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great; yet neither these nor the possession of valued friendsmust deter me from saying that when vested interest shallcease, the advantage of the profession, aye, and of the chemistand the public, would be found in leaving the sale of drugs tothe druggist, and advice to the medical man. Farewell to thepeppermint lozenge, a long farewell to the indispensable tooth-brush. Among minor reforms let us decapitate all our assistant-physicians and assistant-surgeons, at home and abroad, and,throwing away the objectionable frontispiece ’assistant,’ leavethem what they are in reality-physicians and surgeons. Letus unite for adequate remuneration for labour. No false senti-ment about the nobility of doing for nothing work which it ishoped may prove indirectly the source of fees, and which it isfelt ought to be directly paid. The labourer is worthy of hishire.’ ‘t1 fair day’s wage for a fair day’s work,’ may not bevery poetical, but they have the genuine smack of an honestBritish instinct. Such are a few of the measures and principleswhich I commend to the support and consideration of ourrising generation, because they are measures which are equallybeneficial to the profession and the public. Interests which

apparently clash the most are identical. The interest of a

patient is the interest of his medical adviser, the interestof a committee is the interest of a staff of an hospital,the interest of both is the interest of the students and of the

patients. It is the interest of science, still more, perhaps,of mankind, that post-mortem examinations should neverbe refused. The interest of employers and of employed cor-responds. Oh ! that this great fact might make deaf Poor-lawadministrators to hear; that it might restore sight to blindarmy authorities, who are always exhausting’ policy’ in theirdealings with a medical department, and enable them to seethat after all policy, honesty is the best; and that, for thegood of the sister service, it might penetrate the closed port-holes of the wooden heads which ever and anon preside overthe economy of our wooden walls ! Then would it more fullyappear that there is no such thing as the real interest of aclass contradistinguished from the real interest of a commu-nity ; no such thing as the interest of a community contra-distinguished from the interest of a world. It is not theinterest of all men to be attracted by power, by great place,by wealth, by fame, by book-learning; but it is the interestof all to be attracted by wisdom, by virtue, by honesty, bycharity, by happiness, by peace, and by truth."

ST. MAKY’S HOSPITAL.

DR. HANDFIELD 3oBES’ INTRODUCTORY ADDRESS.

AFTER the usual greetings to the older students and friendsof the school, and to those who joined them for the first time,the speaker commenced to touch upon various topics. He

commended the students for the choice of a profession whichthey had made, on the ground that it afforded them no meanopportunity of serving God and bettering their fellows. Thoughit afforded them none of the high prizes which were to be wonin other callings, it brought them into pleasant and friendly re-lations with many who were most worthy of their esteem andregard, and this in itself was no small advantage. To do goodwork, and to be loved for doing it, was surely an enviable lot,and this was in the reach of all who practised their professionintelligently and faithfully. The true tarpos should seek hiseminence not so much in outward distinctions as in attainingincreased power and mastery over disease. For the promotionof this great object combined effort on the part of the profes-sion was strongly advocated. Quackery, he believed, couldnever be suppressed by any legislative interference, and he didnot think it was worth seeking for. Even among our Frenchneighbours quackery flourished, in spite of prohibitions andfines. An instance was related showing that even high attain-ments in physical science are no preservative against the recep-tion of patent absurdities by the mind, which, though fullyaware of their falsehood, cherished them nevertheless. Theextraordinary influence of certain mental states over the bodywas next adverted to, and some remarkable instances werecited both of the prevention or repression of disease by cheer-ful excitement, and of the apparently curative power impartedto insignificant remedial means by strong feelings of hope andfaith. It was notorious that constipation which had requiredon former occasions the strongest drugs, had yielded in a muchshorter space of time to bread-pills while the patient believedhe was taking some very powerful remedy. It was of greatimportance for the student to be well aware of these facts, and

to see their bearing upon the treatment of disease, as well asupon many instances of apparent success of means which everyrational person must believe to be totally without physicalagency. In connexion with this subject the lecturer took oc-casion to state plainly the real ground why the medical profes-sion refused to have anything to do with homoeopathy, or tomeet its practitioners in consultation. It was not that thedoctrine of similia si1JÛlibus was the real obstacle; this, if itwere all, might be held, as many other queer notions had beenheld in men’s minds, and prove no hindrance to their co-

