William Hamilton.

Discussions on philosophy and literature, education and university reform. Chiefly from the Edinburgh review; cor., vindicated, enl., in notes and appendices online

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Online LibraryWilliam HamiltonDiscussions on philosophy and literature, education and university reform. Chiefly from the Edinburgh review; cor., vindicated, enl., in notes and appendices → online text (page 75 of 94)
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pubHc, and inteUigent Enghsh pubhc, appears from the plain; (
spoken evidence of an able and well-informed witness, of whom; |
the Visitors do not communicate the name. It is well worthy of ;
the reader's serious attention; and the result is, that the Edin-, !
burgh medical degree was then regarded in England as nothing
else (alas !) than a fraud upon the nation. And what, now ?

"It is argued, — that the demand for the highest rank in Medicine is
limited, and that to many the possession of it is of no value. Granted. But
is that a reason for increasing the supply? Is that a reason for sending
forth Doctors by hundreds every year? Is it not um-easonable to argue, —
that because the demand for medical men of the highest rank is limited, the
University of Edinbm-gh ought, therefore, to have the privilege of conferring
that rank, with a facility that multiplies the number beyond the demand,
and degrades the distinction it is meant to convey ? One would suppose,
fi'om this line of argument, that Edinburgh College had been so chary of the
honoiu's it has to bestow, that, small as is the existing demand, it was not
effectually supplied from Scotland. But the case is precisely the reverse.
The complaints against the Scotch Univei-sities are — that they supply a
gi-eater number of Doctors than the wants of society require — that they
manufacture a baser article than Oxford and Cambridge, aiSx the same
stamp to it, and introduce it in such quantities into the market, that the
whole cargo is depreciated, — and when their coinage happens to be of ster-
ling worth, that its value is lessened by the plated and Brummagem articles
that have issued fi-om the same mint. - - - - To what extent the demand
of higher qualitications for medical honours at Edinburgh College might
affect the pecuniary interests of its Professors, I am not prepared to say;
but I am sure it would raise the value of then- Diplomas, and settle beyond
a doubt the real merit of their School of ]\Iedicine. I am far from wishing
to underrate the Edinburgh Professors ; but I must be permitted to remark,

* The Faculty, however, annulled all attention to the truth which they thus
spoke, by requesting that a compulsory attendance on their own classes in a
University should be the test of the literary competence " indispensable" in
the medical gi-aduate. They open their petition by saying: — "• They feel it
to be a duty they owe to the Univei-sity and the public, not to allow the pre-
sent occasion to pass without endeavouring to render the degree more respec-
table aud more dignified than it has hitherto been ; and now that the Senatus, ^
in their bouiidless liberality^ have agreed to accept of certificates of attendance ' I
on self- constituted teachers, they will not, it is presumed, be less indulgent to ' I
the radical professors in Universities, who were originally constituted to lay ; •;
the foundations of general knowledge, and to prepare the youth for all the • t|
learned and liberal professions," Ac, &c. (Ev. I. 142.]) \



that under thoir proseut system of conferring degn-es, tlie niiinhur of students
that flock to them for instruction, is no more :i test of the viilue of their lec-
tures, tliau tiie resort of young couples to Gretna Green is a proof of the
piety of the Blacksmith who gives them his nuptial benediction. - - - .
But though some men go to Edinbiu-gh in order to obtain a rank in their
profession, which they could not otherwise acquii-e, and to whicii from tiie
deficiencies of their education, and the mediocrity of their attainments, they
have no right to ])retend, the great majority of students go to learn their
profession ; and where they are well taught, there they will go, Avhether they
expect to be decorated with degrees or not. If the Edinburgh Professors do
their duty, and in comparison with other teachers are duly (jualitied to afford
instruction, they may lose graduates, but they will not lose students by the
change. - - - - On the supposition that a higher and better educated
rliss of medical practitioners is wanted, to a certain but to a limited extent,
wo are asked, — How is that class to be supplied? AVhat sort of education
i- to be required from those who aspii-e to it ? Ought there to be a different
^iuiulard in Scotland from that which is used in England; ought, in short,
I he Scotch Professors to be suffered, at their discretion, to enrol natives of
Lilliput and Bi'obdignag in the same regiment, and send them with certifi-
cates to Loudon, testifying that they are of the same size, and qualified to
(serve in the same company?" — (Ev. I. 145.])

