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ration of a new medical college. A new regiment has itscolours blessed by the church, and religious benedictions attendthe opening of a railway. 3ilay we not venture to hope thenfor the blessing and favour of Almighty God upon an institutionlike this, founded for the training of men fitted to carry thebenefits of our profession to " The poor, the maimed, the lame,and the biind ! " (Long continued cheering.)

"WESTMINSTER HOSPITAL.MR. GUTHRIE’S INTRODUCTORY ADDRESS.

THE Session commenced at this Hospital on Monday, Oct. 3rd,4with an able address by Mr. GUTHRIE, before a large audience,of governors, students, and their friends. During the recessthe alterations commenced last session have been completed,and the school premises now present every feature necessary.for the instruction and comfort of the students. The students’

reading-room is a large commodious room on the ground-floor,and the museum has been transferred from the basement story,and has been placed in a complete state of efficiency.Mr. Guthrie commenced his address punctually at four. After

.-1lOme general preliminary observations, he said, " In the session1850-51, 1,044 students were registered at the College of Sur-.,geons as studying in London; 370 obtained the diploma inthat year. In 1851-52, 1,141 registered; 404 received the

diploma. In the last year, 1852-53, 1,105 were registered;476 obtained the diploma-which number of diplomas grantedin each year includes gentlemen who studied out of London; ,-so that it appears that, of all the students educating in thedifferent schools recognised by the College, very many go forthto the world at large without a certificate of competency in theprofession of surgery, of which they take the title, and thusimpose upon the public; for it may not for a moment beunderstood that all these gentlemen would not obtain suchcertificate of competency or diploma, if they had the informa-tion required to give in exchange for it. This is a lamentablestate of things, demanding the attention of the Legislature ; foralthough I have no desire to interfere with the liberty of thesubject, nor of preventing any persons from employing whom-soever they please to cure or kill them, I would certainlyprevent any and every person from taking a medical designationwho was not entitled to it; nor would I permit any man tohold any public office who was not duly qualified, nor any onenot qualified to obtain remuneration in a court of law for hisservices, nor have any indulgences or immunities whatevergranted him. It may be desirable to inquire what may bethe causes of so many persons being unable to obtain theordinary qualification-of their being less able to do so thanformerly. It has been said that the examinations at the Col-lege of Surgeons are more severe of late, but this is a greaterror, for if any change has taken place, they are less, ratherthan more severe; or, perhaps, it should be said, that whilstthe examinations are the same, the judgments are more lenient.The real fact is, that the students are worse prepared. Whetherthey do not apply themselves with the same assiduity asformerly, or the teachers do not teach with the same appli-cation, is to be ascertained. It is desirable that some amend-ment should take place, and I should be very glad this schoolshould set an example. When I had the honour of beingPresident of the College in 1831-2, one in fourteen onlywas referred or rejected. When again President in 1843,one in eight; and now that I am again the senior Vice-President, the rejections were in the last session, one in six.It may be, and indeed is said, that the study of anatomy inLondon has failed for the want of means, but I am afraidthis is not entirely the case. I know that few students dissectas they ought to do, and that the average in some schools isnot more than one-sixth-in some, one-third of a subject; innone is the average greater, although individually it may begreater or less. Measures are, however, in progress, to obtain,if possible, a larger supply. There are at present in Londoneleven recognised hospitals and twelve schools, one hospitalhaving two schools, and two more are forming. It is possiblethat the number of schools may possibly account for the deca-dence in teaching to which I allude, inasmuch as some smallschools have not paid the teachers, who, in consequence, mayhave been negligent of their duties, and the students have notacquired that information which one party agreed to give andthe other expected to obtain. A lecturer or teacher can alwaysbe obtained, even on the certainty of not being paid. It issufficient that his name shall be announced in the public papersas a teacher in the branch of science he has selected ; but

