MEDICAL 
OFFICE PUPILAGE, 
BY 
Dr. John D. Jackson, 
OF 
DANVILLE, KY. 
Read before the Kentucky State Medical Society, at its Annual 
Meeting, held in Covington, in 1871. 
LOUISVILLE: 
DAVIDSON BROS. & CQ., PRINTERS. 
1871.  ‘QfflCE pUPIL/iQE. 
BY DR. JOHN D. JACKSON, 
Of Danville, Ky. 
Probably, we have no subject which has been more regular in its re- 
currence for discussion at our annual meetings, than that of Medical 
Education; and probably we will have none,.which will more regularly 
arise than this, for future discussion. It is one of those questions of the 
profession which have long agitated us, and which, from the nature of 
things, must long continue to vex us. 
Its discussion has not been confined to state, local, or national associa- 
tions, but the periodical literature of Medicine abounds in it, and the 
theme is frequently heard ringing along the pathway of the quiet every-day 
life of the private practitioner. Indeed, the interest of it is not confined 
within the professional pale, but has passed into the domains of the laity, 
and ever and anon, the secular press and secular circles discuss it after 
their secular ways. 
The words heard are not generally those of laudation, but the querulous 
tones of complaint, not unfrequently rise in the gamut, until the shrill notes 
of actual denunciation are reached. 
It is agreed upon all sides, that medical education in this country is not 
what it should be; that there is a lamentable deficiency somewhere; that 
the medical times are sadly out of joint; and that a great reform is needed. 
Looking around for the place in which reformation should most suitably 
commence, it is to be noted that, by almost common consent, the medical 
colleges of the land seem to be viewed as the fons et origo mali, and that 
within college walls it should begin. 
The catalogue of charges, brought against these institutions of learning, 
is long, and the items various. Medical Office Pupilage. 
To enumerate but a few of the accusations: They are charged with 
gradually shortening the curriculum of medical study, though the sum of 
medical knowledge essential to be learned has been regularly increasing— 
a half century ago the lecture terms extending through six months, while 
now they are nearer three. 
The standard of examinations is said to have been much lowered instead 
of elevated—the meshes of the nets being now of such texture as to gather 
up and cast on the public market the smallest of the small-fry. 
The rivalry for scientific fame, as such, among the contending schools, it 
is asserted no longer exists, but has degenerated into a rivalry for getting 
the largest number of students. 
Instead of hedging in the dignity of the profession, and jealously guard- 
ing its portals against intruders, it is charged that not only has every avenue 
been widely opened, but the most shameful bidding been made, for the 
profane vulgum. 
It is declared that the violent and open contentions of whole faculties, 
ventilating their quarrels in the daily prints as sometimes done, has not 
only lowered the dignity of the calling in the public eye, but has made the 
circumambient air of medical colleges most unwholesome for the ethical 
health of the neophytes resorting to them. 
No preliminary examinations are made preparatory to matriculation as in 
the lowest academical schools of the country, but it is said that any full- 
grown idiot may be enrolled, who will deposit his fee. 
It is asseverated that forty and odd schools have sprung up over the 
country, while the interests of Medicine plainly demand but a tithe of that 
number, in which the leading talent may be concentrated and nourished. 
Even the Thesis, the coup degrace, demanded since time immemorial of 
every medical before quitting the palaestra, to be crowned with the 
honors of the doctorate, has, in certain quarters, been stricken out of the 
curriculum. 
In fine, the accusations against the schools, is longer than the bill of 
charges of the Colonies against King George, or those of Cicero against 
Cataline. 
But, after listening to the maledictions against colleges and the anathem- 
atising of professors, let us pause and ponder. While contending with the 
Lemean Hydra in front, must we shut our eyes to the Augean Stable in 
our rear? While picking out the motes from others’ eyes, shall we be 
blind to the beams in our own ? Shall we forever gaze at the tiles falling 
from dome and turret and roof of the temple, and curse the workmen Medical Office Pupilage. 
3 
enga.ged in high places, and have never a word to say to the delinquent 
laborers among the mudsills, the hewers of stone, and carriers of mortar, 
whose botching at the foundation may be involving the whole superstructure? 
