I

I

I I

I

I

I

I

AK

INTRODUCTOEY LECTURE,

READ TO

THE MEDICAL CLASSES,

IN

KING'S COLLEGE, LONDON, OCTOBEE J, 1847.

BY

GEOKGE BUDD, M.D., F. R. S.

PROFESSOR OF MEDICINE IN KING's COLLEGE, LONDON ; AND FELLOW OF CAIUS COLLEGE, CAMBRIDGE.

LONDON:

JOHN CHURCHILL, PRINCES STREET, SOHO.

1847.

LONDON :

a. J. PAI,MKU, IMtlNTEU, SAVOT STUEKT, STRAND.

AN INTRODUCTORY LECTURE,

Sfc, Sfc.

It falls to my lot, as Dean of the Medical Department for the present year, to deliver the customary Introductory Lecture ; — and, in doing so, I shall address myself chiefly to those who now appear here for the first time, and who are ahout to commence their medical studies within these walls.

It is an important epoch in a man's life, when he first enters on the study of his profession. His previous educa- tion has had for its object, the developement and training of the various faculties with which he is gifted, and the storing of his mind with general knowledge. Now he is to begin to quahfy himself for his particular calling ; and, on the manner in which he does this, will mainly depend his future success. Much, indeed, will still be contingent on subsequent conduct, on health, and on the various accidents of life : The soil may be well prepared, and the seed well planted, but weeds may be sufiered to spring up and choke the growing crops ; or these may at any time, even when the fruits seem almost ready to be gathered, be blighted by a visitation beyond man's control : But so surely as a good tillage brings in due season an abundant harvest, so surely is an earnest

7

application to the work in hand in the years of preparatory study, rewarded by professional success in after life.

In many callings, a man's social position is in a great measure independent of his own exertions ; the individual is merged in the order ; and worldly prosperity is ensured by the interest and support of friends. In the profession which you have chosen, a man is the maker of liis own fortune : the position which he occupies in society, and the esteem in which he is held by his fellow-men, depend mainly on his character, and on the abihty and skill which he is supposed to possess.

The business of Medicine, in its various branches, is to minister to sickness and heal disease. Life has been well described as a perpetual conflict. The delicate machinery of the living body, endowed, though it be, with a power of self- adjustment which is among the most wonderful of its attributes, is liable to be deranged in a thousand ways ; — on the one hand, by agencies from that world without, in which we live and have our being ; and, on the other, by the emotions and passions of the no less wonderful world within. '

It behoves the physician, therefore, to study the physical constitution of man's body, and the relation which it bears to the material things around ; and also, the mind, of which this body is only the minister and servant.

The subject to which your attention will be first directed is Anatomy ; or rather. Anatomy and Physiolog)'.

Few studies are, in their nature, more interesting than this, which has for its object the curious and beautiful structures of which the frame of man is built up, and the wonderful phenomena of life.

It may be inferred, indeed, if we regiud the intellectual pursuits of laymen, that other studies arc more engaging.

7

While hmguage, and history, and mathematics, are often pursued for their own sakes, anatomy is seldom studied except by those who are preparing themselves for the pro- fession of medicine. The reason of this is, that a knowledge of anatomy can only be acquired on the dead ; and there is that in the decay of the dead body which is too repugnant to both mind and sense to be readily encountered, except at the urgent instance of positive duty.

This natural repugnance you will have to overcome ; for it is only in the dissecting-room that you can really learn anatomy. You may, indeed, get a general knowledge of the structure of the body from lectures and books ; but it will be only such a vague knowledge as you would gain of a foreign land from descriptions and plates. You may get a general idea of Jerusalem from the model of it now ex- hibiting in the Egyptian Hall, but the effect on your mind would be very different if you were to visit, and explore in person, the sacred city itself. No — it is only by opening up and unfolding the structures^ of the body with your own hands, that you can impress the facts of anatomy strongly on your mind, and obtain that knowledge of the relative size and position of parts, which is requisite to guide the knife of the surgeon in the hour of emergency ; when the alternative of life or death may hang upon his skill. Deep will be your anguish, and bitter the reflections, with which you will look back on the days of neglected opportunity, if, in that hour, your knowledge should fail.

