It is difficult to imagine, at present, such a state of things, still more difficult to depict the consequences of it, because they would appear like a gross and malignant caricature; but it may be said that there was never a system, or want of system, which was better calculated to ruin the students who came under it, or to degrade the profession as a whole. My memory goes back to a time when models from whom the Bob Sawyer of the Pickwick Papers might have been drawn were anything but rare.

Shortly before my student days, however, the dawn of a better state of things in England began to be visible, in consequence of the establishment of the University of London, and the comparatively very high standard which it placed before its medical graduates.

I say comparatively high standard, for the requirements of the University in those days, and even during the twelve years at a later period, when I was one of the examiners of the medical faculty, were such as would not now be thought more than respectable, and indeed were in many respects very imperfect. But, relatively to the means of learning, the standard was high, and none but the more able and ambitious of the students dreamed of passing the University. Nevertheless, the fact that many men of this stamp did succeed in obtaining their degrees, led others to follow in their steps, and slowly but surely reacted upon the standard of teaching in the better medical schools. Then came the Medical Act of 1858. That Act introduced two immense improvements: one of them was the institution of what is called the Medical Register, upon which the names of all persons recognised by the State as medical practitioners are entered: and the other was the establishment of the Medical Council, which is a kind of Medical Parliament, composed of representatives of the licensing bodies and of leading men in the medical profession nominated by the Crown. The powers given by the Legislature to the Medical Council were found practically to be very limited, but I think that no fair observer of the work will doubt that this much attacked body has excited no small influence in bringing about the great change for the better, which has been effected in the training of men for the medical profession within my recollection.

Another source of improvement must be recognised in the Scottish Universities, and especially in the medical faculty of the University of Edinburgh. The medical education and examinations of this body were for many years the best of their kind in these islands, and I doubt if, at the present moment, the three kingdoms can show a better school of medicine than that of Edinburgh. The vast number of medical students at that University is sufficient evidence of the opinion of those most interested in this subject.

Owing to all those influences, and to the revolution which has taken place in the course of the last twenty years in our conceptions of the proper method of teaching physical science, the training of the medical student in a good school, and the examination test applied by the great majority of the present licensing bodies, reduced now to nineteen, in consequence of the retirement of the Archbishop and the fusion of two of the other licensing bodies, are totally different from what they were even twenty years ago.

I was perfectly astonished, upon one of my sons commencing his medical career the other day, when I contrasted the carefully-watched courses of theoretical and practical instruction, which he is expected to follow with regularity and industry, and the number and nature of the examinations which he will have to pass before he can receive his licence, not only with the monstrous laxity of my own student days, but even with the state of things which obtained when my term of office as examiner in the University of London expired some sixteen years ago.

I have no hesitation in expressing the opinion, which is fully borne out by the evidence taken before the late Royal Commission, that a large proportion of the existing licensing bodies grant their licence on conditions which ensure quite as high a standard as it is practicable or advisable to exact under present circumstances, and that they show every desire to keep pace with the improvements of the times. And I think there can be no doubt that the great majority have so much improved their ways, that their standard is far above that of the ordinary qualification thirty years ago, and I cannot see what excuse there would be for meddling with them if it were not for two other defects which have to be remedied.

Unfortunately there remain two or three black sheep—licensing bodies which simply trade upon their privilege, and sell the cheapest wares they can for shame's sake supply to the bidder. Another defect in the existing system, even where the examination has been so greatly improved as to be good of its kind, is that there are certain licensing bodies which give a qualification for an acquaintance with either medicine or surgery alone, and which more or less ignore obstetrics. This is a revival of the archaic condition of the profession when surgical operations were mostly left to the barbers and obstetrics to the mid-wives, and when the physicians thought themselves, and were considered by the world, the "superior persons" of the profession. I remember a story was current in my young days of a great court physician who was travelling with a friend, like himself, bound on a visit to a country house. The friend fell down in an apoplectic fit, and the physician refused to bleed him because it was contrary to professional etiquette for a physician to perform that operation. Whether the friend died or whether he got better because he was not bled I do not remember, but the moral of the story is the same. On the other hand, a famous surgeon was asked whether he meant to bring up his son to his own calling, "No," he said, "he is such a fool, I mean to make a physician of him."

Nowadays, it is happily recognised that medicine is one and indivisible, and that no one can properly practice one branch who is not familiar with at any rate the principles of all. Thus the two great things that are wanted now are, in the first place, some means of enforcing such a degree of uniformity upon all the examining bodies that none should present a disgracefully low minimum or pass examination; and the second point is that some body or other shall have the power of enforcing upon every candidate for the licence to practice the study of the three branches, what is called the tripartite qualification. All the members of the late commission were agreed that these were the main points to be attended to in any proposals for the further improvement of medical training and qualification.

But such being the ends in view, our notions as to the best way of attaining them were singularly divergent; so that it came about that eleven commissioners made seven reports. There was one main majority report and six minor reports, which differed more or less from it, chiefly as to the best method of attaining these two objects.

The majority report recommended the adoption of what is known as the conjoint scheme. According to this plan the power of granting a licence to practise is to be taken away from all the existing bodies, whether they have done well or ill, and to be placed in the hands of a body of delegates (divisional boards), one for each of the three kingdoms. The licence to practise is to be conferred by passing the delegate examination. The licensee may afterwards, if he pleases, go before any of the existing bodies and indulge in the luxury of another examination and the payment of another fee in order to obtain a title, which does not legally place him in any better position than that which he would occupy without it.

Under these circumstances, of course, the only motive for obtaining the degree of a University or the licence of a medical corporation would be the prestige of these bodies. Hence the "black sheep" would certainly be deserted, while those bodies which have acquired a reputation by doing their duty would suffer less.

But, as the majority report proposes that the existing bodies should be compensated for any loss they might suffer out of the fees of the examiners for the State licence, the curious result would be brought about that the profession of the future would be taxed, for all time, for the purpose of handing over to wholly irresponsible bodies a sum, the amount of which would be large for those who had failed in their duty and small for those who had done it.

The scheme in fact involved a perpetual endowment of the "black sheep," calculated on the maximum of their ill-gained profits. [1] I confess that I found myself unable to assent to a plan which, in addition to the rewarding the evil doers, proposed to take away the privileges of a number of examining bodies which confessedly were doing their duty well, for the sake of getting rid of a few who had failed. It was too much like the Chinaman's device of burning down his house to obtain a poor dish of roast pig—uncertain whether in the end he might not find a mere mass of cinders. What we do know is that the great majority of the existing licensing bodies have marvellously improved in the course of the last twenty years, and are improving. What we do not know is that the complicated scheme of the divisional boards will ever be got to work at all.

My own belief is that every necessary reform may be effected, without any interference with vested interests, without any unjust interference with the prestige of institutions which have been, and still are, extremely valuable, without any question of compensation arising, and by an extremely simple operation. It is only necessary in fact to add a couple of clauses to the Medical Act to this effect: (1) That from and after such a date no person shall be placed upon the Medical Register unless he possesses the threefold qualification. (2) That from and after this date no examination shall be accepted as satisfactory from any licensing body except such as has been carried on in part by examiners appointed by the licensing body, and in part by coadjutor-examiners of equal authority appointed by the Medical Council or other central authority, and acting under their instructions.

In laying down a rule of this kind the State confiscates nothing, and meddles with nobody, but simply acts within its undoubted right of laying down the conditions under which it will confer certain privileges upon medical practitioners. No one can say that the State has not the right to do this; no one can say that the State interferes with any private enterprise or corporate interest unjustly, in laying down its own conditions for its own service. The plan would have the further advantage that all those corporate bodies which have obtained (as many of them have) a great and just prestige by the admirable way in which they have done their work, would reap their just reward in the thronging of students, thenceforward as formerly, to obtain their qualifications; while those who have neglected their duties, who have in some one or two cases, I am sorry to say, absolutely disgraced themselves, would sink into oblivion, and come to a happy and natural euthanasia, in which their misdeeds and themselves would be entirely forgotten.

Two of my colleagues, Professor Turner and Mr. Bryce, M.P., whose practical familiarity with examinations gave their opinions a high value, expressed their substantial approval of this scheme, and I am unable to see the weight of the objections urged against it. It is urged that the difficulty and expense of adequately inspecting so many examinations and of guaranteeing their efficiency would be great, and the difficulty in the way of a fair adjustment of the representation of existing interests and of the representation of new interests upon the general Medical Council would be almost insuperable.

The latter objection is unintelligible to me. I am not aware that any attempt at such adjustment has been fairly discussed, and until that has been done it may be well not to talk about insuperable difficulties. As to the notion that there is any difficulty in getting the coadjutor-examiners, or that the expense will be overwhelming, we have the experience of Scotland, in which every University does, at the present time, appoint its coadjutor-examiners, who do their work just in the way proposed.

Whether in the way I have proposed, or by the Conjoint Scheme, however, this is perfectly certain: the two things I refer to have to be done: you must have the threefold qualification; you must have the limitation of the minimum qualification also; and any scheme for the improvement of the relations of the State to medicine which does not profess to do these two things thoroughly and well, has no chance of finality.

