xt7mgq6qzr8v https://exploreuk.uky.edu/dips/xt7mgq6qzr8v/data/mets.xml Caldwell, Charles, 1772-1853. 1834  books b92-217-30936341 English s.n.], : [S.l. : Contact the Special Collections Research Center for information regarding rights and use of this collection. Medical education Kentucky. Transylvania University. Thoughts on the impolicy of multiplying schools of medicine  / by Charles Caldwell. text Thoughts on the impolicy of multiplying schools of medicine  / by Charles Caldwell. 1834 2002 true xt7mgq6qzr8v section xt7mgq6qzr8v 











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  AN invitation from the Lexington Medical Society, united
to the restless and increasing desire, manifested by a few phy.
sicians, to have one or two new Schools of Medicine erected
in Kentucky, has elicited the following remarks on the sub-
  It may not perhaps be unworthy of notice, that the eager-
ness referred to is of recent date, and has possession chiefly
of some of the junior members of the profession, who are
known to be anxious to attain notoriety, by being elevated
to the rank of official teachers; and who cannot conceal the
fact, disguise it as they may, that they are scheming,under
cover, for their own benefit, not working openly for that of
the public. Most assuredly, for reasons to be rendered here-
after, no motive for their conduct, founded in considerations
of public good, is yet perceptible. All that appears has a
leaning toward self. Nor, in the present posture of the mat-
ter, is it deemed a violation of either truth or delicacy to add,
that it would disclose, in those individuals.a becoming sense
of the relations they bear to the object of theirambition, and
to the enlightened community of the West and South, were
they to wait patiently, until a few more years of study and
experience should have given a fulleF measure of knowledge
and maturity to themselves, before aspiring to the responsible
office of publicly imparting instruction to others.
  It is one of the serious evils of the tirre, that boys are too
solicitous to attain the standing and privileges of men, and
that those who are still in the crudeness of early manhood,
are equally solicitous to usurp the high places of life, not by


                         [ 4 ]
the instrumentality of their superior fitness for them, but by
urging their supposed claims to them, with superior boldness
and pertinacity. Let it not be imagined that we intend, by
these remarks, any censure on young men for attempting to
gratify a laudable ambition. Far from it. The attempt it-
self is laudable, provided it be made, by a becoming use of
honorable means. But those who discredit the morning of
life, by unfounded pretensions, studied artifice, or presump-
tuous effort, prove themselves unworthy of the stations they
aspire to. Not so however with young men, who reach posts
of distinction and trust, by justly deserving and honorably
seeking them. Their merit is the greater, because they are
  The irregular and we might well add unnatural condi-
tion of things, here complained of, is often as strikingly man-
ifested in medicine, as in any of the other walks of society.
Yet in no other perhaps is its impropriety so obvious, or its
effects so pernicious. If ample experience, soundness of
knowledge, and maturity of judgment are necessary any
where, it is in the mental resources of those, who publicly
minister to the health of the people. Having no settled
precedents to guide them, as is the case in the other two
learned professions, their dependence is on themselves. It is
much to be lamented, therefore, that physicians by no means
remarkable for the qualifications just enumerated should
so far overrate and forget themselves, as to grasp at the post
alluded to, and struggle to reach it, with a degree of vehe-
mence, that would be unbecoming in those most highly qual-
ified-and which indeed the qualified never exhibit. Their
self-respect and consciousness of meriting it forbid them.
The deportment of the deserving is modest and dignified.
They wait until their own acts have rendered them conspic-
uous, before they seek for factitious distinction; and then
they seek it, if at all, delicately and 'inoffensively. To men of
an opposite character, whose object is personal aggrandize-
ment, and who cannot attain it by modesty and merit, nature
having branded them with her stamp of mediocrity-to men
of this cast belong the bluster and obtrusiveness, and all the


