第 55 节
作者:
小秋 更新:2021-02-19 17:22 字数:9322
When I compare this direct transfer of the practical experience of a wise man into the mind of a student;every fact one that he can use in the battle of life and death;with the far off; unserviceable 〃scientific〃 truths that I and some others are in the habit of teaching; I cannot help asking myself whether; if we concede that our forefathers taught too little; there is nota possibility that we may sometimes attempt to teach too much。 I almost blush when I think of myself as describing the eight several facets on two slender processes of the palate bone; or the seven little twigs that branch off from the minute tympanic nerve; and I wonder whether my excellent colleague feels in the same way when he pictures himself as giving the constitution of neurin; which as he and I know very well is that of the hydrate of trimethyle…oxethyle…ammonium; or the formula for the production of alloxan; which; though none but the Professors and older students can be expected to remember it; is C10 H4 N4 O6+ 2HO; NO5}=C8 H4 N2 O10+2CO2+N2+NH4 O; NO5。
I can bear the voice of some rough iconoclast addressing the Anatomist and the Chemist in tones of contemptuous indignation: 〃What is this stuff with which you are cramming the brains of young men who are to hold the lives of the community in their hands? Here is a man fallen in a fit; you can tell me all about the eight surfaces of the two processes of the palate bone; but you have not had the sense to loosen that man's neck…cloth; and the old women are all calling you a fool? Here is a fellow that has just swallowed poison。 I want something to turn his stomach inside out at the shortest notice。 Oh; you have forgotten the dose of the sulphate of zinc; but you remember the formula for the production of alloxan!〃
〃Look you; Master Doctor;if I go to a carpenter to come and stop a leak in my roof that is flooding the house; do you suppose I care whether he is a botanist or not? Cannot a man work in wood without knowing all about endogens and exogens; or must he attend Professor Gray's Lectures before he can be trusted to make a box…trap? If my horse casts a shoe; do you think I will not trust a blacksmith to shoe him until I have made sure that he is sound on the distinction between the sesquioxide and the protosesquioxide of iron?〃
But my scientific labor is to lead to useful results by and by; in the next generation; or in some possible remote future。
〃Diavolo!〃 as your Dr。 Rabelais has it;answers the iconoclast; 〃what is that to me and my colic; to me and my strangury? I pay the Captain of the Cunard steamship to carry me quickly and safely to Liverpool; not to make a chart of the Atlantic for after voyagers! If Professor Peirce undertakes to pilot me into Boston Harbor and runs me on Cohasset rocks; what answer is it to tell me that he is Superintendent of the Coast Survey? No; Sir! I want a plain man in a pea…jacket and a sou'wester; who knows the channel of Boston Harbor; and the rocks of Boston Harbor; and the distinguished Professor is quite of my mind as to the matter; for I took the pains to ask him before I ventured to use his name in the way of illustration。〃
I do not know how the remarks of the image…breaker may strike others; but I feel that they put me on my defence with regard to much of my teaching。 Some years ago I ventured to show in an introductory Lecture how very small a proportion of the anatomical facts taught in a regular course; as delivered by myself and others; had any practical bearing whatever on the treatment of disease。 How can I; how can any medical teacher justify himself in teaching anything that is not like to be of practical use to a class of young men who are to hold in their hands the balance in which life and death; ease and anguish; happiness and wretchedness are to be daily weighed?