And Edinbui'gli complains, that her (pooriKol arc not admitted
imong the x«e/e»T£? of the London College ! — But we have been
ielayed too long from the opinion of the Visitors themselves.

" On the subject of the Preliminary Education which should be required
»f candidates for Degi-ees in Medicine, we have had much deliberation, and
d^ 'Cceived a gi-eat deal of evidence. It has appeared to us to be a matter of
nreat importance, that the persons Avho are to practise Medicine should be
lien of enlightened minds, accustomed to exercise their intellectual powers,
.nd familiar with habits of accurate observation aud cautious reflection ; and
]pM hat they shoidd be possessed of such a degree of literary acquirement as
lay secure the respect of those with whom they are to associate in the exer-
ise of their profession. We therefore thought it an indispensable (lualifica-
ion for a Medical Degree that the individual should have some i-easouablo
,.r Icquaintance with the Greek aud Latin languages, aud with Matiieniatics and
'liilosopliy ; and though strong doubts have been expressed by many of the
Ictlical Professors as to the expediency of rendering this an essential coudi-
11, ft'oni an apprehension that it might prevent many persons from taking
■ benefit of the instruction in Medical Science to be obtained ui the Uni-
rsities, we have found our opinion on this point confirmed bi/ even/ one of
ii- eminent Physicians and Surgeons, not belonging to thi' Universities,
liom we examined, as well as by some of th j Medical Professors them-
Ives; v.hile we have also been fully satisfied, by a due consideration of the
utter itself, and of the evidence before us, tlsat there is no solid ground for
10 apprehensions entertained." (Gen. Rep. 5(5.)
Those of the medical professors interested in tlio liighrr lunu-
•I- and lowor qnality of degrees were, liowover, averse iVdiii sucli


preliminary discipline ; and the following is the comment by tb
Visitors on the attempted reasoning of these professors. — An<
first as to the inutility, maintained, of liberal learning for ;
physician : —

" The amount of this would seem to be, that literature is a positive ev
to a Physician ; that it unfits him for the habits and state of mind which h
ought to cultivate ; and that it will be an obstacle to his success in practict
It is difficult to conceive that the learned Medical Faculty could hav
intended to go so far as this ; but it is plain that there is much fallacy in th
assertions, for it can scarcely be called reasoning, which they here adduce
It is unquestionably true, that if a man were to devote himself, in the man
ner stated, to Literature and Science, making these the chief, or almost tb
exclusive objects of his pursuit ; he would not be a good Physician : but thi
is not at all what is intended ; the sole object being, that a Physician shoul
have that liberal education which is implied in a course of University attend
ance. By acquiring this, the mind would be invigorated for any intellectui
pursuit, and it could superinduce no habit disqualifying for the activity (
exertion, or for mingling in society as a medical man must do. Such educa
tion also, it is to be remembered, would be completed, or nearly so, befoi
medical pursuits commenced, certainly long before practice was atteraptec
and would not therefore have the effect which is here supposed." (Rep. E(

Next, as to the effect, argued by the Medical Faculty, that a'
elevation in the standard of Doctoral competency would be fo'
lowed by a reduction in the number of Doctors. On this tlr
Visitors remark : —

" It is thus represented, that because, which is undoubtedly true, tbeii
are men who pi-actise with little or no literary attainment, the general ton
of the profession should be lowered, or at least that no attempt should t
made to elevate it, because the expense being thus increased, the number (
enlightened Graduates would be diminished, and practice would be surrei,
dered, much more than it is, to those of inferior qualifications. But th '
reasoning is far from being conclusive. There is, it is to be lamented, to
great a disposition in many to prefer quackery to sound J\Iedical Science-
and by those who do so, the literature of medical men Avill not be held i,
much estimation. But as no one would contend that, on this accoun
quackery should be prefen*ed to knowledge, upon the same ground it woul;
seem that want of literatm-e should not be preferred to learning. In fact, tli'
preparatory education for which some contend, does not interfere in tl
slightest degree with the medical ; it only tends to make the practitioner ^
more enlightened man." (Rep. Ed. 188.)

