Medicine - The Two Functions of a Medical School Part 1
( Originally Published 1905 )
MANY things have been urged against our nineteenth century civilizationóthat political enfranchisement only ends in anarchy, that the widespread unrest in spiritual matters leads only to unbelief, and that the best commentary on our boasted enlightenment is the picture of Europe in arms and the nations everywhere gnarring at each other's heels. Of practical progress in one direction, however, there can be no doubt; no one can dispute the enormous increase in the comfort of each individual life. Collectively the human race, or portions of it at any rate, may in the past have enjoyed periods of greater repose, and longer intervals of freedom from strife and anxiety; but the day has never been when the unit has been of such value, when the man, and the man alone, has been so much the measure, when the individual as a living organism has seemed so sacred, when the obligations to regard his rights have seemed so imperative. But even these changes are as nothing in comparison with the remarkable increase in his physical well-being. The bitter cry of Isaiah that with the multiplication of the nations their joys have not been increased, still echoes in our ears. The sorrows and troubles of men, it is true, may not have been materially diminished, but bodily pain and suffering, though not abolished, have been assuaged as never before, and the share of each in the Weltschmerz has been enormously lessened.
Sorrows and griefs are companions sure sooner or later to join us on our pilgrimage, and we have become perhaps more sensitive to them, and perhaps less amenable to the old time remedies of the physicians of the soul; but the pains and woes of the body, to which we doctors minister, are decreasing at an extraordinary rate, and in a way that makes one fairly gasp in hopeful anticipation.
In his Grammar of Assent, in a notable passage on suffering, John Henry Newman asks, "Who can weigh and measure the aggregate of pain which this one generation has endured, and will endure, from birth to death? Then add to this all the pain which has fallen and will fall upon our race through centuries past and to come." But take the other view of itóthink of the Nemesis which has overtaken pain during the past fifty years! Anaesthetics and anti-septic surgery have almost manacled the demon, and since their introduction the aggregate of pain which has been prevented far outweighs in civilized communities that which has been suffered. Even the curse of travail has been lifted from the soul of women.
The greatest art is in the concealment of art, and I may say that we of the medical profession excel in this respect. You of the public who hear me, go about the duties of the day profoundly indifferent to the facts I have just mentioned. You do not know, many of you do not care, that for the cross-legged Juno who presided over the arrival of your grandparents, there now sits a benign and straight-legged goddess. You take it for granted that if a shoulder is dislocated there is chloroform and a delicious Nepenthe
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instead of the agony of the pulleys and paraphernalia of fifty years ago. You accept with a selfish complacency, as if you were yourselves to be thanked for it, that the arrows of destruction fly not so thickly, and that the pestilence now rarely walketh in the darkness; still less do you realize that you may now pray the prayer of Hezekiah with a reasonable prospect of its fulfilment, since modern science has made to almost everyone of you the present of a few years.
I say you do not know these things. You hear of them, and the more intelligent among you perhaps ponder them in your hearts, but they are among the things which you take for granted, like the sunshine, and the flowers and the glorious heavens.
'Tis no idle challenge which we physicians throw out to the world when we claim that our mission is of the highest and of the noblest kind, not alone in curing disease but in educating the people in the laws of health, and in preventing the spread of plagues and pestilences; nor can it be gainsaid that of late years our record as a body has been more encouraging in its practical results than those of the other Iearned professions. Not that we all live up to the highest ideals, far from itówe are only men. But we have ideals, which mean much, and they are realizable, which means more. Of course there are Gehazis among us who serve for shekels, whose ears hear only the lowing of the oxen and the jingling of the guineas, but these are exceptions. The rank and file labour earnestly for your good, and self-sacrificing devotion to your interests animates our best work.
The exercises in which we are today engaged form an incident in this beneficent work which is in progress everywhere; an incident which will enable me to dwell upon certain aspects of the university as a factor in the promotion of the physical well-being of the race.