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CHARING-CROSS HOSPITAL

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346 The lecturer next offered suggestions as to the best mode of becoming accomplished members of this noble profession; al- luded to the great advantages for study now afforded by St. Bartholomew’s Hospital, yet warned his hearers against rely- ing upon these; the work, the real hard work, must all be their own. The chief habit to be cultivated was that of un- tiring industry and determined perseverance. He did not be- lieve in the value of so-called talents as opposed to sheer hard work. Talents without industry could effect nothing, whereas industry, even without talents, could do almost anything. It was desirable to find pleasure in work, " labor ipse voll1ptas" should be amongst the student’s mottoes. The sportsman toils over the mountains in pursuit of game, heedless of wet and cold, of fatigue and hunger, for he takes pleasure in the steady pur- suit of an object, and in the exercise of his bodily powers. So likewise it was pleasure of an analogous kind which prompted John Hunter to be up at six in the morning and work till long after midnight. He, too, bad an object to pursue, and took delight in the employment of his intellectual faculties. The ardent student should always strive to make his work plea- surable, and not a mere drudgery. Dr. Kirkes then gave some advice to the students upon the care of their time. They were to keep a jealous, watchful eye upon its expenditure ; to be especially careful of its fragments, which were to be all gathered up and pressed into service. Leisure, however, is needed for mind as well as body; alter- nation of action and repose secures the energy and vigour of both. They were to be very careful in the employment of hours of relaxation-to be used as helps and restoratives, not wasted in indolence or frivolity. For although the advantages for study in a London hospital were great, yet the temptations to idleness were even greater. The lecturer therefore urged the remembrance of home affections as being, after their Christian obligations, one of the greatest inducements to them to follow a virtuous and studious course : the father’s anxiety that the son should do honour to his name and profession; the mother’s fears on launching her son into a new and dangerous sphere of life; the sister’s pride in his success, or grief if he should brinly discredit on his family. With respect to the three principal sources from which their knowledge was to be obtained-viz., lectures, reading, and observation, he advised that equal attention should be given to all, and not that exclusive use should be made of any one to the neglect of the others. Observation and reading should especially go hand in hand; the former shows things as they are, the latter only tells about them. With regard to lectures, he advised them never to leave the theatre in doubt on any point, and to cultivate the friendship of the lecturer. He then offered special remarks to first-year’s students, urging them to adhere to the curriculum laid down for them, and to make - anatomy, physiology, and chemistry their chief study during the ensuing winter; for these constituted the groundwork on which all subsequent knowledge was to be built up. Second- and third-year’s students he urged to devote most of their time to the wards, where they would find living examples of disease, advised them not to neglect the medical wards not to seek after mere curiosities of disease, or rare accidents and unusual onerations. but to studv the ordinary, common- place, every- day forms of disease, for in these especially death reigned triumphant, and upon their treatment of these their future professional success would depend. The lecturer also threw out hints as to their demeanor in the dissecting-room and wards : the former should be regarded as hallowed by the presence of the dead,-the latter, as hallowed by the presence of the sick and suffering, to whom at all times kindness and consideration were due; by the step of the bereaved and deso- late, the fatherless and the orphan; and by the tread of great men passed away. Amongst the numerous difficulties in the way of professional advancement, he alluded to supposed obstacles from imperfect education and scanty means: neither, he said, were really bars to future success, but often proved the very means of effecting it, by stimulatiug to greater exertion. He instanced John Hunter, James Watt, and George Stephenson, as proofs that men whose early youth had been beset with difficulties, and whose education had been neglected, yet had forced their way through all impediments, risen up the hill of fame, and from its summit looked down on multitudes who, with far greater extraneous advantages, were left behind and never reached the top. In