But when these reforms are witnessed, when there is a Medical Council armed with a more real authority than it at present possesses; when a license to practice cannot be obtained without the threefold qualification; and when an even minimum of qualification is exacted for every licence, is there anything else that remains that any one seriously interested in the welfare of the medical profession, as I may most conscientiously declare myself to be, would like to see done? I think there are three things.

In the first place, even now, when a four years' curriculum is required, the time allotted for medical education is too brief. A young man of eighteen beginning to study medicine is probably absolutely ignorant of the existence of such a thing as anatomy, or physiology, or indeed of any branch of physical science. He comes into an entirely new world; he addresses himself to a kind of work of which he has not the smallest experience. Up to that time his work has been with books; he rushes suddenly into work with things, which is as different from work with books as anything can well be. I am quite sure that a very considerable number of young men spend a very large portion of their first session in simply learning how to learn subjects which are entirely new to them. And yet recollect that in this period of four years they have to acquire a knowledge of all the branches of a great and responsible practical calling of medicine, surgery, obstetrics, general pathology, medical jurisprudence, and so forth. Anybody who knows what these things are, and who knows what is the kind of work which is necessary to give a man the confidence which will enable him to stand at the bedside and say to the satisfaction of his own conscience what shall be done, and what shall not be done, must be aware that if a man has only four years to do all that in he will not have much time to spare. But that is not all. As I have said, the young man comes up, probably ignorant of the existence of science; he has never heard a word of chemistry, he has never heard a word of physics, he has not the smallest conception of the outlines of biological science; and all these things have to be learned as well and crammed into the time which in itself is barely sufficient to acquire a fair amount of that knowledge which is requisite for the satisfactory discharge of his professional duties.

Therefore it is quite clear to me that, somehow or other, the curriculum must be lightened. It is not that any of the subjects which I have mentioned need not to be studied, and may be eliminated. The only alternative therefore is to lengthen the time given to study. Everybody will agree with me that the practical necessities of life in this country are such that, for the average medical practitioner at any rate, it is hopeless to think of extending the period of professional study beyond the age of twenty-two. So that as the period of study cannot be extended forwards, the only thing to be done is to extend it backwards.

The question is how this can be done. My own belief is that if the Medical Council, instead of insisting upon that examination in general education which I am sorry to say I believe to be entirely futile, were to insist upon a knowledge of elementary physics, and chemistry, and biology, they would be taking one of the greatest steps which at present can be made for the improvement of medical education. And the improvement would be this. The great majority of the young men who are going into the profession have practically completed their general education—or they might very well have done so—by the age of sixteen or seventeen. If the interval between this age and that at which they commence their purely medical studies were employed in obtaining a practical acquaintance with elementary physics, chemistry, and biology, in my judgment it would be as good as two years added to the course of medical study. And for two reasons: in the first place, because the subject-matter of that which they would learn is germane to their future studies, and is so much gained; in the second place, because you might clear out of the course of their professional study a great deal which at present occupies time and attention; and last, but not least—probably most—they would then come to their medical studies prepared for that learning from Nature which is what they have to do in the course of becoming skilful medical men, and for which at present they are not in the slightest degree prepared by their previous education.

The second wish I have to express concerns London especially, and I may speak of it briefly as a more economical use of the teaching power in the medical schools. At this present time every great hospital in London—and there are ten or eleven of them—has its complete medical school, in which not only are the branches of practical medicine taught, but also those studies in general science, such as chemistry, elementary physics, general anatomy, and a variety of other topics which are what used to be called (and the term was an extremely useful one) the institutes of medicine. That was all very well half a century ago; it is all very ill now, simply because those general branches of science, such as anatomy, physiology, chemistry, physiological chemistry, physiological physics, and so forth, have now become so large, and the mode of teaching them is so completely altered, that it is absolutely impossible for any man to be a thoroughly competent teacher of them, or for any student to be effectually taught without the devotion of the whole time of the person who is engaged in teaching. I undertake to say that it is hopelessly impossible for any man at the present time to keep abreast with the progress of physiology unless he gives his whole mind to it; and the bigger the mind is, the more scope he will find for its employment. Again, teaching has become, and must become still more, practical, and that also involves a large expenditure of time. But if a man is to give his whole time to my business he must live by it, and the resources of the schools do not permit them to maintain ten or eleven physiological specialists.

If the students in their first one or two years were taught the institutes of medicine, in two or three central institutions, it would be perfectly easy to have those subjects taught thoroughly and effectually by persons who gave their whole mind and attention to the subject; while at the same time the medical schools at the hospitals would remain what they ought to be—great institutions in which the largest possible opportunities are laid open for acquiring practical acquaintance with the phenomena of disease. So that the preliminary or earlier half of medical education would take place in the central institutions, and the final half would be devoted altogether to practical studies in the hospitals.

I happen to know that this conception has been entertained, not only by myself, but by a great many of those persons who are most interested in the improvement of medical study for a considerable number of years. I do not know whether anything will come of it this half-century or not; but the thing has to be done. It is not a speculative notion; it lies patent to everybody who is accustomed to teaching, and knows what the necessities of teaching are; and I should very much like to see the first step taken—people making up their minds that it has to be done somehow or other.

The last point to which I may advert is one which concerns the action of the profession itself more than anything else. We have arrangements for teaching, we have arrangements for the testing of qualifications, we have marvellous aids and appliances for the treatment of disease in all sorts of ways; but I do not find in London at the present time, in this little place of four or five million inhabitants which supports so many things, any organisation or any arrangement for advancing the science of medicine, considered as a pure science. I am quite aware that there are medical societies of various kinds; I am not ignorant of the lectureships at the College of Physicians and the College of Surgeons; there is the Brown Institute; and there is the Society for the Advancement of Medicine by Research, but there is no means, so far as I know, by which any person who has the inborn gifts of the investigator and discoverer of new truth, and who desires to apply that to the improvement of medical science, can carry out his intention. In Paris there is the University of Paris, which gives degrees; but there are also the Sorbonne and the College de France, places in which professoriates are established for the express purpose of enabling men who have the power of investigation, the power of advancing knowledge and thereby reacting on practice, to do that which it is their special mission to do. I do not know of anything of the kind in London; and if it should so happen that a Claude Bernard or a Ludwig should turn up in London, I really have not the slightest notion of what we could do with him. We could not turn him to account, and I think we should have to export him to Germany or France. I doubt whether that is a good or a wise condition of things. I do not think it is a condition of things which can exist for any great length of time, now that people are every day becoming more and more awake to the importance of scientific investigation and to the astounding and unexpected manner in which it everywhere reacts upon practical pursuits. I should look upon the establishment of some institution of that kind as a recognition on the part of the medical profession in general, that if their great and beneficent work is to be carried on, they must, like other people who have great and beneficent work to do, contribute to the advancement of knowledge in the only way in which experience shows that it can be advanced.

* * * * *

Footnotes:

[1]The fees to be paid by candidates for admission to the examinations of the Divisional Board should be of such an amount as will be sufficient to cover the cost of the examinations and the other expenses of the Divisional Board, and also to provide the sum required to compensate the medical authorities, or such of them as may be entitled to compensation, for any pecuniary losses they may hereafter sustain by reason of the abolition of their privilege of conferring a licence to practise. Report 50, p. xii.



XIV

THE CONNECTION OF THE BIOLOGICAL SCIENCES WITH MEDICINE

[1881]

The great body of theoretical and practical knowledge which has been accumulated by the labours of some eighty generations, since the dawn of scientific thought in Europe, has no collective English name to which an objection may not be raised; and I use the term "medicine" as that which is least likely to be misunderstood; though, as every one knows, the name is commonly applied, in a narrower sense, to one of the chief divisions of the totality of medical science.

Taken in this broad sense, "medicine" not merely denotes a kind of knowledge, but it comprehends the various applications of that knowledge to the alleviation of the sufferings, the repair of the injuries, and the conservation of the health, of living beings. In fact, the practical aspect of medicine so far dominates over every other, that the "Healing Art" is one of its most widely-received synonyms. It is so difficult to think of medicine otherwise than as something which is necessarily connected with curative treatment, that we are apt to forget that there must be, and is, such a thing as a pure science of medicine—a "pathology" which has no more necessary subservience to practical ends than has zoology or botany.

The logical connection between this purely scientific doctrine of disease, or pathology, and ordinary biology, is easily traced. Living matter is characterised by its innate tendency to exhibit a definite series of the morphological and physiological phenomena which constitute organisation and life. Given a certain range of conditions, and these phenomena remain the same, within narrow limits, for each kind of living thing. They furnish the normal and typical character of the species, and, as such, they are the subject-matter of ordinary biology.

