T. Clifford (Thomas Clifford) Allbutt.

On professional education, with special reference to medicine : an address delivered at King's College, London on October 3, 1905 online

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Online LibraryT. Clifford (Thomas Clifford) AllbuttOn professional education, with special reference to medicine : an address delivered at King's College, London on October 3, 1905 → online text (page 1 of 6)
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THE LIBRARY

OF

THE UNIVERSITY

OF CALIFORNIA

LOS ANGELES



N



Ex Lihris

SIR MICHAEL SADLER

ACQUIRED 1948

WITH THE HELP OF ALUMNI OF THE

SCHOOL OF EDUCATION



BY PROFESSOR T. CLIFFORD ALLBUTT.

Notes on the Composition of Scientific
Papers. Crown 8vo. 3s. net.

The Historical Relations of Medicine
and Surgery. Crown 8vo. 2s. 6d. net.

LONDON: MACMILLAN AND CO., Ltd.



ON PEOFESSIONAL EDUCATION



' ' La puissance de I'tducatimi coiisistc A aiigmenter
le Tunnhre des motifs dans V esprit de I'vidividu."

hlTlRt.



ON

PEOFESSIONAL EDUCATION

WITH SPECIAL REFEEEXCE TO MEDICINE
AN ADDRESS

DELIVERED AT KING'S COLLEGE, LONDON
ON OCTOBER 3, 1905



BY

T. CLIFFOKD ALLBUTT, M.A., M.D., F.IJ.S.

HON. D.SC. OXOX., ETC. ETC.

REGIUS PROFESSOR OF PHYSIC IN THE UNIVERSITY OF CAMBRIDGE



ILontion
MACMILLAN AND CO., Limited

NEW YORK : THE MACMILLAX COMPANY
1906

All rights resen-ed






PREFACE

The request for the publication of this Address is
so general that I trust it may prove on reflection
to be not unworthy of its great theme. I have
ventured to publish the wliole of the manuscript, of
which about two- thirds was delivered.

My thanks are due to the editors of the Lancet and
of the British Medical Journal for their excellent
reports, of which I have ventured to avail myself.
I am indebted also for valuable information to the
columns of these and other professional journals of
various dates, and finally to Dr. Squire Sprigge for
his book on Medicine and the Public (Heiuemann,
1905), which indeed was published after the date
of my Address at King's College, but is based upon
his thesis for the degree of M.D. at Cambridge, of
which I had official cognisance.

As these sheets are finished for the press, we
are all bereaved of a leader in University and
State education, and of a great personal teacher ;
not a few of us of a dear friend. I have now
learned tliat Sir Kichard Jebb addressed the British



623093



vi ON PEOFESSIONAL EDUCATION

Association in South Africa on the subject which was
occupying our thoughts about the same time at King's
College. If my argument, however imperfectly, be
in concord with his (I have not yet seen his Address
even in abstract) I shall be grateful, — grateful to
be a humble servant in a cause in which he was
so illustrious a master. Had he lived he would
have read my words with indulgence ; I dare not
dedicate so slight an offering to his memory.

T. C. A.

Cambridge, Deceynher 11, 1905.



ON PROFESSIONAL EDUCATION^

GentlemI'^n — When the distinguished iuvitatiou
of yovir Medical Board to open this session was
conveyed to me, my responsibility was lightened by
a proposal of the subject of my address — namely,
Medical Education in London. London, like every
other great centre of education, has its own problems
and its own difficulties, but these problems and
these difficulties cannot be solved without the
illumination of the principles which are true for
education everywhere and always. If in England
these principles are little heeded by the public,
and if accordingly secondary education in England
is in grievous defect, it is not for want of preaching.
From Matthew Arnold and Michael Sadler to the
humble empiric who ventures into the pulpit to-day,
of preachers there has been no lack. If I am quali-
fied to deal with the subject yet again, it is that
all my adult life I have been engaged in teaching,
in centres so different as Leeds and Cambridge, and
ought from such conflict of conditions to have

^ An Address delivered at King's College Hospital, under the
title of "Medical Education in London," on October 3, 1905, the
opening of the Medical Session.