Let us remember the fact, that although it is through the doors of the 
colleges that the medical flock is turned out into the highways of life, with 
M. D. branded on their sheepskins, that there have been other pastures, 
and other shepherds. 
I would ask your attention, my brethren—you of the mountain sides and 
the valleys,—you whose modest shops and “ shingles ” are found at the 
cross-roads, the hamlets and villages, towns and cities—all of you, who are 
not wearing the caudal appendage of Professor to your names, to turn with 
me, and make an introspection, and see whether we have true cause for 
self-congratulation, and can say we thank God that we are not as they are, 
that not being guilty ourselves, we can cast stones at our brethren in 
authority. 
To be plain, I have a little to say of the student’s novitiate—his office 
pupilage. 
I would ask, What right has a public to complain of black bread being 
returned by the millers, when they send to mill chaff and smut along with 
the grain to be ground? And what crop must the husbandman expect 
when he sows tares with his wheat ? 
Now we untitled portion of the profession, of the highways and by-ways, 
the market towns and country places, are the recruiting-officers and drill- 
sergeants of the great army—medical, and what right have we to complain 
of the ineffectiveness of the field and staff, if we enlist into the service the 
lame, blind, halt and idiotically afflicted? If we but keep our ears open, 
we may hear some things said of us which are anything else than creditable. 
There is a pretty wide-spread impression, that we doctors will take any- 
thing for a medical student. That when one whose desire is to be a profes- 
sional man, goes to the law and fails, and thence to Methodist preaching and 
don’t succeed, that the “ omnium-gatherum ” of Medicine is his safe refuge, 
one ever ready to receive him with open arms. From our limited field of 
observation, we are humiliatingly compelled to acknowledge this to be too 
true. A father whose family pride has grown parsipassu with the increase 
of his lucre, wants a stupid son to be a professional man, and knowing the 
boy’s dullness to unfit him for the law, applies to the family doctor to 
receive him as a pupil, and nine to one is the chance that he is willingly 
received—for does it not seem a “little big” to have students; and besides, Medical Office Pupilage. 
if one should refuse, and honestly tell the father the truth, that the boy is a 
natural fool, and that it will be impossible for him to ever master one of 
the most difficult of all the professions—one which requires the best of 
native capacity and the best of educational training to succeed at it, why 
the ill will and loss of patronage of the family would at once follow—a 
thing as we know, much to be deprecated. 
Perhaps the boy is of moderate parts and a pretty good education, but 
very sickly; and since the peculiar province of doctors is known to be to 
cure sick people, the parents think learning him to give the physic he is to 
take, will be an economical thing in the youth’s future, inasmuch as he will 
receive all he will give, and they thus desire to apprentice him to physic, 
and instead of being told by the one who is to be his future master, that the 
successful practice of Medicine demands a strong back-bone as well as strong 
head, and that though the applicant may be mentally fitted he is physically 
incompetent, they are allowed to remain undeceived of their false ideas, and 
another candidate for the “jura privilegia et honoras Medicituz" is ad- 
mitted, probably in future years to curse the day when, and the master by 
whom, he was admitted to the study of Medicine. 
But suppose the embryo doctor once taken into an office, what are the 
aids usually found there to develop him ? What is the amount of assist- 
ance which he may on the average expect from his master? What shall 
truth reply ? The chances are even that he will have to inspire him—the 
paraphernalia of an office, which has its conterpart in the shop of the 
Mantuan Apothecary in “Romeo and Juliet:” 
“And about his shelves 
A beggarly account of empty boxes, 
Green earthen pots, bladders, and musty seeds, 
Remnants of pack thread, and old cakes of roses, 
Were thinly scatter’d to make up a show.” 
Added to this shop furniture, the few text-books which his preceptor 
furnished himself with on entering practice—it may be seven years before— 
it may have been a half century—as the scientific springs from which his 
thirsty cravings for knowledge are to be supplied, and the possibility of the 
possession of an incomplete disarticulated skeleton, and we have his 
surroundings. 