operating with their fellows in matters of mutual concernment.But when a medical man believed that the weaker a medicinewas made the stronger were its effects, or that billionths ofcommon salt, silica, or sulphur could exercise curative virtues-though we take in our food much larger quantities of thesame substances every day,--he puts it really out of the powerof a man of ordinary calibre of mind to consult with him.They might as well call two engineers to act together in build-ing a bridge, one of whom believed that the thinner and weakerthe supporting structures were made the greater would be theirpower of enduring strain. It was no intolerance or prejudice,but common honesty, that compelled rational practitioners todecline meeting those who entertained these peculiar views.Were they to do so they must feel that according to their ownprinciples they were acting as charlatans. The charge ofbigotry or unwillingness to receive improvements in medicinewas most completely refuted by the ready way in which theprofession had advocated sanitary improvements, to their ownunquestionable disadvantage.The next subject touched upon was the question how far

diseases could be regarded as sufficiently constant and regularprocesses to make it possible to determine what was calledtheir natural history-that is, to ascertain what course theywould, pursue in the great majority of cases if left entirely tothemselves, without any medical treatment whatever. Thelecturer remarked that it was difficult in many cases to distin-guish between the original morbid action and the complicationsto which it gave rise; that the duration of diseases of thesame kind depended in some considerable measure on theirgravity -that is, on the degree in which the system is

affected by the morbid influence ; and that they were modifiedalso materially in their course by constitution and diathesisand the prevalent epidemic influence. Diseases by their out-ward show might be very much the same, might have thesame names, and be counted in the registers as identical, andyet in their tendencies and essential nature might be mostdifferent. This was completely recognised by the best autho-rities, and yet was far too little considered in discussions on

the treatment of disease. Looking at all the facts, he couldnot but assent to the view which regarded diseases, " not asnosological abstractions, but as deviations from the healthystandard, involving a great variety of elements, each of whichmay in its turn differ in degree, character, and relation in anygiven number of patients brought together for comparison," asit was well expressed by Dr. Sieveking. Now, if the groupsof morbid processes which they called diseases were made upof such varying and unstable materials, how could they hopeto ascertain the periods during which they would continuewhen left to themselves ? Must not these be as varying astheir elements were.The lecturer then dwelt with much force and eloquence on

the importance of the student having a due regard to his reli-gious duties, and some general remarks on the tutorial systemconcluded an able and interesting lecture.

MIDDLESEX HOSPITAL.

INTRODUCTORY ADDRESS BY DR. HALL DAVIS.

AFTER referring to the interest of the occasion, and wel-coming the new students, Dr. Davis said : " The profession,my young friends, which you are about to enter, is one whichin its rude beginnings, no doubt, sprang out of a natural desireimplanted in man to relieve the pain and suffering of his fel-

low-creatures, and, therefore, is almost as ancient as the crea-tion of man on the face of this earth, but, as a distinct pro-fession, founded more than 2000 years ago by Hippocrates, thefather of physic. Since that remote period, however, throughsucceeding generations up to the present time, the powers ofmedical science and art, curative, and preventive of disease,have, under the blessing of Providence, been wonderfully ex-

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tended by the intellect and persevering industry of man, but from contending with him; hence general work was not en-more remarkably so through the developments and valuable couraged, and this individual was not induced to attend pro-applications of science during the last SOO years." perly and equally to all his subjects. The plan recently adoptedThe lecturer then referred, as occurring within that period, of giving one prize for distinction in a combination of subject3

to the discovery, by the illustrious Harvey, of the circulation had no better result; for it was not found that the work doneof the blood, as having of itself effected a complete revolution in each class was nearly up to the mark—a uniform mediocrityin medical science. was the rule; one or two students might, perhaps, be fairly up in

Next, the memorable discovery, byJemier, of vaccination, their knowledge. But the system in itself is childish; men should.of which, for the benefit of the young student, he sketched an come to do earnest work for their own sakes. We do not find thatoutline, was referred to to show what splendid results - prizes are given to those studying for the bar, for the church,namely, the prevention of a disease which had, up to its esta- or for civil engineering. The system of prizes leads men to thinkblishment, about 1798, committed most fearful ravages through- of cramming, and not of fitting themselves for practical work.out the world-might be accomplished by the persevering The clinical work in the wards is certainly less attended toenergy of one man. " Such an example," he added, " formed than formerly. The clinical appointments, on the contrary,a far more enduring monument to Jenner than any memorial are fair and useful rewards, and are not competed for as prizeswhich it had pleased two grateful countries to raise in his re- usually are. Here men must show that they are the best menmembrance, and one worth all the lessons for future devotion for those prizes, however they may have got their information;to his profession which could be set before the student." " and, moreover, they are valuable, not as prizes obtained forJohn Hunter was then mentioned as that of one " of whom past work, but as a means of acquiring still more valuable

