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ADDRESS TO STUDENTS.
SEPTEMBER 5, 1891.
THE LANCET. LONDON: SATURDAY, SEPTEMBER 5, 1891. ADDRESS TO STUDENTS. IN offering an early and cordial greeting to those commencing the study of medicine this autumn, we would recommend timely and due consideration of the means at their disposal in the several Universities and Medical Schools, described at length in another part of this issue, not only with a view to the acquisition of knowledge, but also for the obtaining of those degrees and diplomas which form the natural termination to their career as students. It has occasionally happened that, for the wanh of a little forethought, a student has found himself at a disadvantage towards the end of his curriculum in securing full acknowledgment of the amount of his training and study, owing to some omission as to matriculation or preliminary examination at its commencement. It is perhaps natural that those who plunge for the first time into at once the freedom and severity of student life should be carried away somewhat by the novelty of the situation. But it is desirable that they should realise to the full what a critical epoch it is in their lives-a period in which, customary external restrictions being to a large extent withdrawn, they commence to develop and assert their own individuality, a period in which mutual interests and rivalries abound, lifelong friendships are made, and impressions or habits acquired, which take a large share in the formation of moral and intellectual character. It is well that ;students should be impressed with the important fact that their relatively brief connexion with the medical schools affords opportunities which can be met with but once in a lifetime-opportunities of acquiring valuable knowledge, of having ready access to materials for study arranged largely for their special benefit, and of coming in contact with minds matured by study and practical experience in the profession they are to adopt. This, too, at a time when youthful enthusiasm and emulation should render them most ready to avail themselves of such advantages, amidst surroundings where the influence of tradition, of example, and of companionship tend to maintain and encourage their efforts. Bearing in mind the importance of the few years in which so much has to be acquired, so much accomplished too great stress cannot be laid on the value of proper method in disposing both of time and energy. "A man may be old in hours, though young in years, if he have lost no time," writes FRANCIS BACON, and it is in the adjustment of suitable periods to particular tasks, and the utilisation of the brief and irregular intervals between, that the saving of time practically consists. It has been estimated that the mere difference between rising at six and nine o’clock in the morning for the space of forty years is nearly equivalent to the addition of fifteen years to a man’s lifetime. There may be some idiosvnerasv in the matter of setting uD earlv. but in
No. 3549.
very many cases, both rising late and sitting up late at night are largely the result of indolence. And for many who have sufficient occupation in the daytime, there is a great contrast between the intellectual value of the morning when the brain is fresh and of the evening when it is fatigued, and rather inclined for recreation than fresh effort. Ib must, however, be allowed that this is only a general rule. " The morning for creation, the afternoon for the work of the file, and the evening for reading," is a good arrangement ; and whilst making the best use of ability and time in the acquisition of knowledge, it is well to recognise the curriculum as a means to an end, and to avoid regarding it as a field in which to make the great effort of life-only to drop back into inactivity thereafter. Medicine is ever advancing, widening and altering, so that, besides acquiring that information which has already been found useful, the medical man is being continually called upon to add to his knowledge, and must keep his mind open and active in later years as in his student day?. He should cultivate a familiarity with the great minds in medicine whose wtitings stand as landmarks in past eras, at the same time that he keeps in contact with those now
living who are pre-eminent in activity. But, if possible, of even more importance than the value of time is the value of thought, and it is only the power of commanding and controlling the activity of the brain that can enable us to employ the brief time at our disposal in furthering the objects which we have in view. BARROW, the early adviser of ISAAC NEWTON, poetically observed: "The spirits employed in thought are apt to flutter and fly away, so that it is hard to fix them; our mind being a restless thing, never abiding in a total cessation from thought or from design; and, like a ship in the sea, if not steered to some good purpose by reason, making no useful way, but yet tossed by the waves of fancy, or by the winds of temptation somewhither." Curiosity driven the intellectual appetite, but it requires both direction is and control for the assimilation of sound and useful knowledge. The effect of novelty in producing an impression on the mind is most valuable, but when not followed up by thorough investigation it is useless, and too