But, in your study of anatomy, you must ejctend your regard beyond the usual objects displayed in the disseoting room. The knowledge of anatomy has, of late years, greatly extended. Formerly, little more of the structure of the body was known than could be discovered by the naked eye . but, by the use of the microscope, our powers of vision are

8

immeasurably strengthened ; and the eye penetrates to the very rudiments of organisation. What the telescope has long been to the astronomer, the microscope now is to the anatomist.

When Galileo first turned the telescope to the heavens, he saw countless worlds before hidden from the sight of man : what till then had seemed a milky haze in the firma- ment, was resolved into clusters of stars : the Planets, that before were mere luminous points, appeared as disinct orbs, — some of them (Jupiter, for example) with Satellites circling round them, offering to his astonished and delightful gaze, as it were a miniature, like our modern orreries, of the system of planets, of which the earth is one, which a laborious calculation had shown to be ever revolving round the sun in the same direction as these satellites round their planets, and in similar orbits ; but whose true relations, in- volved as we are in the system, can never be presented to our sight.

The microscope has revealed still greater wonders. At once, it brought into view whole classes of animals never before seen by man ; and, by its aid, the anatomist has at length made out the minute structure of almost all our organs and tissues. This latter knowledge has been acquired gra- dually, and slowly, by the exercise of much sagacity and labour ; for many of the structures in the human body are extremely intricate, the elements of which they are made up being at once minute and closely interwoven. I am proud to say that a considerable share of the recent accessions to our knowledge in this department, has resulted from the labours of men, who, but a few years ago, commenced, as you do to-day, their medical studies in this College.

A knowledge of minute structure is as essential to a fuU comprehension of disease as a knowledge of the broader

9

features of anatomy is to the practice of surgery. For, it is in the ultimate elements of structure that the most serious diseases originate. The large blood-vessels, for example, serve merely as channels to convey the nutrient blood. It is in their ultimate ramifications, invisible to the naked eye, in the very substance of the different tissues, that the process of nutrition takes place. It is from these minute vessels that the materials of the different secretions, and the mate- rials to supply the waste of the body, are drawn ; and it is to these vessels tliat the effete materials of the body, those materials that result from the waste of the tissues, are returned, .jf

It is in the minute structures of the body that these in- cessant changes — these never-ceasing processes of waste and repair — take place ; and it is through some fault in these processes that the most serious diseases are engendered.

Nothing is contributing so much at the present time, to render our knowledge of morbid processes precise, as the study of minute structure. Unless we know what the intimate structure of an organ is, what are the relations of its constituent parts, it is hopeless, in many cases, to attempt to discriminate, and to trace to their respective sources, the various changes that disease produces in it.

A few years ago, the structure of the kidney was un- known ; and, in consequence, the most common and most serious diseases of the organ were not understood. Changes of structure, quite different in kind, were confounded ; or were considered as different stages of the same disease ; and we had no accurate knowledge of the real nature of any of them, or of the way in which they originate.

Thanks to my distinguished colleague, Mr. Bowman, the intimate structure of the kidney has boon laid open to us ; and now, and as an immediate consequence of this discovery,

10

all the confusion I have spoken of is clearing away. Not only can we now discriminate the morbid changes after the death of our patient, when the hidden recesses of the body are open to our scrutiny, but there is every reason to believe, that, before long, we shall be able to distinguish them, with the same certainty and clearness, while the sick man is living ; and that we shall apply our measures for his relief, not with an uncertain hand, and in the tentative manner of former times, but with the assurance, and confidence, of positive knowledge.

I have, perhaps, said enough to show you the importance of studying anatomy in this wide sense. In the most minute and most hidden parts of the body, as well as in its great and striking lineaments, you will find all formed by the highest wisdom — each part perfectly adapted to the purpose which it has to fulfil.

