dreamy
slumber, and her sufferings seem eased for a little while; but
she is recovering from its influence, and is too weak and
debilitated to be again soothed by its wonderful agency. The
operation is unexpectedly prolonged, and becomes more an
more complicated than was just now anticipated. She has
stimulants administered to arouse her exhausted frame, and
she revives a little; and then as the surgeon skilfully and
rapidly divides structure after structure, and at each move-
ment his knife is bathed in fresh blood, you mark the
suppressed suffering the poor creature undergoes; the gash in
her lip when she gnashed her teeth in acute anguish; and
now and then there starts upon the attentive ear the hushed
sound of a half-stifled cry! Can such a scene carry no moral
with it even to the thoughtless and the youngq
One word more. The conduct of students towards
patients must be very considerate. It should be recollected actually present, or only impending, many practitioners are, per<
that all of them are suffering pain in a greater or less haps, somewhat too much disposed to translate those symptoms
degre? and that they are a class of persons peculiarly into the certain indications of cholera. Caution in this respect is
sensitive to kind or rough treatment. Never, therefore necessary.
exhibit brusqueness of temper, and direct all your inquiries As a protective agent against cholera, Mr. BEAMAN, of King-
in a kind and sympathizing tone. Be careful to avoid that street, Covent-garden, a medical practitioner of great experience,
error of young beginners, and, we are sorry to say, even
older men-viz., carrying on anaudible conversation at a
patient’s bedside, concerning the nature of his disorder and its
probabilities of cure. Extreme harm is often inflicted in this
way. Be attentive to whatever you witness in the wards, but
do not hinder and obstruct the dressers and other olderstudents
in the performance of their several duties, and thus lay your-
selves open to reproach as either intrusive or impertinent.
Let the young student be assured, that the exercise of a
moderate share of common sense, a little prudence, and a
courteous and conciliating disposition, will soon procure him
friends, win for him the respect of his teachers, and reward
him with that be&t of all eulogies, the knowledge that he
feels himself to be, what his companions consider him-a
eaell-educatecd gentleman.
THE indications of the march of cholera, if not decisive as to
the approaching of this terrible disease, are at
re-ap earance
least sufficiently marketo leave no doubt as to the necessity of
immediately taking every sanitary precaution to mitigate the
scourge. After traversing a large portion of the Continent the
disease has made its appearance in Newcastle-the very town
where it was first observed in 1849. It is reported, that 86 cases
and 37 deaths have occurred in that town, and almost an equal
number in Gateshead.
Mr. GRAINGER has been deputed by the Board of Health to
advise with the local authorities of Newcastle upon the proper
means of resisting the advances of the disease. The sanitary
condition of these places is of the worst description. It offers a
striking illustration of the well-ascertained law, that cholera, like
other epidemic affections, is most destructive where pure air,
pure water, and cleanliness are most defective. The course to
and be adopted is not more logical than obvious.
asis Great as is the value of medical and individual treatment in
averting or remedying this disease, the general and hygienic
measures are of incalculably greater importance. The whole of
these hygienic measures may be summed up in a few words-
proper DIET, pure AIR and WATER, and CLEANLINESS.
Earnestly enforciag the necessity of immediate attention to
these points of primary importance, we take the opportunity
of reminding the public of the expediency of paying instant
attention to every case of diarrhoea. The alliance between
the diarrhoea now prevalent and actual cholera is, perhaps,
closer than may be suspected; at any rate, the more alarm-
ing symptoms of developed cholera are almost universally
ushered in by diarrhoea. It cannot always be foretold whether
any given case of diarrhoea will terminate in the restoration to
health, or pass into the more dire affection. It may at the same
time be observed, that the real nature of the earlier cases re-
ported as "Asiatic cholera," is open to some question. Every
year some cases of diarrhoea occur in which the symptoms are so
severe, and so closely resembling those observed in the undoubted
epidemic visitations, that it would be difficult or impossible to
discriminate them from Asiatic cholera. When the disease is
of recommends a liberal use of common table salt with the ordinary
meals, taken daily. He strongly insists upon its efficacy. We
shall refer to this subject in the next LAXCET. It is one of
exciting interest at the present moment.
Medical News.
APOTHECARIES’ HALL.&mdash;Names of who
gentlemen
passed their examination in the science and practice of medi-
cine, and received certificates to practise on
T7zursday, Sept. 8th, 1853.
JEPHSON, JOHN HOLMES, Birkenhead.
JONES, SYDNEY.
KELLY, JAMES DOUGLAS, Liverpool.
MUNDIE, &EORCE, Dalston.
EPIDEMIOLOGICAL SOCIETY. - The Cholera Com-
mitteeappointed by this Society are understood to be diligently
engaged in investigating the origin and progress of the present
outbteak of cholera in this country.
ADULTERATION OF SNUFF AND TOBACCO. At
-
Glasgow, Charles York, snuff-dealer, was prosecuted by the In-
land Revenue, and fined, in the mitigated penalty of 1:125, for
mixing peat moss with snuff. He pleaded guilty, and, in exte-
nuation, alleged that he only did what all the other snuff-manu-
facturers did. The solicitor for the revenue denied the allegation,
and declared that of seventy manufacturers he could only dis-
cover two other similar offenders. At the same time Robert
Gordon, tobacco-manufacturer, was fiued, in the mitigated penalty
of .6100, for mixing 35 lbs. of saccharine matter with 250 lbs. of
tobacco, contrary to the statute which prohibits, under a penalty
of .S200, any mixture except water. The tobacco was also for,
feited.