He may be put to work reading Anatomy—it may be the Practice of 
Medicine, but most likely is it, that the first task assigned him by his future 
Mentor, will be the braying of something in a mortar. Leastways, he 
probably soon finds his preceptor to be a practical man, and that attending Medical Office Pupilage. 
calls and mixing medicines are certainly not the least important of the 
labors assigned him. As to his course of reading, whatever the book may 
be, he finds soon that its study gives him full scope for his talents; for by 
his talents alone must he unravel the mysteries, and surmount the difficulties 
which it contains. If his teacher tries to teach him—most probably he 
does so in the most desultory way, he possibly examines him once a week, 
and probably it is once in the month, averaging twelve times a year. Such 
tutelage, of course, inspires corresponding ideas of the nobility of the 
calling for which the juvenile /lisculapius is preparing to fit himself, and 
he soon has his soul to be imbued with two chief ideas: firstly, to get a 
‘‘ sheep-skin,” and secondly, to get practice, probably the ultima-thule of 
his imagination; if he is given to day-dreams, being to farm it and practice 
medicine together, to raise his supplies on his place, and make a thousand 
dollars a year by his practice. With these two main ideas possessing him, 
he whiles away the first year of his pupilage; if he is studious, it may be 
doing a certain amount of study, but if not so by previous training, it is 
most apt to be in a sort of happy-go-lucky way—doing a little reading— 
much loafing, and if he be naturally of a festive disposition, a right smart, 
frolicking. So between pestling and pounding, and reading and fiddling, 
and dancing and ogling, and eating and drinking, the knight of the pestle 
and mortar has been trained for the schools, which being the finishing 
places of one’s medical education, are expected to make up for his any 
little deficiencies, and send him out into the world a model medical man. 
There have been some in the profession, who have strenuously insisted 
that it is not only necessary that a student of Medicine should be endowed 
with an ordinarily good native intellect, but that it is essential prior to his 
entering upon the study of as intricate a science as that of Medicine, that 
the intellect, though even of more than ordinary native strength, should 
have undergone a certain amount of training. With these, some little 
knowledge of the classics, a little knowledge of Latin, and at least a slight 
smattering of Greek have been deemed essential prerequisites to entering 
upon such studies. Not that the study of the classics is a better means of 
training the mind than mathematical studies or the pure logic, but that 
inasmuch as the technology of Medicine is based on Latin and Greek, that 
a certain knowledge of those languages had to be gained while pursuing 
the course of medical study, if not before, and that it would be an immense 
economy of time to enter upon the study thus prepared, was the reason. 
But there have been other some, who have told us that they thought 
quite differently, and who have not only declared that they would not object 6 
Medical Office Pupilage. 
to receiving students ignorant of Latin and innocent of Greek, but they 
decried all learning, and scouted everything beyond “ hard-sense,” refer- 
ring to Hunter and Drake as illustrations—indeed, have gone a step beyond 
this, and seemed to think that the successful practice of Medicine was more 
a matter of instinct than reason—that as “ the woodpecker tappeth the 
hollow beech-tree,” and instinctively findeth the nidus of the worm, so may 
a doctor by his instinct tap his patients’ hollow chests, and find the 
tubercle. 
To this latter some, we would say, that though asses yet live, it should 
be remembered that Balaam is dead, and that miracles are not common 
in modern days, and from the naturalpercussors of Medicine, as from the 
natural bone setters in Surgery, may the good Lord ever deliver us. 
To be eternally presenting instances of the rise of Drake and Hunter 
and a few other prodigies in the profession, who were gifted with powers 
sufficiently prodigious to make them by limited means to overcome the 
greatest obstacles, is to us absurd, and if these gentlemen carry to the bed- 
side such a philosophy—drawing their general rules of practice from such 
special exceptional instances as they can find, we can only say, we would 
dislike to fall into their hands as a patient. 
Such conclusions from special instances have seemed to us as foolish, as 
it would be to say that there was no necessity for a multiplication-table or 
the rules of addition, subtraction and division, and slates and pencils in 
their application, since Zerah Colburn, Joseph Bidder and some others 
have had the power of working out mathematical problems without such 
aids; or that because there are some men like Weston the walker, who 
can walk their seventy-five miles a day, that there is no use for horses and 
buggies, but that we doctors ought all to practice afoot, or that since Hugh 
O’Brien, giant, standing eight feet six inches in his socks as he 
did, could write his name on the ceiling, that the average of mankind 
wouldn’t require to stand on something to do the same, or that since Blind 
Tom composed and played the most difficult pieces without ever having 
seen a note, that all this thing of musical notes is needless, and the gamut, 
music-masters, and musical conservatories, should be abolished. 