                          [ 5 ]
sinister machinations of place-hunting. If we forbear to
name a few physicians, to whose conduct this picture applies,
it is not because they are not known to us. Should any
therefore discover their own likeness in it, they cannot
charge the fault to us. We are as free to sketch a character
s they are to act it. We but copy the original.
  It need scarcely be observed, at this enlightened period of
the world, that Schools of Medicine are institutions of peculiar
importance. Not only are the interests of science concern-
ed in them; they involve the health, lives, prosperity, and
happiness of millions, and, by the doctrines they teach, and
the practices they establish, throw their influence into dis-
tant ages. We feel, even now, more or less of the influ-
ence of the schools of Greece. Such institutions ought not
therefore to be either hastily founded, orin any way lightly act-
ed onor dealt with. They should be erected only after mature
deliberation, and from public motives; and those motives should
be, broad necessity, or a fair prospect of correcting faults, and
efecting improvements. The selfish passions of envy, resent-
ment, disappointed ambition, or the desire of distinction of a
few individals, should have no concern in their establishment.
Nor ought mere locality to have any influence in it, except
so far as it may afford advantages, not to be elsewhere so easi-
ly obtained. And when a medical institution already establish-
ed, has been so administered, for a series of years, as to have
gained -reputation and standing, by the extensive and ac-
knowledged good it has done, no measure should be adopt-
ed, except from public considerations of great weight, to em-
barrass its proceedings, or check its prosperity.-It is not be-
lieved, that from enlightened and public spirited men, free
from bias, these views will be likely to encounter any sen-
rious opposition. We shall take leave of them, therefore,
and offer a few others, which we trust will be found to be
equally valid.
  Though it is known to the public, at least in a general way,
what a school of medicine is,it is notwithstanding believed,
that, by premising a brief description of one, we shall be


                           [ 6]
enabled to render some of our views the more intelligible
and definite. It is therefore that we give it. A school of
medicine is an institution, in which the knowledge of the
Profession is taught in various modes. The chief of these
are, public lectures, experiments, and demonstrations, an op.
portunity to form an acquaintance with the standard works
in medicine by reading, conversation, and public and private
examinations. The school is also invested with authority
to confer medical honors, under the title of degrees.
  That it may be fitted to communicate information, in these
several ways, with benefit to its pupils and the public, and
credit to itself, the institution must possess a corresponding
variety of suitable means. Besides buildings adapted to its
different purposes, it must have a sufficient number of well
qualified Professors-men, who are not only rich in their
possession of the proper kind of knowledge, bat happy in
their mode of imparting it, both orally and in wvriting; add to
this a library competent in size, and judiciously selected, a
full suit of chemical apparatus, and an anatomical museum,
with other facilities for communicating instruction in the lat-
ter branch of science.  With these resources, adminis-
tered with sufficient ability and skill, the school must neces-
sarily do much good, and acquire reputation. Without
them, it cannot fail to prove discreditable in itself, degrade
the profession it ought to exalt, and endanger the lives of the
community, by sending among them, to take charge of their
health, a tribe of superficially educated physicians. Hence,
in founding an institution of the sort, the first thing to be done
is, to furnish it with the requisite means to instruct.
  That the Medical School of Transylvania possesses the sev-
eral provisions and fitnesses here enumerated, will not be
denied, by those who are qualified and unprejudiced judges.
In their suitableness to their several purposes, her buildings
are not surpassed, by those of any similar institution in the
United States; of her Faculty, as a body, the competency
has never been called in question, but has been spoken of in
terms of high commendation; her library, large already, and


                             [ 7 ]
yearly increasing, is one of the best selected in the country,
many of its works being of uncommon value; and the chem-
ical apparatus, and anatomical museum, with other provisions
in the latter line, are amply sufficient for all the experiments
'and demonstrations requisite in teaching. In making these
provisions, to which there is nothing comparable, west of the
mountains, and which, in real usefulness to a medical class,
are perhaps not surpassed -in any, and in but few instances
equalled, by the means and arrangements of the Atlantic
schools, near thirly-five thousanl dollars have been expended.
.'But it is believed that a brief recital of what the School
of Transylvania has done, will be at once its justest and
highest encomium. It has been in operation. fourteen years,
in which  time it has instructed near three thousand pupils,
from seventeen or eighteen States of the Union, and conferred
degrees   on  about   seven  hundred.    Nor are the practi-

