port of all who have to act, would have been | duced an unexpected rise in patients. Nor for the most part lost in a life devoted to ab- is the profession itself by any means unanistract inquiry. The man of science, as far as mous on the matter. There are many, and his researches are concerned — and if he be such are generally called "highly practireal, he and his researches are one needs cal," who delight in making a mock of all no such source of strength. He has only quiet- science, and feel a special pleasure in adoptly, humbly, and truthfully to push forward ing courses for which no reason can be renin the way that opens up for him the more dered: the Pharisees, as it were, of Mediclearly the longer he pursues it. "Duty" cine, worshipping the traditions of the eldto such a one is superfluous, if not unintelli- ers, and accepting no physiological docgible. Men of pure science, again, are con- trines until they have, in process of time, tent often to look forward to the results of acquired the stamp of the sect. In the eyes their labours as useful only in future. Sir of such men, Physiology, if not unclean, is Benjamin Brodie had that longing to see at least nothing more than a mere playthe immediate fruits of his works, which is thing, wholly useless in everyday life. Oth characteristic of a practical mind. Even in ers again, on the other hand, are perhaps his abstruser speculations, such as those too " hastily scientific," too ready to accept which he developed in his old age, it was the flickering light of a few academical disnot so much the love of abstract truth as the putations as a guide through the darkness hope of achieving good that stirred him. of the human body, too willing to act upon His Psychological Inquiries are to be regard- any advice that is written in letters of ed as not so much an effort in mental science, Chemistry or Physiology, and not in the as a transcript from the note-book of a phy- language of common sense. To such, sician, who, calmly talking over and wisely Chemistry or Galvanism, or some other secconsidering the symptoms of humanity, tion of knowledge, is a shibboleth, and the points out what he considers the best treat- recent advance of Physical Science the ment and remedies to be adopted. But if dawning of a millennium. A third class, Sir Benjamin Brodie might not have become forming, as we believe, the bulk of the a leader in science, he did become one of the profession, while refusing no ray of light or greatest of English surgeons. His success offer of help that comes from Physiology or justified his choice. Chemistry or elsewhere, temper the zeal and eagerness of science with the wisdom and caution of experience. They may be said to be practical in re and scientific in modo, inasmuch as they are distinguished, not by their wearing the externals of science, not by their resting their treatment on the result of vivisections and chemical experiments, not by their giving themselves up to any dominant scientific doctrines, but by their studying their cases and governing their practice in that truthful, unwearied, catholic spirit, and trustful obedience to nature, which is the token of all science properly so called. They feel that the bedside and laboratory are as yet too far apart for them to pass rapidly from one to the other; but they feel, too, that truth and success are to be won by the same means in both. It is very interesting to observe the position he took in reference to the conflicting claims of the science of life and the art of healing. There is very considerable difficulty in judging fairly of the mutual relations of these two things. Though, theoretically considered, the latter is the practical application of the former, practically speaking they stand apart from each other. A physiologist is not necessarily a good practitioner, but rather the contrary; and the converse is equally true. It is matter of uncertainty, and yet not without importance, how far the two should be combined. If we turn to the public for advice, we find them in a state of hopeless contradiction or vacillation. At one moment they shrink from every thing that is not entirely practical, and make haste to shun any manifestation of science, as foreboding unwise and dangerous treatment. It is said of Sir Charles Bell that the falling off of his patients after the appearance of a scientific memoir from him, generally led him to publish a practical clinical lecture, with a hope of restoring the balance. At another time the public rush all agape after the latest scientific discovery, and hope all things of the last new physiological theory. Very often an abstruse paper has happily pro It need hardly be said that it was to this last class that Sir Benjamin Brodie belonged. His youthful intercourse with the muse of pure science prevented him from ever disparaging her, while his having felt, from personal knowledge, how fragmentary and uncertain, how far behind the urgent necessities of everyday life, were the doctrines of Physiology, saved him from blindly following their lead. Ever anxious to connect the phenomena of disease with those of health, ever striving to lay bare the deep seated general laws governing both alike, he was still aware that what he knew cast but a stray light on what he had to do, that, while now and then some far off truth in Physiology lighted up the obscurity of a harassing case, it happened far more frequently that relief came both to the patient and the doctor through a quick following up of the hints that accident or acute observation started, through treatment which science neither suggested nor could give a reason for. He saw that the honest performance of his practical duties could leave him but little leisure for scientific pursuits, that he could not be a great surgeon and a remarkable physiologist at the same time. He did not care, or rather he saw he was not the man to be, like Young, a great philosopher and a moderate practitioner. But he felt that he could carry into his active life the same spirit than had already given him so great a success in his leisure studies, and the walls of St. George's Hospital could testify to the way in which he set to work. Every day he spent hours there. He studied the cases