much novelty is of all things the most wearying. The great secret of success in medical as in other work is to take full advantage of present opportunities, recording carefully and graphically a few complete impressions, without confusing oneself with a quantity of fragmentary and illegible notes; and it is a good rule not to occupy with reading the hours during which objective and practical work is available. But in the midst of his work the student should be careful of health. Much of his time must necessarily be spent in a vitiated atmosphere and amidst depressing surroundings, where he is exposed to accidents and contagion not met with to the same extent apart from his calling. The best work is done when in the best health, and this depends on a suitable balance between mental and physical exertion, with plenty of fresh air, and regularity with regard to food and rest. It is far better, when necessary, to take a brief holiday to avoid being ill, than to endure a longer absence from work enforced by illness ;and one who is to advise others in the recovery K
526 and maintenance of health should himself be foremost in setting an example of healthy living. Apart, however, from the technicalities of professional knowledge there are numerous occasions on which demands are made upon the sympathy and worldly knowledge of a medical practitioner. He is often the only stranger whose presence and assistance are sought in some of the most momentous episodes in human life. As in the Roman days, when each individual sought direction philosopho suo, the medical man is called upon to give advice in other things than pure physic. His studies, then, must go beyond actual medical literature, and he must lose no chance of familiarising himself with individuals of every temperament and class, that, like ST. PAUL, he may be " all things to all men," and be able to say with ENNIUS, Homo sum, humani nihil a me alieoum puto. THE PROPOSED NEW TEACHING UNIVERSITY IN LONDON. IN the Students’ Number of THE LANCET of 1890 we pointed out that the attempts to satisfy the legitimate demands of the average London medical student for a degree in Medicine had then come to a deadlock. The negotiations between the various bodies interested were in a most unsatisfactory condition. The Univerof London had forward a scheme which had sity put been accepted with some hesitation by the authorities of King’s and University Colleges, but which had excited the determined opposition of the provincial colleges and of a large number of its own graduates. The Royal Colleges ,of Physicians and Surgeons were not in accord as to -its acceptance or rejection, for whilst the former body was ,prepared to assume the place assigned to it as a constituent ,part of the Senate, the latter would only agree to join in the formation of a Conjoint Examining Board with the Senate, and refused to take part in any closer or more intimate connexion with the University. We could only express a hope that, in the interest of the London medical student, these difficulties might be surmounted. After the vacation the .Senate of the University of London, as a result of its negotiations with those who objected to its then scheme, formulated another which was practically almost a complete reversal of the former one. London students in Arts and Science were to be put under a London committee, provincial collegiate students under a second committee, and non-collegiate students under still another. Medical students were to undergo an examination for the "Pass M.B." degree under the direction of a Conjoint Board appointed by the Senate of the University and the Royal Colleges, whilst candidates for "honours"were to be examined under the authority of the University alone. Such a complex arrangement pleased only those who supported the claims of the Royal Colleges to control all pass medical examinations in London. It failed to satisfy King’s and University Colleges, and it rather increased than removed the objections of the graduates of the University of London. The Senate, however, decided to submit the scheme to Convocation, and this body, at its meeting in May last, rejected it by a large and decisive majority. The Senate was prevented by this vote from applying to the Privy Council for a new Charter, and, as we have frequently pointed out, it then found that its traditions and
superior examining board for the Biitish too strongly rooted to permit of its being able to loyally perform the duties of a local teaching university for London. A mere glance at the conditions of medical and general education and examination in Scotland, the provinces, and Germany at once shows
history Empire
as
a
were