Outside the range of these conditions, the normal course of the cycle of vital phenomena is disturbed; abnormal structure makes its appearance, or the proper character and mutual adjustment of the functions cease to be preserved. The extent and the importance of these deviations from the typical life may vary indefinitely. They may have no noticeable influence on the general well-being of the economy, or they may favour it. On the other hand, they may be of such a nature as to impede the activities of the organism, or even to involve its destruction.

In the first case, these perturbations are ranged under the wide and somewhat vague category of "variations"; in the second, they are called lesions, states of poisoning, or diseases; and, as morbid states, they lie within the province of pathology. No sharp line of demarcation can be drawn between the two classes of phenomena. No one can say where anatomical variations end and tumours begin, nor where modification of function, which may at first promote health, passes into disease. All that can be said is, that whatever change of structure or function is hurtful belongs to pathology. Hence it is obvious that pathology is a branch of biology; it is the morphology, the physiology, the distribution, the aetiology of abnormal life.

However obvious this conclusion may be now, it was nowise apparent in the infancy of medicine. For it is a peculiarity of the physical sciences that they are independent in proportion as they are imperfect; and it is only as they advance that the bonds which really unite them all become apparent. Astronomy had no manifest connection with terrestrial physics before the publication of the "Principia"; that of chemistry with physics is of still more modern revelation; that of physics and chemistry with physiology, has been stoutly denied within the recollection of most of us, and perhaps still may be.

Or, to take a case which affords a closer parallel with that of medicine. Agriculture has been cultivated from the earliest times, and, from a remote antiquity, men have attained considerable practical skill in the cultivation of the useful plants, and have empirically established many scientific truths concerning the conditions under which they flourish. But, it is within the memory of many of us, that chemistry on the one hand, and vegetable physiology on the other, attained a stage of development such that they were able to furnish a sound basis for scientific agriculture. Similarly, medicine took its rise in the practical needs of mankind. At first, studied without reference to any other branch of knowledge, it long maintained, indeed still to some extent maintains, that independence. Historically, its connection with the biological sciences has been slowly established, and the full extent and intimacy of that connection are only now beginning to be apparent. I trust I have not been mistaken in supposing that an attempt to give a brief sketch of the steps by which a philosophical necessity has become an historical reality, may not be devoid of interest, possibly of instruction, to the members of this great Congress, profoundly interested as all are in the scientific development of medicine.

The history of medicine is more complete and fuller than that of any other science, except, perhaps, astronomy; and, if we follow back the long record as far as clear evidence lights us, we find ourselves taken to the early stages of the civilisation of Greece. The oldest hospitals were the temples of Aesculapius; to these Asclepeia, always erected on healthy sites, hard by fresh springs and surrounded by shady groves, the sick and the maimed resorted to seek the aid of the god of health. Votive tablets or inscriptions recorded the symptoms, no less than the gratitude, of those who were healed; and, from these primitive clinical records, the half-priestly, half-philosophic caste of the Asclepiads compiled the data upon which the earliest generalisations of medicine, as an inductive science, were based.

In this state, pathology, like all the inductive sciences at their origin, was merely natural history; it registered the phenomena of disease, classified them, and ventured upon a prognosis, wherever the observation of constant co-existences and sequences suggested a rational expectation of the like recurrence under similar circumstances.

Further than this it hardly went. In fact, in the then state of knowledge, and in the condition of philosophical speculation at that time, neither the causes of the morbid state, nor the rationale of treatment, were likely to be sought for as we seek for them now. The anger of a god was a sufficient reason for the existence of a malady, and a dream ample warranty for therapeutic measures; that a physical phenomenon must needs have a physical cause was not the implied or expressed axiom that it is to us moderns.

The great man whose name is inseparably connected with the foundation of medicine, Hippocrates, certainly knew very little, indeed practically nothing, of anatomy or physiology; and he would, probably, have been perplexed even to imagine the possibility of a connection between the zoological studies of his contemporary Democritus and medicine. Nevertheless, in so far as he, and those who worked before and after him, in the same spirit, ascertained, as matters of experience, that a wound, or a luxation, or a fever, presented such and such symptoms, and that the return of the patient to health was facilitated by such and such measures, they established laws of nature, and began the construction of the science of pathology. All true science begins with empiricism—though all true science is such exactly, in so far as it strives to pass out of the empirical stage into that of the deduction of empirical from more general truths. Thus, it is not wonderful, that the early physicians had little or nothing to do with the development of biological science; and, on the other hand, that the early biologists did not much concern themselves with medicine. There is nothing to show that the Asclepiads took any prominent share in the work of founding anatomy, physiology, zoology, and botany. Rather do these seem to have sprung from the early philosophers, who were essentially natural philosophers, animated by the characteristically Greek thirst for knowledge as such. Pythagoras, Alcmeon, Democritus, Diogenes of Apollonia, are all credited with anatomical and physiological investigations; and, though Aristotle is said to have belonged to an Asclepiad family, and not improbably owed his taste for anatomical and zoological inquiries to the teachings of his father, the physician Nicomachus, the "Historia Animalium," and the treatise "De Partibus Animalium," are as free from any allusion to medicine as if they had issued from a modern biological laboratory.

It may be added, that it is not easy to see in what way it could have benefited a physician of Alexander's time to know all that Aristotle knew on these subjects. His human anatomy was too rough to avail much in diagnosis; his physiology was too erroneous to supply data for pathological reasoning. But when the Alexandrian school, with Erasistratus and Herophilus at their head, turned to account the opportunities of studying human structure, afforded to them by the Ptolemies, the value of the large amount of accurate knowledge thus obtained to the surgeon for his operations, and to the physician for his diagnosis of internal disorders, became obvious, and a connection was established between anatomy and medicine, which has ever become closer and closer. Since the revival of learning, surgery, medical diagnosis, and anatomy have gone hand in hand. Morgagni called his great work, "De sedibus et causis morborum per anatomen indagatis," and not only showed the way to search out the localities and the causes of disease by anatomy, but himself travelled wonderfully far upon the road. Bichat, discriminating the grosser constituents of the organs and parts of the body, one from another, pointed out the direction which modern research must take; until, at length, histology, a science of yesterday, as it seems to many of us, has carried the work of Morgagni as far as the microscope can take us, and has extended the realm of pathological anatomy to the limits of the invisible world.

Thanks to the intimate alliance of morphology with medicine, the natural history of disease has, at the present day, attained a high degree of perfection. Accurate regional anatomy has rendered practicable the exploration of the most hidden parts of the organism, and the determination, during life, of morbid changes in them; anatomical and histological post-mortem investigations have supplied physicians with a clear basis upon which to rest the classification, of diseases, and with unerring tests of the accuracy or inaccuracy of their diagnoses.

If men could be satisfied with pure knowledge, the extreme precision with which, in these days, a sufferer may be told what is happening, and what is likely to happen, even in the most recondite parts of his bodily frame, should be as satisfactory to the patient as it is to the scientific pathologist who gives him the information. But I am afraid it is not; and even the practising physician, while nowise under-estimating the regulative value of accurate diagnosis, must often lament that so much of his knowledge rather prevents him from doing wrong than helps him to do right.

A scorner of physic once said that nature and disease may be compared to two men fighting, the doctor to a blind man with a club, who strikes into the melee, sometimes hitting the disease, and sometimes hitting nature. The matter is not mended if you suppose the blind man's hearing to be so acute that he can register every stage of the struggle, and pretty clearly predict how it will end. He had better not meddle at all, until his eyes are opened, until he can see the exact position of the antagonists, and make sure of the effect of his blows. But that which it behoves the physician to see, not, indeed, with his bodily eye, but with clear, intellectual vision, is a process, and the chain of causation involved in that process. Disease, as we have seen, is a perturbation of the normal activities of a living body, and it is, and must remain, unintelligible, so long as we are ignorant of the nature of these normal activities. In other words, there could be no real science of pathology until the science of physiology had reached a degree of perfection unattained, and indeed unattainable, until quite recent times.

So far as medicine is concerned, I am not sure that physiology, such as it was down to the time of Harvey, might as well not have existed. Nay, it is perhaps no exaggeration to say that, within the memory of living men, justly renowned practitioners of medicine and surgery knew less physiology than is now to be learned from the most elementary text-book; and, beyond a few broad facts, regarded what they did know as of extremely little practical importance. Nor am I disposed to blame them for this conclusion; physiology must be useless, or worse than useless, to pathology, so long as its fundamental conceptions are erroneous.

Harvey is often said to be the founder of modern physiology; and there can be no question that the elucidations of the function of the heart, of the nature of the pulse, and of the course of the blood, put forth in the ever-memorable little essay, "De motu cordis," directly worked a revolution in men's views of the nature and of the concatenation of some of the most important physiological processes among the higher animals; while, indirectly, their influence was perhaps even more remarkable.

But, though Harvey made this signal and perennially important contribution to the physiology of the moderns, his general conception of vital processes was essentially identical with that of the ancients; and, in the "Exercitationes de generatione," and notably in the singular chapter "De calido innato," he shows himself a true son of Galen and of Aristotle.

