im away from his
bread-winning pursuits.

But it is of no use to grumble about this state of things unless
one is prepared to indicate some sort of practical remedy. And I
believe--and I venture to make the statement because I am wholly
independent of all sorts of medical schools, and may, therefore, say
what I believe without being supposed to be affected by any personal
interest--but I say I believe that the remedy for this state of
things, for that imperfection of our theoretical knowledge which keeps
down the ability of England at the present time in medical matters,
is a mere affair of mechanical arrangement; that so long as you have
a dozen medical schools scattered about in different parts of the
metropolis, and dividing the students among them, so long, in all the
smaller schools at any rate, it is impossible that any other state of
things than that which I have been depicting should obtain. Professors
must live; to live they must occupy themselves with practice, and
if they occupy themselves with practice, the pursuit of the abstract
branches of science must go to the wall. All this is a plain and
obvious matter of common-sense reasoning. I believe you will never
alter this state of things until, either by consent or by _force
majeure_--and I should be very sorry to see the latter applied--but
until there is some new arrangement, and until all the theoretical
branches of the profession, the institutes of medicine, are taught in
London in not more than one or two, or at the outside three, central
institutions, no good will be effected. If that large body of men, the
medical students of London, were obliged in the first place to get a
knowledge of the theoretical branches of their profession in two or
three central schools, there would be abundant means for maintaining
able professors--not, indeed, for enriching them, as they would be
able to enrich themselves by practice--but for enabling them to make
that choice which such men are so willing to make; namely, the choice
between wealth and a modest competency, when that modest competency
is to be combined with a scientific career, and the means of advancing
knowledge. I do not believe that all the talking about, and tinkering
of, medical education will do the slightest good until the fact
is clearly recognized, that men must be thoroughly grounded in the
theoretical branches of their profession, and that to this end the
teaching of those theoretical branches mus