TR ANSYLVANIA.-This institution has been in operation fourteen years, the ,ff-
pound;eenth course of lectures in it being now in progress. According to its Record.
book, its classes, and the degrees conferred by it, have been as follows:
      YEARS.                NO. OF PUPILS.       NO. OF DEGREES.
      1819-20                    37                       7
      1820-1                     93                      1
      1821-2                    138                      37
      1822-3                    171                      51
      1823-4                    200                      47
      1824-5                    234                      57
      1825-6                    281                      65
      1826-7                    190                      53
      1827-8                    152                      53
      1828-9                    206                      40
      1829-30                   199                     81
      1830-1                    210                     so
      1831-2                    215                     74
      1832-3         3                                  69
      1833-4                    262
  TotaL                        2810                    699
  It is believed, from this view of it, that, for its vigorous prosperity, and the
rapid increasase of its classes, the Medical School of Transylvania is without
a parallel. Certainly, in tho United States, there is nothing comparable to it.
At the commencement of the present century, when the Medical School of
Philadelphia had been in operation about forty years, it did not number more,
we believe, than 200 hundred pupils. It now contains about 400-3umor says


                            [ 8 ]
tioners it has formed, whether in medicine or surgery, infe-
rior to any of their age in the country. To the truth of
this, experience testifies. For the last eight or nine years,
it has been, in numbers, the second medical institution in
the United States; and, throughout the Mississippi Val-
ley, where it is best known, we believe its reputation has
been equal to the first. It appears to us, therefore, that we
may safely add, without rendering ourselves obnoxious to the
charge of boasting, that Kentucky has just reason to be
proud of the school she has founded. It has doubtless been
more creditable to her, among her sister States, than any of
her other seats of instruction-perhaps we might have said
than all of them united. Drawing pupils, as it alone does,
from every corner of the West, there is no improper assump-
tion, in calling it the SCHOOL OF THE WES-T. Nor is the
whole amount of its usefulness, to its parent State, yet reci-
ted. By the pupils it has educated from other States, it has
borught into Kentucky a large sum of money-at least from
fioe to six hundred thousand dollars-perhaps more-a liberal
bonus for the charter it holds. In a word, it has done its du-
ty, and not only met, but greatly surpassed public expectation.
These facts have never been denied; nor can they be, con-
sistently with truth.
   Out of the foregoing view of things arise one or two ques-
tions, which seem worthy of a brief and candid examination.
   1. Does the public interest call for another School of Med-
icine in the State of Kentucky
   2. If not, is it consistent with good faith and sound policy,
 in the Legislature, to authorize the establishment of one

 a few more. In thirty-three years then, that school has added about 200 to its
 classes; while, in less than half the time, the school of Traneyvania hasformed a
 class of 262.
 This isthe highest eulogy the institution can receive. The most elequent
 and forcible language in praise of it, would be spiritless and feeble, contrasted
 with the power of the foregoing figures. And the same fiPres constitute the
 most cogent and conclusive argument, that man can urge, against an unneces-
 sary attempt to injure it.


                          [ 9 ]
   To these questions it is believed that satisfactory answers
can be given; and,when given, it is further believed, that they
will render the general subject better understood, than it
appears to be at present. We shall consider them in the or-
der in which they are proposed.
   1. Does the public interest call for another school of med-
cine in the State of Kentucky T
  From no view of this question which we are capable of
taking, and we have examined it attentively, is any reason
perceived for answering it affirmatively. Nor do we believe
that any exists. On the contrary, every consideration that
bears on it, has a negative aspect.
  All the youth, desirous of medical knowledge, whether be-
longing to the State of Kentucky,or coming from other States,
who present themselves to the School of Transylvania, are
instructed and treated generally, we believe, to their satisfac-
tion. We have certainly heard of no'complaints from them,
on any score, beyond what some few make of all schools, and
which will be made occasionally of every school, that human
wisdom can erect, or human talents and industry administer.
The misfortune, in these cases, iS, that the complaints of the
few, whom nothing can satisfy, are too often received, as
the complaints of the many, who approve in silence. Nor is
it unimportant to add, that the fault-finders are usually
among the least intellectual and respectable members of the
school. If they murmur or condemn, on account of not re-
ceiving knowledge, the defect is in themselves-tbeir want
of capacity or want of industry-or both.
  Boarding and subsistence arc furnished to the young gen-
tlemen, in Lexington, at a cheaper rate, as is confidently be-
lieved, than they can be procured, equally good, in any oth-
er city of the United States. Do any of the pupils fall sickt
They are faithfully attended and prescribed for, by the Fac.
ulty, without charge, and affectionately nursed, by the fami-
lies in which they reside.
  Not only are the lecture rooms spacious and convenient,
but so warmed and ventilated, as to be pleasant and of a