With the study of anatomy is inseparably connected that of physiology. It is impossible to regard the form and structure of a part, without speculating on its action and uses ; and it is the business of physiology to teach us the action and uses of the several parts of the living machine.

Few studies take so wide a range. To acquire a perfect knowledge of human physiology, we must know the pro- perties of the matter by which we are surrounded, and of which our material fabric is built up, and the laws which regulate almost all the forces in nature.

In the microcosm of man's body, gravitation, and heat, and light, and electricity, and the other subtle agencies of nature, all play their part. For, the materials of which living beings are made, are not only not exempt from the general laws of matter, but these laws are often enhsted, in the higher animals especially, in the service of the most important functions of the body.

11

A man may be familiar with the anatomy of the eye, and may know the chemical compositioii of its several humours ; but unless he has also some knowledge of the laws which govern the refraction of light, it is impossible that he can comprehend all the purposes of its beautiful and delicate mechanism.

He may have studied the structure of the larynx, or have carefully dissected the ear, but unless he has some know- ledge of the laws which regulate the pi'oduction and propa- gation of sound, he cannot fully comprehend the uses of their several parts.

But the physiologist must not only consider the material fabric of man's body, and its subserviency to the general laws of matter : he must consider, also, his spiritual nature ; — the will, of which the hands are but to do the bidding ; the reason, and the instincts and affections, of which the senses are but the ministers, and for which the organs of speech, with all their elaborate mechanical contrivance, serve but as the means of expression.

It is commonly imagined, and probably with some truth, that the study of anatomy disposes to scepticism and religious unbelief; that men who are long engaged in considering the mere mechanism of the human body, and " who frequently contemplate the processes of decay through which all its organs must pass after death, and the entire subjection of every part of the animal frame to the laws of chemistry, acquire habits of imagination unfavourable to the hope of an independent existence of the thinking principle, or of a renewed existence of the whole man." The study of phy- siology, in a comprehensive sense, tends to raise us above such a narrow and chilling view of man's destiny.

In contemplating the living man, we regard not only his wonderful material fabric, but we see him endowed with

12

faculties which the laws of matter cannot explain — a creature of intelligence; with a moral sense judging of right and! wrong ; and with a desire and a hope of a future and higher existence : and we feel, to borrow the words of an eloquent writer, that " this inner man, the veiled God in the statue, is not of stone, like the statue itself." And since we find that in the material framework every part is perfectly adapted to its end, and to man's wants — the eye for sight, and the ear for hearing — and is perfectly suited both to the material things around, and to man's intellectual and moral nature ; that, considered with reference to the world without and the world within, it is perfect and complete : we may naturally infer that the intellectual and moral powers and capacities, which make up the inner man, which, are, indeed, perfectly suited, like the bodily organs, to the material things around, but which are confessedly unsatisfied with their relations to them — that these faculties and powers have other, and higher, relations, in a different sphere : that there is a coin- pleteness, and a wise purpose, in every faculty of the mind, as there is in every part of the bodily frame : and that the desire, therefore, of a future and higher existence, has not been implanted in us in vain ; and that the promise of it given to the heart will not be broken.

We are thus led to consider the body with all its attri- butes, as, after all, but the mere tabernacle of the spirit, whose operations we may in some degree trace, but about whose end and destiny we know nothing more than has been imparted to us by direct revelation.

The science of Physiology has, of late years, made great advances. Dependent, as it is, on other departments of science, it has followed their onward movement.

Many of the functions of living bodies have been eluci- dated by the recent discoveries in structural anatomy. The

13

relations of the constituent parts, of the different organs, thus revealed to us, have served to explain their action and uses.

Much respecting the action and uses of the several parts of man's body has also been made out by the study of com- parative anatomy ; — by the study, that is, of the structure of other living beings, compared with that of man.