For Harvey, the blood possesses powers superior to those of the elements; it is the seat of a soul which is not only vegetative, but also sensitive and motor. The blood maintains and fashions all parts of the body, "idque summa cum providentia et intellectu in finem certum agens, quasi ratiocinio quodam uteretur."

Here is the doctrine of the "pneuma," the product of the philosophical mould into which the animism of primitive men ran in Greece, in full force. Nor did its strength abate for long after Harvey's time. The same ingrained tendency of the human mind to suppose that a process is explained when it is ascribed to a power of which nothing is known except that it is the hypothetical agent of the process, gave rise, in the next century, to the animism of Stahl; and, later, to the doctrine of a vital principle, that "asylum ignorantiae" of physiologists, which has so easily accounted for everything and explained nothing, down to our own times.

Now the essence of modern, as contrasted with ancient, physiological science appears to me to lie in its antagonism to animistic hypotheses and animistic phraseology. It offers physical explanations of vital phenomena, or frankly confesses that it has none to offer. And, so far as I know, the first person who gave expression to this modern view of physiology, who was bold enough to enunciate the proposition that vital phenomena, like all the other phenomena of the physical world, are, in ultimate analysis, resolvable into matter and motion, was Rene Descartes.

The fifty-four years of life of this most original and powerful thinker are widely overlapped, on both sides, by the eighty of Harvey, who survived his younger contemporary by seven years, and takes pleasure in acknowledging the French philosopher's appreciation of his great discovery.

In fact, Descartes accepted the doctrine of the circulation as propounded by "Harvaeus medecin d'Angleterre," and gave a full account of it in his first work, the famous "Discours de la Methode," which was published in 1637, only nine years after the exercitation "De motu cordis"; and, though differing from Harvey on some important points (in which it may be noted, in passing, Descartes was wrong and Harvey right), he always speaks of him with great respect. And so important does the subject seem to Descartes, that he returns to it in the "Traite des Passions," and in the "Traite de l'Homme."

It is easy to see that Harvey's work must have had a peculiar significance for the subtle thinker, to whom we owe both the spiritualistic and the materialistic philosophies of modern times. It was in the very year of its publication, 1628, that Descartes withdrew into that life of solitary investigation and meditation of which his philosophy was the fruit. And, as the course of his speculations led him to establish an absolute distinction of nature between the material and the mental worlds, he was logically compelled to seek for the explanation of the phenomena of the material world within itself; and having allotted the realm of thought to the soul, to see nothing but extension and motion in the rest of nature. Descartes uses "thought" as the equivalent of our modern term "consciousness." Thought is the function of the soul, and its only function. Our natural heat and all the movements of the body, says he, do not depend on the soul. Death does not take place from any fault of the soul, but only because some of the principal parts of the body become corrupted. The body of a living man differs from that of a dead man in the same way as a watch or other automaton (that is to say, a machine which moves of itself) when it is wound up and has, in itself, the physical principle of the movements which the mechanism is adapted to perform, differs from the same watch, or other machine, when it is broken, and the physical principle of its movement no longer exists. All the actions which are common to us and the lower animals depend only on the conformation of our organs, and the course which the animal spirits take in the brain, the nerves, and the muscles; in the same way as the movement of a watch is produced by nothing but the force of its spring and the figure of its wheels and other parts.

Descartes' "Treatise on Man" is a sketch of human physiology, in which a bold attempt is made to explain all the phenomena of life, except those of consciousness, by physical reasonings. To a mind turned in this direction, Harvey's exposition of the heart and vessels as a hydraulic mechanism must have been supremely welcome.

Descartes was not a mere philosophical theorist, but a hardworking dissector and experimenter, and he held the strongest opinion respecting the practical value of the new conception which he was introducing. He speaks of the importance of preserving health, and of the dependence of the mind on the body being so close that, perhaps, the only way of making men wiser and better than they are, is to be sought in medical science. "It is true," says he, "that as medicine is now practised it contains little that is very useful; but without any desire to depreciate, I am sure that there is no one, even among professional men, who will not declare that all we know is very little as compared with that which remains to be known; and that we might escape an infinity of diseases of the mind, no less than of the body, and even perhaps from the weakness of old age, if we had sufficient knowledge of their causes, and of all the remedies with which nature has provided us." [1] So strongly impressed was Descartes with this, that he resolved to spend the rest of his life in trying to acquire such a knowledge of nature as would lead to the construction of a better medical doctrine. [2] The anti-Cartesians found material for cheap ridicule in these aspirations of the philosopher; and it is almost needless to say that, in the thirteen years which elapsed between the publication of the "Discours" and the death of Descartes, he did not contribute much to their realisation. But, for the next century, all progress in physiology took place along the lines which Descartes laid down.

The greatest physiological and pathological work of the seventeenth century, Borelli's treatise "De Motu Animalium," is, to all intents and purposes, a development of Descartes' fundamental conception; and the same may be said of the physiology and pathology of Boerhaave, whose authority dominated in the medical world of the first half of the eighteenth century.

With the origin of modern chemistry, and of electrical science, in the latter half of the eighteenth century, aids in the analysis of the phenomena of life, of which Descartes could not have dreamed, were offered to the physiologist. And the greater part of the gigantic progress which has been made in the present century is a justification of the prevision of Descartes. For it consists, essentially, in a more and more complete resolution of the grosser organs of the living body into physicochemical mechanisms.

"I shall try to explain our whole bodily machinery in such a way, that it will be no more necessary for us to suppose that the soul produces such movements as are not voluntary, than it is to think that there is in a clock a soul which causes it to show the hours." [3] These words of Descartes might be appropriately taken as a motto by the author of any modern treatise on physiology.

But though, as I think, there is no doubt that Descartes was the first to propound the fundamental conception of the living body as a physical mechanism, which is the distinctive feature of modern, as contrasted with ancient physiology, he was misled by the natural temptation to carry out, in all its details, a parallel between the machines with which he was familiar, such as clocks and pieces of hydraulic apparatus, and the living machine. In all such machines there is a central source of power, and the parts of the machine are merely passive distributors of that power. The Cartesian school conceived of the living body as a machine of this kind; and herein they might have learned from Galen, who, whatever ill use he may have made of the doctrine of "natural faculties," nevertheless had the great merit of perceiving that local forces play a great part in physiology.

The same truth was recognised by Glisson, but it was first prominently brought forward in the Hallerian doctrine of the "vis insita" of muscles. If muscle can contract without nerve, there is an end of the Cartesian mechanical explanation of its contraction by the influx of animal spirits.

The discoveries of Trembley tended in the same direction. In the freshwater Hydra, no trace was to be found of that complicated machinery upon which the performance of the functions in the higher animals was supposed to depend. And yet the hydra moved, fed, grew, multiplied, and its fragments exhibited all the powers of the whole. And, finally, the work of Caspar F. Wolff, [4] by demonstrating the fact that the growth and development of both plants and animals take place antecedently to the existence of their grosser organs, and are, in fact, the causes and not the consequences of organisation (as then understood), sapped the foundations of the Cartesian physiology as a complete expression of vital phenomena.

For Wolff, the physical basis of life is a fluid, possessed of a "vis essentialis" and a "solidescibilitas," in virtue of which it gives rise to organisation; and, as he points out, this conclusion strikes at the root of the whole iatro-mechanical system.

In this country, the great authority of John Hunter exerted a similar influence; though it must be admitted that the too sibylline utterances which are the outcome of Hunter's struggles to define his conceptions are often susceptible of more than one interpretation. Nevertheless, on some points Hunter is clear enough. For example, he is of opinion that "Spirit is only a property of matter" ("Introduction to Natural History," p. 6), he is prepared to renounce animism, (l.c. p. 8), and his conception of life is so completely physical that he thinks of it as something which can exist in a state of combination in the food. "The aliment we take in has in it, in a fixed state, the real life; and this does not become active until it has got into the lungs; for there it is freed from its prison" ("Observations on Physiology," p. 113). He also thinks that "It is more in accord with the general principles of the animal machine to suppose that none of its effects are produced from any mechanical principle whatever; and that every effect is produced from an action in the part; which action is produced by a stimulus upon the part which acts, or upon some other part with which this part sympathises so as to take up the whole action" (l.c. p. 152).

And Hunter is as clear as Wolff, with whose work he was probably unacquainted, that "whatever life is, it most certainly does not depend upon structure or organisation" (l.c. p. 114).

Of course it is impossible that Hunter could have intended to deny the existence of purely mechanical operations in the animal body. But while, with Borelli and Boerhaave, he looked upon absorption, nutrition, and secretion as operations effected by means of the small vessels, he differed from the mechanical physiologists, who regarded these operations as the result of the mechanical properties of the small vessels, such as the size, form, and disposition of their canals and apertures. Hunter, on the contrary, considers them to be the effect of properties of these vessels which are not mechanical but vital. "The vessels," says he, "have more of the polypus in them than any other part of the body," and he talks of the "living and sensitive principles of the arteries," and even of the "dispositions or feelings of the arteries." "When the blood is good and genuine the sensations of the arteries, or the dispositions for sensation, are agreeable.... It is then they dispose of the blood to the best advantage, increasing the growth of the whole, supplying any losses, keeping up a due succession, etc." (l.c. p. 133).

