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THE TEACHING OF PHYSIOLOGY.
67
Correspondence. "Audi alteram partem."
THE TEACHING OF PHYSIOLOGY. To tlte Editor of THE LANCET. SiR,-Perhaps a word from a teacher upon the teaching of physiology may not be considered out of place at the present moment.
Amongst the last-issued regulations of the College of Surgeons, besides attendance upon a course of lectures, such as has been heretofore given on general anatomy and physiology during one winter session, the candidate for examination is required to have attended "a practical course of general anatomy and physiology during another winter or summer session, consisting of not less than thirty meetings of the class." Under the form of explanatory note, it is stated that by the practical course referred to "it is meant that the learners themselves shall individually be engaged in the necessary experiments, manipulations, &c. It is not necessary to look back far to find that physiology has been undergoing a rapid growth in importance as a branch of medical education. Some twenty-five years ago only, it was not deemed requisite that it should be given as a special course. Physiology, or what was taught of it, was then tacked on to another subject. Amongst the courses enumerated in a school prospectus, for instance, might be found one on anatomy, descriptive, surgical, and physiological," and no thing more relating to physiology. Subsequently, the teaching of physiology was enforced as an independent branch of science, and now practical instruction is demanded in addition to the ordinary lecturer’s course. That the student should obtain a good serviceable knowledge of physiology at the outset of his studentship career I consider of the greatest importance, because it forms a necessary foundation for the acquirement of a knowledge of disease ; and, proceeding in compliance with the College" regulations, the following, based upon fifteen years’ experience in teaching the subject, is my opinion of what will constitute the best plan for attaining the object desired. The course of lectures I consider should be given with experimental illustrations. Physiology is as much a science requiring the aid of experimental illustration in teaching it as chemistry or natural philosophy. Many of the experiments involve only the application of chemistry or physics, but with anaesthetics like chloroform, puff-ball, &c., at our disposal, the introduction of experiments upon the living animal is also practicable. I believe that no approach to anything like the commission of cruelty would be tolerated by a class of medical students for thesake of their instruction, even if attempted by the teacher ; but, thanks to the progress of knowledge, there are experiments upon the living animal that can now be performed as a means of instruction without risk of giving offence to the feelings of any well-constituted mind. A course of lectures undertaken in such a manner necessitates the provision of a suitable laboratory and assistance to enable it to be properly carried out. With respect to the practical course in which the students themselves are to be engaged in manipulating, I cannot think that it has been contemplated by the authorities of the College of Surgeons to set men to work at performing actual physiological experiments. If such were attempted, I am persuaded it would prove not only a failure, but even an abuse. The generality of experiments require a considerable amount of time, patience, and skill to be bestowed upon them to produce a successful result. Taxed as he is with the number of subjects he has to learn, it is beyond the power of the medical student to give himself up sufficiently to physiology to acquire the requisite dexterity foi experiments in a manner to derive performing physiological any benefit from them. He may, however, with great advantage see the experiments performed, and this opportunity, as I have already said, should be afforded him in the course of lectures he has to attend. °
"
"
The microscopic examination of the fluids and textures, with and without the co-operation of influencing agents, forms, on the other hand, practical work in connexion with physiology upon which the time of the student can with much advantage be bestowed. This is work the performance of which has been felt to be wanted, and has been already for some time past carried out at some of the medical schools. Ibis the kind of work which I consider the practical course of the College will be found to be susceptible of principally resolving itself into; and if so, the new regulations of the College will amount to this-that what has hitherto been voluntarily undertaken by a few is, in future, to be compulsorily carried out by all. I believe the time is not far distant when pathology will be deemed to require the same kind of step that has now been taken for physiology. Chemical manipulations with some of the fluids may also be advantageously brought in. There is some amount of practical work of this kind which unquestionably ought, in some way or other, to be undertaken. Looking to the student’sadvantage, the only question for consideration is whether it would fall in best in connexion with practical chemistry or with the microscopic work associated with physiology. There is this to be said, that taken in conjunction with practical chemistry the student has already his test tube in his hand, and his reagents before him; but, on the other hand, the physiologist is in a better position than the chemist to direct the student’s attention to that which is most likely to be of service to him hereafter. In Dr. Odling’s guide book, however, for the practical chemistry course, I notice that this subject is embraced, and, therefore, take it that these chemical manipulations have been already considered as forming a part of the practical chemistry course. It is, I would suggest, an open question which course they can be most advantageously comprised in. The interest to the profession of all matters connected with medical education must form my excuse for seeking permission to occupy your space with this letter. I remain, Sir, yours obediently, F. W. PAVY. PAVY-. Grosvenor-street, Dec. 24h, 1870.