Since Dr. Drake has been so freely alluded to upon this floor in past days 
as an instance of the futility of all classical knowledge in the study of 
Medicine, we will take the liberty of quoting a page or so from an Address 
on Medical Education, delivered in the city just opposite us, before a class 
of students of the “ Medical College of Ohio,” some years berore we were 
born: Medical Office Pupilage. 
“Although Medicine is ranked with the learned professions, not a few of 
its professors are signally deficient in learning.* This is the case, not only 
in the Western States, where for obvious reasons it might be expected, but 
in almost every part of the Union, with the exception of some of our large 
cities. Writing as I do, for practical effect, and to promote reform, I am 
constrained to say, that even at this late period the profession abounds in 
students and practitioners, who are radically defective in spelling, gram- 
mar, etymology, descriptive geography, arithmetic, and I might add book- 
keeping, but that they generally apply themselves to the study of that 
important branch, with a diligence which supplies the want of early op- 
portunities. Grammar, and spelling especially, (to use the language in 
which I once heard a physician speak of the circulation of the blood), ap- 
pear to be among the ‘ secret arcanums of nature which Dr. Hamilton 
said never ivould be found out! ’ Nothing is more common than to 
commit gross violations of both in the directions which we write for our 
patients; and what is still more humbling to the pride of the profession, it 
would be an affair of little magnitude; but extending to many of the 
graduates of all our Universities, it calls for unreserved exposure, and un- 
qualified reprehension. Before the Revolution the schools of the Colonies 
were generally bad, and till lately those of the West were not fitted to im- 
part a good elementary education; but at present they are so improved as 
to leave no excuse for the literary ignorance, which disgraces the profes- 
sion. It would certainly not be unreasonable to require that every youth 
who aspires to connect himself with a liberal pursuit, should first learn to 
spell and write his mother tongue with as much accuracy as a country 
school-master; if either his genius or misfortunes preclude such require- 
ments, he had better take to some calling which does not demand them. 
* * * “ But is the education which our common schools confer 
a sufficient preparation for the study of Medicine ? It certainly is not. To 
a familiar acquaintance with the branches which have been enumerated, 
the intended student of Medicine, should add a competent knowledge of 
the elements of physical geography, general history, the art of composition, 
algebra, geometry and mechanics. If these acquirements are not made 
before he enters on his professional studies, he will most probably remain 
without them through his whole life; the effects of which will be sufficient- 
*0f course, on this occasion. I expect the reader to understand the word 
professor, as synonymous with practitioner, and not as referring to public 
teachers, whose commissions must be regarded as evidence of learning, 
should other proofs happen now and then to be wanting. 8 
Medical Office Pupilage. 
ly obvious to others, if not felt by himself. * * * 
“ The United States are, perhaps, the only civilized country in modern 
times, where it has been seriously doubted whether the language and 
literature of the ancients should make a part of the studies of professional 
men. Of the various causes which have combined to suggest this question 
one of the most operative is the spirit of liberal inquiry, which originated, 
and is cherished by our free institutions. No people are so unshackled by 
prejudices and precedents; none so excursive; none so experimental as the 
American. If they do not ‘ try all things, and hold fast to that which is 
good,’ they try many and are strongly disposed to fix upon something new. 
“Another cause contributing to excite some doubt, is the successful 
acquisition of business by physicians who lived and died in ignorance of 
Greek and Latin. With such examples before us, it was natural to ask 
whether the study of the dead languages should be regarded as indispens- 
able or even beneficial to the candidate for the honors of the profession ; 
and not a few have been ready at all times to answer in the negative. In 
this inquiry there has been much to lead us astray. 