If we follow Hunter's conceptions to their logical issue, the life of one of the higher animals is essentially the sum of the lives of all the vessels, each of which is a sort of physiological unit, answering to a polype; and, as health is the result of the normal "action of the vessels," so is disease an effect of their abnormal action. Hunter thus stands in thought, as in time, midway between Borelli on the one hand, and Bichat on the other.

The acute founder of general anatomy, in fact, outdoes Hunter in his desire to exclude physical reasonings from the realm of life. Except in the interpretation of the action of the sense organs, he will not allow physics to have anything to do with physiology.

"To apply the physical sciences to physiology is to explain the phenomena of living bodies by the laws of inert bodies. Now this is a false principle, hence all its consequences are marked with the same stamp. Let us leave to chemistry its affinity; to physics, its elasticity and its gravity. Let us invoke for physiology only sensibility and contractility." [5]

Of all the unfortunate dicta of men of eminent ability this seems one of the most unhappy, when we think of what the application of the methods and the data of physics and chemistry has done towards bringing physiology into its present state. It is not too much to say that one-half of a modern text-book of physiology consists of applied physics and chemistry; and that it is exactly in the exploration of the phenomena of sensibility and contractility that physics and chemistry have exerted the most potent influence.

Nevertheless, Bichat rendered a solid service to physiological progress by insisting upon the fact that what we call life, in one of the higher animals, is not an indivisible unitary archaeus dominating, from its central seat, the parts of the organism, but a compound result of the synthesis of the separate lives of those parts.

"All animals," says he, "are assemblages of different organs, each of which performs its function and concurs, after its fashion, in the preservation of the whole. They are so many special machines in the general machine which constitutes the individual. But each of these special machines is itself compounded of many tissues of very different natures, which in truth constitute the elements of those organs" (l.c. lxxix.). "The conception of a proper vitality is applicable only to these simple tissues, and not to the organs themselves" (l.c. lxxxiv.).

And Bichat proceeds to make the obvious application of this doctrine of synthetic life, if I may so call it, to pathology. Since diseases are only alterations of vital properties, and the properties of each tissue are distinct from those of the rest, it is evident that the diseases of each tissue must be different from those of the rest. Therefore, in any organ composed of different tissues, one may be diseased and the other remain healthy; and this is what happens in most cases (l.c. lxxxv.).

In a spirit of true prophecy, Bichat says, "We have arrived at an epoch in which pathological anatomy should start afresh." For, as the analysis of the organs had led him to the tissues as the physiological units of the organism; so, in a succeeding generation, the analysis of the tissues led to the cell as the physiological element of the tissues. The contemporaneous study of development brought out the same result; and the zoologists and botanists, exploring the simplest and the lowest forms of animated beings, confirmed the great induction of the cell theory. Thus the apparently opposed views, which have been battling with one another ever since the middle of the last century, have proved to be each half the truth.

The proposition of Descartes that the body of a living man is a machine, the actions of which are explicable by the known laws of matter and motion, is unquestionably largely true. But it is also true, that the living body is a synthesis of innumerable physiological elements, each of which may nearly be described, in Wolff's words, as a fluid possessed of a "vis essentialis" and a "solidescibilitas"; or, in modern phrase, as protoplasm susceptible of structural metamorphosis and functional metabolism: and that the only machinery, in the precise sense in which the Cartesian school understood mechanism, is, that which co-ordinates and regulates these physiological units into an organic whole.

In fact, the body is a machine of the nature of an army, not of that of a watch or of a hydraulic apparatus. Of this army each cell is a soldier, an organ a brigade, the central nervous system headquarters and field telegraph, the alimentary and circulatory system the commissariat. Losses are made good by recruits born in camp, and the life of the individual is a campaign, conducted successfully for a number of years, but with certain defeat in the long run.

The efficacy of an army, at any given moment, depends on the health of the individual soldier, and on the perfection of the machinery by which he is led and brought into action at the proper time; and, therefore, if the analogy holds good, there can be only two kinds of diseases, the one dependent on abnormal states of the physiological units, the other on perturbations of their co-ordinating and alimentative machinery.

Hence, the establishment of the cell theory, in normal biology, was swiftly followed by a "cellular pathology," as its logical counterpart. I need not remind you how great an instrument of investigation this doctrine has proved in the hands of the man of genius to whom its development is due, and who would probably be the last to forget that abnormal conditions of the co-ordinative and distributive machinery of the body are no less important factors of disease.

Henceforward, as it appears to me, the connection of medicine with the biological sciences is clearly indicated. Pure pathology is that branch of biology which defines the particular perturbation of cell-life, or of the co-ordinating machinery, or of both, on which the phenomena of disease depend.

Those who are conversant with the present state of biology will hardly hesitate to admit that the conception of the life of one of the higher animals as the summation of the lives of a cell aggregate, brought into harmonious action by a co-ordinative machinery formed by some of these cells, constitutes a permanent acquisition of physiological science. But the last form of the battle between the animistic and the physical views of life is seen in the contention whether the physical analysis of vital phenomena can be carried beyond this point or not.

There are some to whom living protoplasm is a substance, even such as Harvey conceived the blood to be, "summa cum providentia et intellectu in finem certum agens, quasi ratiocinio quodam;" and who look with as little favour as Bichat did, upon any attempt to apply the principles and the methods of physics and chemistry to the investigation of the vital processes of growth, metabolism, and contractility. They stand upon the ancient ways; only, in accordance with that progress towards democracy, which a great political writer has declared to be the fatal characteristic of modern times, they substitute a republic formed by a few billion of "animulae" for the monarchy of the all-pervading "anima."

Others, on the contrary, supported by a robust faith in the universal applicability of the principles laid down by Descartes, and seeing that the actions called "vital" are, so far as we have any means of knowing, nothing but changes of place of particles of matter, look to molecular physics to achieve the analysis of the living protoplasm itself into a molecular mechanism. If there is any truth in the received doctrines of physics, that contrast between living and inert matter, on which Bichat lays so much stress, does not exist. In nature, nothing is at rest, nothing is amorphous; the simplest particle of that which men in their blindness are pleased to call "brute matter" is a vast aggregate of molecular mechanisms performing complicated movements of immense rapidity, and sensitively adjusting themselves to every change in the surrounding world. Living matter differs from other matter in degree and not in kind; the microcosm repeats the macrocosm; and one chain of causation connects the nebulous original of suns and planetary systems with the protoplasmic foundation of life and organisation.

From this point of view, pathology is the analogue of the theory of perturbations in astronomy; and therapeutics resolves itself into the discovery of the means by which a system of forces competent to eliminate any given perturbation may be introduced into the economy. And, as pathology bases itself upon normal physiology, so therapeutics rests upon pharmacology; which is, strictly speaking, a part of the great biological topic of the influence of conditions on the living organism, and has no scientific foundation apart from physiology.

It appears to me that there is no more hopeful indication of the progress of medicine towards the ideal of Descartes than is to be derived from a comparison of the state of pharmacology, at the present day, with that which existed forty years ago. If we consider the knowledge positively acquired, in this short time, of the modus operandi of urari, of atropia, of physostigmin, of veratria, of casca, of strychnia, of bromide of potassium, of phosphorus, there can surely be no ground for doubting that, sooner or later, the pharmacologist will supply the physician with the means of affecting, in any desired sense, the functions of any physiological element of the body. It will, in short, become possible to introduce into the economy a molecular mechanism which, like a very cunningly-contrived torpedo, shall find its way to some particular group of living elements, and cause an explosion among them, leaving the rest untouched.

The search for the explanation of diseased states in modified cell-life; the discovery of the important part played by parasitic organisms in the aetiology of disease; the elucidation of the action of medicaments by the methods and the data of experimental physiology; appear to me to be the greatest steps which have ever been made towards the establishment of medicine on a scientific basis. I need hardly say they could not have been made except for the advance of normal biology.

There can be no question, then, as to the nature or the value of the connection between medicine and the biological sciences. There can be no doubt that the future of pathology and of therapeutics, and, therefore, that of practical medicine, depends upon the extent to which those who occupy themselves with these subjects are trained in the methods and impregnated with the fundamental truths of biology.

And, in conclusion, I venture to suggest that the collective sagacity of this congress could occupy itself with no more important question than with this: How is medical education to be arranged, so that, without entangling the student in those details of the systematist which are valueless to him, he may be enabled to obtain a firm grasp of the great truths respecting animal and vegetable life, without which, notwithstanding all the progress of scientific medicine, he will still find himself an empiric?

* * * * *

Footnotes:

[1] Discours de la Methode, 6e partie, Ed. Cousin, p. 193.

[2] Ibid. pp. 193 and 211.

[3] De la Formation du Foetus.

[4] Theoria Generationis, 1759.

[5] Anatomie generale, i. p. liv.