For myself, I am however inchned to think, that wore tli
Degree in Medicine raised in Edinburgh to its ancient and legit
mate literary eminence, (though the profession might then attrac
many whom it does not now.) the nuntbcr of Kdinbuvoli oraduatc,



!'* would be greatly decreased. But so it ought. The present pi-npor-

'V tion is, in truth, not honourable to the University, and useless, nay

™'| pernicious to the public. The effect, 1 repeat, is, — to deprive the

j nation of what a University was privileged to secure, — an ascer-

m I tained class of liberally educated physicians ; for thus the highest

^rgrce is reduced to a level with the lowest licence, the only dif-

. rence being, that more has been paid for the higher name, and

that the larger price has gone into different pockets. By the

loduction of the j)hysician to an unlearned practitioner, it is not

Medicine only, as a hberal study, which has suffered ; it is not

..Illy that the bodies of the lieges have been turned over to the

murderous confidence of ignorant dogmatics (See above p. 252).

The learning of its medical profession is a foot in the tripod of a

country's erudition ; and this foot being broken, the whole tripod,

that is the whole professional and liberal learning of a country,

loses a principal support. (See above, p. 333, sq.)

The Visitors then proceed to adduce, in support of a Ubcral
education in the medical graduate, the evidence of the three phy-
sicians, at the time, of the highest professional reputation in this
rity, — Dr John Thomson, Dr Abercrombie, and Dr Davidson.
The first two are well known as authors ; I therefore quote only
the opinion of the last, whom all who knew, admired, not only for
his rare medical skill, but for his great general talent and most
varied acquirements,

" The first poiut I would remark on is Preliminary Ediic ation. The first
subject that attracted my attention, in reflecting upon the Education of
Medical Graduates, was that of Preliminary/ Instruction^ for which but very
slight provision is made in the Statuta Soleunia of this University, an
ao/iuaintance with Latin being only required ; whilst the means, till lately,
iiiployed to ascertain the proficiency of the Students, even in that language,
i'l not appear to be the best suited for the purpose. I cannot help thinking
that more extensive literary and scientific education should be required from
'hose who mean to take out a ^Medical Degree, as extensive as can reason-
ably be expected in young men of seventeen or eighteen, at which age the
-tudy of ^Medicine will probably commence. I conceive that the branches of
Preparatory Education should be Greek, Latin, French, and Mathematics ;
wliiLst Natural Philosophy, Logic, Moral Philosophy, and Natural History,
may be acquired, either before beginning the study of Medicine, or may be
attended to along with the Medical Classes. I presume, that, though Natu-
ral Philosophy, Logic, and Ethics, will probably be studied, either at this
'•r some other University, Languages, with Mathematics, may be acfpiired
wherever such instruction can be procured ; and that the proficiency of the
Students in those branches of knowledge may be certified cither liy Dipln-
iiiits, Certificates from respectable Schools or Academies, or Ity Iheii- undrr-