                          [ 10 J
suitable temperature, in all sorts of weather. Five of the
Professors meet their classes, each six times in the week, and
the sixth nine times, the entire Faculty delivering weekly thir-
ty-nine lectures, and occasionally extra ones. This is believ-
ed to be a heavier service than is rendered, by the same num-
ber of Professors, in any other medical school in the Union.
Besides being briefly examined several times every week, du-
ring the sessions of the school, each pupil, on presenting
himself for a degree, having previously attended two cours-
es of lectures, and prepared and submitted to inspection a
written Thesis, sustains a strict examination of an hour.
The terms on which the young gentlemen procure books
from the library are liberal and easy; and there is opened to
them a free access to the Professors, for a solution of such
difficulties as may occur to them, in their studies. It may
not be amiss to observe, that matriculation and the use of the
library, which,in the medical school of Philadelphia, cost the
pupils fifteen dollars, are afforded to them in the school of
Transylvania, for fice dollars. Nor is this all. In the library
used by the Philadelphia school, there are no text books, each
pupil being obliged to purchase those he wants, or do with-
out them; while several hundred dollars have been expend-
ed, in the purchase of text books for the Transylvania libra-
ry. In fact, no exertion is spared by the Faculty of Tran-
sylvania, to render the instruction imparted as rich and va-
ned, and, at the same time, as inviting to the pupils as possi-
ble. And, as already stated, the result is, that no physicians
of their age, in the United States, have higher professional
reputations, or are more successful in their practice, than
those who are educated in the SCHOOL OF THE WEST. These
several statements are matters of record. It does not ap-
pear therefore, that either the interest of Kentucky, or that
of the western States generally, calls, at present, for the
establishment of another medical institution.  To say the
least of it, the work necessary for the completion of the en-
terprise would be superfluous, and the requisite funds ex-
pended to no purpose of public usefulness.


                         [ 11)
  Is it alleged that the erection of a rival school would render
the Professors of Transylvania more faithful and strenuous
in the discharge of their duties To make the most of this, it is
but a conjecture; and it is believed to be a mistaken one.
The Professors are and always have been urged to their du-
ty, by their knowledge of its importance, by a settled per-
suasion that the faithful performance of it would redound to
their honor and advantage, and secure to them the approba-
tion of their own consciences, and by their sense of the deep
responsibility it imposes. A dread of being surpassed by oth-
ers has had no place among their motives. It is believed
that were they the only public medical instructors west of the
mountains, they would act precisely as they do now. This
belief is sustained by their strict devotedness to their duties,
when they had no western rivals. We say "western rivals;"
for they have always had, in the schools east of the moun-
tains, rivals sufficient to urge them to their duty, were such
an incentive necessary. They well know, that if their lec-
tures fall below the lectures delivered in the schools of the
east, the young men of the west will repair to those schools
to receive instruction. Hence they give their whole time to
their classes, during the sessions of the school, and much of
the intervals to the improvement of their lectures; and were
they surrounded by rival institutions, they could do no more.
That competition is useful in many things, is not denied. But
it will appear hereafter,that, in the present case, any further
western competition, instituted immediately, would be a
source of mischief. We are no general defenders of what
are called monopolies; but the reverse. Neither can we
however unite with those, who denounce them altogether.
Though wrong and injurious in most cases,they are useful and
necessary in some. The copy-right of a literary work, and
the patent-right for a work of art are monopolies, while they
last. But they are absolutely necessary to the encourage-
ment of genius. An incorporated company to construct a
a turnpike or rail-road, or to form a canal, is a monopoly.
Yet it is often essential to the public welfare. Nor are there