“ Our fore-fathers (most of whom were illiterate) emigrated to a forest, 
which it has been the work of their sons to subdue. In the prosecution of 
this Herculean task, and the subsequent establishment of institutions— 
political, social, and literary, they frequently experienced a want of appro- 
priate means, and were compelled by the exigencies of their novel and try 
ing situation to think and act with originality. Hence arose a feeling of 
self-reliance; a spirit of independence; a disregard of ancient custom; to 
which we may, in a great degree, ascribe that indifference to the languages 
and learning of antiquity, which characterizes the majority of our citizens. 
Thus physical circumstances have indirectly exercised a mastery over moral 
causes, and'given a deflection to our European character, which promises 
to become permanent. Moral causes, however, have contributed to the 
same effect. 
“ In migrating from the Old World our ancestors took leave of the in 
stitutions devoted to classical instruction; and hence a generation of 
necessity grew up in comparative ignorance. It would be in vain to hope 
that a due respect for the learned languages, or even a conviction of their 
utility could survive such a transition; and hence we find that in the 
United States a want of acquaintance with them has been no obstacle to the 
attainment of high relative distinction in any of the pursuits of society. 
How long this will continue the case, it is not easy to forsee. A perception Medical Office Pupilage. 
9 
■of their value appears to be returning; but I cannot suppose that they will 
■ever attain to the rank which they hold in the estimation of our brethren 
of Europe. 
“ Meanwhile it is the duty of those who can exercise any control over 
public sentiment in this respect to exert themselves; and if all who are 
interested in the dignity of the medical profession, could be brought to 
unite their efforts in favor of a more classical preparation for young men 
designed for the study, it cannot be doubted that much might be accomplish- 
ed in a single generation. 
“A physician who is ignorant of the Latin and Greek languages, what- 
ever may be his genius and professional skill, must, to the eye of sound 
scholarship, appear defective and uncultivated. For more than two thousand 
years these languages, especially the former, were the vehicles of all medi- 
cal knowledge, except the little contributed by the Arabians; and ’til 
within a century our professional ancestors wrote and prescribed, and 
thought and lectured in Latin. It was indeed to the profession a universal 
language; affording the means of an easy and accurate correspondence 
among all the schools and physicians of Europe. Even down to the 
present time, the lectures in most of the Italian and German Universities 
are delivered in Latin; while the examination of candidates, in many 
others, is conducted in the same language. Thus it has had a most pro- 
tracted and intimate companionship with Medicine; to the nomenclature of 
which it has freely lent its opulent vocabulary. Many of its words, no 
doubt, as well as those drawn from the dialects of Greece, are intended to 
convey, in their new situation, ideas materially different from their vernacu- 
lar import; but in attempting to understand even these, the student is greatly 
assisted by an acquaintance with their primitive signification. With this 
knowledge of our dependence on the languages and literature of the 
ancients to deny that the study of them must be beneficial, is scarcely less 
absurd than to affirm on the other hand, that every classical scholar is of 
necessity a physician. 
* * * “ It is sorrowful to see what every physician must have 
seen, the exertions of a generous young man consigned to the study of 
Medicine, with a mind untutored and unstored; to witness his ill-directed 
efforts—strong but comparatively unavailing; his fitful application; his 
embarrassments under every difficulty; his disappointments and despond- 
ency; above all his mortification, from consciousness of superior abilities, 
united with a perpetual conviction of inferior progress. No devotedness 10 
Medical Office RupRage. 
t o study, no intensity of ambition, no energy of intellect, not the whole- 
combined, can make such an one what he would have been with early 
culture, nor raise him to the standard erected by his own vivid imagination. 
He may satisfy his friends, but must himself remain dissatisfied and un- 
happy.”'* 
To quote a man who had written thus in behalf of a high standard of 
preliminary education, as an advocate and example of the futility of any thing 
like a high order of learning in Medicine, must have required great bold- 
ness. We could not have summoned courage to have done so, we confess, 
fearing lest the bones of Drake should have turned in their resting-place, 
and his ghost have revisited earth to have haunted our midnight pillow. 