that came under his care with as much assiduous, conscientious, painstaking accuracy as if he were preparing his notes for publication in the Philosophical Transactions. He felt that every patient called for as much research as any subject of his previous memoirs. The public soon began to learn that a man of such a temper was one who could be fully trusted. The few patients quickly became many. In 1816 he married, upon an income of £1500 a year; and after the publication, in 1819, of his papers on Diseases of Joints, in the form of a book, his practice very rapidly increased. In 1823 his annual income from fees alone amounted to £6500, being about half of what is stated to be the limit which it in no year ceeded. dicrous an account is given in the Life of Sir Astley Cooper. In 1828 he became surgeon to the King, and in 1830 he treated with great temporary success the dropsy of that monarch. In 1832 he became, upon the death of Sir Everard Home, sergeantsurgeon to King William IV. In 1834 he was elevated to the rank of baronet, and thus received the highest political honour open to the profession. In 1822 the resignation of Mr. Griffiths changed his position at St. George's Hospital from that of assistant-surgeon to full surgeon. In 1828 the partial retirement of Sir Astley Cooper largely increased his practice, particularly in the department of Operative Surgery. In 1830 the pressing demands of his private duties compelled him to give up his systematic course of surgical lectures at St. George's, though for some years afterwards he continued to give occasional clinical discourses. In 1834 he became, by virtue of his position as sergeant-surgeon, one of the examiners at the Royal College of Surgeons. In 1837, looking forward to some leisure in the coming years, he purchased Broome Park, at Betchworth in Surrey. In 1840, " After having filled the place of assistant-surgeon for fourteen years, and that of surgeon for eighteen years," he resigned his office, at the early age of fifty-six, partly because he now began to feel the necessity of diminishing the amount of his labours, and partly from a generous wish to increase the opportunities of the active and deserving young men he saw around him. With the exception of memorable occasions such as these, his life might seem to lookers-on full of sameness: patients in the morning, patients in the afternoon, patients in the evening, and even in the night, with, at one period of his life, the frequent harex-assment of long provincial journeys. But, though objectively monotonous, it was subIn the life of a busy surgeon, and es- jectively of great and varied interest. Even pecially of one enjoying unbroken success the private patients had sometimes charms and uniform progress, there are naturally that were not limited to the fees they but few events of which others will care to brought. The treatment of many cases bebe told. In the autobiography we meet came, of course, after a while, a mere matmore than once with such a remark as, ter of dry routine. A few questions, a rap"During this time my recollection furnish- id glance, and both the nature of the dises me with very little that is worthy of be- ease and the proper remedy we at once diing recorded. My mode of life was uniform vined. Little mental exertion was required enough." The chief facts of Brodie's ex- for, and therefore little pleasure deternal history may soon be enumerated. In rived from, instances of maladies which had 1817 he gained, through his straightforward been seen and studied again and again. conduct, the friendship of Sir William All cases, however, were not of this descripKnighton, and upon the advice of that gentleman, was called in to see the wonderful sebaceous tumour on the head of King George IV., of the removal of which so lu tion. Every day was sure to bring to his observing eye some feature of disease that awakened curiosity and stimulated the mind, something that had been looked for long, something that had not been expect- again and again turn when baffled in his ed at all. No day could fail to add fresh art. But his unwritten influence was far links to various chains of thought, to bring larger than his written. With the death of fresh proofs or new corrections of growing such a man there is lost to the world a store theories and views. Especially true was of wisdom, in which it can never share. In this of his hospital experience, where dis- the case of Brodie this was perhaps larger ease could be studied more rigidly and with than with most distinguished men. He himgreater scientific accuracy than in the pri- self was wont to say that nine-tenths of his vate consulting-room, and where the intel- knowledge would perish with him. All his lectual pleasure of observing any striking life long, however, and especially during his symptom or result of treatment was increas- later years, he was working upon the men of ed by the satisfaction of explaining its im- his time in a way which was but dimly visiportance or meaning to a group of intelli- ble to himself, and which cannot perhaps gent and inquiring students. "Some of even as yet be fully appreciated by others. my happiest hours," he writes, "were those We have said that he was emphatically a during which I was occupied in the wards representative man; he was a pattern to the of St. George's Hospital, with my pupils public of what the profession might and round me, answering their inquries, and ex- ought to be, and an example to the profesplaining the cases to them at the bedside of sion of what it might and ought to become. the patients." Science, again, was a never- In both functions he did great and good failing source of pleasure to him. He took service. Before his time men had been part in all the new and stirring discoveries, much accustomed to associate eminence in and mixed with all the distinguished men of the surgical profession with individual talent his time. And if he needed or cared for marred by coarseness, abrupt humour, or other excitements he had his share in them personal vanity, and often united with great too. The surgeon who rises to be the lead-ignorance in matters outside the art. Brodie ing surgeon of the day is necessarily showed them that general culture, science, brought