I hope we are not all wrong。 Oftentimes in finding how sadly ignorant of really essential and vital facts and rules were some of those whom we had been larding with the choicest scraps of science; I have doubted whether the old one…man system of teaching; when the one man was of the right sort; did not turn out better working physicians than our more elaborate method。 The best practitioner I ever knew was mainly shaped to excellence in that way。 I can understand perfectly the regrets of my friend Dr。 John Brown of Edinburgh; for the good that was lost with the old apprenticeship system。 I understand as well Dr。 Latham's fear 〃that many men of the best abilities and good education will be deterred from prosecuting physic as a profession; in consequence of the necessity indiscriminately laid upon all for impossible attainments。〃
I feel therefore impelled to say a very few words in defence of that system of teaching adopted in our Colleges; by which we wish to supplement and complete the instruction given by private individuals or by what are often called Summer Schools。
The reason why we teach so much that is not practical and in itself useful; is because we find that the easiest way of teaching what is practical and useful。 If we could in any way eliminate all that would help a man to deal successfully with disease; and teach it by itself so that it should be as tenaciously rooted in the memory; as easily summoned when wanted; as fertile in suggestion of related facts; as satisfactory to the peremptory demands of the intelligence as if taught in its scientific connections; I think it would be our duty so to teach the momentous truths of medicine; and to regard all useless additions as an intrusion on the time which should be otherwise occupied。
But we cannot successfully eliminate and teach by itself that which is purely practical。 The easiest and surest why of acquiring facts is to learn them in groups; in systems; and systematized knowledge is science。 You can very often carry two facts fastened together more easily than one by itself; as a housemaid can carry two pails of water with a hoop more easily than one without it。 You can remember a man's face; made up of many features; better than you can his nose or his mouth or his eye…brow。 Scores of proverbs show you that you can remember two lines that rhyme better than one without the jingle。 The ancients; who knew the laws of memory; grouped the seven cities that contended for the honor of being Homer's birthplace in a line thus given by Aulus Gellius :
Smurna; Rodos; Colophon; Salamin; Ios; Argos; Athenai。
I remember; in the earlier political days of Martin Van Buren; that Colonel Stone; of the 〃New York Commercial;〃 or one of his correspondents; said that six towns of New York would claim in the same way to have been the birth…place of the 〃Little Magician;〃 as he was then called; and thus he gave their names; any one of which I should long ago have forgotten; but which as a group have stuck tight in my memory from that day to this;
Catskill; Saugerties; Redhook; Kinderhook; Scaghticoke; Schodac。
If the memory gains so much by mere rhythmical association; how much more will it gain when isolated facts are brought together under laws and principles; when organs are examined in their natural connections; when structure is coupled with function; and healthy and diseased action are studied as they pass one into the other! Systematic; or scientific study is invaluable as supplying a natural kind of mnemonics; if for nothing else。 You cannot properly learn the facts you want from Anatomy and Chemistry in any way so easily as by taking them in their regular order; with other allied facts; only there must be common sense exercised in leaving out a great deal which belongs to each of the two branches as pure science。 The dullest of teachers is the one who does not know what to omit。
The larger aim of scientific training is to furnish you with principles to which you will be able to refer isolated facts; and so bring these within the range of recorded experience。 See what the 〃London Times〃 said about the three Germans who cracked open John Bull Chatwood's strong…box at the Fair the other day; while the three Englishmen hammered away in vain at Brother Jonathan Herring's。 The Englishmen represented brute force。 The Germans had been trained to appreciate principle。 The Englishman 〃knows his business by rote and rule of thumb〃science; which would 〃teach him to do in an hour what has hitherto occupied him two hours;〃 〃is in a manner forbidden to him。〃 To this cause the 〃Times〃 attributes the falling off of English workmen in comparison with those of the Continent。
Granting all this; we must not expect too much from 〃science〃 as distinguished from common experience。 There are ten thousand experimenters without special apparatus for every one in the laboratory。 Accident is the great chemist and toxicologist。 Battle is the great vivisector。 Hunger has instituted researches on food such as no Liebig; no Academic Commission has ever recorded。
Medicine; sometimes impertinently; often ignorantly; often carelessly called 〃allopathy;〃 appropriates everything from every source that can be of the slightest use to anybody who is ailing in any way; or like to be ailing from any cause。 It learned from a monk how to use antimony; from a Jesuit how to cure agues; from a friar how to cut