conclusion, the lecturer warned them against supposing that study ended when the diploma was gained; the same habits of close study and observation were to be carried into practice. Their profession was to be pursued in an earnest, conscientious spirit, remembering that they were sent forth as " Priests of the holy flame of life." Disappointments and failures at times were inevitable, but they were not to be daunted by them, considering that the issues of life and death are in a higher hand, and that man’s part is only to fulfil his duty faithfully and in a Christian spirit. CHARING-CROSS HOSPITAL. INTRODUCTORY LECTURE BY MR. E. CANTON. MR. CANTON commenced his Address with a sketch of the various branches of knowledge to which the student will have to devote his attention, and then showed the close relationship that existed between them, and how the study of one subject actually led to the further investigation of others. The inti. mate connexion of the practice of medicine with that of sur. gery was dwelt on, and illustrations given of the importance of associating the two studies. Clinical information was espe. cially recommended, and the much-neglected habit of making notes of disease at the bed-side of the patient was strongly in. sisted on as one of the greatest utility. " The notes should be at first brief, but explicit; increase of experience will confer facility of expression, which time and observation will enable you to correct and amplify; whilst a steady perseverance in this system will ultimately find you in possession of a large body of well-recorded cases and obser- vations, which have, as it were, been insensibly transferred to mental tablets, and a store of information thus amassed which brings with it a just claim hereafter to the proud title of a skil. ful practitioner." The department of the medical man in the sick chamber was commented on, and kindness to the poor, both in health and sickness, enjoined. " By this kindly consideration much may be accomplished; and we should never forget, that in the treatment of the sick in hospital, and at their own miserable dwellings, we have not only to combat with illness, but to attack it in the formidable garb of associated poverty. Disease and want are in league to destroy; skill and kindness should combine to preserve. In your attendance upon the sick you should be cheerful, but not frivolous; attentive, but not intrusive; and determined, though not ungentle; and you may ofttimes do as much by thus in- stilling a confident reliance as by directing an appropriate medicine. " In speaking of the necessity of attending to study, and of mastering difficulties by degrees, ic was observed that ‘‘ no sudden resolves or quick actions, as a general rule, were com- mendable ; safer it is to travel along the equable path of know- ledge with measured pace and becoming confidence than to rush headlong to the goal with hasty step and overweening re- liance. Remember the path of the tortoise and the hare- adopt the motto, ’festina lente.’ I would advise you to enter upon your studies with a resolution bent upon their pursuit in the manner they have been commenced-a manner to be cha- racterized by patience and perseverance, but free from that in- judicious arclour which would overleap difficulties at a bound, and seize upon knowledge at a grasp. Such undue efforts are profitless and enervating; the mind’s power fails under the exertion, and apathy, usurping the place of anxiety, becomes mated with ignorance. With the talented author of ’ Pro- verbial Philosphy i would say. "Let the cool streams of prudence temper the hot springs of zeal; So shalt tliou gain the honourable end, nor lose the midway prize: So shall thy life be useful, and thy oung heart happy." In referring to attendance at lectures and examinations, it as remarked : " Yonr entrance upon a lecture commenced, is an annoyance to the teacher, an interruption to the studious, and an act of injustice to yourselves. During lecture hour, let attention, observation, and reflection be your attendant guides; and whilst profitably employing the fleeting time, bear ever in re. collection that this dawning assiduity is the fair herald of a meridian sunshine of success; but levity of manner and habi- tual frivolity bespeak instability of purpose and littleness of mind : they are the ignoble parents of a triple offspring—neg- ligence, ignorance, and want. At examinations you will have every opportunity of judging of the knowledge you have already acquired, or of estimating the deficiency you have yet to supply. At these ordeals, the intelligent reply, but the blind are dumb: the industrious are here brought to light, whilst the idle re- ’ main in self-created obscurity; and little are the feelings of
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Page 1: CHARING-CROSS HOSPITAL

