guy's hospital. introductory address by mr. a. ernest maylaed

1
824 the other hand, we have the experiments which accident does for us, and above all the incalculably large amount of crude experiment which is popularly done lay man on man under our present ordinary conditions of social life, and which gives us its results for our interpretation." This was illustrated in the case of cholera : on the one hand were Professor Thiersch’s scientific infection experiments performed on mice ; on the other the experiments in connexion with water- supply, in the 1848 and 1853 epidemics, performed on half a million of people in South London. Both gave the same result. "The experiments which illustrated the danger- ousness of sewage-polluted water-supplies cost many thou- sands of human lives ; the scientific experiments which, with infinitely more exactitude justified a presumption of dangerousness, cost the lives of fourteen mice." Passing on to the bases of all true medical work, anatomy, physiology and pathology, he said that anatomy contem- plates the parts of the body in a state of rest, the struc- tures on which functions play. Physiology contemplates the parts of the body as living and in process of change, change not only of a mechanical kind, but change of energy and of form, which are the necessary results of function. Pathology is but a part of physiology, the one de- claring what is normal in function, the other what is more or less a departure from the normal. Hippocrates more than 2000 years ago proclaimed pathology to be a branch of the science of nature ; the slowness of its development can only be explained by the equal slowness of the progress of the natural sciences themselves. Of late years, however, advances have been truly made by leaps and bounds. Professor Schroeder in Germany and M. Pasteur in France, by their investigations on fermentation and putrefaction, and M. Chauveau on the particulate nature of contagia, opened up an entirely new world to us all. We have now not only to study the causes as well as the changes of the disease in the body, but also the doings of the bacteria outside the body and withip it. These facts applied to the State at large, forming what is called State medicine, have increased the average duration of life and diminished the suffering consequent on bad health and disease. Each succeeding year shows more andmore clearly the great value of physics in the department of preventive medicine. Sir John Simon years ago showed the important part which medicine played in the political economy of the country, and he succeeded in due time in bringing the State and the medical profession into organised relation with one another. Next was pointed out the manner in which physics may be applied for remedial purposes. Change, muscular and nervous, lies at the root of all recreation. The students were reminded that " all work and no play makes Jack a dull boy, and that games and the pleasures of exercise may well be enjoyed during their pursuit after knowledge. Extremes should be avoided, and when really tired rest was a necessity, for fatigue implies diminution of the physico-chemical changes connected with the evolution of force. In some states, movement, exercise and massage may be useful; in others, air, fresh air, or change of air, more of nature’s medi- cines, as are also heat, electricity and light ; the last of these having been experimentally shown by the lecturer to produce some very singular effects in connexion with sunburn. Lastly, the lecturer said that we come to the consideration of the administration of medicines. Here empiricism has hitherto been almost supreme, but, thanks to the sciences, clearer and more certain views are taking its place. Materia medica or the knowledge of the re- medies employed in medicine has its divisions, its depart- ments, each and all being worked on scientific principles. Pharmacology is the knowledge of the mode of the action of drugs upon the body generally and upon its various parts. Therapeutics imply the administration of remedies suitable for the relief of particular symptoms in proper doses and proportions. Long and complicated prescriptions are to be avoided. Not a single drug ought to enter the body except under clear intention of what object it is to fulfil there. Compounds may be good cookery, but do not form scientific medicine. We cannot by any amount of training make a man distinguish himself in a subject to which he is by nature unfitted. Like a real artist the man must have" the touch of the finger of God, of the all-informing, all-creating imagination. " " There’s a divinity that shapes our ends, Rough-hew them how we will." In conclusion, Dr. Bowles warned the students against mis- taken views of materialism. The "ars medendi " is practi- cally illimitable. In Bacon’s use of the term, it is coexten- sive with the whole field of terrestrial nature and the students of the physical and biological sciences are emphati. cally the servants of nature. SirThoma.sBrowne, in his "Religio Medici, " tells us that nature is the art of God.’’ Do not ever be bewildered into supposing that there is any antagonism between religion and science ; there is no such antagonism. The man of science interprets the physical laws, and equally with the teacher of religion tells us of the greatness and grandeur of the Creator. Every discovery of the scientist can only tend to increase our wonder at the omniscience and perfec- tion of the ways of God. - GUY’S HOSPITAL. INTRODUCTORY ADDRESS BY MR. A. ERNEST MAYLAED. MR. MAYLARD, after expressing his appreciation of the honour which he felt had been conferred upon him in asking him to come from Glasgow to deliver the opening address, proceeded in the course of his remarks to speak of the value of cultivating a spirit of inquiry. He said he con- sidered it one of the best attributes possessed by a student and one of the best faculties to maintain throughout life. "We needed nowadays, more perhaps than at any previous period, to cultivate an attitude of mind which was ever seeking to know the truth. Our profession was one which was pecu. liarly handicapped in the matter of advance. It was so easy to promulgate a principle or theory, but so difficult to be certain that its basis was sound. It was true enough that we spoke of the science of medicine and surgery, and yet we could not speak of the science of human nature. It was too variable in its formation and function to admit of the framing of general laws. Hence true advance was often hindered by the innumerable practices founded on some false theory or inculcated on insufficient grounds. One, perhaps, of the commonest errors to which we were addicted was that of generalising from a too limited field of experience, assuming, for instance, that what proved suit- able or successful in one or two individual cases would effect a like result in all others. Again, we were often apt to forget that within the greater part, if not within the whole period of its existence, the human body had a constant inherent tendency to return to a certain normal standard, and we were apt to assume that measures adopted by us effected results which in reality were due to nature’s own work. How should we then as inquiring students contend with these difficulties; or what should be our attitude in respect to them ? If we constantly cultivated and exercised a spirit of searching inquiry we should, in the first place, ourselves not be ready to make assertions which we honestly felt had not yet stood the test of a sufficiently extended experience; and in the second we should not be over hasty in adopting every nostrum that is put under our nose, every treatment we read about, without being first fully satisfied as to the veracity of the statements made or the merits of the claims advanced," To illustrate more fully and graphically how a student should exercise and cultivate his faculty of inquiry, Mr. Maylard proceeded to picture in imagination a case of a wound dressed antiseptically. The practical treatment of such a case was carried out with the most elaborate details, formed on a very simple principle. The questions which the inquiring student would ask were whether every detail of the procedure was an accurate fulfilment of the conditions required by the principle, did every agent employed effect the result desired It was pointed out that in view of the rapid development of the science of bacteriology many new theories and practices based upon them were and would be sent forth into the medical world. But every inquiring student should be cautious in not accepting too hastily conclusions which a more careful and prolonged consideration may prove after all to be based on some false or mistaken theory. In conclusion, Mr. Maylard said : "If the faculty of inquiry was to be exercised to its fullest advantage in our pro- fessional life, it must be cultivated to an equal extent in all our relations to the world around us. It should form as much a part of our religion and our politics as our profession. It was hardly possible to think of a man as a bigoted sectarian, a purely party politician or a rampant advocate of any sect or subject, whose mind had been broadened and his views extended, by a searching inquiry into the subject at issue. Dogmatism in any shape or form was not an attribute that belonged to the followers of our profession. It indicated a limited, not an extensive, knowledge. It is for us ever to be seeking and making each truth as it is found, not the limit of our inquiry but the basis for the discovery of another."