after a time he finds this is not enough: he wants moneyas well as notoriety, and must be paid, or becomes careless. Ilately heard it said, that an official person, desirous of seeinghow matters were conducted in a provincial school, went at thehour of lecture to hear it, and found three or four pupils, butno lecturer. In the course of time it was announced therewould be no lecture that day, and the would-be hearer thoughthe would, at least call on and pay his respects to the lecturer.On asking for him at his home, and being mistaken for a patient,he was told he was not at home, but might be found perhaps inthe news-room, and there, report says, he was found reading thenewspaper. In a printed paper, giving some account of a

metropolitan school, it is stated that the teacher of anatomy,when he gave a demonstration in the dissecting-room, did notgive an anatomical lecture that day in the anatomical theatre,although one of the essential requirements of his office, and itis further stated that his description of the bones occupied himuntil Christmas. If this be true, how could all other parts,subjects in anatomy, be duly taught by the end of March 1 It is

unnecessary to say that they could not; but nevertheless cer-

tificates were given that they were taught. The Council of theCollege of Surgeons interfered, as they have done on othersimilar occasions, and withdrew the recognition of the school,with the happiest effect. Few able and thoroughly efficient menwill labour beyond a certain point without a reasonable pecu-niary reward, and when that cannot be obtained by teachinganatomy and surgery, the school should be closed. Medicalschools are, or have been, of two kinds, public and private-public when attached to hospitals, and private when established

’ independently. They are considered officially alike when inthe immediate vicinity of an hospital recognised as competent

, for the purpose of instruction; but they are not equallyI valuable when the school is at a distance from such hospital.i In both cases, when the student is at a distance from anf hospital he is compelled to attend, he becomes a sort of peri-. patetic ; and as physic, surgery, anatomy, &c., are not learned

by walking the streets, he fails to acquire the information.In former days the emoluments of teachers, when surgeonsof hospitals and men of distinguished reputation, and whenthe schools of medicine and teachers were fewer in number,were often so considerable as to be scarcely credible.

" There is a rule, that I should wish substituted for the cus-tom in all hospitals-it is, that after a surgeon has completedhis 65tli year he should be relieved from the active and labo-rious duties of his office, and be appointed consulting surgeon.The only good reason that can be advanced against this is, thathe may not have saved money, and that abstraction of his incomearising from the hospital student fees may leave him in advancingyears in an uncomfortable situation. ’ This may easily be obviatedby dividing the fees in a different manner, and granting to thosewho may hereafter retire from the more laborious duties at 65 ashare with those who succeed to them. Surgeons of hospitalswould not then remain until they die, or are totally unfit fortheir duties ; and their successors, instead of being fifty years ofage, or almost past their work, when appointed, would be moreearly placed in situations in which they might render im-portant services to the public, and obtain for themselves a re-muneration for their services through their better opportunities,as to render the sum awarded to the consultant a matter of no

consequence. The retention of elderly gentlemen as surgeons to: this hospital long after they were able to do the duty as it

ought to be done, was one cause of its decadence from thathigh and palmy reputation it enjoyed 30 or 40 years ago,and which we hope now to restore to the state it thenenjoyed. The governors of hospitals in general have begunto learn that hospitals are supported for the benefit of the sickpoor, and not for that of physicians and surgeons. They, someyears ago, in this hospital, adopted the resolution I proposed tothem-of making their physicians and surgeons consultants at65; they have lately again determined to do so ; and they willin future act upon it, I trust, without favour or affection to anyone. They have also ordained that the attendance of thosegentlemen shall be daily and punctual, as far as is practicable.The hospital is, then, in the best possible condition, and anaugmentation, even of the advantages now enjoyed in teach-ing, may be honestly and reasonably expected, if all themedical officers and teachers continue to act together, as theyhave lately done, for the public good, of which there is noreason to doubt. The museum is sufficient, and in good order.The school has been lately built behind the hospital, and con-tains every comfort for the purpose which can reasonably bedesired; and the teaching department, independent of the hos-pital, is in a very satisfactory state, and the gentlemen whoconduct it assure me their best energies shall be devoted to