But regarding this part of our subject we will simply say that in England 
the law does not permit any man to commence study as an Apothecary, un 
til he has been registered as having passed a satisfactory examination in 
the following subjects, viz: I. English Language, including Vulgar and 
Decimal Fractions; Algebra, including simple Equations. 3. Geometry: 
First Two Books of Euclid. 4. Latin, including Translation and Gram- 
mar. 5. Greek, and one of the following subjects, at the option of the 
candidate: 1. French; 2. German; 3. Natural Philosophy, including 
Mechanics, Hydrostatics and Pneumatics.f Yet with a foundation gener- 
ally far inferior to that of the English Apothecary, do we plume ourselves, 
and with Yankee modesty boast the superiority of American Medicine, and 
American Doctors overall the balance of creation. 
But we will not weary you further regarding this part of our subject. 
Mrs. Glass says, in her Cookery-Book: “ F'irst catch you a hare, then pro- 
ceed to cook it.” So having gotten our young gentleman, what shall we 
do with him? And here, just, as next in importance to getting the hare 
is the importance of getting the good cook to prepare it, so we might say 
a word or so of the preceptors’ qualifications, which we can not put better 
than in a sentence from Dr. Drake, from whom we again quote: 
“It is not sufficient that a private preceptor has talents and learning. He 
must be devoted to his profession, jealous of its character, and ambitious 
of its honors. With such feeling he will awaken high aspirations in the 
bosom of the youth, whose destiny is committed to his keeping, enamour 
him with the sciences, whose rudiments he is to acquire, and animate him 
in the toil which their difficulties impose.” 
*Practical Essays on Medical Education and the Profession in the United 
States. By Daniel Drake, M.D., Professor in the Medical College of Ohio, 
Cincinnati, Ohio. Published by Roff& Young, 1832. 
t Vide—Medical Times and Gazette (London), June, 18<>7. Medical Office Pupilage. 
11 
There is a custom prevalent regarding the taking of office pupils against 
which we would earnestly protest—it is the charging of no fee to the 
student. It is a general law in political economy that those things which 
cost nothing, are worth nothing, and it applies in all its force here. The 
doctor, like every one possessing the ordinary instincts of humanity, is in- 
clined to demand a quid pro quo, and where nothing is given, is too apt to 
require nothing of the student in the way of study, and to give nothing in 
return in the way of instruction. Let the rule be to demand a moderate 
fee, and the obligation will then be mutual, as it should,—the student will 
feel the obligation to study to be greater on his part, and the preceptor, that 
his obligations to endeavor to instruct the student, to be then imperious up- 
on him. 
The first thing which we believe a preceptor should do for his pupil, should 
be to give him a general idea of the field which lays before him, and the pains 
and penalties, the pleasures and honors, which await him in its cultivation. 
Let him at the entrance be taught the difference between medicine and 
quackery, the distinction between the true and false laborers. Give him 
clear ideas of the ethics of the profession by having him read the “ Hip- 
pocratic Oath,” and the “ Code of Ethics of the American Medical As- 
sociation,” or better still, Dr. Percival's little work, from >vhich our code 
was extracted. And let the master see to it, that his daily life, in the 
presence of his student, illustrates what he indoctrinates—that he ever 
practices what he preaches—“minus valentprcecepta, quam exempla." As 
Dr. Drake has said, teach him to be “devoted to his profession, jealous of 
its character, and ambitious of its honors.” In one word, if the preceptor 
can infuse into his student a love of his profession, success is half insured. 
However, not only should the pupil be fully imbued with the responsibilities 
of his situation, but the preceptor, we would say, has equal responsibilities 
on his side and should be just as fully conscious of them, when he assumes 
the serious trust of the medical education of a young man, in whose charge 
are to be placed the future lives and bodily comfort of his fellow-mortals. 
He should never forget that, in a great degree, the young man’s future 
success as a member of the medical profession, and the lives and happiness, 
probably, of a large community will hereafter depend on the efficiency with 
which he shall instruct the now doubly impressionable medical neophyte. 
The teacher and taught should alike be inspired by a laudable ambition— 
the master to have his scholar advance beyond his own attainments, and 
the scholar to prove himself worthy of his master, by giving all his efforts 12 
Medical Office Pupilage. 
to the attainment of the goal set up before him. As in every other voca- 
tion in life no teacher is apt to be successful, who has not got his heart in 
his work, and who does not go at it con amore. Whenever inclined to 
weary of his work, let him remember “ qui docet discit," and knowing that 
in teaching others, he is learning himself, his self-interest will assist in 
sustaining him. A word as to the paraphernalia required by the teacher. 