346

The lecturer next offered suggestions as to the best mode ofbecoming accomplished members of this noble profession; al-luded to the great advantages for study now afforded by St.Bartholomew’s Hospital, yet warned his hearers against rely-ing upon these; the work, the real hard work, must all betheir own. The chief habit to be cultivated was that of un-

tiring industry and determined perseverance. He did not be-lieve in the value of so-called talents as opposed to sheer hardwork. Talents without industry could effect nothing, whereasindustry, even without talents, could do almost anything. Itwas desirable to find pleasure in work, " labor ipse voll1ptas"should be amongst the student’s mottoes. The sportsman toilsover the mountains in pursuit of game, heedless of wet and cold,of fatigue and hunger, for he takes pleasure in the steady pur-suit of an object, and in the exercise of his bodily powers. Solikewise it was pleasure of an analogous kind which promptedJohn Hunter to be up at six in the morning and work till longafter midnight. He, too, bad an object to pursue, and tookdelight in the employment of his intellectual faculties. Theardent student should always strive to make his work plea-surable, and not a mere drudgery.

Dr. Kirkes then gave some advice to the students upon thecare of their time. They were to keep a jealous, watchful eyeupon its expenditure ; to be especially careful of its fragments,which were to be all gathered up and pressed into service.Leisure, however, is needed for mind as well as body; alter-nation of action and repose secures the energy and vigour ofboth. They were to be very careful in the employment ofhours of relaxation-to be used as helps and restoratives, notwasted in indolence or frivolity. For although the advantagesfor study in a London hospital were great, yet the temptationsto idleness were even greater. The lecturer therefore urgedthe remembrance of home affections as being, after theirChristian obligations, one of the greatest inducements to themto follow a virtuous and studious course : the father’s anxietythat the son should do honour to his name and profession; themother’s fears on launching her son into a new and dangeroussphere of life; the sister’s pride in his success, or grief if heshould brinly discredit on his family.With respect to the three principal sources from which their

knowledge was to be obtained-viz., lectures, reading, andobservation, he advised that equal attention should be given toall, and not that exclusive use should be made of any one tothe neglect of the others. Observation and reading shouldespecially go hand in hand; the former shows things as theyare, the latter only tells about them. With regard to lectures,he advised them never to leave the theatre in doubt on anypoint, and to cultivate the friendship of the lecturer. He thenoffered special remarks to first-year’s students, urging them toadhere to the curriculum laid down for them, and to make

- anatomy, physiology, and chemistry their chief study duringthe ensuing winter; for these constituted the groundwork onwhich all subsequent knowledge was to be built up. Second-and third-year’s students he urged to devote most of their timeto the wards, where they would find living examples ofdisease, advised them not to neglect the medical wardsnot to seek after mere curiosities of disease, or rare accidentsand unusual onerations. but to studv the ordinary, common-

place, every- day forms of disease, for in these especially deathreigned triumphant, and upon their treatment of these theirfuture professional success would depend. The lecturer alsothrew out hints as to their demeanor in the dissecting-roomand wards : the former should be regarded as hallowed by thepresence of the dead,-the latter, as hallowed by the presenceof the sick and suffering, to whom at all times kindness andconsideration were due; by the step of the bereaved and deso-late, the fatherless and the orphan; and by the tread of greatmen passed away.Amongst the numerous difficulties in the way of professional

advancement, he alluded to supposed obstacles from imperfecteducation and scanty means: neither, he said, were really barsto future success, but often proved the very means of effectingit, by stimulatiug to greater exertion. He instanced JohnHunter, James Watt, and George Stephenson, as proofs thatmen whose early youth had been beset with difficulties, andwhose education had been neglected, yet had forced their waythrough all impediments, risen up the hill of fame, and fromits summit looked down on multitudes who, with far greaterextraneous advantages, were left behind and never reached thetop.In conclusion, the lecturer warned them against supposing

that study ended when the diploma was gained; the samehabits of close study and observation were to be carried into practice. Their profession was to be pursued in an earnest,

conscientious spirit, remembering that they were sent forth as" Priests of the holy flame of life." Disappointments andfailures at times were inevitable, but they were not to bedaunted by them, considering that the issues of life and deathare in a higher hand, and that man’s part is only to fulfil hisduty faithfully and in a Christian spirit.

CHARING-CROSS HOSPITAL.

INTRODUCTORY LECTURE BY MR. E. CANTON.

MR. CANTON commenced his Address with a sketch of thevarious branches of knowledge to which the student will haveto devote his attention, and then showed the close relationshipthat existed between them, and how the study of one subjectactually led to the further investigation of others. The inti.mate connexion of the practice of medicine with that of sur.gery was dwelt on, and illustrations given of the importanceof associating the two studies. Clinical information was espe.cially recommended, and the much-neglected habit of makingnotes of disease at the bed-side of the patient was strongly in.sisted on as one of the greatest utility." The notes should be at first brief, but explicit; increase of

experience will confer facility of expression, which time andobservation will enable you to correct and amplify; whilst asteady perseverance in this system will ultimately find you inpossession of a large body of well-recorded cases and obser-vations, which have, as it were, been insensibly transferred tomental tablets, and a store of information thus amassed whichbrings with it a just claim hereafter to the proud title of a skil.ful practitioner."The department of the medical man in the sick chamber was

commented on, and kindness to the poor, both in health andsickness, enjoined." By this kindly consideration much may be accomplished;

and we should never forget, that in the treatment of the sickin hospital, and at their own miserable dwellings, we have notonly to combat with illness, but to attack it in the formidablegarb of associated poverty. Disease and want are in league todestroy; skill and kindness should combine to preserve. Inyour attendance upon the sick you should be cheerful, but notfrivolous; attentive, but not intrusive; and determined, thoughnot ungentle; and you may ofttimes do as much by thus in-stilling a confident reliance as by directing an appropriatemedicine. "

In speaking of the necessity of attending to study, and ofmastering difficulties by degrees, ic was observed that ‘‘ nosudden resolves or quick actions, as a general rule, were com-mendable ; safer it is to travel along the equable path of know-ledge with measured pace and becoming confidence than torush headlong to the goal with hasty step and overweening re-liance. Remember the path of the tortoise and the hare-adopt the motto, ’festina lente.’ I would advise you to enter

upon your studies with a resolution bent upon their pursuit inthe manner they have been commenced-a manner to be cha-racterized by patience and perseverance, but free from that in-judicious arclour which would overleap difficulties at a bound,and seize upon knowledge at a grasp. Such undue efforts areprofitless and enervating; the mind’s power fails under theexertion, and apathy, usurping the place of anxiety, becomesmated with ignorance. With the talented author of ’ Pro-verbial Philosphy i would say.