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its service. The Council of the College of Surgeons have de- aided by a professor of physiology and histology, or microscopic "Cdared four years to be the shortest period of study they will anatomy, this gentleman should relieve him, after the descrip-acknowledge as sufficient for instruction-one to be passed tion of each system on part, and give their physiology. Forin the study principally of pharmacy, and three, including example : after the lecturer or anatomy has fully described the-vacations, -by attendance on an hospital and school of physic bones, the physiologist should follow; after the demonstrationand surgery. Formerly, two sessions only were required, and of the muscles the other should succeed; and a lecture of anI have to regret the share I took in insisting on three, for hour-and-a-half’s duration each day would embrace the whole of

students have not ’come up better prepared for their final the subjects in the time specified. The demonstrator of anatomyexaminations than they did twenty years ago, whilst the -should give a demonstration each morning for one hour in theexpenses to their 1 arents have been greatly augmented, and dissecting-room of such parts as had been duly prepared by onetheir.-morals have not certainly-been benefited by a-third of the students under his superintendence the previous day, sowinter’s,residence in London. It is said that they will not that by a frequent repetition of the anatomy and relative situa--work the second year, but idle away their time, and acquire tion of the most important parts concerned in the practice ofhabits -which Tender them unwilling to work the third. ’The surgery, they might be’ thoroughly fixed in the mind of theevils alluded to might, however,’ be materially prevented student. It should, however, be borne in mind that a thoroughduring-the whole period of study, if the physicians and sur- knowledge of anatomy is the great point to be acquired duringgeons of hospitals and the various teachers wvould note weekly the four years of study ordained by the Council of the College,the attendance of their students, and refuse certificates to of Surgeons. The second course, beginning in January, mightthose who failed to attend-an unpleasant duty nearly all have be a repetition of the first, with such omissions or additions asrefused to perform in a thoroughly efficient manner,when called the teacher may think advisable, and might be ended on-the-upon officialiyto do it, the refusal being headed, in one-instance, last ’day of April, thus completing the session of seven months’in -writing, not : only by legislators, peers of the realm, but by teaching, - formerly ordained by the College of Surgeons ; butelective legislators in the House of Commons ; and until these which/for no,good reason that I am aware of, now terminatesgentlemen shall refrain from such interference in their capacity at. six months, or the end of March, thus depriving the studentof governors .and councillors of hospitals and colleges, no of one month’s opportunity for dissecting. The means or

superintending body will be able to enforce a compliance -with manner of instruction at present pursued, renders another-partysuch regulations as they-may think necessary. - in many instances absolutely necessary to enable students who

After speaking of the present regulations of the Council of the have been inattentive to undergo their ultimate examinationCollege of Surgeons respecting the attendance on lectures, with success. This gentleman is -called a ’grinder,’ and it isMr. Guthrie proceeded to say, No man can-be taught any prac- said that some so employed make from I,OOOl. to 3,{)OOl: a-year.tical branch of learning by lectures. They’can only-point out They work hard, and, I believe, deserve the money. They beatto him what he ought to learn, and by giving him a general into the heads-of negligent students that information whichknowledge of the subject, enable him afterwards to work out they had failed to acquire during the proper period of theirpractically. I was once told by a student that he could describe studies, and- when thus ground, polished, or wound up to theany part in the human body, or in anatomy, he had not seen, proper-point, they select ’their day for examination, and veryjust as well as one he had seen; nevertheless he did not know often succeed. Information thus acquired is evanescent; it isthe very part< he had described to me when they -were placed soon -forgotten. In a few minutes it is remembered nobefore him. He could state accurately enough the difference longer. It cannot be otherwise; and the- necessity for suchbetween a hernia, a hydrocele, and a varicocele. -He was instruction is much to be deplored. It ought to be supersededeloquent on the subject of the latter feeling like a bag of earth- in anatomy and surgery by the demonstrator in each school. Heworms; albeit he had never felt a bag of earth-worms, and did should be the grinder and polisher of the students under the pro-not know practically what sort of feeling it conveyed, and when fessors-of-each of these branches, and the knowledge which isI brought him here, and showed him these diseases, he could not now very evanescent, if thus acquired, would be long, if not per-tell- one from the other, for he had never seen them. Lectures manently remembered. I am desirous, in conclusion, to relieveon all subjects should certainly be delivered annually. A student your minds from some false impressions which are generallyshould attend one course of each, or make up in a second course promulgated, with-regard to the Court of Examiners of thefor such parts as may have been accidentally omitted in the- first. College of Surgeons. The members divide into four parts,More is,-in my opinion, unnecessary, as taking up time which or tables, two of which examine in anatomy, two in sur-