XV

THE SCHOOL BOARDS: WHAT THEY CAN DO, AND WHAT THEY MAY DO.

[1870]

An electioneering manifesto would be out of place in the pages of this Review; but any suspicion that may arise in the mind of the reader that the following pages partake of that nature, will be dispelled, if he reflect that they cannot be published [1] until after the day on which the ratepayers of the metropolis will have decided which candidates for seats upon the Metropolitan School Board they will take, and which they will leave.

As one of those candidates, I may be permitted to say, that I feel much in the frame of mind of the Irish bricklayer's labourer, who bet another that he could not carry him to the top of the ladder in his hod. The challenged hodman won his wager, but as the stakes were handed over, the challenger wistfully remarked, "I'd great hopes of falling at the third round from the top." And, in view of the work and the worry which awaits the members of the School Boards, I must confess to an occasional ungrateful hope that the friends who are toiling upwards with me in their hod, may, when they reach "the third round from the top," let me fall back into peace and quietness.

But whether fortune befriend me in this rough method, or not, I should like to submit to those of whom I am potential, but of whom I may not be an actual, colleague, and to others who may be interested in this most important problem—how to get the Education Act to work efficiently—some considerations as to what are the duties of the members of the School Boards, and what are the limits of their power.

I suppose no one will be disposed to dispute the proposition, that the prime duty of every member of such a Board is to endeavour to administer the Act honestly; or in accordance, not only with its letter, but with its spirit. And if so, it would seem that the first step towards this very desirable end is, to obtain a clear notion of what that letter signifies, and what that spirit implies; or, in other words, what the clauses of the Act are intended to enjoin and to forbid. So that it is really not admissible, except for factious and abusive purposes, to assume that any one who endeavours to get at this clear meaning is desirous only of raising quibbles and making difficulties.

Reading the Act with this desire to understand it, I find that its provisions may be classified, as might naturally be expected, under two heads: the one set relating to the subject-matter of education; the other to the establishment, maintenance, and administration of the schools in which that education is to be conducted.

Now it is a most important circumstance, that all the sections of the Act, except four, belong to the latter division; that is, they refer to mere matters of administration. The four sections in question are the seventh, the fourteenth, the sixteenth, and the ninety-seventh. Of these, the seventh, the fourteenth, and the ninety-seventh deal with the subject-matter of education, while the sixteenth defines the nature of the relations which are to exist between the "Education Department" (an euphemism for the future Minister of Education) and the School Boards. It is the sixteenth clause which is the most important, and, in some respects, the most remarkable of all. It runs thus:—

"If the School Board do, or permit, any act in contravention of, or fail to comply with, the regulations, according to which a school provided by them is required by this Act to be conducted, the Education Department may declare the School Board to be, and such Board shall accordingly be deemed to be, a Board in default, and the Education Department may proceed accordingly; and every act, or omission, of any member of the School Board, or manager appointed by them, or any person under the control of the Board, shall be deemed to be permitted by the Board, unless the contrary be proved.

"If any dispute arises as to whether the School Board have done, or permitted, any act in contravention of, or have failed to comply with, the said regulations, the matter shall be referred to the Education Department, whose decision thereon shall be final."

It will be observed that this clause gives the Minister of Education absolute power over the doings of the School Boards. He is not only the administrator of the Act, but he is its interpreter. I had imagined that on the occurrence of a dispute, not as regards a question of pure administration, but as to the meaning of a clause of the Act, a case might be taken and referred to a court of justice. But I am led to believe that the Legislature has, in the present instance, deliberately taken this power out of the hands of the judges and lodged it in those of the Minister of Education, who, in accordance with our method of making Ministers, will necessarily be a political partisan, and who may be a strong theological sectary into the bargain. And I am informed by members of Parliament who watched the progress of the Act, that the responsibility for this unusual state of things rests, not with the Government, but with the Legislature, which exhibited a singular disposition to accumulate power in the hands of the future Minister of Education, and to evade the more troublesome difficulties of the education question by leaving them to be settled between that Minister and the School Boards.

I express no opinion whether it is, or is not, desirable that such powers of controlling all the School Boards in the country should be possessed by a person who may be, like Mr. Forster, eminently likely to use these powers justly and wisely, but who also may be quite the reverse. I merely wish to draw attention to the fact that such powers are given to the Minister, whether he be fit or unfit. The extent of these powers becomes apparent when the other sections of the Act referred to are considered. The fourth clause of the seventh section says:—

"The school shall be conducted in accordance with the conditions required to be fulfilled by an elementary school in order to obtain an annual Parliamentary grant."

What these conditions are appears from the following clauses of the ninety-seventh section:—

"The conditions required to be fulfilled by an elementary school in order to obtain an annual Parliamentary grant shall be those contained in the minutes of the Education Department in force for the time being.... Provided that no such minute of the Education Department, not in force at the time of the passing of this Act, shall be deemed to be in force until it has lain for not less than one month on the table of both Houses of Parliament."

Let us consider how this will work in practice. A school established by a School Board may receive support from three sources—from the rates, the school fees, and the Parliamentary grant. The latter may be as great as the two former taken together; and as it may be assumed, without much risk of error, that a constant pressure will be exerted by the ratepayers on the members who represent them to get as much out of the Government, and as little out of the rates, as possible, the School Boards will have a very strong motive for shaping the education they give, as nearly as may be, on the model which the Education Minister offers for their imitation, and for the copying of which he is prepared to pay.

The Revised Code did not compel any schoolmaster to leave off teaching anything; but, by the very simple process of refusing to pay for many kinds of teaching, it has practically put an end to them. Mr. Forster is said to be engaged in revising the Revised Code; a successor of his may re-revise it—and there will be no sort of check upon these revisions and counter revisions, except the possibility of a Parliamentary debate, when the revised, or added, minutes are laid upon the table. What chance is there that any such debate will take place on a matter of detail relating to elementary education—a subject with which members of the Legislature, having been, for the most part, sent to our public schools thirty years ago, have not the least practical acquaintance, and for which they care nothing, unless it derives a political value from its connection with sectarian politics?

I cannot but think, then, that the School Boards will have the appearance, but not the reality, of freedom of action, in regard to the subject-matter of what is commonly called "secular" education.

As respects what is commonly called "religious" education, the power of the Minister of Education is even more despotic. An interest, almost amounting to pathos, attaches itself, in my mind, to the frantic exertions which are at present going on in almost every school division, to elect certain candidates whose names have never before been heard of in connection with education, and who are either sectarian partisans, or nothing. In my own particular division, a body organised ad hoc is moving heaven and earth to get the seven seats filled by seven gentlemen, four of whom are good Churchmen, and three no less good Dissenters. But why should this seven times heated fiery furnace of theological zeal be so desirous to shed its genial warmth over the London School Board? Can it be that these zealous sectaries mean to evade the solemn pledge given in the Act?

"No religious catechism or religious formulary which is distinctive of any particular denomination shall be taught in the school."

I confess I should have thought it my duty to reject any such suggestion, as dishonouring to a number of worthy persons, if it had not been for a leading article and some correspondence which appeared in the Guardian of November 9th, 1870.

The Guardian is, as everybody knows, one of the best of the "religious" newspapers; and, personally, I have every reason to speak highly of the fairness, and indeed kindness, with which the editor is good enough to deal with a writer who must, in many ways, be so objectionable to him as myself. I quote the following passages from a leading article on a letter of mine, therefore, with all respect, and with a genuine conviction that the course of conduct advocated by the writer must appear to him in a very different light from that under which I see it:—

"The first of these points is the interpretation which Professor Huxley puts on the 'Cowper-Temple clause.' It is, in fact, that which we foretold some time ago as likely to be forced upon it by those who think with him. The clause itself was one of those compromises which it is very difficult to define or to maintain logically. On the one side was the simple freedom to School Boards to establish what schools they pleased, which Mr. Forster originally gave, but against which the Nonconformists lifted up their voices, because they conceived it likely to give too much power to the Church. On the other side there was the proposition to make the schools secular—intelligible enough, but in the consideration of public opinion simply impossible—and there was the vague impracticable idea, which Mr. Gladstone thoroughly tore to pieces, of enacting that the teaching of all school-masters in the new schools should be strictly 'undenominational.' The Cowper-Temple clause was, we repeat, proposed simply to tide over the difficulty. It was to satisfy the Nonconformists and the 'unsectarian,' as distinct from the secular party of the League, by forbidding all distinctive 'catechisms and formularies,' which might have the effect of openly assigning the schools to this or that religious body. It refused, at the same time, to attempt the impossible task of defining what was undenominational; and its author even contended, if we understood him correctly, that it would in no way, even indirectly, interfere with the substantial teaching of any master in any school. This assertion we always believed to be untenable; we could not see how, in the face of this clause, a distinctly denominational tone could be honestly given to schools nominally general. But beyond this mere suggestion of an attempt at a general tone of comprehensiveness in religious teaching it was not intended to go, and only because such was its limitation was it accepted by the Government and by the House.