great deeds in medical science might be referred to with na- knowledge. It is hoped by the lecturers that the alterationtional pricle"-viz., his rich contributions to our knowledge will have the beneficial effect of encouraging a more devotedof human and comparative anatomy, and that marvel of his attention to clinical work. A quotation from the autobiographyindustry and intellect-the Hunterian Museum in the College of Sir Benj. Brodie was given in illustration of his views onof Surgeons; his works on the Blood, and on Gunshot Wounds, the same subject. " I can easily conceive that if I had beenformed likewise distinguished evidence of his talents and love tempted to compete for prizes as students are, and to getof work. crammed for various examinations, my position in life after-

Cuvier’s services to science, " his brilliant investigations on wards would have been very different from what it has beenfossil remains, and his labours in other departments of natural in reality." "

history,--for these his Sovereign gratefully conferred upon The importance to the maintenance of health of judicioushim a high but deserved honour never given to the devotees of management in the selection of proper times for study wasmedical science in this country-that of the peerage." then commented on by the lecturer, who observed that allThe French nation might well be proud of another name- work must end in failure if the pupil devoted to study the

that of Laennec, who, through his brilliant discovery of aus- hours stolen from nature’s requirements for the restoration ofcultation and his invention of the stethoscope, afforded a the wear and tear of the body. The student would do well totriumphant instance of the successful application of scientific seek due relaxation of the mind from professional work byprinciples to the advancement of practical medicine; for a con- turning his attention at suitable times to some kind of usefulsiderable certainty could now be obtained in the diagnosis of mental recreation.chest diseases, and hence its benefits in promoting an earlier The advantage of taking part in the proceedings of theand therefore a more successful treatment have been incalcu- Students’ Medical Society was then represented.lable. Previous to this valuable improvement in our means of The lecturer observed that there were other modes of spend-inquiry, diagnosis had been involved in the greatest obscurity. ing time which were not to be commended ; there was no lack

These were instanced as only a very few of the great lights of demoralizing pleasures as temptations to draw off youngwhich had illumined our profession. "Other honoured names men coming here as students from the path of duty; but foramong the illustrious departed might well have been referred their peace of mind, in love to those in their own homes, whoto," the lecturer said, " in connexion with their respective looked hopefully to their well-doing, and who, in many cases,labours of love and usefulness in the advancement of their had made sacrifices to send them to college, he would counselprofession : as those of Ambrose Pare, Levret, Larrey, Dupuy- them to avoid such temptations if they would wish to abidetren, and many others on the Continent ; of Sydenham, by the contract into which they should enter that day to doCullen, Abercrombie, Wm. Hunter, Denman, Astley Cooper, their duty in life with all their might, and to keep ever inJohn and Charles Bell, Liston, Brodie, James M’Grigor, and their minds the conviction that not even their own lives mustothers of our own countrymen, who have in various ways con- be dearer than the duties of their profession.ferred great benefits on medical science......And what was the Attention was next directed to the fact that those who hadmoving impulse so fruitful for good in the cases of these dis- been most prominent in their brave and good deeds as medicaltinguished men? What in other lives had led to the disco- heroes in our various wars, who had sacrificed their lives toverics and their wonderful results of a Galileo, of a Newton their cause of duty, had also been devoted students of theirand a Herschel, of an Arkwright, a Watt, and a Stephenson- profession. Let the Government of this country reflect on theto the triumphant successes of a Hannibal, a Caesar, and in value of such services, and if they would secure for the armymore recent times to those of Drake, Howe, Duncan, and and navy the most efficient medical skill, let the ministers andNelson-of a Marlborough, a Wellington, a Havelock, and a other authorities in those departments hasten to redressClyde ‘’ It was that quality so necessary to success in all grievances which are justly complained of by the professionhuman exertions, and which I warmly commend you to cul- at large-grievances which, by deterring the best men, as thetivate-an earnest determination to succeed in whatever they rule, from entering them, cannot but be highly prejudicial toundertook....... Follow out this rule of action from the very the interests of those services.first throughout your studies here and throughout your pro- The lecturer then drew attention to a very few of the mostfessional life, which should be indeed one of persistent work pressing grievances which affected the comfort and efficiencythus only will you keep up with the ever onward march of of the medical officers, both of the army and navy; and added,medical science." that the Royal College of Physicians of London, sympathizingThe lecturer then dwelt on the necessity of a good pre- with the present position of those officers, had, through their

liminary general education, that they might the better secure President ’and Censors, addressed in June last an appeal to thethe confidence of the highly-educated classes of society ; it Minister for War and to the First Lord of the Admiralty inwas necessary, if they wished to take their proper position support of improvements being made in the status of theseamongst other professions, that they should, ere they entered officers. "And may they venture to hope that this appealupon practice, have gone through this mental training-this may not have been made in vain." For under present regula-refining influence. tions of the army and navy the professors at the different