may be more usefully employed. The certificates’ usually-given gery, and each- table reports that the student is good, bad,of such attendances are sometimes fraudulent; little dependence or indifferent. If on the aggregate of the four there iscan- be placed on the accuracy of any of them, and the sooner one indifferent, it is considered as nothing. Two indifferentsthey are abolished the better, being, in many instances, as-great causes the person to undergo a written examination on the sub-a discredit to those who give as to those who receive them. It sequent week; one bad does the same; but it requires the fourought not to be difficult to say what’might be substituted for tables to report against a man to cause his immediate rejection.them; but it can only be done, I fear,-with advantage’when the The’president, at the written examination, gives the questions,College of Surgeons and the Society of Apothecaries shall cease and three hours are allowed for answering them, more ifto act on antagonistic principles-when the curricula, as they desired; they are then read, and the decision is that of theare termed, for the education of a surgeon and apothecary, or whole court. It is obvious that no one examiner can, then,general practitioner, shall be alike.- Anatomy is the nambeau reject an individual, as students are very apt to suppose; andwhich lights the student in his way to the acquirement of pro- they may be assured a rejection is always a matter of regretfessional knowledge; it is the most important study for the to the examiners, which they would willingly avoid if con-surgeon, yet it is one to which less attention is paid than it sistent with their duty-although I have often had the gratifi-deserves, and this occurs, perhaps, as much from the manner of cation of hearing men when they have come up for the secondteaching as from any defect in the attention of the student. time, after six months’ further study, acknowledge the serviceFormerly the largest and best-paying schools had only one, or at the rejection had done them, in making them, through shamemost two teachers of anatomy, physiology, and pathology, and and a proper sense of honour, labour more diligently. I may alsoone demonstrator in the dissecting-room; and it frequently add, in order to remove another error, that it is of no pecuniaryhappened that when the teachers taught in turns,’ the unem- consequence to the examiners whether a student obtains. his

ployed one demonstrated. When one person devoted himself diploma or not. Their remuneration is the same for rejectionsto the teaching of anatomy, of which there is no example in as for admissions; but those examiners only are paid who at-the present day,-he was constantly with his students; he knew tend. You will observe there are several branches of sciencethem well, how much knowledge each possessed, and how taught in your schooI I have not alluded to, as being unneces-much instruction each required to have beat into him. At pre- sary. Lest, however, you should think I have regarded withsent there are professors of anatomy, of general anatomy, of too little respect the great advances which have of late yearsdescriptive anatomy, of surgical anatomy, of morbid anatomy, been made in physiological and histological teaching, I mayof microscopic anatomy. There are demonstrators of anatomy, say I have done so because you can receive every instruc-proseotors and superintendents of dissection, professors of tion, and the greatest possible assistance in your leisure mo-physiology and pathology, all for one science, most of whom, or ments after your ordinary education has been gone through,as many of them as exist together, teach for an hour a day, from Mr. Quekett, the resident conservator at the College ofthat a return in some degree to the old method would be very Surgeons, where demonstrations are open to you without ex-advantageous to the student. I would-suggest that the teacher pense, during ten months in the year; and it would be highlyof anatomy should begin his course on the st of October, and satisfactory to me to see the appointment, in a similar mannercontinue :t daily, six days in each week until the middle of the of a professor of chemical pathology, or of animal chemistry,following January, when it should be completed. When he is whose demonstrations would, I am satisfied be of the utmost

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advantage to the profession at large, and most acceptable tothose who had leisure in the commencement of practice to at-tend to them."