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Page 1: GUY'S HOSPITAL. INTRODUCTORY ADDRESS BY MR. A. ERNEST MAYLAED

824

the other hand, we have the experiments which accident doesfor us, and above all the incalculably large amount of crudeexperiment which is popularly done lay man on man underour present ordinary conditions of social life, and which givesus its results for our interpretation." This was illustratedin the case of cholera : on the one hand were ProfessorThiersch’s scientific infection experiments performed on mice ;on the other the experiments in connexion with water-

supply, in the 1848 and 1853 epidemics, performed on halfa million of people in South London. Both gave the sameresult. "The experiments which illustrated the danger-ousness of sewage-polluted water-supplies cost many thou-sands of human lives ; the scientific experiments which,with infinitely more exactitude justified a presumption of

dangerousness, cost the lives of fourteen mice." Passingon to the bases of all true medical work, anatomy,physiology and pathology, he said that anatomy contem-plates the parts of the body in a state of rest, the struc-tures on which functions play. Physiology contemplatesthe parts of the body as living and in process of change,change not only of a mechanical kind, but change of

energy and of form, which are the necessary results offunction. Pathology is but a part of physiology, the one de-claring what is normal in function, the other what is moreor less a departure from the normal. Hippocrates more than2000 years ago proclaimed pathology to be a branch of thescience of nature ; the slowness of its development can onlybe explained by the equal slowness of the progress of thenatural sciences themselves. Of late years, however,advances have been truly made by leaps and bounds.Professor Schroeder in Germany and M. Pasteur in France,by their investigations on fermentation and putrefaction, andM. Chauveau on the particulate nature of contagia, openedup an entirely new world to us all. We have now not only tostudy the causes as well as the changes of the disease in thebody, but also the doings of the bacteria outside the body andwithip it. These facts applied to the State at large, formingwhat is called State medicine, have increased the averageduration of life and diminished the suffering consequent on badhealth and disease. Each succeeding year shows more andmoreclearly the great value of physics in the department of preventivemedicine. Sir John Simon years ago showed the importantpart which medicine played in the political economy of thecountry, and he succeeded in due time in bringing the Stateand the medical profession into organised relation with oneanother. Next was pointed out the manner in which physicsmay be applied for remedial purposes. Change, muscularand nervous, lies at the root of all recreation. The studentswere reminded that " all work and no play makes Jack a dullboy, and that games and the pleasures of exercise may wellbe enjoyed during their pursuit after knowledge. Extremesshould be avoided, and when really tired rest was a necessity,for fatigue implies diminution of the physico-chemical changesconnected with the evolution of force. In some states,movement, exercise and massage may be useful; in others,air, fresh air, or change of air, more of nature’s medi-cines, as are also heat, electricity and light ; the lastof these having been experimentally shown by the lecturerto produce some very singular effects in connexion withsunburn. Lastly, the lecturer said that we come to theconsideration of the administration of medicines. Here

