medical essays-第81节
按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！
nt habitat； but I never saw him do more than look as if he wanted to cut a good dollop out of a patient he was examining。 The short； square； substantial man with iron…gray hair； ruddy face； and white apron is Baron Larrey； Napoleon's favorite surgeon； the most honest man he ever saw；it is reputed that he called him。 To go round the Hotel des Invalides with Larrey was to live over the campaigns of Napoleon； to look on the sun of Austerlitz； to hear the cannons of Marengo； to struggle through the icy waters of the Beresina； to shiver in the snows of the Russian retreat； and to gaze through the battle smoke upon the last charge of the red lancers on the redder field of Waterloo。 Larrey was still strong and sturdy as I saw him； and few portraits remain printed in livelier colors on the tablet of my memory。
Leave the little group of students which gathers about Larrey beneath the gilded dome of the Invalides and follow me to the Hotel Dieu； where rules and reigns the master…surgeon of his day； at least so far as Paris and France are concerned；the illustrious Baron Dupuytren。 No man disputed his reign； some envied his supremacy。 Lisfranc shrugged his shoulders as he spoke of 〃ce grand homme de 1'autre cots de la riviere；〃 that great man on the other side of the river； but the great man he remained； until he bowed before the mandate which none may disobey。 〃Three times；〃 said Bouillaud； 〃did the apoplectic thunderbolt fall on that robust brain；〃it yielded at last as the old bald cliff that is riven and crashes down into the valley。 I saw him before the first thunderbolt had descended： a square； solid man； with a high and full…domed head； oracular in his utterances； indifferent to those around him； sometimes； it was said； very rough with them。 He spoke in low； even tones； with quiet fluency； and was listened to with that hush of rapt attention which I have hardly seen in any circle of listeners unless when such men as ex…President John Quincy Adams or Daniel Webster were the speakers。 I do not think that Dupuytren has left a record which explains his influence； but in point of fact he dominated those around him in a remarkable manner。 You must have all witnessed something of the same kind。 The personal presence of some men carries command with it； and their accents silence the crowd around them； when the same words from other lips might fall comparatively unheeded。
As for Lisfranc； I can say little more of him than that he was a great drawer of blood and hewer of members。 I remember his ordering a wholesale bleeding of his patients； right and left； whatever might be the matter with them； one morning when a phlebotomizing fit was on him。 I recollect his regretting the splendid guardsmen of the old Empire；for what？ because they had such magnificent thighs to amputate。 I got along about as far as that with him； when I ceased to be a follower of M。 Lisfranc。
The name of Velpeau must have reached many of you； for he died in 1867； and his many works made his name widely known。 Coming to Paris in wooden shoes； starving； almost； at first； he raised himself to great eminence as a surgeon and as an author； and at last obtained the Professorship to which his talents and learning entitled him。 His example may be an encouragement to some of my younger hearers who are born； not with the silver spoon in their mouths； but with the two…tined iron fork in their hands。 It is a poor thing to take up their milk porridge with in their young days； but in after years it will often transfix the solid dumplings that roll out of the silver spoon。 So Velpeau found it。 He had not what is called genius； he was far from prepossessing in aspect； looking as if he might have wielded the sledge…hammer （as I think he had done in early life） rather than the lancet； but he had industry； determination； intelligence； character； and he made his way to distinction and prosperity； as some of you sitting on these benches and wondering anxiously what is to become of you in the struggle for life will have done before the twentieth century has got halfway through its first quarter。 A good sound head over a pair of wooden shoes is a great deal better than a wooden head belonging to an owner who cases his feet in calf…skin； but a good brain is not enough without a stout heart to fill the four great conduits which carry at once fuel and fire to that mightiest of engines。
How many of you who are before me are familiarly acquainted with the name of Broussais； or even with that of Andral？ Both were lecturing at the Ecole de Medicine； and I often heard them。 Broussais was in those days like an old volcano； which has pretty nearly used up its fire and brimstone； but is still boiling and bubbling in its interior； and now and then sends up a spirt of lava and a volley of pebbles。 His theories of gastro…enteritis； of irritation and inflammation as the cause of disease； and the practice which sprang from them； ran over the fields of medicine for a time like flame over the grass of the prairies。 The way in which that knotty…featured； savage old man would bring out the word irritationwith rattling and rolling reduplication of the resonant letter rmight have taught a lesson in articulation to Salvini。 But Broussais's theory was languishing and well…nigh become obsolete； and this； no doubt； added vehemence to his defence of his cherished dogmas。
Old theories； and old men who cling to them； must take themselves out of the way as the new generation with its fresh thoughts and altered habits of mind comes forward to take the place of that which is dying out。 This was a truth which the fiery old theorist found it very hard to learn； and harder to bear； as it was forced upon him。 For the hour of his lecture was succeeded by that of a younger and far more popular professor。 As his lecture drew towards its close； the benches； thinly sprinkled with students； began to fill up； the doors creaked open and banged back oftener and oftener； until at last the sound grew almost continuous； and the voice of the lecturer became a leonine growl as he strove in vain to be heard over the noise of doors and footsteps。
Broussais was now sixty…two years old。 The new generation had outgrown his doctrines； and the Professor for whose hour the benches had filled themselves belonged to that new generation。 Gabriel Andral was little more than half the age of Broussais； in the full prime and vigor of manhood at thirty…seven years。 He was a rapid； fluent； fervid； and imaginative speaker； pleasing in aspect and manner；a strong contrast to the harsh； vituperative old man who had just preceded him。 His Clinique Medicale is still valuable as a collection of cases； and his researches on the blood； conducted in association with Gavarret； contributed new and valuable facts to science。 But I remember him chiefly as one of those instructors whose natural eloquence made it delightful to listen to him。 I doubt if I or my fellow…students did full justice either to him or to the famous physician of Hotel Dieu； Chomel。 We had addicted ourselves almost too closely to the words of another master； by whom we were ready to swear as against all teachers that ever were or ever would be。
This object of our reverence； I might almost say idolatry； was one whose name is well known to most of the young men before me； even to those who may know comparatively little of his works and teachings。 Pierre Charles Alexandre Louis； at the age of forty…seven； as I recall him； was a tall； rather spare； dignified personage； of serene and grave aspect； but with a pleasant smile and kindly voice for the student with whom he came into personal relations。 If I summed up the lessons of Louis in two expressions； they would be these； I do not hold him answerable for the words； but I will condense them after my own fashion in French； and then give them to you； expanded somewhat； in English：
Formez toujours des idees nettes。 Fuyez toujours les a peu pres。
Always make sure that you form a distinct and clear idea of the matter you are considering。
Always avoid vague approximations where exact estimates are possible； about so many；about so much； instead of the precise number and quantity。
Now； if there is anything on which the biological sciences have prided themselves in these latter years it is the substitution of quantitative for qualitative formulae。 The 〃numerical system；〃 of which Louis was the great advocate； if not the absolute originator； was an attempt to substitute series of carefully recorded facts； rigidly counted and closely compared； for those never…ending records of vague； unverifiable conclusions with which the classics of the healing art were overloaded。 The history of practical medicine had been like the story of the Danaides。 〃Experience 〃 had been； from time immemorial； pouring its flowing treasures into buckets full of holes。 At the existing rate of supply and leakage they would never be filled； nothing would ever be settled in medicine。 But cases thoroughly recorded and mathematically analyzed would always be available for future use； and when accumulated in sufficient number would lead to results which would be trustworthy； and belong to science。
You young men who are fo
