trade in medical education. How can a monopoly be maintained now by any one body, when all come under the same regulations? This so-called monopoly of the Scottish Universities is, I venture to say, but an expression of the success which has attended the thorough training given by their system, and when accusations of such a character are brought forward, one cannot but suspect that underneath this cry for protection for the public there lies that of protection from the success of the Scottish Universities. I myself do not believe that any equitable plan of reform would appreciably affect the present position of the Scottish medical schools, so long as they continue to offer to the student the advantages of sound training and the opportunities for practical work which have contributed so largely to their success. The Scottish Universities assume a higher position than that of merely having care for self-interest; and found their opposition to the proposed alterations upon the prejudicial effect which they believe they must have on the social status of the medical profession in the future of the nation. The value of the natural history sciences, and their position in medical education, is no new subject of contention, and I should not at this time have introduced so trite a matter, for I cannot profess to advance any new arguments, but for the recent utterances in a weekly medical journal of one, from whom, as a graduate of a sister University, and for a time an assistant upon the teaching staff of this University, a want of appreciation in this respect was hardly to be expected. Giving reasons for the opposition by the Liverpool School to the proposal to include the power of granting a medical degree in the charter of the new Victoria University, he makes "some observations to show that the University of London ought to supply the desired degree," and in the course of these he passes a condemnation upon the system of study and examination enforced by that body. I have no intention of expressing here any opinion upon the character of these tests, and had the writer contented himself with a criticism of that system, his remarks would have passed as the opinion of a teacher in a great provincial school. But, leaving the particular case of the University of London, the writer attacks in somewhat strong terms the principle of the introduction of the primary sciences into the medical curriculum, and appealing to his personal experience of, and connection with the Scottish Universities, poses as an illustration of the small amount of benefit which these sciences afford to a practitioner. But he shall speak for himself. He says: "The examiners seem to think that the medical practitioner ought to be a peripatetic encyclopædia of botany, organie chemistry, mathematics, natural philosophy, zoology, and metaphysics-an excellent preparation, no doubt, for enabling the future doctor to treat the measles, manage a forceps case, or amputate a leg. I remember being pretty well dosed with these subjects myself. What Edinburgh man can ever forget the terrors of the botany examination? All I can now say of the matter is, that my teachers did me a great injustice in wilfully compelling me to throw away a vast amount of valuable time and brain power in painfully burdening my memory with a collection of facts, not one of which has ever enabled me to do a patient a halfpenny worth of good, so far as I can remember. Ah! we are told, but look what a splendid mental training this is! Very likely. We used to be told that when we were boys, and had to excogitate from our wearied pates stumbling Latin hexameters and cranky Greek iambics, while we could not point out Dresden on the map, and knew as much about the French Revolution as we did about the Justinian Pandects. Mental gymnastics, forsooth! When a man is nineteen or twenty years of age, it is time he dropped these, and began to learn something useful." It needs no great attention to recognise how valueless is all this intensity of expression, for it is nothing more, in support of the doctrine the writer wishes to advance, and as an argument against the present position of the natural history sciences (for it is with them only I am dealing), in medical education. Instead of an indictment against these, I venture to think the writer has framed one against himself. Few will be, from what he says, convinced of the injustice of his examiners. One is rather tempted to ascribe injustice, were there any, to his own act. For the reference to memory " painfully burdened" with facts, and to the "terrors" of examination, lead one to strongly suspect that his mind, never having subjected itself to that discipline of the scientific method which so greatly increases its power and efficiency, was unable, or at least unwilling, to assimilate the matters with which it had to deal, and that his "mental gymnastics" were confined to the acquirement of the "trick or "craft of examinations," as it has been termed, obtained by the system of "cram "-a system to which the terrors of not only the botany examination in Edinburgh, but of all examinations, are due. And in place of demonstrating the worthlessness of the natural history sciences in medical education, he rather furnishes a warning against cram." May one not consider that the writer, in his letter, does himself an injustice, by estimating so cheaply the amount of good which has accrued to him from his early college career; for it is difficult to believe that the mind, at that time so plastic and susceptible, should be uninfluenced by contact with scientific facts; and surely it is not reasonable to deny effect to a cause, merely because one cannot register its amount? It is indeed to be regretted that the writer was compelled "to throw away a vast amount of brain power," which might have served him now, and prevented his falling into the error of confounding the literary with the scientific method. This was not to be anticipated from one who, as he tells us, speaks with the authority of a fourteen years' experience in teaching the ingenuous youth of this country. But his comparison of the mental training from classical studies at school with the