For, in looking through the scale of animated nature, we see some of the cardinal functions of life, which, in man, ai-e involved one with another, and performed by complicated apparatus, becoming, as we descend the scale, more distinct and separate, and, so to speak, analysed for our instruction ; the instruments by which they are performed stripped of theu' refinements, one by one, until they appear in the greatest possible simplicity, with no other constituents than are absolutely essential to the work.

Thus, by surveying the animal kingdom from man, the highest and most complex member of it, to the lowest and most simple, the comparative anatomist has been able to extricate from among the various forms which their structures and organs assume, the fundamental elements of the various secreting glands and of the different organs of sense.

By extending his view to the vegetable kingdom, he sees the processes of absorption, assimilation, secretion, and repro- duction by sexes, all actively going forward, and doing their wonderful work, without feeUng or spontaneous motion — without the help, that is, of nervous system, or contractile fibre. And, when he sees in this kingdom these processes attaining their highest power and perfection ; rearing up the beautiful structures of plants in endless variety — from the lofty pine to the lowly snow plant ; distilling their elaborate juices; unfolding then- flowers, and ripening their fruits ; he must needs infer, that, although in the animal economy,

14

these same processes have become modified and complicated by the introduction of nervous influence, and quickened b\ the help of contractile fibre, yet, that neither the nervous influence nor the contractile fibre is fundamental in the work.

But if Anatomy, in this extended sense, be essential to a clear understanding of the functions of the Living body, Chemistry, another subject to which your attention v/ill be at once directed, is still more so.

To convince you of this, it is perhaps enough for me to - mention, that the great function of respiration — which is, as it were, the mainspring which keeps the machine at work . — and which is so needful for the maintenance of all our* higher faculties, that the breath is figuratively spoken of as i the life — that this great function, is, in its essence, nothing • more than a chemical change : the union, in fact, of so much oxygen with the materials of the body : a simple process of ' oxidation, or combustion.

Chemical change is indeed, a necessary condition for the manifestation of life. Modern research has led to the infer- ence, that all the forces which are placed at an animars dis- posal, are efiected by an expenditure of the materials of its body. The maintenance of the temperature of the body ; the movements of the muscles ; the operations, probably, of the mind — are all attended by an expenditure of the materials of which the body is composed. A constant interchange is thus taking place : the materials that have served their pur- pose pass out of the body as dead matter, and thence a con- tinual need of food, that is, of fresh material, to supply the waste.

Between these two, and opposite processes — of waste and repair — studied in all their details, and intermediate steps, and contingent results, both healthy and morbid, wide is the

15

scope for chemical iuvestigatiou ! Not respiration only, but digestion, and secretion, and the thousand intermediate pro- ducts into which the food passes after its reception into the body until it is cast out as dead matter, are so many objects for the chemist to elucidate. The only clue to the intimate nature of these manifold changes of matter is to he found in chemical analysis.

The changes themselves, are among the most interesting phenomena of nature. How truly wonderful are the changes of form which the raw material undergoes when it is con- verted by assimilation into living tissue ! How wonderful the new properties which are then communicated to it !

Take, for example, an egg, when newly laid. The white is a homogeneous fluid without form. The yolk has, it is true, a regular form, but if the slightest violence be done to the film in which it is enveloped, it flows into a shapeless mass. But place this egg, uninjured, under the breast of a hen, or, more simply still, in an oven artificially heated. Watch it from day to day, as closely as you will, and, to all outward appearance, nothing transpires. Weigh it, and you will find that nothing is added to its mass. On the contrary, its weight has slightly diminished. But within the thin shell which shuts it from the world without, the forces of life are quietly doing their mysterious work — aggregating the denser atoms into bone and cartilage ; weaving the softer matters into skin, and muscle, and nerve, and other tissues — and at the end of three short weeks, what was at first an uncon- scious fluid mass, breaks its prison wall, and comes forth a living bird ; with the form and structure peculiar to its kind, and, more than all, endowed with sight and other senses, and with instinct and intelligence to find its food, and make itself a home, in the new world into which it is bora.