B



2 ON PEOFESSIONAL EDUCATION

harvested some wisdom. If without the added
dignity of my office I should scarcely dare to
address you, on the other hand I must beware lest
I give an official colour to my opinions, lest
I seem to engage my University in doctrines which
it may have no mind to. Cucullns non facit
mo7iaclium ; whatsoever then may be inconveniently
said by the professor pray write down quickly
to the account of the individual. This at least I
may plead, that I will say nothing lightly ; my
convictions are not of yesterday.

Education and instruction. — Education, as
contrasted with instruction, is a drawing forth of
faculties, a quickening, enlarging, and refining
of them when brought out, and an establish-
ment of them in habits ; so that virtue and reason
become easy and pleasant to us. The word is
used of mind rather than of morals, or of the
powers of the body; but by mind we signify both
intellect and imagination, and their issue in right
action. The more complex the organism can become
the more stable it will be, the more it will be in
touch with outward contingencies ; the more it can
use and modify these conditions, the more will be
the play at the periphery of the organism, the
more, in a word, the life. Education, then, is not
the formation of a rigid framework, but of a
capacity for ideas and for various and supple
adaptations. But, speaking generally, and within
civil societies, individuals vary more than circum-
stances, in other words, out of similar circumstances
individuals draw widely different advantages; so that



ON PKOFESSIONAL EDUCATION 3

although up to a certain period of life education
may be laid out on broad indiscriminate lines
proper for all young persons, yet for adolescents
by rapid decrees it must become more and more
diverse and several, dividing itself into the educa-
tion of classes, of groups, and of individuals. Now,
such specific or technical educations are difficult
only in the sense of the difficulty of persuading
the English parent of the value of any education
whatever ; the ends and the methods are pretty
clearly seen ; the means it is which are wanting,
the means of money, of equipment, and of time,
which is money, and the provision and endowment
of those engines for making knowledge, called
universities, without which sources the technical
colleges would soon dry up.

The problem of education in modern England
is that of general schooling, of ascertaining the
modes which shall prove most valuable to put
each person during his youth in touch with the
sum of conditions under which he is to lead the
best life possible to him ; this done he may the
more efficiently be adapted to specific or personal
functions. Although these personal and specific
conditions are never so narrow and so specific as
to prevent some occupation with those wider
conditions which were held in view during his
general education, yet without a somewhat fuller
sense of the sum of the conditions of life he cannot
measure the relative values of things ; he will, as
we say, lack common sense. Now the larger and
more copious the ideas the more difficult are they



4 ON PROFESSIONAL EDUCATION

to handle, the more difficult it is to order them in
their relative values, that is to say, with " common
sense," for this quality is the easier the meaner the
range of thought. When the ideation is high some
defect of common sense is readily forgiven. The
importance of a universal training of the instrument
of mind, before the adaptation of it to special engage-
ments, will be better understood when we realise that
truth is neither wholly without us nor wholly within
us, but is a function of fact and temperament.
Now temperament is partly native, but largely also
the creature of habit, and habits — such as the
habit of virtue and of comprehensive and precise
thinking — are the creatures of education, and
especially of education in the plastic years of life.
Thus the man whose mind has been built up on
universal lines, whatsoever his calling, is enabled
to free himself from the conventions and temporary
notions of the mere " practical man," to distinguish
the important from the unimportant truths, and to
drop swiftly upon cardinal features — upon the facts
which matter.

Secondaky education. — Now — to begin with
secondary education — to teach every boy every-
thing is obviously impossible ; the difficulty is
so to select certain things from the whole of
things as best to educe universal conceptions or
ideas. That we liave been successful in creating
such a general education no one will be hardy
enough to assert. From our public schools our
young men derive many fine qualities. As
Herodotus says of the Persian youths, they are



ON PROFESSIONAL EDUCATION 5

taught to ride and to speak the truth ; and, indeed,
when our country loses its manliness and its
veracity it will lose all things. But these fine
qualities do not meet the sum of conditions under
which the Englishman has to live ; he has to do
more than to speak and to act with spirit and
uprightness, and to read the sporting papers with
intelligence. If he is to be equal to the conflict
of modern life he must be able to reason both on
man and on nature, to measure his own capacities, to
read the hearts and habits of men, and to foresee
the trend of natural laws. For these ends, besides
energy and will, he must have a curiosity for know-
ledge, some intellectual seriousness and flexibility,
some endurance of attention, some self-possession,
and some ideas : qualities eminently in defect in the
average products of our public schools.