"Let the cool streams of prudence temper the hot springs of zeal;So shalt tliou gain the honourable end, nor lose the midway prize:So shall thy life be useful, and thy oung heart happy."

In referring to attendance at lectures and examinations, itas remarked :" Yonr entrance upon a lecture commenced, is an annoyance

to the teacher, an interruption to the studious, and an act ofinjustice to yourselves. During lecture hour, let attention,observation, and reflection be your attendant guides; andwhilst profitably employing the fleeting time, bear ever in re.collection that this dawning assiduity is the fair herald of ameridian sunshine of success; but levity of manner and habi-tual frivolity bespeak instability of purpose and littleness ofmind : they are the ignoble parents of a triple offspring—neg-ligence, ignorance, and want. At examinations you will haveevery opportunity of judging of the knowledge you have alreadyacquired, or of estimating the deficiency you have yet to supply.At these ordeals, the intelligent reply, but the blind are dumb:

the industrious are here brought to light, whilst the idle re-’ main in self-created obscurity; and little are the feelings of

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347

that student to be envied who could leave the scene of thatsilence with a pleasantry on his tongue-without annoyance athis heart." The conclusion of the Lecture ran thus :" The journey end of your pupilage will be rewarded with

that becoming satisfaction which engender reliance upon self,has sprung from merit, and been fostered to maturity by per-severance. You may then look back upon the past with plea-sure-towards the future, with hope. Bear also in mind, thatit is not you alone who will feel the pleasure of this well-earnedsuccess; from many a tongue will fluw words of approval andgratulation; many a heart will bound with pride at the joyoustidings; and, above all, your return to home will be greetedwith the glowing reward of increased affection, when, withhonest satisfaction you resign the trust so confidingly reposedin you, proudly feeling that you have neither squandered pro-digally your time, nor lavished unprofitably, it may be, thehard earnings of an anxious parent."

ST. GEORGE’S HOSPITAL.

INTRODUCTORY ADDRESS BY DR. FULLER.

DR. FULLER began his Address by recalling to the seniorpart of his audience the difficulties and temptations they hadhad to encounter at the outset of their professional career, andmade this a ground for addressing the remainder of his re-marks to those who are now about to commence their studiesin London. He first pointed out the nature of their adoptedcalling, and the motives with which it ought to be pursued." If," he said, " it be true that a profession which has for itsobject the saving of human life, and the prevention of humansuffering-which calls forth the noblest qualities of the mind,enlarges its sympathies, and tends to clear it of prejudice anderror-which brings us into direct and intimate relation withour suffering fellow-creatures, and by giving us an insight intohuman nature under every form and every aspect enables us tolearn wisdom from the dearly-bought experience of others; ifsuch a profession be worthy of our choice, you may be trulythankful for the selection you have made. A life of honourableusefulness lies before you such as does not fall to the lot ofevery one. The profession of medicine, if worthily pursued,is a noble and beneficent vocation-softening and humanizingthose who follow it, leading them to regard with leniency theweaknesses of their fellow-creatures, and prompting them tospare no effort to relieve their mental anguish or assuage theirbodily suffering." He urged them to take a high view of theirprofession, and to follow it steadily and constantly, in thehope that while it may one day yield them an honourable sub-sistence it may also enable them to cultivate those qualitieswhich serve to distinguish a Christian gentleman. He then

proceeded to offer them advice respecting the choice of friendsand companions, and warned them not only against the idleand dissolute, but against the good-natured, well-meaning, butthoughtless, whose inexperience leads them to imagine thatthere can be no harm in a little temporary self-indulgence, alittle time devoted to the so-called pleasures of a London life." Nothing," he said, " can be more fatal to your success andhappiness. Thousands have trodden this dangerous road, andtheir example has shown that he whose course is marked atthe outset by negligence and irregularity, is gradually led onto other idleness and into evil company, and finds himself atthe close of his hospital career without the knowledge requisitefor the proper exercise of his profession, and without a cha-racter calculated to assist him in anv effort he mav be then in-duced to make to redeem his misspent hours." He urged them ! to begin as they intended to go on: to be regular and constantin attendance at lectures, diligent in the dissecting-room,earnest in their private studies, zealous in the pursuit of thatpractical knowledge which is only to be acquired in the wardsof the hospital. "The study you have embraced," he said," is one to engross your whole attention, even if it had no re-lation to your future career through life ; but forming as itdoes the groundwork of that profession which you have cleli-berately chosen, you are bound to devote your whole energiesto its prosecution. You are bound to do so for the sake of yourown reputation and future happiness--for the sake of thosefriends who have given you your education, and who are stillassisting you, and for the sake of those poor suffering fellow-creatures who will one -day look to you for relief. Above all,you are bound to do so as the servants of an all-wise Provi-dence, who has been pleased to enrol you amongst the number