"But now we are told that it is to be construed as doing precisely that which it refused to do. A 'formulary,' it seems, is a collection of formulas, and formulas are simply propositions of whatever kind touching religious faith. All such propositions, if they cannot be accepted by all Christian denominations, are to be proscribed; and it is added significantly that the Jews also are a denomination, and so that any teaching distinctively Christian is perhaps to be excluded, lest it should interfere with their freedom and rights. Are we then to fall back on the simple reading of the letter of the Bible? No! this, it is granted, would be an 'unworthy pretence.' The teacher is to give 'grammatical, geographical, or historical explanations;' but he is to keep clear of 'theology proper,' because, as Professor Huxley takes great pains to prove, there is no theological teaching which is not opposed by some sect or other, from Roman Catholicism on the one hand to Unitarianism on the other. It was not, perhaps, hard to see that this difficulty would be started; and to those who, like Professor Huxley look at it theoretically, without much practical experience of schools, it may appear serious or unanswerable. But there is very little in it practically; when it is faced determinately and handled firmly, it will soon shrink into its true dimensions. The class who are least frightened at it are the school teachers, simply because they know most about it. It is quite clear that the school managers must be cautioned against allowing their schools to be made places of proselytism: but when this is done, the case is simple enough. Leave the masters under this general understanding to teach freely; if there in ground of complaint, let it be made, but leave the onus probandi on the objectors. For extreme peculiarities of belief or unbelief there is the Conscience Clause; as to the mass of parents, they will be more anxious to have religion taught than afraid of its assuming this or that particular shade. They will trust the school managers and teachers till they have reason to distrust them, and experience has shown that they may trust them safely enough. Any attempt to throw the burden of making the teaching undenominational upon the managers must be sternly resisted: it is simply evading the intentions of the Act in an elaborate attempt to carry them out. We thank Professor Huxley for the warning. To be forewarned is to be forearmed."

A good deal of light seems to me to be thrown on the practical significance of the opinions expressed in the foregoing extract by the following interesting letter, which appeared in the same paper:—

"Sir,—I venture to send to you the substance of a correspondence with the Education Department upon the question of the lawfulness of religious teaching in rate schools under section 14 (2) of the Act. I asked whether the words 'which is distinctive,' &c., taken grammatically as limiting the prohibition of any religious formulary, might be construed as allowing (subject, however, to the other provisions of the Act) any religious formulary common to any two denominations anywhere in England to be taught in such schools; and if practically the limit could not be so extended, but would have to be fixed according to the special circumstances of each district, then what degree of general acceptance in a district would exempt such a formulary from the prohibition? The answer to this was as follows:—'It was understood, when clause 14 of the Education Act was discussed in the House of Commons, that, according to a well-known rule of interpreting Acts of Parliament, "denomination" must be held to include "denominations." When any dispute is referred to the Education Department under the last paragraph of section 16, it will be dealt with according to the circumstances of the case.'

"Upon my asking further if I might hence infer that the lawfulness of teaching any religious formulary in a rate school would thus depend exclusively on local circumstances, and would accordingly be so decided by the Education Department in case of dispute, I was informed in explanation that 'their lordships'' letter was intended to convey to me that no general rule, beyond that stated in the first paragraph of their letter, could at present be laid down by them; and that their decision in each particular case must depend on the special circumstances accompanying it.

"I think it would appear from this that it may yet be in many cases both lawful and expedient to teach religious formularies in rate schools. H. I.

"Steyning, November 5, 1870."

Of course I do not mean to suggest that the editor of the Guardian is bound by the opinions of his correspondent; but I cannot help thinking that I do not misrepresent him, when I say that he also thinks "that it may yet be, in many cases, both lawful and expedient to teach religious formularies in rate schools under these circumstances."

It is not uncharitable, therefore, to assume that, the express words of the Act of Parliament notwithstanding, all the sectaries who are toiling so hard for seats in the London School Board have the lively hope of the gentleman from Steyning, that it may be "both lawful and expedient to teach religious formularies in rate schools;" and that they mean to do their utmost to bring this happy consummation about. [2]

Now the pathetic emotion to which I have referred, as accompanying my contemplations of the violent struggles of so many excellent persons, is caused by the circumstance that, so far as I can judge, their labour is in vain.

Supposing that the London School Board contains, as it probably will do, a majority of sectaries; and that they carry over the heads of a minority, a resolution that certain theological formulas, about which they all happen to agree,—say, for example, the doctrine of the Trinity,—shall be taught in the schools. Do they fondly imagine that the minority will not at once dispute their interpretation of the Act, and appeal to the Education Department to settle that dispute? And if so, do they suppose that any Minister of Education, who wants to keep his place, will tighten boundaries which the Legislature has left loose; and will give a "final decision" which shall be offensive to every Unitarian and to every Jew in the House of Commons, besides creating a precedent which will afterwards be used to the injury of every Nonconformist? The editor of the Guardian tells his friends sternly to resist every attempt to throw the burden of making the teaching undenominational on the managers, and thanks me for the warning I have given him. I return the thanks, with interest, for his warning, as to the course the party he represents intends to pursue, and for enabling me thus to draw public attention to a perfectly constitutional and effectual mode of checkmating them.

And, in truth, it is wonderful to note the surprising entanglement into which our able editor gets himself in the struggle between his native honesty and judgment and the necessities of his party. "We could not see," says he, "in the face of this clause how a distinct denominational tone could be honestly given to schools nominally general." There speaks the honest and clear-headed man. "Any attempt to throw the burden of making the teaching undenominational must be sternly resisted." There speaks the advocate holding a brief for his party. "Verily," as Trinculo says, "the monster hath two mouths:" the one, the forward mouth, tells us very justly that the teaching cannot "honestly" be "distinctly denominational;" but the other, the backward mouth, asserts that it must by no manner of means be "undenominational." Putting the two utterances together, I can only interpret them to mean that the teaching is to be "indistinctly denominational." If the editor of the Guardian had not shown signs of anger at my use of the term "theological fog," I should have been tempted to suppose it must have been what he had in his mind, under the name of "indistinct denominationalism." But this reading being plainly inadmissible, I can only imagine that he inculcates the teaching of formulas common to a number of denominations.

But the Education Department has already told the gentleman from Steyning that any such proceeding will be illegal. "According to a well-known rule of interpreting Acts of Parliament, 'denomination' would be held to include 'denominations.'" In other words, we must read the Act thus:—

"No religious catechism or religious formulary which is distinctive of any particular denominations shall be taught."

Thus we are really very much indebted to the editor of the Guardian and his correspondent. The one has shown us that the sectaries mean to try to get as much denominational teaching as they can agree upon among themselves, forced into the elementary schools; while the other has obtained a formal declaration from the Educational Department that any such attempt will contravene the Act of Parliament, and that, therefore, the unsectarian, law-abiding members of the School Boards may safely reckon upon bringing down upon their opponents the heavy hand of the Minister of Education. [3]

So much for the powers of the School Boards. Limited as they seem to be, it by no means follows that such Boards, if they are composed of intelligent and practical men, really more in earnest about education than about sectarian squabbles, may not exert a very great amount of influence. And, from many circumstances, this is especially likely to be the case with the London School Board, which, if it conducts itself wisely, may become a true educational parliaments as subordinate in authority to the Minister of Education, theoretically, as the Legislature is to the Crown, and yet, like the Legislature, possessed of great practical authority. And I suppose that no Minister of Education would be other than glad to have the aid of the deliberations of such a body, or fail to pay careful attention to its recommendations.

What, then, ought to be the nature and scope of the education which a School Board should endeavour to give to every child under its influence, and for which it should try to obtain the aid of the Parliamentary grants? In my judgment it should include at least the following kinds of instruction and of discipline:—

1. Physical training and drill, as part of the regular business of the school.

It is impossible to insist too much on the importance of this part of education for the children of the poor of great towns. All the conditions of their lives are unfavourable to their physical well-being. They are badly lodged, badly housed, badly fed, and live from one year's end to another in bad air, without chance of a change. They have no play-grounds; they amuse themselves with marbles and chuck-farthing, instead of cricket or hare-and-hounds; and if it were not for the wonderful instinct which leads all poor children of tender years to run under the feet of cab-horses whenever they can, I know not how they would learn to use their limbs with agility.

Now there is no real difficulty about teaching drill and the simpler kinds of gymnastics. It is done admirably well, for example, in the North Surrey Union schools; and a year or two ago when I had an opportunity of inspecting these schools, I was greatly struck with the effect of such training upon the poor little waifs and strays of humanity, mostly picked out of the gutter, who are being made into cleanly, healthy, and useful members of society in that excellent institution.