That the seeds of these qualities are within us
we may know by this that they are far more evident
in young women, who do not go to public schools ;
and in the long run not brains only but morals also
depend on these more generous features. Too many
of our manly and honest young fellows fall into a
good-natured, well-mannered selfishness ; into acqui-
escence in common standards; into contentment with
very scanty mental furniture. If, then, the public
school does much for our boys, it is at the cost of
certain virtues. The faults of which I have spoken
depend in part on a weakening of the family life
and of the family bond, with a consequent loss of
much of the variety and many of the gentlenesses
which are nurtured in the home, and with an



6 ON PEOFESSIONAL EDUCATION

aggravation of caste distinctions. The American
common schools, which do not break into the home,
and which bring classes together, have in this
respect a great advantage over our own. I think
no " educationalist " has noted how much our public
school system depends upon a foolish horror of
dialects, an intolerance unknown in France and
Germany. Even in our own kingdom the Scotch
and the Irish tongues are acceptable ; but in England
for a father to permit his son to associate with the
lads of his province so as to catch the dialect, of
Yorkshire, let us say, or of Suffolk or Somersetshire,
is, as things are, to consent to his social failure. A
Frenchman and an Italian may drop h's with im-
punity, but the English boy who does it will find
advancement closed against him. In this respect
our public schools thrive on a folly. With the outcry
against athletics I have little sympathy : it is not the
athletics which do harm, but the publicity and the
noise of them. If the University Boat-race and
the " Eton v. Harrow " cannot be helped, no other
public school or university games should be the
sport of the public.

The salient defect of the boy, as he leaves school,
is his subservience to a wooden routine or conven-
tion which seems there to be perpetuated, and
prolongs the imitative stage of childhood into early
manhood. It is sad to see a lad with a frank,
bright, affectionate habit — nn hon naturcl — falling
under this awkward compound of self-distrust and
self-consciousness, which is, I think, peculiar to the
English youth, and generates a reserve which.



ON PEOFESSIONAL EDUCATION 7

although consistent with modesty, is not modesty.
Its nature is not easy to read, and the subjects of
it are least able to read it; but it appears to be
no chrysalid stage before a transformation, but the
negative posture of minds deficient in ideas, and
ungainly in the use of the few they have. It comes
in great part, I think, of what we may call, as truly
as paradoxically, tlie secluded life of the public
school. The tendency of the units of all aggregates,
if not animated and developed by external provoca-
tions, is towards the mean position ; that is, in the
public school, to the monotonous pattern of Smith
major. By the crust of this custom the boy's
initiative is palsied, his manners are embarrassed,
and he has not moral courage to express himself
frankly — ' lest he give himself away ' as he calls it,
lest this precious convention, which he admires in
Smith major, be disturbed ; so he tries to put on a
cloak of indifference in which he is absurdly untrue
to himself. With the spirit of Greek he is as deeply
imbued as with Chinese.^ Now unhappily this frost

^ After the return of the revise sheets of this tract to the
printer that delightful book the Upton Letters came into my
hands. I cannot forbear to despatch one short extract from it,
though I am well aware how it puts my poor argument into
the shade. Yet is tliere not in the last sentence a note of
dispirited acquiescence, a want of vehement revolt, which makes
one think perhaps we need other schoolmasters, and need them
different ? Or are the Upton Letters the ironical smile of a man
about to spring ?

" I declare that it makes me very sad sometimes to see these
well-groomed, well-mannered, rational, manlj' boys all taking the
same view of things, all doing the same things, smiling politely
at the eccentricity of anj^ one who finds matter for serious interest



8 ON PEOFESSIONAL EDUCATION

sets in at the plastic age when mental expansion
and freedom of thought and emotion are most
precious, and in the shell of it the youth withdraws
himself from the influence of men from whom he
might be led to a wider outlook. In those who
come under more generous and formative influ-
ences, as in a university for example, this shell
begins to chip, in Cambridge usually by the end of
the second year of residence ; then, discovering his
own mind and character, the unit becomes a person,
and often a very interesting person, one no longer
tired at the very notion of continuous thought. If,
on the other hand, the youth passes into common
society undisciplined by any such influences, as the
reserve of the school cloister gets rubbed off, his
scantiness in ideas, contentment in stereotyped
phrases and purposes, and intolerance of all mental
effort, intellectual or imaginative, lie exposed and
untransformed. Thus but too often men reach
the prime of life common -minded, incapable, and
even intolerant of ideas, that is of large and