empiricism has hitherto been almost supreme, but, thanksto the sciences, clearer and more certain views are takingits place. Materia medica or the knowledge of the re-

medies employed in medicine has its divisions, its depart-ments, each and all being worked on scientific principles.Pharmacology is the knowledge of the mode of the actionof drugs upon the body generally and upon its various parts.Therapeutics imply the administration of remedies suitablefor the relief of particular symptoms in proper doses andproportions. Long and complicated prescriptions are to beavoided. Not a single drug ought to enter the body exceptunder clear intention of what object it is to fulfil there.Compounds may be good cookery, but do not form scientificmedicine. We cannot by any amount of training make aman distinguish himself in a subject to which he is by natureunfitted. Like a real artist the man must have" the touchof the finger of God, of the all-informing, all-creatingimagination. "

" There’s a divinity that shapes our ends,Rough-hew them how we will."

In conclusion, Dr. Bowles warned the students against mis-taken views of materialism. The "ars medendi " is practi-cally illimitable. In Bacon’s use of the term, it is coexten-

sive with the whole field of terrestrial nature and thestudents of the physical and biological sciences are emphati.cally the servants of nature. SirThoma.sBrowne, in his "ReligioMedici," tells us that nature is the art of God.’’ Do not ever bebewildered into supposing that there is any antagonism betweenreligion and science ; there is no such antagonism. Theman of science interprets the physical laws, and equally withthe teacher of religion tells us of the greatness and grandeurof the Creator. Every discovery of the scientist can onlytend to increase our wonder at the omniscience and perfec-tion of the ways of God.

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GUY’S HOSPITAL.INTRODUCTORY ADDRESS BY MR. A. ERNEST MAYLAED.

MR. MAYLARD, after expressing his appreciation of thehonour which he felt had been conferred upon him inasking him to come from Glasgow to deliver the openingaddress, proceeded in the course of his remarks to speak ofthe value of cultivating a spirit of inquiry. He said he con-sidered it one of the best attributes possessed by a studentand one of the best faculties to maintain throughout life."We needed nowadays, more perhaps than at any previousperiod, to cultivate an attitude of mind which was ever seekingto know the truth. Our profession was one which was pecu.liarly handicapped in the matter of advance. It was so

easy to promulgate a principle or theory, but so difficult tobe certain that its basis was sound. It was true enoughthat we spoke of the science of medicine and surgery,and yet we could not speak of the science of humannature. It was too variable in its formation and functionto admit of the framing of general laws. Hence trueadvance was often hindered by the innumerable practicesfounded on some false theory or inculcated on insufficientgrounds. One, perhaps, of the commonest errors to which wewere addicted was that of generalising from a too limited fieldof experience, assuming, for instance, that what proved suit-able or successful in one or two individual cases would effecta like result in all others. Again, we were often apt toforget that within the greater part, if not within the wholeperiod of its existence, the human body had a constantinherent tendency to return to a certain normal standard, andwe were apt to assume that measures adopted by us effectedresults which in reality were due to nature’s own work. Howshould we then as inquiring students contend with thesedifficulties; or what should be our attitude in respect tothem ? If we constantly cultivated and exercised a spirit ofsearching inquiry we should, in the first place, ourselves notbe ready to make assertions which we honestly felt had notyet stood the test of a sufficiently extended experience; andin the second we should not be over hasty in adopting everynostrum that is put under our nose, every treatment we readabout, without being first fully satisfied as to the veracity ofthe statements made or the merits of the claims advanced,"To illustrate more fully and graphically how a student shouldexercise and cultivate his faculty of inquiry, Mr. Maylardproceeded to picture in imagination a case of a wound dressedantiseptically. The practical treatment of such a case wascarried out with the most elaborate details, formed on a verysimple principle. The questions which the inquiring studentwould ask were whether every detail of the procedure was anaccurate fulfilment of the conditions required by the principle,did every agent employed effect the result desired It waspointed out that in view of the rapid development of thescience of bacteriology many new theories and practicesbased upon them were and would be sent forth into themedical world. But every inquiring student should becautious in not accepting too hastily conclusions which amore careful and prolonged consideration may prove afterall to be based on some false or mistaken theory. Inconclusion, Mr. Maylard said : "If the faculty of inquirywas to be exercised to its fullest advantage in our pro-fessional life, it must be cultivated to an equal extent in allour relations to the world around us. It should form asmuch a part of our religion and our politics as our profession.It was hardly possible to think of a man as a bigotedsectarian, a purely party politician or a rampant advocate ofany sect or subject, whose mind had been broadened and hisviews extended, by a searching inquiry into the subject atissue. Dogmatism in any shape or form was not an attributethat belonged to the followers of our profession. It indicateda limited, not an extensive, knowledge. It is for us ever tobe seeking and making each truth as it is found, not the limitof our inquiry but the basis for the discovery of another."