Report of the Commissioners appointed to inquire into the hospitals of Dublin : with appendices / presented to both Houses of Parliament by command of Her Marjesty.
- Ireland. Dublin Hospitals' Commission.
- Date:
- 1856
Licence: Public Domain Mark
Credit: Report of the Commissioners appointed to inquire into the hospitals of Dublin : with appendices / presented to both Houses of Parliament by command of Her Marjesty. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![more or less speedily, destroys the patient: and he affirms that the only mode of treating tliis formidable disease is by the exhibition of mercury in every stage, and that this is a certain cure. Thus taught, the student proceeds to his hospital, and there finds that the surgeon whose practice he attends, considei's that the disease at its onset assumes a variety of forms, that these are followed by trains of symptoms very nearly resembling each other, and trequentl}- confused; that if the disease be left to itself it will often wear itself out, and the ])atient get well; or that one kind requires, for its cure, treatment of the most simple kind, whilst the other calls for mercurial treatment, but of the mildest kind. From listening to principles and witnessing practice so directly contrar}-, what certain knowledge can the student obtain ? His practical experience is too small to enable him to determine between the contending principle and practice; and the result is, that when he has passed through his professional education and assumes the charge of patients, he, for the first time only, begins, if intelligent and observant, to acquire a small knowledge of the treatment of disease, the propriety of which he only satisfies himself with after repeated cases have come under his care, Avhilst, from the confused information he has derived from his contr'adictory teachers, he may have employed every remedy but the right or^the most effective one, and the patient dies or passes through a long protracted illness, either of which might, perhaps, have been prevented had the medical attendant possessed any certain prin- ciples on which to act. So, then, is clearly shown the necessity of the student being instructed in both principles and practice b}^ the same teachers, who should illustrate, by their hospital cases, the teaching of their lectures. Another advantage of the nearness of the elementary school and hospital is the sa\'ing of the student's time. Although the two be only half a mile, or less, apart, every occasion for passing from one to the other occupies time, which is just so much wasted and lost to the day's work. Whereas, on the contrary, if the school and hospital be close together, two or three minutes pass the student from the laboratory, dissecting-room, or lecture theatre, to the hospital wards, so that he is, or ought to be, always at hand, and ready to go into the hospital to witness the first appearance of accidents that are brought in, and the methods of discrimination, which form a most important branch of surgical knowledge. Nor less beneficial to the student is his constant, almost hourly intercourse with his teachers and fellow students, who, as it were, form one large family. The mutual interest thus excited in each for the other, and the attachments there formed, help largely to the support of the hospital and school, by attracting to it the sons of those who have an aftectionate remem- brance of the benefits, professional and social, which they enjoyed during their student life, and who will continue to take deep interest in the well-being of the institution where they laid the foundation of their professional reputation, and be desirous their children also should enjoy its advantages. Nor less are the medical and surgical officers of an hospital advantaged by their connexion with an elementary school, which ought always to be attached to it. Putting aside the pecuniary benefit obtained, they are compelled to arrange the practical knowledge they have acquired in the wards for the establishment of the principles upon which the treatment of disease depends, so as to enable their communication to the students in as terse and clear manner as possible; and thus, for the instruction of others, themselves are constrained to continue students of disease so long as their connexion with the hospital and school con- tinues, as is right and requisite they should. The public also ai'e deeply concerned in the matter. Supporting, as they do, more or less directly, these invaluable institutions, from which those holding hospital appointments derive such large advantage, they have a right to require them to impart to the students the results of the experience and practical knowledge they have thus become possessed of, and which can be obtained from no other source than hospitals and infirmaries, as nowhere else can disease and its treatment be so constantly and satisfactorily watched; so that the advantages which hospital officers enjoy must necessarily make them the most fitting persons for teachers and examiners. No one has right to hold a hospital appointment simply for his own advantage, either direct or indirect; but in return, for the benefit he derives from it, he is bound to impart to the students the results of his experience; and if, from large and increasing private professional engagement, he is unable or indisposed to give up the necessary time for attendance on the patients, and for the elementary and clinical instruction of the pupils, he ouglit not to retain an office which might be more advanta- geously filled in relation both to students and patients. From the preceding observations it is apparent, that in the establishment of an elementary school of medicine and surgery in connexion with Steevens's Hospital, it is pm-posed that the medical and surgical officers should be requested to assume the A'arious teacher- ships which Avill have to b ■ established; but that if the present staft be of insufficient num- ber to fill these appointments, or if there be satisfactory cause for either of the ]jresent officers being indisposed to take part in the new school, tlicn it being necessary that for the completion of the teaching estabHshment foreign aid should be called in, there ought to be an engagement on the part of the Governors that the persons received as teachers should be elected accoi'ding to the precedence of their appointments as assistant physicians or surgeons, in preference to others unconnected with the school, and subsequently should become physician or surgeon as vacancies occur. By holding out such advantages there is great probability that there will be no serious difficulty in completing the full number of teachers from most eligible candidates. As in the estabHshment and support of a school it is necessary the members of it should G](https://iiif.wellcomecollection.org/image/b24749400_0043.jp2/full/800%2C/0/default.jpg)