how much London is behind in its facilities for university teaching and influence. Gresham College and the University of London were both founded for local pur. poses, and have both deviated into other lines than those designed by their founders. London and Constantinople alone of European capitals have no local teaching university, and consequently no local body which can confer degrees on their own students on fair and equitable terms. Bat since the vote of Convocation in May last, the movement in favour of a local Teaching University in London has made such rapid and unexpected progress that its formation appears to be almost secured; and we hope that in our Students’ Number of 1892 we may not only be able to con. gratulate our readers on its establishment, but also to announce that its regulations and by-laws have been ramed, and that it is ready to make a working start. The two years after the report of the Royal Commission were spent in weary and unprofitable conferences, so that a speedy settlement seemed even more remote last year than when that report was issued ; but after the vote of Convocation the Lord President of the Privy Council took upon himself the direction of affairs, and, to the surprise of all the bodies who had so long been negotiating to no purpose, and of those who were watching the movement, a Committee of the Privy Council was at once appointed, and an early day fixed for the hearing of counsel on behalf of the various parties interested. A short interval was then granted for further conferences, which again proved fruitless; and on July 13th the Lords of the Privy Council gave their decision practically on the lines of the Draft Charter proposed by King’s and University Colleges, but with suggestions for some minor modifications, to which the authorities of the Teaching Colleges at once assented. On the 29th of July the revised Draft Charter was passed, and as in the interim the Royal Colleges had decided to decline to be represented on the Council of the proposed University in the manner recommended by the Lords of the Privy Council, whilst the ten London medical schools had unanimously agreed to become Colleges of Medicine in the University and to accept the representation offered to them on the Council, their Lordships ordered the necessary amendments to be made, that they might be constituted Colleges of Medicine from the foundation of the University. We scarcely expected in September last that the prediction we then made would be so closely and so quickly fulniled—viz., that if the University of London and the Royal Colleges could not agree to a scheme which would relieve the medical student of his acknowledged grievance, and which the Teaching Colleges and the majority of the graduates of the existing University could at the same time accept, " the alternative would be the continuance of the existing University under its present conditions, and the formation of a separate Teaching University by a federation of the Teaching Colleges and the Medical Schools." The Draft Charter
THE LANCET. LONDON: SATURDAY, SEPTEMBER 5, 1891. ADDRESS TO STUDENTS. IN offering an early and cordial greeting to those commencing the study of medicine this autumn, we would recommend timely and due consideration of the means at their disposal in the several Universities and Medical Schools, described at length in another part of this issue, not only with a view to the acquisition of knowledge, but also for the obtaining of those degrees and diplomas which form the natural termination to their career as students. It has occasionally happened that, for the wanh of a little forethought, a student has found himself at a disadvantage towards the end of his curriculum in securing full acknowledgment of the amount of his training and study, owing to some omission as to matriculation or preliminary examination at its commencement. It is perhaps natural that those who plunge for the first time into at once the freedom and severity of student life should be carried away somewhat by the novelty of the situation. But it is desirable that they should realise to the full what a critical epoch it is in their lives-a period in which, customary external restrictions being to a large extent withdrawn, they commence to develop and assert their own individuality, a period in which mutual interests and rivalries abound, lifelong friendships are made, and impressions or habits acquired, which take a large share in the formation of moral and intellectual character. It is well that ;students should be impressed with the important fact that their relatively brief connexion with the medical schools affords opportunities which can be met with but once in a lifetime-opportunities of acquiring valuable knowledge, of having ready access to materials for study arranged largely for their special benefit, and of coming in contact with minds matured by study and practical experience in the profession they are to adopt. This, too, at a time when youthful enthusiasm and emulation should render them most ready to avail themselves of such advantages, amidst surroundings where the influence of tradition, of example, and of companionship tend to maintain and encourage their efforts. Bearing in mind the importance of the few years in which so much has to be acquired, so much accomplished too great stress cannot be laid on the value of proper method in disposing both of time and energy. "A man may be old in hours, though young in years, if he have lost no time," writes FRANCIS BACON, and it is in the adjustment of suitable periods to particular tasks, and the utilisation of the brief and irregular intervals between, that the saving of time practically consists. It has been estimated that the mere difference between rising at six and nine o’clock in the morning for the space of forty years is nearly equivalent to the addition of fifteen years to a man’s lifetime. There may be some idiosvnerasv in the matter of setting uD earlv. but in
No. 3549.
