DOCTORS AND CULTURE.
1.,\T E have read the lectures delivered this year at the have of the Medical Schools with a certain regret. One of them, Dr. Manson's, on the rat as the great propagator of plague, may prove most useful, and all of them are full of thought and penetrated with philanthropic feeling, but we could wish to have seen more stress laid on the advantage of liberal culture to the whole profession. On the contrary, there was a slight disposition to undervalue it, or, rather, to inculcate a range of scientific study at once so extensive, so full of experiment, and so exclusive that little time would be left for the acquisition of general knowledge. The lecturers seem mentally overwhelmed by the flood of knowledge pour- ing in, and disposed to say, like some speculators in journalism, "Read the telegrams and never mind history." We cannot but think that this is a mistake. It is true that doctors have shared in the general advance of education, and that Bob Sawyer belongs to a past generation ; and it is also true that many of the chiefs of the profession are highly informed men ; but the rank-and-file still need a caution that power of thought is as valuable to a physician as experience, and that if he has to "mix his medicines with brains" the brains must be cultivated as well as the faculty of perception. The tendency is still towards a concentration of thought upon science, and especially science as applied to the cure of disease, which makes of doctors more of a caste than the members of any other profession, except the Navy. One of the great advan- tages of science, its extreme interestingness, which makes its devotees feel all other knowledge a little dull, increases this concentration, until, if literature has not taken a strong and early grip, it is likely to be neglected altogether. The "humanities," as they used to be called, seem tedious or use- less, and nothing that is tedious is ever studied with the best effect. That seems to us a misfortune at once for the corn- munity and for the profestdon. The community is utterly
dependent upon doctors, not only for help in time of accident or of disease, but for that instruction in hygiene which, as the world goes on, would become the only medical science in general use but that men are disobedient and grow old, and from both causes need occasionally advice which is not hygienic, and remedies which no mere hygienist can supply. To the victim of insomnia, for example, it matters little that the air is clean and the water pure and his food most nourishing; be needs something else, and what it is he rarely or never discovers for himself. The community, therefore, being dependent, needs doctors who are wide.minded and receptive, and capable of understanding the sick ; and those qualities, which are but different names for intelligence, in- terest, and sympathy, belong much more to the educated than to those who are only instructed. Nobody doubts that an able man will make a better doctor than a stupid one, and nobody in any other profession doubts that a wide general education at once develops ability and gives it edge. Yet many lecturers on medicine seem half to doubt whether general reading is not so much time thrown away, whether the whole youth of those who intend to be physicians ought not to be devoted to science and experiment, and whether, therefore, general University training is not much better avoided. The result is a certain latent cleavage between doctors and other educated men which is most injurious to both,—to the doctor because it thins alike his interests and his knowledge, to the others because they fail in the sym- pathy with medicine, which, if it existed, would doable the doctors' beneficial influence. We would ask any doctor whether when any epidemic is present, be does not find the difficulty of driving his ideas into the heads even of the educated almost maddening. There ought to be no difficulty at all, and would not be if doctors were trusted as other experts are trusted,—that is, implicitly. The reason for that is a certain difference in ways of thinking, produced by a difference of culture, which we contend ought not to exist. The doctor who convinces a graduate is the doctor who was a graduate himself, and while a graduate learned something besides anatomy and pathology. It is all very well to say that the doctor who cures you is the only doctor who is trusted, but the common experience of mankind tells a different tale. It is the doctor who cares you, and whom you feel to be your intellectual equal or superior, in whose ideas upon hygiene as well as medicine you place implicit trust.
The usual answers to the demand for a broad education for the whole profession are, we take it, three. One, and the subtlest, is that the mind predisposed to scientific inquiry is not, as a rule, interested in the humanities, and therefore wastes time in studying them. We should deny the force of the assertion even if it were undeniably true, as we should deny that a little good reading could ever be thrown away upon any minds, but we prefer to ask if the assertion is true. Are men of science so narrow-minded that they can acquire no knowledge of anything but facts and their correlation? The scientific men must know themselves best; but until they say so pretty unanimously we must consider the assertion no more true than the similar one that no mathematician ever could master Greek. The human mind is not cloven like that, nor are University lists so wanting in Double Firsts. The man of letters can learn anatomy just as he can learn mathematics, and the man of science can acquire letters or history just as he can acquire, and constantly does acquire, a knowledge of sciences which he will never put to any bene- ficial use. The medical profession does not want fools, and the man who is mentally strong can learn anything that he must, though naturally when there is no "must" he prefers to learn interesting things or things which pay. The notion that Huxley could not have learned Greek is nonsense, and one need not possess Huxley's powers to have, up to a certain point, capacities that are various. Then comes the objection of time, to which the brutal but perfectly true answer is that a man has always time to learn anything he wants to know, and that a man can study letters and science just as rapidly as science and mathematics. If he cannot he is not quite competent, and any system which automatically weeded out those who are not quite competent would be most beneficial to the medical or any other profession. And, finally, there is the very serious question of money. Do we mean, we shall be asked, to exclude from the profession all who cannot pay for a very expensive education, or do we think that men culti- vated as we suggest, in two branches of thought, will be content with the wages of country doctors ? The reply is, that we certainly intend to exclude nobody who is educated, and that the twofold education costs no more than the exclu- sive one, or costs at the utmost one more year of study ; and that as for pay, the better educated a man is, the better his chance of exacting decent payment. That doctors on the outskirts of cities, and too many country doctors, are infamously paid we readily and heartily admit, but one main reason of that is a certain want of consideration in the social sense, which is a consequence of the ancient tradition that they were not quite gentlemen. No idea could, as regards the majority, be now more false, and it is rapidly dying away, but the doctor remains the only man who is habitually swindled, whose charges excite a preposterous amount of annoyance, and who is put upon by "clubs" in a way which, if they tried it upon tradesmen, would produce an angry strike. We believe that this form of oppression, which could be a good deal obviated by a new system of payment, each patient paying a minute fee as well as his bill, is least in proportion as the doctor shows himself a thoroughly educated gentleman,—a character which the poor grasp with extraordinary rapidity. As for the ranks of the profession being unduly depleted by any such danger of want of income, we have only to say, and we say it with some sadness, that we do not believe any profession will be emptied by any prospect of poverty whatever. Education is too widely diffused, small incomes are too numerous, and, above all, the competition is too keen. Anyhow, the man of letters who is a doctor in a poor neighbourhood will be a happier man than the doctor who in all but the new scientific know- ledge, of which be must get something, is really closely allied to the "potticary " of a hundred years ago. We want the doctors even in the slums to be as educated as barristers, as devoted as the clergy, and as well paid as the publicans; and if the profession will but struggle for that ideal it will come.
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