                          [ 12]
wanting other enterprises of great usefulness, that would not
be embarked in, except under the sanction of special privi-
leges. All that has been said and written about monopolies
in teaching medicine is mere cant. With as much proprie-
ty might invectives be uttered against the exclusive posses-
sion, which a man claims in the affections of his wife, or a
woman in those of her husband. No monopoly, in the ex-
ceptionable meaning of the terms is wished for, in the busi-
ness of medical instruction. The desire is to save that bu.
siness from degradation. And it requires but little penetra-
tion to foresee, that if such an arrangement be not maintain.
ed, as to secure a comfortable subsistence to those who en-
gage in it, it will never be conducted by competent men. It
will pass into the hands of sciolists and smatterers, and be-
come an object of disrepute.-Admitting it proved, then, as
we trust it has been, that the public interest does not re-
quire another school of medicine, in the State of Kentucky.
  2. Is it consistent with good faith and sound policy, in the
Legislature, to authorize the establishment of one
  This question divides itself into two branches, to each of
which, as appears to us, the answer should be negative.
For the following reasons, we consider the faith of Kentucky
virtually pledged, not to countenance the erection of an-
other medical school, except at the call of actual necessity,
or to attain some object of great utility.
  The school of Transylvania being a State institution, the
Trustees are State officers. Their legal acts therefore, as
such, are binding on the State. On the invitation of those
officers, in their corporate capacity, three physicians aban-
doned their business and establishments, in three distant
States, one in Pennsylvania, another in Virginia, and the
third in Tennessee, and repaired to Transylvania, to become
Professors in it, and stake their reputations and fortunes, and
the subsistence of their families on its prosperity. A fourth
physician removed, on the same ground, and under similar
circumstances, from a remote part of the State of Kentucky.
Of the six medical Professors then, in the school of Transyl-


                          [ 13]
vania, four came to it at heavy pecuniary sacrifices, on the
invitation of the State, and, as they firmly believed, on its
virtually pledgedfaith, that, as long as they should continue
to perform their duties, as teachers, to public satisfaction,
nothing would be unnecessanly done by legislative authority,
to injure the institution, and perhaps ruin them. To strength-
en the case, they came without fixed salaries, depending en-
tirely on the income from the institution, to reward them for
their first sacrifice, and subsequent labours. Had they been
salary officers, whose pay would continue, though the school
might dwindle, the whole complexion and nature of their
engagement with the State, and their relation to it, would
have been different. Under such circumstances, the erection
of another similar institution, however prejudicial to the
Profession and the public, would have been no material vio.
lation of faith toward them. But, in the existing condition
of things, the reverse is deemed true.
  Suppose the four Professors from a distance, or either of
them, had been told, that, in from two or three, to six or
seven years, from the time of their election, the State would,
without any reason founded in public necessity or public
good, but merely to gratify a few disappointed or discontent-
ed and aspiring physicians, authorize the erection of a rival
institution, within seventy miles of Lexington, would they,
at the hazard of all they were worth, have accepted the in-
vitation to become teachers No certainly. The proffered
honour, connected with probable ruin, would not have re-
ceived from them a second thought. Thefirst would have
been to reject; and it would have beenfinal. And if a rival
institution be now erected, to divide the interests and patron-
age of the State, and the profits of teaching, it does not re-
quire a spirit of prophecy to foretell, that no physician of
standing will ever hereafter quit his distant home and thriv-
ing establishment, to unite his fate with the fortunes of Tran-
sylvania. Vacant chairs must, in time to come, be filled
from Lexington, or some adjacent place. There being no
longer presented even a probable reward to balance a certain


                         [ 14]
sacrifice, ageneral selection from the States will be precluded,
and none but adventurers without character, can be drawn
from a distance. It is not our intention, in these remarks,
to underrate, or in any way disparage the talents or attain-
ments of the physicians of Lexington, or of any portion of
the neighbouring country. Far from it. We know the re-
spectability and worth of many of them, and cherish a due
regard for their characters. It will not however be denied,
that the wider the sphere, from which Professors may be
drawn, to fill vacancies, the greater must be the probability
of procuring able ones. Nor is the converse of this less
true, but stands as an axiom, which no one will dispute.
  Under this head another consideration might be urged
with no little propriety and force. One of the original foun-
ders of the Transylvania school of medicine came to it from
a distance, and is still in it. He resorted to it on an expe-
riment deemed by every one uncertain and hazardous. The
current of opinion was decidedly against the probability of
success. Ile joined his colleagues, and commenced his la-
bours, with a very small class, and corresponding profits.
For several years, the remuneration received by him was
decidedly below the labours encountered, and the expenses
incurred. But did he evade his duties or falter in his exer-
tions Let those answer the question, who are familiar with
the origin and progress of the institution. In the course of
time, and by the labours of the Faculty, the school having
attained its present standing, is it consistent with the prin-
ciples of either generosity or justice, to diminish its classes,
lop its honours, and reduce its income, without even the sem-
blance of a public reason, to gratify the ambition and per-
baps the resentment of physicians, who performed not a
solitarv act in erecting it The school of Transylvania has
given the tone to medical. teaching in the west, and render-
ed it fashionable, and an object of desire. Is it honorable
or manly then, in individuals, who have had no hand in pro-
ducing this condition of things, to avail themselves of it, for
their own personal benefit alone, and to the injury of those