16

Destroy tlie bird's life at the moment of its birth, and sub- mit its various tissues to chemical analysis, and you will find only those material elements which originally composed the

egg- There is no other department of physical science which, of late years, has had such a lively and stirring interest, as Chemistry : there is no other from which important and startling discoveries have broken upon us in such quick succession : and there is no branch of chemical investiga- tion which has attracted more attention, or been cultivated with more success, than that which relates to the composi- tion and functions of organised beings. Hardly a year has passed away without being marked by some signal addition to our knowledge: and, looldng at what chemistry has abeady achieved in this department, it is impossible to doubt that it will go on giving us deeper and clearer insight into many of the phenomena of life, and that in so doing, not less than from its more obvious service in providing us with new remedies, or presenting us with those we akeady have in more convenient and efficient forms, that it will go on con- tinually adding to our power of preventing and curing disease.

Another subject that will occupy your attention before your first year of study has expired, is Botany. The con- nection of Botany with Medicine is obvious enough. It is from the vegetable kingdom that a large proportion of our most valuable remedies are derived, and, as you will by-and- bye see, a study of the structure, and composition, and vital properties of plants, has thrown much hght on the most important functions of animal life, and on the great scheme of animated nature.

The subjects of which I have yet spoken, constitute the preliminary part of your professional education. Well

17

grounded in these, — in Anatomy, and Physiology, and Che- mistry, and Botany — you will enter on the study for which all this knowledge is merely to prepare you ;— the study of diseases, and of the means by which they may be cured or reUeved.

In this latter division of your studies, there is only a part of your work that can be carried on within these walls. From lectures and from books, you can learn only the ^w/;?- ciples of medicine — the general results to which past experi- ence has led. No description can pourtray all that is characteristic in the physiognomy of disease, and no extent of reading can give you the power of appreciating in practice, those minute differences on which the judgment of the practitioner must often be founded. For this, you require not only reading, but actual and personal observation. You must see what cannot be described, and you must educate your eye, and your ear, and your hand, to see, and hear, and feel, what the untutored senses could not discover ; or, at least, could not rightly and promptly distinguish. You will have ample opportunities of doing this in the wards of the hospital — and I cannot too strongly exhort you, to avail yourselves fully of them : not to go there once or twice a week, and make the wards a mere place of gossip and lounging; for the secret infirmities of our fellow-men are not to be opened up to the gaze of impertinence, or of idle curiosity ; but to go there day by day, for the purpose of diligent study, watching the cases from first to last, and taking notes of them, or of many of the most instructive of them, with your own hands; — and this you may do without any offence to the patients, if you do it considerately, and with good feeling, and, as I trust you will, in an earnest and truth- seeking spirit.

I have now given you a hasty sketch of the subjects that

c

18

will hencefortli mainly engage your attention. It would be a waste of words to say more of their importance, or to allude further to the various motives that should impel you to enter on the study of them with the earnestness of men commencing the serious business of life.

If you do enter on them in this spirit, and by persevering industry overcome the difficulties that will meet you at first, there is but little fear that your interest in them will flag as you proceed ; — ^for, it is a law of our nature that the more we dwell on any subject really worthy of our thoughts, the more deeply do we become interested in it. If you look around you in the world, you will see numbers of gifted men devoting their lives to different subjects — one to History, another to Language, a third to Mathematics, a fourth to Geology — none of them impelled by motives of worldly gain, but carried on by the interest which they feel in the subject. And if you inqviire further, you will generally find that some accidental circumstance — the particular school or college to which he was sent, or the pursuits of his early associates — determined for each one what should be the chief occupation of his future life : that, at first, he had no particular bias for the subject, but that, as he went on, its interest grew upon him, until it ended by absorbing the principal part of his attention and time. I am quite sure that this increasing interest is felt by all who enter with earnestness on the study of medicine. As they proceed, new objects of attraction are continually unfolded, new sources of interest continually present themselves — and it often happens that what was commenced as a toilsome work of duty, becomes at length a constant source of delight.

