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BY JAMES B. HERRICK, A. B., M. D., CHICAGO, ILLINOIS.
PROFESSOR OF MEDICINE IN RUSH MEDICAL COLLEGE
THERE is a tendency in these hurrying modern times to seize upon that which is new and quickly to forget the old. In religion we hear of a higher criticism and a new theology. A teacher of forty declared to me that another teacher, a psychologist, a man of fifty, had not kept up with the times and did not possess the faintest conception of what is meant by modern psychology. Sociology of twenty years ago makes the student of present social conditions smile. Methods of warfare of a generation back seem ridiculous now. The artisan apprentice in order to secure employment gives up his trade and takes to running a machine only to find in a few years that a still more recent invention again necessitates a change of labor. We open the paper in the morning and are so accustomed to the announcements of wonderful achievements that we are but little surprised when we learn of telegraphic communication through miles of space with no guiding wire. A new novel is hurriedly written, extensively advertised, sold by the tens of thousands, read by hundreds of thousands, and in a year is nearly forgotten, a new candidate for present popular favor having appeared. Invention, innovation, advance, research, discovery, rapid adaptation characterize
Medicine shares, and takes no inconsiderable part, in creating this ozonized atmosphere of activity. New facts are being constantly put before the medical student until he feels, when he leaves school, that he will have a hard time indeed to keep pace with the advance of modern discovery. He no sooner learns the rudiments of bacteriology and its application in aseptic surgery and practical diagnosis than he is tortured by the necessity of attempting to solve the mysteries of the bewildering facts of physical chemistry and the newer hematology. He must be on the alert for new remedies, new methods of treatment, new aids to diagnosis, new facts in the etiology and pathogenesis of disease, and he plans to have the latest text-books, the most wide-awake medical journals, the most approved instrumental and laboratory armamentarium so that he may be quick to grasp and apply the very latest knowledge.
* Read at the meeting of the WASHTENAW COUNTY MEDICAL SOCIETY held at Ann Arbor, Michigan, December 17, 1902.
Now all of this is right and necessary; this spirit is to be encouraged. But growing out of this seeking after the new there is a tendency not altogether praiseworthy, to forget or ignore, if not absolutely despise, the past. Many of the modern achievements are but the stages in a process of evolution whose earlier history is not without interest and value, and which earlier history deserves to be studiously considered. And in this paper I wish briefly to discuss the importance to the student and physician of an acquaintance with older standard medical literature. In a medical sense, I suppose, literature of twenty years ago is old.
I trust that in acknowledging at the outset the importance and necessity of a careful study of recent literature I may not be charged with being one-sided and nonprogressive. I do not wish to be regarded as the laudator temporis acti nor even as giving the politic advice of Pope to hold the middle and supposedly safe position of the trimmer,
“ Be not the first by whom the new are tried,
One may and often should do both, hold fast that which is good in the past while reaching out for that which is true, beautiful and permanent in the future. Nor do I overlook the fact that one of the most desirable yet hardest things is to forget, to forget faulty methods, wrong conclusions, and to rid the mind of rubbish, worn out and effete material, so as to make room for that which is fresin, life-giving and worthy of remembrance.
I believe that I am speaking on a subject that will, in the near future, be more generally recognized as of value than at present. There is, I think, a revival of interest in older medical writers, their lives and their work. Societies are formed for the study of medical history, biographies of noted physicians are frequently appearing, shorter biographical sketches are made the subject of addresses, the earlier medical history of societies, colleges and towns is hunted up by some interested physician who turns from his regular daily routine of work along modern lines to make an excursion into some forgotten nook or corner of the medical world, and feels enjoyment, relaxation and invigoration as he investigates the lives and writings of medical worthies of the past.