                          I 5 3
to whom the public are indebted for it Would it not be
much more to their credit, as well as ultimately to their
benefit, to devote their time to increasing their stores of
knowledge, and accomplishing themselves in the modes of
communicating it, that they might become well qualified to
fill the vacancies that time must necessarily create in the
school Were these questions submitted to a court of hon-
our and conscience, the reply to them would not be doubtful.
And we hold the people of the west and south to be such a
  Another, and perhaps a simpler and clearer view of this
subject may be presented. The Trustees of Transylvania
University, we repeat, called from a distance four of the
present Professors, to the chairs they occupy in the Medical
department. Suppose these Trustees had themselves the
authority to found another medical school, would it be con-
sistent with good faith in them to do so, to the injury or ruin
of faithful and competent officers of their own creation, with-
out an absolute necessity for the act, or some certain and
important public benefit to be derived from it Certainly
it would not. Such a measure would be a palpable infraction
of a solemn compact, unless a condition to that effect had
been originally expressed.  But, the Trustees being the
representatives of the Legislature, in this matter, their of
cial acts are binding on the State.
  For the foregoing reasons, we are compelled to believe,
that between the State of Kentucky and those Professors of
the medical school of Transylvania, who were called from
remote places, a sacred compact exists, the tenor of which
is, that, as long as the latter shall acquit themselves of their
duty, to the reasonable satisfaction of all who have an in-
terest in it, the former will not causelessly and seriously injure
them. Should they fail in their duty, from incapacity or oth-
erwise, the remedy is plain. Let them be dismissed, and
their places filled with abler incumbents. But even under
these circumstances, no good reason is perceived, why the
school should be crippled, by the establishment of another.


                          [ 16]
One medical school is not only enough for Kentucky now,
but will continue so, for a century to come-perhaps much
longer. When the pupils of the west shall have become too
numerous for the two schools now existing in it, additional
ones will be erected by other States, to supply the demand.
It is the interest of Kentucky therefore to unite her means
and energies, not divide them. The former measure will
strengthen, while the latter would enfeeble her.
  As respects the policy of erecting another medical
school in the State, we are strangers to any thing calculated
to recommend it. In our opinion, it is exclusively unwise.
That it would lower the tone of medical education, and the
general standard of the Profession throughout the State,
cannot be doubted, by any one, who has a competent knowl-
edge of the subject. This it would do by rendering medi-
cine comparatively a trivial pursuit, lessening its honours
and emoluments, and ultimately consigning it to an inferior
class of men. Talk as we may of disinterested benevo-
lence, patriotism, philanthropy, and an abstract love of scib
ence, it is only talk.  That profession, which insures the
highest reward, and the most distinguished reputation, to
those engaged in it, commands the highest talents, and, from
the constitution of human nature, will continue to do so.
The well known fact, that young men, who are most abun-
dantly gifted, generally resort to the bar, is proof of this.
Reduce the medical profession so low, in all respects, as to
bring it within the reach of the feeble minded, and it will
be soon overcrowded with smatterers in knowledge, and the
common handicraft trades will be preferred to it.
  To teach medicine by lectures, in such a way, as to em
brace and present all the necessary views and expositions in
it, and keep pace with the rapid advance of the science, is
an arduous task. It furnishes employment sufficient for any
individual, whatever may be his industry, the strength and
readiness of his talents, or the measure of his attainments.
To learn to teach it perfectly, far from being, as some seem
to think it, the pastime of a few years, spent lightly, or in


                          L 17 i
the bustle of business, is the work of a lifetime, devoted to
study. A more palpable mistake cannot be made, than to
imagine, that, because a physician has acquired standing avid
popularity as a practitioner, and written a few respectable
essays, he is therefore competent to the business of teaching.
He who believes and asserts this has but a very limited
knowledge of the extent and depth of the science of medi-
cine, and of the difficulty of framing and maturing a con-
densed system of instruction in it. Merely to write essays,
and practice medicine successfully, are comparatively light
and circumscribed efforts, and do not, of themselves, evince
either great depth of research, strength of thought, variety
and richne