I trust, then, that some of you, by engaging earnestly in your present pursuits, will become imbued with this spirit ;

19

and that you will qualify yourselves, not only to enter on your profession, well prepared to bear its heavy responsi- biUties, but also, Hke some of those who have gone before you, to take your rank in the world, as men of science, eager and able to carry forward the great work of advance- ment in the particular line you have chosen. For, to borrow, and apply to medicine, the fervid words of one who is a bright ornament of this age and country : " there are secrets of nature we would fain see revealed, while we yet live in the flesh —resources hidden in her fertile bosom for the well-being of man we would fain see opened up, for the use of the generation to which we belong."

But to acquire this happy frame of mind, which will in- vest your pursuits with a growing interest, or, indeed, to gain the social advantages which our profession offers, you must labour, labour long and earnestly, to overcome the diffi- culties which will everywhere meet you at first. The time has long gone by when success in any Hberal profession, in this country, can be earned without toil. The man who would gain distinction in the Church, or at the Bar, must devote his whole energies to his profession for years together. It is the same with Medicine. And let not any of us murmur at this condition. Our mission here, is, by labour, to pro- duce order out of disorder. The man who labours with his hands, who cultivates the fields, or makes roads, or builds houses, and by so doing, helps to convert what was desolate and waste into a habitable and fruitful country : The man who labours with his head, and advances our knowledge, making clear and subservient to man's use, what was before obscure and unapplied : All who labour in the right direc- tion, benefit their kind. Without the toil of man, the coun- try would be uninhabitable : the undrained marshes would breed pestilences, and the soil would not yield a sufficient

20

increase for man's use. Even the fruits of the earth only attain their full perfection under culture. The apple, the potato, the pine, the flowers with which our gardens are decked, are very different from their wild prototypes.

Let there he no murmur or repining, then, that you will meet with difficulties, and will have to encounter toil, in the particular path you have chosen. But, as I just now re- marked, the trial is chiefly at the beginning. As you ad- vance, your interest in the subject will increase, and the labour will be productive of pleasure. It has been truly said, by one of our most eloquent writers, that " all work of man is as the swimmer's ; a waste ocean threatens to devour him; if he front it not bravely, it will keep its word. By incessant wise defiance of it, lusty rebuke and buffet of it, behold how it loyally supports him, bears him as its con- queror along. It is so with all things that man undertakes in this world."

But, in taking up your residence among us, you not only enter on new studies, but you contract fresh relations, ■which involve new duties.

The College, of which the act of matriculation makes you a member, though founded only a few years ago, is already a large establishment. More than a thousand students are receiving their education within its walls. About one-half of these, younger than yourselves, are engaged on the preli- minary part of a liberal education. The others, about your own standing, are engaged, some in the department of gene- ral literature and science ; some in the depai-tment of engi- neering; some in the study of medicine; some in that of divinity.

To all these, your fellow-servants in the College, you are in a certain measure responsible for your conduct. For, in every society, the conduct of each individual member affects

21

in some degree the character of the whole body. Of course, the smaller the community, the more important every indi- vidual member becomes with reference to it, and the more his good or ill-conduct affects the rest. But, even in the largest communities, this reflected influence is felt. The character of a nation is affected by the frequency of crime among its people ; and a single man, eminent for learning or virtue, may be its glory, and boast, and strength, for ages to come. In the society, then, into which you are now ad- mitted, all your fellow-students have a direct personal inte- rest in your character and conduct.