While some men have the gift of illustrating by few and very simple 
objects much better than others with many, yet every preceptor will require 
something more than the ordinary text-books—a certain number of special 
ly illustrated works, a certain number of instalments, a certain amount of 
apparatus, and a few preparations. 
As to the text-books to be chosen, and the order of their study, this is a 
matter for the judgment of each teacher, and something in each case may 
depend upon the individual peculiarities of the student. But this much we 
will say, that the preceptor who does his duty by his pupils, must try to 
have them recite daily. Daily recitations in the study of Medicine are just 
as essential as the recitations which are' daily demanded of all students 
of literature and science in the academical institutions of the land. 
As in all efficient literary teaching, the teacher selects and dwells 
upon the important things, directing the scholars’ attention particularly to 
them, so should the medical teacher. A pupil ought to be made to write 
out digests or synopses of certain parts of his reading, and when somewhat 
advanced, and having seen one or several cases of disease, to keep notes 
of them, read what may have been written by certain authorities with re- 
ference thereto, and write a thesis thereupon, to be revised and commented 
upon by his preceptor. As in the teaching of the natural sciences, every 
good teacher tries to illustrate by experimental demonstrations as far as 
possible, so should it be when practicable, in the teaching of Medicine, a 
large portion of whose field can be taught in no other way effectively. 
Every private preceptor should teach his pupil, as far as possible, all the 
chirurgical or manipulative parts of the profession, and he should go from 
his office to the schools an adept in minor surgery, skilled in the applica- 
tion of bandages and the ordinary apparatus, together with some practical 
knowledge of microscopy, opthalmoscopy and laryngoscopy. We believe 
that it is especially during the period of the student’s office pupilage, that 
he should devote himself to practical Anatomy, that he should go up to the 
schools with a fair knowledge of Anatomy gained by actual dissection. 
Doubtless many are ready to declare the feasibility of gaining a knowledge Medical Office Pupilage. 
13 
of practical Anatomy while studying in a country office, as impracticable. 
To these, we would say, that we are personally familiar with all the dif- 
fiulties and dangers incident to such study, which are not a few in a State 
like ours, which while it continues to make all dissection penal, still vies 
with the more enlightened countries in exacting the highest degree of 
knowledge and skill from medical men in the exercise of their vocation; but, 
as “ where there’s a will there’s away,” we will say that there is scarcely a 
country doctor who has not got it in his power to dissect, if he desires to, 
and is only willing to spend a little money and trouble for the purpose; a 
greater difficulty than the legal one is in the bosom of the profession 
itself, the narrow-minded jealousies so frequently existing among doctors, 
preventing that co-operation, which could easily surmount all obstacles. 
Where two or three practitioners live together in a town, who are proper- 
ly qualified, and who properly harmonize, by a union, private teaching may 
be made much easier, and more efficient than as usually conducted by 
single individuals. 
Where Medical Societies exist, it would not be a bad move, we think, 
for all practitioners to agree to take no pupils, who were not pronounced 
properly prepared to study Medicine, after having undergone a preliminary 
examination at the hands of the Society. 
But,—although we have not near said all we have in mind, and especially 
regarding the minutiae of office instruction, we perceive that we are weary- 
ing you, and will close by saying that no member of the “ Kentucky 
State Medical Society,” who has, or ever shall have an office pupil, but 
should feel the weight of responsibilities to be as great, and should be as 
proud of them as any public professor. Let him do his full duty by his 
profession in refusing all students whose talents and acquirements are not 
such as to make future success in the profession very probable, and let him 
do his full duty by his students when he may have taken them. 
I would say, as a plain country doctor,—as in the case of charity, so let our 
reformation commence at home; when having done our whole duty, we 
can then conscientiously and freely devote ourselves to the attacking of 
abuses in other quarters. 
In the freedom of what we have said, doubtless there are some who 
will take offence, but old sores need vinegar, not oil, and malignant growths 
require no soothing unguent, but rather the knife and actual cautery.