Dr. Davis, having next indicated the method which they medical colleges can scarcely advise their pupils to enter eithershould pursue generally in their studies, proceeded to make of those services until the most pressing grievances affectingsome observations on the prize system. He observed that, the efficiency of their medical officers have been removed.since the previous session, the committee of lecturers had "After this digression on a subject intimately associated withdecided, after full consideration, that it would be for the best the welfare of our profession, I will now proceed with a sum-interests of the school to discontinue class-prizes under the old mary of the different departments of medical study as set forthplan, still generally followed in medical schools, of distributing in the curriculum." "

prizes in each class. It was often found that a student would The several subjects of the lectures having been briefly re-give his time almost exclusively to one subject, and as that viewed, the speaker next observed upon the method to bewas generally known in the school, other pupils were deterred pursued by the pupil in his hospital studies, and dwelt upon

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the value of clinical work in the wards and out-patient depart-ments. The duty of each clinical pupil to take notes of theimportant points of each case was next inculcated as a habitof present advantage in practical study as well as of futuresatisfaction in the bearings of such a previous course of steadywork on our success in practice.The lecturer having rendered a tribute of thankful acknow-

ledgment to the chairman and other governors of the hospitalwho had devoted so much of their valuable time to its efficientworking, and had, by the judicious liberality and wisdom oftheir management, placed such valuable means of clinicalinstruction in the hands of the hospital staff, so multiplyingthe blessings of charity and of medical knowledge in the cureof disease. continl1Rtl follows :-I need scarcely remind my young friends. of the kind con-

sideration and forbearance which all patients, whether poor orrich, should receive at our hands. A kind word and manner,a sympathy in their sufferings, whether of body or mind, youcan readily understand should be cherished on all occasions asof essential value in your ministrations to whatever class yourservices are rendered. Certainly in the case of the poorsufferers in the hospital beds, more careful we should be thanless so, remembering their privations, their helplessness, and,therefore, the greater need they have for our sympathy. Kindwords and gentle actions will soothe many a wound, and aword of encouragement will inspire hope and confidence, andboth will go a great way towards the restoration of yourpatient’s health. The same consideration I would ask youalso to extend to the poor hospital patient who, in the timeof her greatest need for help and sympathy in the pangs ofchildbirth, has been consigned to your professional care, andbe as tender in your bearing towards her, and as faithful toyour engagement to help her through her trouble, as you wouldhereafter be in the instance of a private patient. A contraryconduct would be a cruelty to the poor sufferer, a discredit toyour humanity and to the reputation of the hospital andschool. In your hospital work there is a duty of great import-ance not to be lost sight of, and that is, when unhappily thepatient’s disease has baffled all our efforts towards saving life,your attendance at the post-mortem inquiry to study the ap-pearances left by the disease; and in regard to these appearancesyou will be enlightened by your special teachers in morbidanatomy, as also by the physician or surgeon in the case."

"

The lecturer concluded by impressing upon his young hearersthe solemnity of the medical mission, and its fitness to evoke the Imost reverential feelings and the highest qualities of the mindand spirit.

-- i

ST. THOMAS’S HOSPITAL.

INTRODUCTORY ADDRESS BY DR. ORD.

"How best to do the daily work?" This is the greatproblem of our life-the problem which must constantly oc-cupy the most earnest attention of men conscious of the true

meaning and teachings of religion. For to do the daily workwell, for the sake of the work and not of its results, for thesake of God and not for man, is pleasing as an act of faith, oflove, and of conscience. And it is, further, a good doing ofthat kind which brings its reward for the most part in thepresent time, not alone by conferring inward comfort, but alsoby success and esteem of the world-rewards of importancesecondary to the first, but assuredly also legitimate objects ofpursuit. Men are not slow to note in their fellows the energyand alacrity in daily duty which have their source in deeperand nobler feeling ; service not of the letter but of the spirit,not of rule but of interpretation, and hence of necessity pro-gressive. Whence it comes often that by its material fruitswe can, to some extent, measure the spirit of our living, andlearn a little of our shortcomings. And we can look also toour fellows as our judges. Looking round us, we may seeplainly enough that men and things are estimated, and haveiniluence and power, more and more according to their actualworth and benefit to society, less and less in virtue of any pre-scriptive position.