In every community this mutual dependence of its mem - bers renders it necessary for the security and well-being of the whole, that some one should be entrusted with power to punish the offences of individual members against the com- munity. In every civilized nation, whatever be its form of government, there must be a regular administration of jus- tice, and an organized system of police. The society could not be held together without it. So it is in smaller commu- nities. The business of a college like this cannot be carried on ; the society cannot acquire any good reputation, or even continue to exist, without the preservation of order and discipline. The discipline is established on behalf of the whole body, and for their benefit. In educated communities, however, written laws and delegated authority are less needed to secure these ends. Through the conviction that the con- duct of each affects the character of all, as members of the same body, an enlightened public opinion is formed, which, especially when it is founded on sound religion, is, itself, the most efficient means of restraint. In the colleges of our old Universities, it is by this public opinion among the students themselves — which condemns, and resents as an injury to the whole community, any dishonourable or ungentleman-like

28

conduct in one of its members,— it is by this public opinion, much more than by any acts of authority, that a high tone of feeling is maintained. And it is the consciousness of being constantly exposed to the judgment of this public opinion, and the necessity of regulating the conduct by its standard, that so deeply modifies the character and deport- ment of the men who are there educated, giving them, (I speak, of course, of its general effect,) the feelings and the habits of gentlemen.

To a large proportion of those who are educated in our old Universities, this modification of character and deportment is of more importance, and has far more influence on their subsequent position in society, and success in life, than the mere knowledge which they there acquire. This effect on character and deportment is, as I have already observed, mainly the result of an enlightened public opinion among the members of the society, and is independent of the par- ticular subjects of study. In our two old Universities, the subjects of study are very different. In one, history and literature are especially cultivated ; and, in the other, physi- cal science. The students come away from their respective Universities with their minds very diff'erently stored; — but the effect of the collegiate life, with its wholesome disci- pUne, on their character and conduct, has been just the same. So it will be, we trust, with the men educated in the various departments of this College. One will leave the College with a knowledge of the dead languages and of the past history of Greece and Rome ; another, with a know- ledge of the exact sciences ; another, with a knowledge of medicine, and of the sciences subsidiary to it ; another, with a knowledge of divinity : but all will have had their charac- ters more or less modified in the way 1 have explained ; and, feeling this, they will quit the College, to pursue their

23

different paths in life, still in some degree connected by a feeling of fraternity, and with a respect for each other, as men of well-disciplined and cultivated minds.

It is, I think, impossible to over-estimate the influence which the old Universities, by their well-ordered collegiate life, have had in forming the character of the Enghsh gentry. And deeply impressed with the importance of this influence, it gives me great satisfaction to remark, that the Council of this College are increasing the accommodation for the resi- dence of medical students ; that the collegiate life and disci- pline, as applied to medical students, which was first established here, has met with general favour ; and that other medical schoolsin the metropolis are following, or are preparing to fol- low, as far as their means will allow them, the example which this College has set. Nothing will tend so much as the exten- sion and development of this system to raise the character of the medical practitioner. There has been for some years past a cry throughout the country for medical reform ; and there can be no doubt that some of the medical institutions of the country require remodelling. But it is not by legisla- tive enactments for the suppression of quackery — and it is not by giving to one standard of education the social rank and privileges of a higher, and by thus repressing a generous emulation and discouraging high attainments among us, that the character or condition of the profession can be raised : but it is by improving, generally, the character of medical education; by making the course of preparatory study comprehensive and long; — and, more than all, by extending more widely among our students, the advantages of a colle- giate life.

I have, perhaps, said enough to induce you, not only to enter with earnestness on the study of your profession, but also, from the first, to render a willing obedience to the re-

24

gulations and discipline to which you will here be subject. Whatever any of you may think of the restraint which this imposes on younow, the time will come when you will per- ceive and enjoy the advantages of it. This institution is founded and organized for your benefit, and to benefit society through you. Its object is to qualify you not only for the particular duties of your calling, but also, as gentle- men and Christians, to take a place in society becoming the members of a liberal profession.

It remains, then, Gentlemen, for you to do your part, to see that in the important stage of life on which you are now entering, your are not wanting to yourselves.

THE END.

>

LONDON: PRINTBD BY G. J, TiiLMKR, SaVOV STREET.