going au Examinatiou by the Professors of this University. If I were asked Mi
the reasons for recommending a more extensive Preliminary Education forH
Medical Graduates, I should be puzzled, not from the difficulty of discover- ■■/
ing them, but from the fear of that ridicule which attaches itself to advancing ||
arguments in favour of au opinion which is so manifestly correct as to
require no support. A preliminary Scientific and Literary education appears
to be the best, if not the only proper preparation of the youthful mind for
entering upon the study of so extensive and ditficult a subject as Medicine,
where au immediate demand is made for close attention, much discrimination,
and an acquaintance with many subjects not strictly Medical. Experience
has convinced me that those Students whose minds have been previously
cultivated, make the most steady and rapid progress in their new pursuits,
which are much less difficult to them than to those who are totally unscien-
tific and deficiently educated. I know, besides, that it is a common subject
of regret amongst most Physicians, as it is with myself, that they did not
make use of youth, leisure, and opportunity, in laying a broad and deep
foundation of general knowledge, on which to rest their Medical acquire-
ments. I may be permitted to add, that were I not convinced of the neces-
sity for a liberal education, preliminary to the study of Medicine, I should
surrender my doubts to the authority of much wiser men, in England, Ire-
land, France, Germany, and Italy, by whose influence it has been established
in the Medical Schools of those countries ; nor should I be inclined to sub- i
mit less willingly to the decision of the Faculty of Arts in this College, who
strongly recommended a preparatory education for the Medical Graduates,
in a Memorial presented, I believe, to the Senatus Academicus (which I had
the advantage of perusing). A competent knowledge of Greek appears to
be requisite for the Medical Students, fi-om the fact that much of the lan-
guage and terminology of Anatomy, Medicine, Botany, &c., is derived from
that language, not only from 'the Greeks having been our earliest masters la
many of the sciences, but also for the sake of convenience, from such terms
being short, expressive, and explanatory, and ill supplied by the tedious
circumlocutions of modern tongues. With these terms, of constant occur-
rence both in lectures and in books, the uneducated Student cannot fail to
be puzzled ; and he must either content himself with ignorance of their
import, or bestow much time, and suffer no very agreeable fatigue, in hunt-
ing out their etymology. Independently of all these reasons, it appears to '
me, at least unseemly, that the members of a learned profession should
be ignorant of the language in which those wrote who w^ere their original
instructors, and whose works are still, after the flight of ages, by no means
unworthy of serious and attentive perusal. It seems, moreover, peculiaiiy
unfitting that the Magnates of the Medical Profession (those who have
acquired either real or imaginary dignity from Degrees, to which some pri-
vileges belong,) should not possess the standard education of gentlemen, nor
be able to take that, station in societj^ which a cultivated intellect is entitled j
to assume."— (Rep. Ed. 180, Ev. I. 503.) I

The Visitors then go on to say : —

" There is much other evidence to the same eff'ect ; but it is suflicient to !
point out the leading views upon the subject ; the particular giounds of !


opiuion it would be impossible, within the limits of this Report, In detail.
f" The oonclusiou to be deduced seems unquestionably to ho. decidedly in jhvuur
(if a superior Prelititimtry Education to that tcliich is now required. Tliis
can be obtained, apparently, without the slightest hardship: the more ele-
mentary parts of it being procured previously to the commencement of
medical stutlies, and the more advanced during the prosecution of those stu-
dies ; an arrangement which it is in evidence could without difficulty be made.
It would thus not be essential that there should be the Degree of JNIaster of
Arts, but merely that there should be an acquaintance ^\ith the learned lan-
guages and other branches of knowledge ; aud by combining with the I\Iedi-
cal Classes what can be acquired only at a University, the residence in
Edinburgh would not be prolonged. The character of the Medical Profes-
sion would thus be much raised, and provision made, as has been already
stated, for spreading throughout the country enlightened and well-informed
men, who might be instrumental in increasing to a great degree the advan-
tages to be derived from social intercourse, Avhile they would have access to
sources of enjoyment peculiarly valuable in the sequestrateil situation in
which many Medical Practitioners must spend the great part of life." — (Rep.
Ed. 189.) '

To conclude this part of the subject : —

We have here two diametrically oppo.sitc opinions. On the
one side, against the demand of a liberal accomplishment in the
jiliysician, we have six out of the seven holders of an academical
monopoly, a body strongly and exclusively interested in the
creation of medical graduates, at the lowest qualification, and in
the greatest number. On the other side, we have the authority
of all Universities out of Scotland, and of the luhole disinterested
intelligence, in this and every other country, professional and non-
[irofessional, intra and extra-academical. The Medical Faculty —
tlie monopolising body — of this University, spoke, I doubt not,
inly as it thought. But as the opinions of men in general, are,
u general, only a reflex of their interests ; so it is difiicult even
nr a mind, however vigorous and independent, to resist the mag-
lotic influence, as it were, of the ordinary minds with which it
nts in consort : and thus is to be explained, the otherwise inex-
plicable fact, that men of high intelligence and the most upright
ntentions are so often found engaged in the championship of mca-
ures, which, had they acted of and from themselves, they would
utellcctually and morally contemn. In fact, from individual mcm-
'■rs of the Medical Faculty, and their personal accomplishments,
light be drawn a signal manifestation of the fallacy of its con-
unct Report. But this is needless. As Ilobbes has well observed :
-Were it for the profit of a governing body, that the three
iiglcs of a triangle should not 1)0 equal to two right angles, the




doctrine that they were, would, by that body, inevitably be
denounced, as false and pernicious. The best, certainly the most
curious, examples of this truth, are, indeed, to be found in the
History of Medicine,— and of medicine, too, when yet a learned
and philosophical profession. For this, on the one hand, ist
nothing else than a marvellous History of Variations : and, on the
other, only a still more marvellous history of how every suc-
cessive variation has, by medical bodies, been first furiously
denounced, and (though always laughed at by the wiser wits)'
then bigotedly adopted. Homoeopathy and the Water Cure are,i
now and here, blindly anathematised as heretical; in the next'
generation, it is not improbable, that these same doctrines may be
no less blindly preached, as exclusively orthodox. — Such is poor
human nature ! Such is corporate, such is medical authority !