very many cases, both rising late and sitting up late at night are largely the result of indolence. And for many who have sufficient occupation in the daytime, there is a great contrast between the intellectual value of the morning when the brain is fresh and of the evening when it is fatigued, and rather inclined for recreation than fresh effort. Ib must, however, be allowed that this is only a general rule. " The morning for creation, the afternoon for the work of the file, and the evening for reading," is a good arrangement ; and whilst making the best use of ability and time in the acquisition of knowledge, it is well to recognise the curriculum as a means to an end, and to avoid regarding it as a field in which to make the great effort of life-only to drop back into inactivity thereafter. Medicine is ever advancing, widening and altering, so that, besides acquiring that information which has already been found useful, the medical man is being continually called upon to add to his knowledge, and must keep his mind open and active in later years as in his student day?. He should cultivate a familiarity with the great minds in medicine whose wtitings stand as landmarks in past eras, at the same time that he keeps in contact with those now
living who are pre-eminent in activity. But, if possible, of even more importance than the value of time is the value of thought, and it is only the power of commanding and controlling the activity of the brain that can enable us to employ the brief time at our disposal in furthering the objects which we have in view. BARROW, the early adviser of ISAAC NEWTON, poetically observed: "The spirits employed in thought are apt to flutter and fly away, so that it is hard to fix them; our mind being a restless thing, never abiding in a total cessation from thought or from design; and, like a ship in the sea, if not steered to some good purpose by reason, making no useful way, but yet tossed by the waves of fancy, or by the winds of temptation somewhither." Curiosity driven the intellectual appetite, but it requires both direction is and control for the assimilation of sound and useful knowledge. The effect of novelty in producing an impression on the mind is most valuable, but when not followed up by thorough investigation it is useless, and too much novelty is of all things the most wearying. The great secret of success in medical as in other work is to take full advantage of present opportunities, recording carefully and graphically a few complete impressions, without confusing oneself with a quantity of fragmentary and illegible notes; and it is a good rule not to occupy with reading the hours during which objective and practical work is available. But in the midst of his work the student should be careful of health. Much of his time must necessarily be spent in a vitiated atmosphere and amidst depressing surroundings, where he is exposed to accidents and contagion not met with to the same extent apart from his calling. The best work is done when in the best health, and this depends on a suitable balance between mental and physical exertion, with plenty of fresh air, and regularity with regard to food and rest. It is far better, when necessary, to take a brief holiday to avoid being ill, than to endure a longer absence from work enforced by illness ;and one who is to advise others in the recovery K
526 and maintenance of health should himself be foremost in setting an example of healthy living. Apart, however, from the technicalities of professional knowledge there are numerous occasions on which demands are made upon the sympathy and worldly knowledge of a medical practitioner. He is often the only stranger whose presence and assistance are sought in some of the most momentous episodes in human life. As in the Roman days, when each individual sought direction philosopho suo, the medical man is called upon to give advice in other things than pure physic. His studies, then, must go beyond actual medical literature, and he must lose no chance of familiarising himself with individuals of every temperament and class, that, like ST. PAUL, he may be " all things to all men," and be able to say with ENNIUS, Homo sum, humani nihil a me alieoum puto. THE PROPOSED NEW TEACHING UNIVERSITY IN LONDON. IN the Students’ Number of THE LANCET of 1890 we pointed out that the attempts to satisfy the legitimate demands of the average London medical student for a degree in Medicine had then come to a deadlock. The negotiations between the various bodies interested were in a most unsatisfactory condition. The Univerof London had forward a scheme which had sity put been accepted with some hesitation by the authorities of King’s and University Colleges, but which had excited the determined opposition of the provincial colleges and of a large number of its own graduates. The Royal Colleges ,of Physicians and Surgeons were not in accord as to -its acceptance or rejection, for whilst the former body was ,prepared to assume the place assigned