THE AMALGAMATION OF MEDICAL SCHOOLS. To the Editor of THE LANCET. SiR,-The article in last week’s LANCET on " the Amalof Medical Schools" appears to me calculated to erroneous an impression of the position of the Hospital Medical College with respect to the suggested amalgamation, that I venture to trouble you with an explanation of the real state of the case, so far as the Middlesex Hospital is concerned, and trust to your wellknown fairness and courtesy for its insertion in your forthcoming number. No active steps are being taken, or have at any time been taken, by the Middlesex Hospital Staff or Medical School towards amalgamation with either of the other medical schools named in your article, neither are there any negotiations now on foot to bring about that object. In fact, the question of amalgamation with any other medical school has never, since I have been a member of the staff, been mentioned at any meeting of the authorities, lay or medical, of the Middlesex Hospital. It is true, indeed, that about eighteen months ago certain members of the Middlesex Hospital staff, of whom I was one, were invited privately as individuals, but in no way as representatives of our school, to meet certain of the medical Professors of University College, in order to discuss the possibility of drawing up a scheme for amalgamation. At the close of the deliberations we stated our readiness to consider any scheme for amalgamation which might be proposed by the authorities of University College, and, if we approved of it, to submit it to our colleagues, and ultimately to the lay authorities of the hospital. From that time, however, up to the present moment, we have received no further communication on the subject. I can readily believe that, especially in view of the recent regulations of the College of Surgeons, the means of securing a much wider field of practice must be a question engaging the anxious attention of the medical
gamation
convey so Middlesex
hospital
Correspondence. "Audi alteram partem."
THE TEACHING OF PHYSIOLOGY. To tlte Editor of THE LANCET. SiR,-Perhaps a word from a teacher upon the teaching of physiology may not be considered out of place at the present moment.
Amongst the last-issued regulations of the College of Surgeons, besides attendance upon a course of lectures, such as has been heretofore given on general anatomy and physiology during one winter session, the candidate for examination is required to have attended "a practical course of general anatomy and physiology during another winter or summer session, consisting of not less than thirty meetings of the class." Under the form of explanatory note, it is stated that by the practical course referred to "it is meant that the learners themselves shall individually be engaged in the necessary experiments, manipulations, &c. It is not necessary to look back far to find that physiology has been undergoing a rapid growth in importance as a branch of medical education. Some twenty-five years ago only, it was not deemed requisite that it should be given as a special course. Physiology, or what was taught of it, was then tacked on to another subject. Amongst the courses enumerated in a school prospectus, for instance, might be found one on anatomy, descriptive, surgical, and physiological," and no thing more relating to physiology. Subsequently, the teaching of physiology was enforced as an independent branch of science, and now practical instruction is demanded in addition to the ordinary lecturer’s course. That the student should obtain a good serviceable knowledge of physiology at the outset of his studentship career I consider of the greatest importance, because it forms a necessary foundation for the acquirement of a knowledge of disease ; and, proceeding in compliance with the College" regulations, the following, based upon fifteen years’ experience in teaching the subject, is my opinion of what will constitute the best plan for attaining the object desired. The course of lectures I consider should be given with experimental illustrations. Physiology is as much a science requiring the aid of experimental illustration in teaching it as chemistry or natural philosophy. Many of the experiments involve only the application of chemistry or physics, but with anaesthetics like chloroform, puff-ball, &c., at our disposal, the introduction of experiments upon the living animal is also practicable. I believe that no approach to anything like the commission of cruelty would be tolerated by a class of medical students for thesake of their instruction, even if attempted by the teacher ; but, thanks to the progress of knowledge, there are experiments upon the living animal that can now be performed as a means of instruction without risk of giving offence to the feelings of any well-constituted mind. A course of lectures undertaken in such a manner necessitates the provision of a suitable laboratory and assistance to enable it to be properly carried out. With respect to the practical course in which the students themselves are to be