The next point is the Examination for medical degrees. On
this the Visitors thus report : —

" The Examination for Degrees in Medicine have hitlierto been conducted'
by the Members of the Medical Faculty, exclusive of the Professors of the)
Medical Classes recently instituted by the Crowi, and each Candidate has
been required to pay a sum of Ten Guineas, which is divided equally amongi
the Examining Professors.

" We are of opinion that this system is liable to very serious objections.
The emoluments of the Professors who examine ought not to depend on the
number of Candidates for Degrees. At present the fees drawn by the several
Professors from this source are very considerable, in consequence of the great'
number of Candidates ; and it appears from the evidence that the number of
Degrees conferred has been continually increasing diu'ing many years, in a^
proportion much greater than corresponds to the rate of increase in the num-i
ber of Students attending the Medical School of Edinburgh.

" No explanation has been given of this extraordinary increase in the
number of Degrees, and we are satisfied that it cannot be accounted for fi-om
any external causes. We are of opinion that the present system has a neces-
sary tendency to render the Examinations less strict than they might other-
wise be, and practically to lower the standard of qualifications in the estima-
tion of the Faculty. It is, besides, scarcely to be doubted, that there mnst
be a natural reluctance in Professors to reject Candidates, to many of whom
the fees paid to the Examiners may be a very serious sacrifice. Although
most of the Professors in the INIedical Faculty entertain opinions adverse to
any extension of the subjects of examination, and are strongly impressed
with the idea that the importance and value of the University as a School of; Ij
IMedicine ought to be estimated by the number of the Degrees annually con
ferred, an entirely diflferent opinion has been strongly expressed by all thej'
other Physicians and Surgeons whom we have examined, being persons veryi
extensively engaged in the practice of their profession. It should seem to
us, that the value of the Degree must bear a proportion to the nature of the




qualifications required for it ; and we have already observed, that it does
not appear to us, that either the reputation of the University as a Scliool of
Medicine, or the number of Students resorting to it for instruction, will be
regulated merely by the number of those who may obtain Degrees. It has
never been found, in regard to objects of such importance in professional
ptirsuits, that the risk of fiiilure has tended in any degree to diminish the
number of those endeavouring to qualify themselves for attaining them." —
(Gen. Rep. 64.)

What is here said by the Visitors is most true.
As to their first observation : — Nothing can be more inconsistent
with every principle of academical policy than to make it tlie
private interest of an examiner to be remiss or perverse in the
performance of his public duty. But this is here done, and done,
among others, in three ways. For, in the circumstances of the
Edinburgh medical examinations : it is, 1°, made directly tlic
i, I interest of the examiner, to pass as many, to reject as few candi-
es, as possible ; 2°, it is made indirectly his interest, to allow
SXtra attendance on his class to compensate for deficiency in the
'xamination;* and 3*, he is enabled to exercise w^ith impunity,
lis favour or disfavour in the passing or rejection of any candi-
late. — Theoretically, this examination is thus utterly vicious ;
leither is theory here contradicted by experience. f

Xor is their second observation less correct. As to the large-
less of the relative number of Medical Degrees granted by the
^niversity of Edinburgh: — this, so far from being, in my opinion,
natter of honour and satisfaction, should, in the circumstances,
ause only humiliation and regret. For it exhibits nothing but
lecline ; — dechne in the number of medical students, — decline in
he requirements of examination, — decline in the qualification of
he candidates. Comparing the first decade of the present half

Online LibraryWilliam HamiltonDiscussions on philosophy and literature, education and university reform. Chiefly from the Edinburgh review; cor., vindicated, enl., in notes and appendices → online text (page 75 of 94)