discipline which the Natural History Sciences supply is proof of his failing to recognise wherein lies the real value of these sciences in education. It is, I think, hardly necessary to point out to an audience such as this, the different influence as a training which the learning derived from books, and the knowledge acquired by a study of things, as immediately made known by nature, have on the mind. One certainly expects to find in one who assumes the function of criticising and of reforming a system of education a thorough knowledge of the part which each subject in the system occupies or is capable of occupying, not only of itself, but also in relation to the whole. But when, as in the present instance, a critic displays so gross a misconception of the true faculty which the Natural History Sciences perform in medical education, it is, I consider, one's duty to show at what rate to estimate his opinions. The grounds of the value of the Natural History Sciences in medical education are twofold. In the first place, and most important, they supply a mental training which can be attained by no other means. The mind is brought directly into contact with fact. The student does not merely read about a thing, but learns to see for himself what it really is; and the fact becoming in this manner known to him, his intellect is exercised in drawing inferences from the fact, and thus becomes practised in the simplest form of induction. If, then, the Natural History Sciences are to be of use in disciplining the mind, it is evident that their teaching must be thoroughly practical. Take up alone the theoretical side, and their power in imparting method is reduced. In the second place, as holding the position of the fundamental sciences of life, the Natural History Sciences are of value to the medical student. The student studies life's manifestations in their most simple expressions, and thereby obtains an insight into the manner of Nature's working which affords him a valuable clue to the explanation of many of those complicated phenomena exhibited in its highest development Man. And there is yet another point of view from which the Natural History Sciences may be regarded as beneficial in education. The beauty of the objects with which they deal is well calculated to give us pleasure and delight, which we cannot afford to neglect, and should endeavour to cultivate. Do not mistake me to say that a knowledge of these sciences will of itself augment our appreciation of this beauty. But it is of value in furnishing us with a catalogue of the pictures in Nature's gallery, in leading us to search for the beautiful in nature, and thereby opening up to us an unlimited field of enjoyment and recreation. In commencing my remarks I disavowed the intention of offering to you counsel or advice, but, ere I close, allow me, addressing myself to those who are now entering upon their medical studies, to impress upon them the importance of a close attention at the outset of their career to the Natural History Sciences, which, neglected now, can never in future life be properly learned. Some there are who press the student at once into hospital work, holding that he cannot too early familiarise himself with the aspects of disease; and the neglect of the fundamental sciences which such a procedure involves, is, they think, amply compensated by the experience acquired. But, gentlemen, honest work, upon the foundations of science, alone will furnish a basis upon which to build the superstructure of the knowledge requisite for the proper practice of your profession. Those who hurry into hospital work may for a time appear to succeed, they may seem to make rapid progress, and to have outstripped all who have devoted the early portion of their course to scientific work; but be not deceived, the advantage is not real, the success is but transient, for wanting the broad basis of a general knowledge of life, they are unable in the future to appreciate the wide issues which the healing art involves; they are apt to practise their profession as a mere routine of empiricism; they fail to grasp the idea that it is a science as well as an art. I have done; and, in conclusion, I congratulate you on the commencement of another session. A season of hard mental work lies before you. Set to it diligently, earnestly; at the same time do not forget that besides the mind, the body must be exercised, and do not allow a desire for success in your studies to interfere with a due and proper amount of recreation. Remember that to work too much is as hurtful as to work too little, that the best work is accomplished when the sound mind is associated with a sound body. And in all things, in every field in which your energy may be exerted, strive to fulfil the precept, "Whatsoever thy hand findeth to do, do it with thy might." CLINICAL REPORT OF THREE CASES OF MALIG- BY DR. JAS. PATTERSON CASSELLS, No. of Case, 1100.-Mrs. G., æt 51, was admitted as an out patient at the above Dispensary, on the 11th August, 1874. She complained of having a great itching in her left ear for seven years past, and that she had "growths" in her ear "burned" with caustic. On examining the ear, I found what appeared to be an eczematous thickening of the whole tissues of the meatus. The membrana tympani was imperfectly seen, owing to the concentric closure of the canal. No polypous or other tumour existed in the meatus at this date. She did not return to the Dispensary for advice till the 18th October, 1877. During this interval of three years she had been gradually getting worse with her ear, and now for the first time she had decided pain in the organ. This was of a lancinating character, and greatly disturbed her sleep. The beds in the Dispensary being all occupied at this time, I had the patient removed to the "Training Home for Nurses,' after having examined her ear, and having found a tumour in it of a malignant character. A portion of this tumour was examined immediately after she was admitted to the Home by Dr. Foulis, who pronounced the disease to be a "very malignant" growth. It may be said here, at this stage in the history of the case, and in the absence of all complications, |