into close contact with all phases of and philosophy were helpmates rather than life, the highest as well as the lowest. He sees, moreover, characters at seasons when real features come to the surface, and learns secrets which are hid from all the world. He has, perhaps, on the whole, better opportunities than most men of getting behind the scenes, and seems to take some part in all the life of his time. Among that knowledge which was buried in the grave with Brodie, a great deal that appeared to him most likely worthless, would be highly prized by many a gossipping mind. It is difficult to form a just estimate of the good effected by such a life as Brodie's. The number of valuable lives spared or lengthened, the amount of human suffering lessened by his skill, with the benefits to mankind thus indirectly wrought; all, in fact, that is implied by the well-known Homeric line which asserts that a healer is worth a hundred other men, by no means comprises all he did. His professional writings, though they were but few, were of the highest order. His book on Diseases of Joints at once took, and has since maintained the rank of a standard work. It may be said to have inaugurated a new epoch in the treatment of those maladies. And the same observation will apply to his other larger treatises, while his various short observations, occasional papers, and lectures, are a rich mine of practical ideas and suggestive hints, to which a practitioner will hindrances to professional ability, and that it was best for one who aspired to be a leading surgeon, not to discard nor to affect to despise the mind and manners of a gentleman. The whole tenor of his life did much to raise the surgical art in the opinion of the world. Equally beneficial was his influence upon his brethren. The profession and the public are not always agreed as to who deserve to be considered the most eminent surgeons or physicians, but for once they heartily joined in ranking Sir Benjamin Brodie as facile princeps. Perhaps no one was ever so universally esteemed and looked up to by his fellows as was he. This was partly due to the great respect he in turn felt for his fellows. The large class of general practitioners, to whose care, after all, the health of the community is in the main intrusted, he always held in high estimation. He never delighted, as many in his position do, in snubbing them. On the contrary, whenever he was called in consultation to some obscure spot in the country, he used to take with him a list of questions, to be put to his humble brother, in order that he might learn something from the latter's experience, and he was wont to say that many a time the benefit which he himself in this way received was greater than that which he was able to bestow upon the patient. An acknowledged leader of the profession, such as he was, would naturally have a great power of moulding and forming the minds cal art was only one example; and if he and characters of others, especially of those had ambition, it was ambition of the purest who entered the profession at the time when quality, mixed with nothing that was not he was in the zenith of his fame. Every proper to a noble mind. In Cooper's eyes, student who entered the hospitals would be the healing art was a sphere in which natusure to see in himself, with more or less dis- ral ability, a quick hand and eye, a tact in tinctness, a future Brodie. And it was well dealing with men and things, were sure to for the profession that it had a man of meet with success. Brodie saw in it a Brodie's stamp at its head. He was, in continual attempt, oftentimes unsuccessful many respects, far fitter to hold that position and disappointing, to solve baffling probthan his immediate predecessor, Sir Astley | lems, a path of duty which could only be Cooper, whose acknowledged eminence, happily trod with the help of a watchful being beyond defence, need not fear criti- study of nature, a faithful, childlike, humble cism. No two men could be more unlike obedience to all she taught, and a wise apthan were these distinguished surgeons. preciation of all the hints she gave. The The only point in which they touched was influence of Cooper's example was to make the love each bore to science, and they young surgeons inclined to overrate their differed even in their attitude towards own importance, to think much of the exscience. Brodie looked upon Anatomy ternals of their art, of personal address and chiefly as the basis of Physiology; and in skill in the use of the knife, and to be calPhysiology he saw a means of intellectual culating rather how they should deal with culture, a stronghold of the healing art, and patients than treat diseases. Brodie taught a great help towards solving the riddle of them to look upon themselves, not as single human nature. His own physiological la- individuals about to secure the admiration bours were connected with important ques- and fees of a large clientèle, but as members tions, the answers to which turned both the of a body which, by its history, its educathoughts and practices of men. Sir Astley tion, and its connections with science, was Cooper loved Anatomy partly for its own called to great exertions in order to oversake, just as he loved dissecting, partly on come or to soothe the sufferings of manaccount of its direct utility in Mechanical kind. Surgery, and partly because it was a path along which he might tread towards fame. And his own labours were prompted by one or other of these feelings. The one was in his proper sphere when in the midst of quiet discussion, the other when, with the help of students, he was dissecting an elephant under adverse circumstances. And not only by virtue of his moral nature and temper was Brodie's influence over his brethren a benign one; in the more strictly intellectual features of his professional character he was equally potent for good. His method of healing, which by the force of example became the method of many others, may be briefly described as the union of skilled diagnosis with a wise and happy adaptation of ordinary remedies. By his excellence in diagnosis he helped very materially to construct the edifice of modern Medicine, and to keep his particular department of Surgery