-

ST. THOMAS’S HOSPITAL.

DR. RISDON BENNETT’S INTRODUCTORY LECTURE.

AFTER an exordium, having reference to the ancient prestigeof St. Thomas’s Hospital, as a medical school, and the interestnaturally excited by the commencement of a new medicalsession, Dr. Bennett proceeded to address himself directly to thestudents. He began by calling on them to reflect on the natureand responsibilities of the profession on which they were enter-ing, and to consider the words of Lord Bacon in reference to thegreatest error in the pursuit of knowledge-" the mistaking ormisplacing of the last or furthest end of knowledge." He assuredthem, that if they entered on medical studies, with a view " togive a good account of the gift of reason to the benefit and useof man and the glory of the Creator," they would not be disap-pointed, for that in no field of human labour was success morecertain. But, for this end, they must be prepared to exert alltheir powers with untiring zeal and determination-must cul-tivate a spirit of humility, self-abnegation, and sacrifice, andremember that it is the special vocation of the physician to live,not for himself, but for others. He then jproceeded to explainthe nature of the peculiar difficulties of medical science, and thenecessity for thorough intellectual training, preparatory toentering on the study and practice of the profession. Heshowed that not merely in theoretical studies, but also in thepractice of their art, the exercise of well-trained intellectualfaculties was required, and that the cultivation of the observingpowers was not, as some had imagined, sufficient. It was thenshown how a well-trained mind would save them from mereroutinism on the one hand, and from the varying follies anddelusions of the day on the other. It was vain, he said, tillpublic education was much further advanced, to expect a cessationof such senseless absurdities as table-moving, spirit-rappings, andhomoeopathy ; but that it was a disgrace to those who professedto have been educated for a scientific profession to be led astrayby such fool’s sport. But assuming that by preliminaryeducation the essential educational powers had been acquired,and that a solid foundation for future knowledge has been laid,by a mastery. of the scientific branches of medical study, hecalled on them to betake themselves at once to the most carefuland painstaking observations, and to set out with the convictiondeeply impressed on their minds, that, in order to become goodpractitioners, and thus fitted to fulfil their high duties, theymust be daily, constant, truthful observers. The importance oftruthfulness and freedom from prejudice was then illustratedby the numerous instances of false or pretended experience thatwere rife, e. g., that of Hahnemann, who, at the time, pretendedto have proved by experience that almost all diseases are pro-duced by syphilis, or the itch, having a few years before provedby like experience, that nearly all diseases are produced bycoffee ! But even an honest, unprejudiced, and well-educatedobserver needed favourable circumstances in order to acquiresound and real experience. These circumstances beginners wouldfind more advantageously associated in a large well-regulatedhospital than elsewhere. Students were, therefore, earnestly en-treated to avail themselves of opportunities they would haveduring their stay at the hospital. Dr. Bennett then proceeded tosay,

" It is grievous to observe, as we too often do, with how littleprofit many students attend the wards of a hospital; frequentlyfinishing their studies (in more senses than one), and enteringon- the responsible practical duties of their professions unfa-miliar with the most ordinary aspects of disease. The tact,and judgment, and therapeutic skill, which are only to begained by time and practice, it would be unreasonable to expectthe student to possess on leaving the hospital. But everystudent, in such a field for observation as this, may, and oughtto make himself familiar with the common forms of disease, beable to discriminate the leading types, and draw an accuratediagnosis. I am quite aware that the varied objects to whichthe student’s attention is enforced, and the time and labourwhich many of them require, necessarily interfere with clinicalpursuits. But, surely it is a great error to neglect the end forthe means-a great error to strive for distinction as an anato-mist and physiologist, and enter on practice ignorant of how tomake your anatomical knowledge available in reducing a dislo-cation or treating a fracture. Of what avail is it that amongyour fellow-students you prove yourself ’facile princeps’ in

chemistry or morbid anatomy, and are unskilled in their appli-cations to the diagnosis and treatment of disease 1 Many aniadustrious, conscientious student, I doubt not, deeply feels this,