of those whom he employs as the channels of his mercy andthe ministers of his earthly blessings, and who one day willrequire at your hands an account of the talents committed toyour charge." He then proceeded to point out the necessityfor learning to regulate the feelings and behaviour, to disci-pline the mind, and to follow strictly in the path of moral rec-titude. " You must learn," he said, "to cultivate habits of £order, method, and punctuality, so as to be able to economizeyour time; you must acquire the habit of directing the wholeattention to the subject before you, so as to analyse and reasonon it correctly; you must learn to be exact in observation, andscrupulously accurate in your record of facts-to discriminatebetween the important and the unimportant, and so to arrangeand classify your knowledge as to have it always available in

practice. But beyond all this, if yon would succeed in yourcareer, and occupy an honourable position in the world, you

! must learn to cherish self-respect and honesty of purpose-feelings inconsistent with mean and dishonourable actions: youmust evince integrity of conduct, generosity of character, andkindliness of feeling towards your professional brethren; you.must acquire the habit of self-restraint which shall enable youto bear with the waywardness of your patients, and a gentle-ness of manner and cheerfulness of disposition which shallrender you a welcome visitor to them; you must learn to sym-pathize with them in their afflictions, to counsel them in theirdistress, and in every way so to regulate their feelings at tomake yourselves their friends as well as their advisers. Thereis no walk of life," he continued, " in which persevering in-dustry and good moral conduct meet with a surer or more last-ing reward, or in which a life of idleness and misconduct morecertainly leads to misery and ruin."

Alluding to the differences in talent and attainments whichwould be manifest between them, Dr. Fuller urged the lesshighly gifted not to be downhearted, but rather to strive themore earnestly after knowledge. He told them that the mentalpowers admit of development to a degree of which, perhaps,they had little conception, and that they will soon discoverthat moderate ability, backed by well-directed mental dis-cipline and steady industry, will enable anyone of them tocompete with the most talented of his neighbours. " Many,"he said, "have gone before you, who, with little talent, andagainst every disadvantage, have won their way to affluenceand respect ; and he who devotes himself in earnest to his work,and with an honest, upright heart walks manfully along thepath he has chosen, will seldom, if ever, fail in obtaining a.

reasonable amount of professional success."Dr. Fuller then discussed the difficulties they would have to

encounter, and assured them that they would not meet withany which may not be easily overcome. " Believe me," hesaid, the path which you are about to tread is not beset byany obstacles which may not be overcome by steady industryand application. It has its own, its special difficulties, but sohas every walk through life ; and he who would be useful,happy, and contented, must meet them in a proper spirit, andmake the exertion which is necessary to overcome them."After referring to the multiplicity of new and isolated factswhich will be brought before them in the different lectures, andto the difficulty they will experience in arranging and classify-

ing them, Dr. Fuller urged them to take every opportunity ofverifying these facts for themselves, by observation in the dis-secting rooms and in the wards of the hospital. "The most.valuable knowledge we possess," he observed, " is that whichwe have acquired by long-continued observation and experience.It cannot to any great extent be communicated to otherseither orally or by writing, and therefore the utmost that canbe said of books and lectures is, that they are faithful outlinessimplified and adapted for vour instruction. and intended tobe filled, up by your personal observation. Go, then, to tho-

sources whence you may obtain the knowledge necessary to

enable you to fill them up. Go to the bed-side, with a note-book in your hand ; preserve a record of the cases which comebefore you; illustrate them if you are able by sketches anddrawings ; and in the evening arrange them methodically,study their details, compare them with one another, and discussthem with your fellow-students. W’hilst so doing you will findthat many things occur to you which had previously escapedyour notice ; you will be led to view symptoms in a differentlight, or to trace some unobserved connexion between them ;and if you diligently carry out this system of note-talsing, youwill be surprised, when you leave this scene of your labours, tofind how large a store of facts you will have accumulated-facts, moreover, of a practical nature, which will serve as

references in after years, and prove most valuable guides toyou through lifA " .


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