Why should one read any of the older medical writers? We cannot claim for them as we can for the great writers of polite literature that their works are for all men and for all time. So far as the medical writer treats of facts correctly observed and accurately reported his contribution has a permanent value. But these facts were seen only in the light of the time in which he lived. New facts and new principles seen by clearer light throw the old facts into the shade. The book loses, therefore, much in intrinsic value. Classic polite literature deal
ing with human nature, the customs of the age and with imperishable and unchanging things such as truth, love, beauty is, the best of it, as valuable today as years ago. Homer, Dante, Schiller, Balzac have written for all time. But there were giants in medicine fifty and a hundred years ago, yes, even centuries ago. And contact with minds like those of Hippocrates, Sydenham, Rush, Laennec can but be beneficial. And it would be laughable if it were not almost sad, to see a young physician spending hours in reading weak articles in the medical journals, cheaply written, unscientific, based on poor or faulty observation, often reiterating in diluted form the ideas of some greater man, when that same physician might have the elevating inspiration of an evening's association with some of the master minds of the past. There are yellow medical journals and there is much of the dime novel and the Mary J. Holmes in present medical literature, vicious, trashy, wishywashy stuff, and it is a mystery why students and physicians pore over this instead of reading the medical Thackerays, Hawthornes, Hugos or Goethes. For though every fact recorded by Hippocrates were false —which is not so—though Virchow's views on cellular pathology must be modified to fit in with later knowledge, though Bright's description of the kidney in disease is far from complete, the reading and the study of the writings of these men is as invigorating as a breath of sea air or a change of climate to the invalid. Merely to listen to the talk of an old man of strong. vigorous mind is an inspiration even though we may not believe all that he says. Who would not go today to hear Linnaeus speak on botany, or Darwin on evolution, or Kant on psychology, or Morse on the telegraph, though he knew he would hear much that was behind the times ?
So, one reason for studying these older writers is that one is then in good company, is benefitted by this favorable environment and is strengthened by contact with these great minds.
But the inexperienced student turns to the new largely because it is new, and because there is a glamour about it that attracts, and he feels that anything that has the recent mark of freshness upon it is proper for study. In this way he wastes time in reading much that is mediocre, poor or even harmful, and this largely because he has had no training in discriminating between the good and bad in medical literature; he has no standard by which to judge. His medical literary taste has been poorly cultivated. He lacks judgment in such matters. I take it that one of the great benefits to be derived from reading standard medical authors, authors whose writings after the test of time can be called classic, is that it tends to elevate our ideals and makes us keener critics of the medical writing of the day. Read the masterly monograph of Koch on "Tuberculosis," terse, systematic, scientific, the result of an immense amount of research, epoch-making in its influence, its conclusions scarcely changed by twenty years of study and investigation by others—read this, I say, and see how tame will then appear much of the present magazine literature. Your taste has been improved, you are more exacting in your demands upon the writer whom you will read, your standard has been elevated. But so surely as we read only the weaker contributions of today, our tastes are depraved and our standards lowered. I would not be misunderstood. Good medical literature is abundant today. But our students have too little training in the ability to tell what is good and what is bad, the original from that which is worked over. Reading standard medical authors cultivates this power of discrimination.
Let me quote something that Latham wrote over sixty-five years ago. We shall see that our problem of how to select the best from the mass of medical writing is not a new one. And we must admit that what he says is as true today as it was in Latham's time, even truer when we consider the greater number of books and magazines that are yearly put forth. “In the shape of practical treatises our own age and country has bred, and is breeding, and the press is assisting at the birth of, the oddest and most worthless trash; and this often obtains a wide circulation, and a strange popularity. While you are watching various diseases. you cannot help feeling a desire to know what they have said concerning them, who have expressly written about them, and in your wish to read something, you are, without direction or warning, as likely to lay your hand upon a bad book as a good one; nay, more likely, for a bad book is generally a very easy book, having been composed by its author with no labour of mind whatever; whereas a good book, though it be not necessarily a hard one, yet, since it contains important facts, duly arranged, and reasoned upon with care, must require from the reader some portion of the same attention and study to comprehend and profit by it as it required from the writer to compose it. A good book, at all events, is never a very easy book, and never suddenly popular."*
Then again this will tend to overcome what is in some respects pernicious habit, that of reading articles in epitome or abstract. Our journals are crowded with these abstracts, and some are made up of nothing else. With the multiplicity of articles it is of course a physical impossibility for one to read all, or any great proportion of all, articles, even of the good ones. But because this is so, it is unwise to rely too implicitly on abstracts. It leads to habits of superficiality; and it is a rare synopsis that gives us the substance and the spirit of the original. And this, perhaps, is not to be wondered at when we consider that the abstract is often made in a perfunctory way by a hack worker, who may or may not be a physician, and who has no interest in the subject beyond the mechanical performance of his set task of filling so many columns with the given material. And often the abstract is an abstract of an abstract. One solid article carefully read and thoroughly digested is worth many abstracts. And if time fails for the careful reading of an article I believe it is often better to read it hurriedly yourself, to skim it, than to trust too implicitly in the epitome made by another.
There is room for discussion on this topic of the medical abstract. I admit that it has a field of usefulness. I am no opponent of the yearbooks with their resumés of progress. But all these must be rightly
* Latham's Works, Volume II, page 43; New Sydenham Society, 1879.