in books, in art, or music : all splendidly reticent about their
inner thoughts, with a courteous respect for the formalities of
religion, and the formalities of work : perfectly correct, perfectly
complaisant, with no irregularities or angular preferences of their
own, with no admiration for anything but athletic successes, and
no contempt for anything except originality of ideas. They are
so nice, so gentlemanly, so easy to get on with, and yet, in
another region, they are so dull, so unimaginative, so narrow-
minded. They cannot of course be all intellectual or cultivated,
but they might be more tolerant, more just, more wise. They
ought to be able to admire vigour and enthusiasm in every
department instead of in one or two, and it is we who ought
to make them feel so, and we have already too much to do."



ON PROFESSIONAL EDUCATION 9

systematic couceptious of present and coming events ;
and consequently are incurable empirics, and have no
higher philosophy than that of muddling through.^

Compulsory Greek. — It was mainly because of
the dialectical and mechanical methods of it, and of
its exclusiveness, that I joined those in Cambridge
who opposed " Compulsory Greek," a liberal move-
ment arrested once more, as the old story goes, by
reactionary clergy. The current teaching of Greek
and Latin is a parody of education ; not only does
it restrict the range of teacher and pupil, but the
imaginations of both are stunted. Until they begin
grammars — begin them, that is, without any appre-
hension of the language and ideas of which the gram-
mars are arid abstractions — the bent of children is
quick and real ; but under this inculcation their
imaginative conception of reality begins to wither,
and its place is taken by formulas, rhetorical words
and philological bones ; their fancy is discouraged,
and they discover that, after all, things are not in-
teresting. As research keeps science-teaching alive,
so classical training, if divorced from history, litera-
ture, and philosopliy, must starve. That such teach-
ing of Greek will be changed from within I see no
sign ; never in any age have reforms in education
come from the schoolmaster, but from new conditions
and demands in an enlightened society ; the school-
master has always been not the reformer but the
reformed. There is no state so perilous as that

^ To " muddle " is to mop up etlects without analysis, apprecia-
tion, and government of causes — to act, for example, as we are
now doing with the "unemployed."



10 ON PEOFESSIONAL EDUCATION

in which things seem good to us, and at present in
England the schoolmaster is complacent, the public is
indifferent.^ In the sixteenth century the humanist,
lacking in the historic sense, believed the literatures
of Latin and Greek to contain all that could be
useful to man in all departments of life ; as
the medievalist believed that the sources of
knowledge were to be found not in origins
but in disputations. Yet the medievalist, in his
zealous search for a universal idea, a unifying
cause, or a key to the world's secrets, aimed at a
complete cultivation of all fields of knowledge ; and
in the early renaissance the classics were welcomed
not so much as language and philology but as the
sources of new ideas. Gradually, however, edu-
cational like ecclesiastical machinery closed in upon
and stifled the spirit which created it. Now, by a
curious inversion of things, the scientific study of
facts is the lever by which liberal culture has been
reawakened, and we are beginning to see that the
ideas and methods of natural science, instead of
being merely curious or commercial, are, if not the
flower of education, at any rate the stem and
branches. Though analysis can never be form, it
is by scientific methods that the new power is
entering into letters and philosophy ; for as we ob-
serve fully and accurately we must soon begin to
select, and then the imagination must conspire to
suf'gest the directions in which truths may lie. As

1 It is fair to add that in tlie Perse school at Cambridge
Dr. Rouse seems to be creating a new method and awakening
new interests in his classical pupils.



ON PEOFESSIONAL EDUCATION 11

the poet must liave his own organising intelligence,
so the man of science must grow his own visions.

Development of imagination. — And yet in
most schools, if not in all, far from an amalgamation
of science and letters, these hemispheres of educa-
tion are cleft asunder. The school is cleft into
a " modern " and an antique (?) side : as if all
education were not to be modern, as if there could
be two essentially different ways of educating boys !
I question if there are three headmasters in England
who govern and inspire their " modern side," to say
nothino- of so co-ordinatincj letters and science that
eacli shall supplement the other, and both unite in
fertility. And on both " sides," while the memory is
exercised, and the intellect somewhat called upon,
the imagination, the centre of creative life, the
source of great action, is left out in the cold.