So, as the circle of months places us again and again in theportals of the academic year, it is that we should make some Isurvey of our past and its results, that we may see how farwe have done our work well. In this hospital, indeed, wehave at present every inducement to be careful in self-regard :for wo have before us a rare opportunity. I have oftenthc-.-.’ht that, to men striving ever so earnestly in their em- ! i

ployment, a long interruption coming once in a life may bringrich fruit of improvement. Placed for years face to face withour tasks, we seem to tend to make unequal judgment of therelative importance of their several portions ; we fall into

grooves, having originally cut them well, and in accordancewith surrounding circumstances, but failing now to see thathere and there we must alter their direction. There are, per-chance, good fruits hanging over our head, which escape aswe tend with single mind the roots and stem of the tree;and for the best of us still exists the risk of a gradual fallinginto prejudicial habits. If, then, we can be removed for atime from the responsibility and neighbourhood of regular andcontinuous duty, so that we can contemplate what we havedone and are doing, and can substitute rest and thought foractivity and tension, there is hope that we may afterwards

j recommence our work upon a new and better foundation.,

Now St. Thomas’s Hospital has fallen upon such a period ofrest. Removed from the site consecrated for several hundredyears to the healing of the sick, and long time casting aboutfor a fit resting-place, the administrators of her large resourceshave enjoyed a full opportunity of carrying out some such self-

investigation as I have described. Of the results we can

already in part judge. Those of you who have seen the plansof the new hospital will, I think, agree with me that theydeclare themselves, even on slight examination, to be the off-spring of wide care and thought. Those who know somethingof the history of them well know with what care all the goodand bad points in the old building have been considered, withwhat industry comparison and inquiry have been institutedwith reference to nearly all important hospitals at home andabroad, and with what readiness advice and suggestions havebeen received from all persons whose opinions appear to be ofvalue.

! Then comes the filling of the building. As in men we see

habits and usages of good origin becoming prejudicial in lapseof time and change of circumstances, so we might expect tofind many points in the administration of an old institutionwhich demand reformation. Men’s ways and needs and cir-cumstances change even within a generation: Powers andoffices beneficial at one period are useless or worse than use-less at another; routine everywhere tends to creep in, drag-ging all things down to one level of unsympathizing inexpan-sive coldness. If, as there is every reason to believe, ouradministrators are bent upon treating these matters with thesame breadth and earnestness as they have treated the otherparts of the building, we may wish them good speed in a taskof great difficulty and delicacy. To-day, however, we aremore particularly concerned with the school, which, using thehospital for purposes of illustration and practical instruction,and adding also instruction of its own, performs that functionof training of men for the treatment of the sick outside thehospital, which is only secondary to the duty of caring for thesick within its walls. The school has to follow the fortunes ofthe hospital, and, at first sight, suffers more by the presenteclipse. But if we recognise the fact that the size and import-ance of a medical school will depend in a great measure uponthe size and importance of the hospital to which it is attached,we shall see that success lies ready for us on condition thatwe carefully examine and criticize our work, and fit it to pre-sent requirements. I see around me men who have a clear

sight and firm grasp of the widening knowledge of the time-men whose position and attainments add much to the dif-fidence with which I speak here now; I see, also, some nearerto myself in years, of well-known promise and sincerity ofpurpose. In their hands, working in hearty oneness, we mayexpect to see the school flourishing in the spirit of its formerdignity. Our opportunities will be large, and we must usethem worthily. Granting that the progress of our professionhas been as great of late years as people are accustomed toassert, I think no one will venture to say that the efficiencyand results of clinical teaching have been in proportion to ouropportunities. It will be for us so to organize our work that wemay turn to good account sources of knowledge and progressnow little used or unnoticed. By the recent appointment ofDr. Thudichum, we have received a colleague well known forability and zeal in the path of scientific research, who may beexpected to make fruitful many of the hints and suggestionsafforded by the cases under care in the hospital. The exampleonce set, and the spirit of inquiry aroused, we may hope thatthe whole mass of our school may be leavened by it, and thatMt. Thomas’s may be able from year to year to make valuableadditions to the sum of solid, well-founded, scientific know-ledge.

Next, in regarding the school as a place of instruction, Vie