to it as a constituent ,part of the Senate, the latter would only agree to join in the formation of a Conjoint Examining Board with the Senate, and refused to take part in any closer or more intimate connexion with the University. We could only express a hope that, in the interest of the London medical student, these difficulties might be surmounted. After the vacation the .Senate of the University of London, as a result of its negotiations with those who objected to its then scheme, formulated another which was practically almost a complete reversal of the former one. London students in Arts and Science were to be put under a London committee, provincial collegiate students under a second committee, and non-collegiate students under still another. Medical students were to undergo an examination for the "Pass M.B." degree under the direction of a Conjoint Board appointed by the Senate of the University and the Royal Colleges, whilst candidates for "honours"were to be examined under the authority of the University alone. Such a complex arrangement pleased only those who supported the claims of the Royal Colleges to control all pass medical examinations in London. It failed to satisfy King’s and University Colleges, and it rather increased than removed the objections of the graduates of the University of London. The Senate, however, decided to submit the scheme to Convocation, and this body, at its meeting in May last, rejected it by a large and decisive majority. The Senate was prevented by this vote from applying to the Privy Council for a new Charter, and, as we have frequently pointed out, it then found that its traditions and
superior examining board for the Biitish too strongly rooted to permit of its being able to loyally perform the duties of a local teaching university for London. A mere glance at the conditions of medical and general education and examination in Scotland, the provinces, and Germany at once shows
history Empire
as
a
were
how much London is behind in its facilities for university teaching and influence. Gresham College and the University of London were both founded for local pur. poses, and have both deviated into other lines than those designed by their founders. London and Constantinople alone of European capitals have no local teaching university, and consequently no local body which can confer degrees on their own students on fair and equitable terms. Bat since the vote of Convocation in May last, the movement in favour of a local Teaching University in London has made such rapid and unexpected progress that its formation appears to be almost secured; and we hope that in our Students’ Number of 1892 we may not only be able to con. gratulate our readers on its establishment, but also to announce that its regulations and by-laws have been ramed, and that it is ready to make a working start. The two years after the report of the Royal Commission were spent in weary and unprofitable conferences, so that a speedy settlement seemed even more remote last year than when that report was issued ; but after the vote of Convocation the Lord President of the Privy Council took upon himself the direction of affairs, and, to the surprise of all the bodies who had so long been negotiating to no purpose, and of those who were watching the movement, a Committee of the Privy Council was at once appointed, and an early day fixed for the hearing of counsel on behalf of the various parties interested. A short interval was then granted for further conferences, which again proved fruitless; and on July 13th the Lords of the Privy Council gave their decision practically on the lines of the Draft Charter proposed by King’s and University Colleges, but with suggestions for some minor modifications, to which the authorities of the Teaching Colleges at once assented. On the 29th of July the revised Draft Charter was passed, and as in the interim the Royal Colleges had decided to decline to be represented on the Council of the proposed University in the manner recommended by the Lords of the Privy Council, whilst the ten London medical schools had unanimously agreed to become Colleges of Medicine in the University and to accept the representation offered to them on the Council, their Lordships ordered the necessary amendments to be made, that they might be constituted Colleges of Medicine from the foundation of the University. We scarcely expected in September last that the prediction we then made would be so closely and so quickly fulniled—viz., that if the University of London and the Royal Colleges could not agree to a scheme which would relieve the medical student of his acknowledged grievance, and which the Teaching Colleges and the majority of the graduates of the existing University could at the same time accept, " the alternative would be the continuance of the existing University under its present conditions, and the formation of a separate Teaching University by a federation of the Teaching Colleges and the Medical Schools." The Draft Charter