Whatever doubts people may entertain about the efficacy of natural selection, there can be none about artificial selection; and the breeder who should attempt to make, or keep up, a fine stock of pigs, or sheep, under the conditions to which the children of the poor are exposed, would be the laughing-stock even of the bucolic mind. Parliament has already done something in this direction by declining to be an accomplice in the asphyxiation of school children. It refuses to make any grant to a school in which the cubical contents of the school-room are inadequate to allow of proper respiration. I should like to see it make another step in the same direction, and either refuse to give a grant to a school in which physical training is not a part of the programme, or, at any rate, offer to pay upon such training. If something of the kind is not done, the English physique, which has been, and is still, on the whole, a grand one, will become as extinct as the dodo in the great towns.

And then the moral and intellectual effect of drill, as an introduction to, and aid of, all other sorts of training, must not be overlooked. If you want to break in a colt, surely the first thing to do is to catch him and get him quietly to face his trainer; to know his voice and bear his hand; to learn that colts have something else to do with their heels than to kick them up whenever they feel so inclined; and to discover that the dreadful human figure has no desire to devour, or even to beat him, but that, in case of attention and obedience, he may hope for patting and even a sieve of oats.

But, your "street Arabs," and other neglected poor children, are rather worse and wilder than colts; for the reason that the horse-colt has only his animal instincts in him, and his mother, the mare, has been always tender over him, and never came home drunk and kicked him in her life; while the man-colt is inspired by that very real devil, perverted manhood, and his mother may have done all that and more. So, on the whole, it may probably be even more expedient to begin your attempt to get at the higher nature of the child, than at that of the colt, from the physical side.

2. Next in order to physical training I put the instruction of children, and especially of girls, in the elements of household work and of domestic economy; in the first place for their own sakes, and in the second for that of their future employers.

Every one who knows anything of the life of the English poor is aware of the misery and waste caused by their want of knowledge of domestic economy, and by their lack of habits of frugality and method. I suppose it is no exaggeration to say that a poor Frenchwoman would make the money which the wife of a poor Englishman spends in food go twice as far, and at the same time turn out twice as palatable a dinner. Why Englishmen, who are so notoriously fond of good living, should be so helplessly incompetent in the art of cookery, is one of the great mysteries of nature; but from the varied abominations of the railway refreshment-rooms to the monotonous dinners of the poor, English feeding is either wasteful or nasty, or both.

And as to domestic service, the groans of the housewives of England ascend to heaven! In five cases out of six the girl who takes a "place" has to be trained by her mistress in the first rudiments of decency and order; and it is a mercy if she does not turn up her nose at anything like the mention of an honest and proper economy. Thousands of young girls are said to starve, or worse, yearly in London; and at the same time thousands of mistresses of households are ready to pay high wages for a decent housemaid, or cook, or a fair workwoman; and can by no means get what they want.

Surely, if the elementary schools are worth anything, they may put an end to a state of things which is demoralising the poor, while it is wasting the lives of those better off in small worries and annoyances.

3. But the boys and girls for whose education the School Boards have to provide, have not merely to discharge domestic duties, but each of them is a member of a social and political organisation of great complexity, and has, in future life, to fit himself into that organisation, or be crushed by it. To this end it is surely needful, not only that they should be made acquainted with the elementary laws of conduct, but that their affections should be trained, so as to love with all their hearts that conduct which tends to the attainment of the highest good for themselves and their fellow men, and to hate with all their hearts that opposite course of action which is fraught with evil.

So far as the laws of conduct are determined by the intellect, I apprehend that they belong to science, and to that part of science which is called morality. But the engagement of the affections in favour of that particular kind of conduct which we call good, seems to me to be something quite beyond mere science. And I cannot but think that it, together with the awe and reverence, which have no kinship with base fear, but arise whenever one tries to pierce below the surface of things, whether they be material or spiritual, constitutes all that has any unchangeable reality in religion.

And just as I think it would be a mistake to confound the science, morality, with the affection, religion; so do I conceive it to be a most lamentable and mischievous error, that the science, theology, is so confounded in the minds of many—indeed, I might say, of the majority of men.

I do not express any opinion as to whether theology is a true science, or whether it does not come under the apostolic definition of "science falsely so called;" though I may be permitted to express the belief that if the Apostle to whom that much misapplied phrase is due could make the acquaintance of much of modern theology, he would not hesitate a moment in declaring that it is exactly what he meant the words to denote.

But it is at any rate conceivable, that the nature of the Deity, and his relations to the universe, and more especially to mankind, are capable of being ascertained, either inductively or deductively, or by both processes. And, if they have been ascertained, then a body of science has been formed which is very properly called theology.

Further, there can be no doubt that affection for the Being thus defined and described by theologic science would be properly termed religion; but it would not be the whole of religion. The affection for the ethical ideal defined by moral science would claim equal if not superior rights. For suppose theology established the existence of an evil deity—and some theologies, even Christian ones, have come very near this,—is the religious affection to be transferred from the ethical ideal to any such omnipotent demon? I trow not. Better a thousand times that the human race should perish under his thunderbolts than it should say, "Evil, be thou my good."

There is nothing new, that I know of, in this statement of the relations of religion with the science of morality on the one hand and that of theology on the other. But I believe it to be altogether true, and very needful, at this time, to be clearly and emphatically recognised as such, by those who have to deal with the education question.

We are divided into two parties—the advocates of so-called "religious" teaching on the one hand, and those of so-called "secular" teaching on the other. And both parties seem to me to be not only hopelessly wrong, but in such a position that if either succeeded completely, it would discover, before many years were over, that it had made a great mistake and done serious evil to the cause of education.

For, leaving aside the more far-seeing minority on each side, what the "religious" party is crying for is mere theology, under the name of religion; while the "secularists" have unwisely and wrongfully admitted the assumption of their opponents, and demand the abolition of all "religious" teaching, when they only want to be free of theology—Burning your ship to get rid of the cockroaches!

But my belief is, that no human being, and no society composed of human beings, ever did, or ever will, come to much, unless their conduct was governed and guided by the love of some ethical ideal. Undoubtedly, your gutter child may be converted by mere intellectual drill into "the subtlest of all the beasts of the field;" but we know what has become of the original of that description, and there is no need to increase the number of those who imitate him successfully without being aided by the rates. And if I were compelled to choose for one of my own children, between a school in which real religious instruction is given, and one without it, I should prefer the former, even though the child might have to take a good deal of theology with it. Nine-tenths of a dose of bark is mere half-rotten wood; but one swallows it for the sake of the particles of quinine, the beneficial effect of which may be weakened, but is not destroyed, by the wooden dilution, unless in a few cases of exceptionally tender stomachs.

Hence, when the great mass of the English people declare that they want to have the children in the elementary schools taught the Bible, and when it is plain from the terms of the Act, the debates in and out of Parliament, and especially the emphatic declarations of the Vice-President of the Council, that it was intended that such Bible-reading should be permitted, unless good cause for prohibiting it could be shown, I do not see what reason there is for opposing that wish. Certainly, I, individually, could with no shadow of consistency oppose the teaching of the children of other people to do that which my own children are taught to do. And, even if the reading the Bible were not, as I think it is, consonant with political reason and justice, and with a desire to act in the spirit of the education measure, I am disposed to think it might still be well to read that book in the elementary schools.

I have always been strongly in favour of secular education, in the sense of education without theology; but I must confess I have been no less seriously perplexed to know by what practical measures the religious feeling, which is the essential basis of conduct, was to be kept up, in the present utterly chaotic state of opinion on these matters, without the use of the Bible. The Pagan moralists lack life and colour, and even the noble Stoic, Marcus Antonius, is too high and refined for an ordinary child. Take the Bible as a whole; make the severest deductions which fair criticism can dictate for shortcomings and positive errors; eliminate, as a sensible lay-teacher would do, if left to himself, all that it is not desirable for children to occupy themselves with; and there still remains in this old literature a vast residuum of moral beauty and grandeur. And then consider the great historical fact that, for three centuries, this book has been woven into the life of all that is best and noblest in English history; that it has become the national epic of Britain, and is as familiar to noble and simple, from John-o'-Groat's House to Land's End, as Dante and Tasso once were to the Italians; that it is written in the noblest and purest English, and abounds in exquisite beauties of mere literary form; and, finally, that it forbids the veriest hind who never left his village to be ignorant of the existence of other countries and other civilisations, and of a great past, stretching back to the furthest limits of the oldest nations in the world. By the study of what other book could children be so much humanised and made to feel that each figure in that vast historical procession fills, like themselves, but a momentary space in the interval between two eternities; and earns the blessings or the curses of all time, according to its effort to do good and hate evil, even as they also are earning their payment for their work?

On the whole, then, I am in favour of reading the Bible, with such grammatical, geographical, and historical explanations by a lay-teacher as may be needful, with rigid exclusion of any further theological teaching than that contained in the Bible itself. And in stating what this is, the teacher would do well not to go beyond the precise words of the Bible; for if he does, he will, in the first place, undertake a task beyond his strength, seeing that all the Jewish and Christian sects have been at work upon that subject for more than two thousand years, and have not yet arrived, and are not in the least likely to arrive, at an agreement; and, in the second place, he will certainly begin to teach something distinctively denominational, and thereby come into violent collision with the Act of Parliament.