One of the ablest of our headmasters said to
me that if he were called upon to educate the
imaginations of his boys he would scarcely know
how to begiu.^ By some thoughtful men it is said
that a contemplation of the " laws " of nature
suffices to kindle and feed the imagination ; that a
study of gravitation, for example, of the theory
of ions, or of natural selection, has this effect ; an
opinion which even in the adult I hesitate to
support. The imaginative or making faculty of

^ In his address to the Royal Society on November 30, 1905,
Sir William Huggins lamented the failure of modern education
to foster the sentiments of wonder and admiration. I ought
here, however, to recall the admirable training of the young
imagination by the plays at Bradfield College.



12 ON PROFESSIONAL EDUCATION

man is fed, not by abstractions or summaries of
analytic processes attained by observation from tlie
outside, but by images ; not by watching things but
by living in them. To be in love and to trace the
psychology of lovers are in polar difference. Baude-
laire touched the heart of the matter, if with im-
perfect truth, when he said, " It would be prodigious
for a critic to become a poet, but it is impossible for
a poet not to contain a critic." Tlie greater the
images — creations and deeds — the more intense the
life in them, the stronger the imagination. A sense
of natural order has its impressiveness, but scarcely
makes the glory and dominion of the heavens as
did the belief, chimera as it was, that stars bore in
their orbits the fate of kings or of men unborn.

Some consequence yet hanging in the stars
Shall bitterly begin his fearful date.

By scientific analysis, it is true, we disintegrate
the imperfect images of the past, such as those of
astrology, and clear the ground for new ideas ; but
the laws thus discovered are not the new ideas : no
theory of colours will make a Titian. By calling his
ultimate analysis, his remotest abstraction, a syn-
thesis, Spencer hoodwinked us all : such is the
power of a word.

Specialisation. — In the discussion of educational
problems we hear much of the baneful effects of this
process, and have worked ourselves up into an alarm
about it. Yet is it not better that a young man
should know something well, should realise what
knowledge costs to get, and learn to look below



ON PEOFESSIONAL EDUCATION 13

superficial plausibilities, than pride himself on
acquirements, general enough no doubt, but general
in their vagueness, shallowness, and inaccuracy ?

Too often, indeed, with this rather ugly noun we
console ourselves for our ignorance of some depart-
ment of knowledge with which we find another
person is conversant. Yet surely by what gate
soever we enter into the kingdom of nature and
man, by the East or by the West, by the North or
by the South, her kingdom is boundless in domain,
sensitive in every direction, and in riches inexhaust-
ible. If then the " specialisation " be narrow the
contraction is not in nature herself, but in the mind
of teacher, or of pupil, or of both of them. A uniform
development of all the faculties, as we have seen,
can belong only to the earlier stages even of school
life; the abilities of the older boy as he matures
will, if he is worth much, betray a bias in one or
more directions ; and I am satisfied that if the two
main coefficients of mind — the intellect and the
imagination — are fostered, it proves best in the end
to promote development in each person on the
lines of his own nature.

To whip up the weaker faculties to keep pace
with the stronger, hinders these and really forces
the weaker to little ultimate purpose ; whereas to
promote a generous growth of the more powerful
gifts of the individual mind so enlightens and
animates the whole that subordinate faculties are
drawn onward with the rest. Otherwise the march
must be set at the rate of the slowest factors. In
adolescence and at the university the same principles



14 ON PROFESSIONAL EDUCATION

hold good. A youug man who in certain directions
begins to feel his strength is encouraged ; and
by mastering the subject or subjects for which he is
best adapted, he forms as he progresses truer and
truer conceptions of what knowledge is, and what
methods are ; and will not fail by this measure to
test and to call into play such other faculties he may
possess. As I have already insisted — it is not so
much what a man is taught as hoio he is taught it ;
but I will reiterate the compensatory truth which is
most neglected, that there is one kind of "specialism"
which to some men is ruinous, and is mischievous to
all ; namely, to cultivate apart either intellect or
imagination. " Specialise " each as you please, but
do not sunder them, nor neglect either of them.

The power of ideas. — When we declare, as


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Online LibraryT. Clifford (Thomas Clifford) AllbuttOn professional education, with special reference to medicine : an address delivered at King's College, London on October 3, 1905 → online text (page 1 of 6)