engaged in manipulating, I cannot think that it has been contemplated by the authorities of the College of Surgeons to set men to work at performing actual physiological experiments. If such were attempted, I am persuaded it would prove not only a failure, but even an abuse. The generality of experiments require a considerable amount of time, patience, and skill to be bestowed upon them to produce a successful result. Taxed as he is with the number of subjects he has to learn, it is beyond the power of the medical student to give himself up sufficiently to physiology to acquire the requisite dexterity foi experiments in a manner to derive performing physiological any benefit from them. He may, however, with great advantage see the experiments performed, and this opportunity, as I have already said, should be afforded him in the course of lectures he has to attend. °
"
"
The microscopic examination of the fluids and textures, with and without the co-operation of influencing agents, forms, on the other hand, practical work in connexion with physiology upon which the time of the student can with much advantage be bestowed. This is work the performance of which has been felt to be wanted, and has been already for some time past carried out at some of the medical schools. Ibis the kind of work which I consider the practical course of the College will be found to be susceptible of principally resolving itself into; and if so, the new regulations of the College will amount to this-that what has hitherto been voluntarily undertaken by a few is, in future, to be compulsorily carried out by all. I believe the time is not far distant when pathology will be deemed to require the same kind of step that has now been taken for physiology. Chemical manipulations with some of the fluids may also be advantageously brought in. There is some amount of practical work of this kind which unquestionably ought, in some way or other, to be undertaken. Looking to the student’sadvantage, the only question for consideration is whether it would fall in best in connexion with practical chemistry or with the microscopic work associated with physiology. There is this to be said, that taken in conjunction with practical chemistry the student has already his test tube in his hand, and his reagents before him; but, on the other hand, the physiologist is in a better position than the chemist to direct the student’s attention to that which is most likely to be of service to him hereafter. In Dr. Odling’s guide book, however, for the practical chemistry course, I notice that this subject is embraced, and, therefore, take it that these chemical manipulations have been already considered as forming a part of the practical chemistry course. It is, I would suggest, an open question which course they can be most advantageously comprised in. The interest to the profession of all matters connected with medical education must form my excuse for seeking permission to occupy your space with this letter. I remain, Sir, yours obediently, F. W. PAVY. PAVY-. Grosvenor-street, Dec. 24h, 1870.
THE AMALGAMATION OF MEDICAL SCHOOLS. To the Editor of THE LANCET. SiR,-The article in last week’s LANCET on " the Amalof Medical Schools" appears to me calculated to erroneous an impression of the position of the Hospital Medical College with respect to the suggested amalgamation, that I venture to trouble you with an explanation of the real state of the case, so far as the Middlesex Hospital is concerned, and trust to your wellknown fairness and courtesy for its insertion in your forthcoming number. No active steps are being taken, or have at any time been taken, by the Middlesex Hospital Staff or Medical School towards amalgamation with either of the other medical schools named in your article, neither are there any negotiations now on foot to bring about that object. In fact, the question of amalgamation with any other medical school has never, since I have been a member of the staff, been mentioned at any meeting of the authorities, lay or medical, of the Middlesex Hospital. It is true, indeed, that about eighteen months ago certain members of the Middlesex Hospital staff, of whom I was one, were invited privately as individuals, but in no way as representatives of our school, to meet certain of the medical Professors of University College, in order to discuss the possibility of drawing up a scheme for amalgamation. At the close of the deliberations we stated our readiness to consider any scheme for amalgamation which might be proposed by the authorities of University College, and, if we approved of it, to submit it to our colleagues, and ultimately to the lay authorities of the hospital. From that time, however, up to the present moment, we have received no further communication on the subject. I can readily believe that, especially in view of the recent regulations of the College of Surgeons, the means of securing a much wider field of practice must be a question engaging the anxious attention of the medical
gamation
convey so Middlesex
hospital