and hopes and intends to apply diligently to practical studies, assoon as he has passed his examinations. But how great are thedisadvantages under which he will labour if he have not madeconsiderable progress in such studies before he leaves the hos-pital ! How great is the risk to his reputation and success inlife, as well as to the honour of his profession and the life of hispatients, if he set out unskilled in the exercise of the veryduties for which all his studies should have fitted him ! Iwould not for a moment be supposed to undervalue the aca-demic honours and scientific distinctions, that may be acquiredby students of medicine, any more than in any other profession.I believe that in a great majority of instances they are not mereempty honours, but have a lasting beneficial influence on a manthrough life. The most distinguished students will, generallyspeaking, prove the most distinguished practitioners. Thecharacter which a man acquires in after life he will usually befound to have laid the foundations for whilst a student. Butthe character you are to acquire is that of good practitioners.If, then, you ask me what is the first requisite for this, Ianswer, clinical education; what the second, I reply, clinicaleducation; what the third, again I say, clinical education.Neither scientific acquirements nor genius will answer insteadof patient observations at the bed-side. On the former yourmedical reputation must be founded; but it is on the latterthat the superstructure must be raised. This, however, at first,is tedious and irksome, and the fruit thereof not immediatelyapparent. It yields no present brilliant results, but ratherdisappointment and discouragement. You will need, therefore,all the stimulus arising from a deeply-grounded conviction ofits paramount importance; and that however scant the first-

; fruits may be, the ultimate harvest will amply repay all yourtoil. If you devote yourselves to these studies during yourt hospital-life, you will find that, in various ways, first difficultieswill be materially smoothed. On the other hand, if you en-Icounter them unaided, you will find them far greater, and morevaried than you at all anticipated. There need be no hesitationL in affirming that most men, however well-informed in thetheoretical parts of their profession, if they have acquired theirr knowledge unaided by clinical observations, will find themselves,when first called practically to apply their knowledge, com-, pletely at sea, whether as regards diagnosis or treatment., However graphic the oral or written description of a diseases may be, it is only a practised eye that will recognise the

original. However clear and definite and sound may be theprinciples of treatment laid down by your instructors, unlessyou have seen these principles carried into effect, and practisedthem yourselves, they never can be anything more than un-certain and hazardous guides for you.

" Such sentiments are not new, they have long been entertainedand deeply felt by those who have thought at all on the subjectof medical education. But it is only lately that any correspond-ing efforts have been made to enforce attention to them.However incompetent the public may be to judge of the quali-fications of a medical man, they can generally discern whetherhe is practically familiar with the disease he treats, and will givepractical evidence of their discernment. And let me here say,that the public are fully licensed to require that those who havereceived a license to practice, should have given proof, notmerely of competent knowledge, but also of competency to usethat knowledge. Now I know of no means by which this com-petency can be attained so well as by means of a large well-regulated hospital; and without hesitation, therefore, I say thatthe public, for whose benefit hospitals are founded, have a rightto require that they should be made subservient to the publicwelfare, by affording every facility for the practical education ofthose to whose care the lives and health of the public are to beentrusted. And how immeasurably is the benefit of a hospitalextended if it is made the means of affording succour to the dis-tressed, and relief to the sick, not merely within the narrow limitsof its walls, but throughout the world, and that over its portalsmay be inscribed, ’ Quse regio in terris nostri non plena laboris.’

"

The establishment of a Chair of Clinical Medicine in theschool of St. Thomas’s was then alluded to, and also the ap-pointment of Dr. R. D. Thompson to the Clinical Chair.Having spoken of some points in connection with clinicalstudies, the Doctor proceeded to say that the intellectual quali-fications to which he had been adverting, when viewed in con-

, nection with the exercise of medical art, became moral duties:- for incompetency and ignorance in medical men was a crime.&ccedil; In fact, every view that was taken of the character of a medical1 man showed the paramount importance of the moral and higher- elements of man’s nature. He denied that in the present dayi there was any just ground for accusing the profession as a body, with making a perverted use of science by turning it against