on a level with the rapidly developing one of the pure physicians. To one not conversant with the details of disease, the mere distinguishing one disease from others may seem to be only preliminary to the more difficult task of treatment; but in reality it is much more than half the struggle. The true appreciation of a malady being rightly got, the manner of curing it follows in most cases as a matter of course. For true diagnosis, the accurate sorting and setting apart the various sets of symptoms which we call diseases, must not be confounded with a mere superficial disIf tribution of names. A name may be given without trouble, and therefore without result; but two diseases, alike in their superficial and external phenomena, but unlike In his professional capacity, Cooper was brilliant, somewhat off-hand and hasty perhaps, delighting in difficult and extraordinary operations, restless under the necessity of minutely and laboriously investigating an obscure case, in his glory when an unforeseen accident in the operating theatre dismayed his fellows, and called for prompt decision and immediate action. Brodie, though never failing in emergencies, disliked the glamour of operations, looked upon the knife as a reproach rather than as a credit, was cautious and wisely slow in judgment though quick in ratiocination, to the last modest and retiring, and shone most when thought and wisdom were most required. Both loved their profession, but Cooper loved fame more than the accomplishment of duties, and it may perhaps be said, loved praise more than fame. Brodie loved anything more than his profession, it was that general pursuit of truth and performance of duty of which the surgi open in their deep-seated and fundamental quali- and fashion here, as elsewhere, has a powerties, cannot be distinguished until we have ful sway. Other practitioners are fond of gone right down into the essential nature confining themselves purposely and rigidly of each. Diagnosis is in fact merely the ex- to a very scanty list of drugs, like Brodie's pression of Pathology, the science of dis- old master in pharmacy, who in his " ease. And it is only by knowing diseases shop" had many show-bottles, but, for the that we can hope to cure them. It is as- most part, only four use-bottles, one for tonishing sometimes to witness how effectu- each of the quarters from which he believed al the simplest remedies and plainest direc- the wind of disease to blow. It is a very tions turn out when they are suggested by common thing to hear men, accounted rean accurate knowledge of the nature of the markably successful men, exclaim in their malady, in other words, when a correct old age, "Give me opium, quinine, and diagnosis has been made. In ninety-nine sulphur," or, "calomel, digitalis, and anticases out of a hundred, when a particular mony, and I will cure all diseases that can treatment has been remarkably successful be cured;" and tales have been told of after the failure of many others, the result those who had but one prescription, which, has been due to the therapeutic blow hav- if not regarded as a panacea, was at least ing been directed, not at random, but with offered as treatment to all sorts and conclear intent. A slight tap in the right ditions of men. On the other hand, there place will do what no amount of beating the is a small class of men who state that they bush could effect. Many of the diseases conscientiously abstain from every treatwhich afflict us are so dreadful because ment for which they cannot render a reason they are mere shadows. They torment us from beginning to end. It need scarcely in the gloom of ignorance; when light ap- be said that Brodie belonged to none of proaches they melt away almost of them these. While accepting no treatment rashselves. And though there are many which ly, and never obstinately refusing to receive we fail to touch, even when we seem to assistance either from the newest elegant know most about them, we have, through pharmaceutical preparation or from the diagnosis, at least the melancholy satisfac- latest and most ingenious mechanical confaction of foreseeing all their gravity. In trivance, he held that many remedies, howthe art of diagnosis Sir Benjamin Brodie ever old-fashioned, were of the greatest use was a master, and great was the delight when one had learned from experience the which he took in the work. His other exact time and place in which to employ characteristic, the wise use of remedies, them. His scientific culture was too proalmost necessarily followed from his efficien- nounced to allow him ever to fail of reaping cy in this. Perfection of diagnosis and the first and last fruits of Physiology and multiplicity of remedies are always to be Pathology, while his practical wisdom and found existing in an inverse ratio to each humility kept him from ever discarding an other. He who is careless in his analysis unmistakable help because he could not will be profuse with his prescriptions; and write down the scientific formula of its ache who has gone to the bottom of a malady tion; and we may safely say that the great will not have to go much further in seeking bulk of the profession is treading in the for the cure. Apart, however, from those same path. It is confessedly difficult to remedies suggested by the results of diag- disentangle the influence of a single man nosis, there are also a large number of purely empirical remedies and plans of treatment, satisfactory indications for which fail either because the nature of the disease can with our present knowledge be probed to a certain depth only, or because our knowledge of the modus operandi of drugs and other therapeutic agents is so imperfect. The various members of the medical profession vary very much in their attitude towards these sealed missives of cure. Some from the mixed impulses of an age; but the fact is patent, that during the past half century the progress of the healing art, and the intellectnal and moral development of those that practise it, have taken place exactly in that direction towards which all Sir Benjamin Brodie's efforts turned. Everywhere, even in the humblest representative, may be seen the same drawing near to science, the same desire to rest all treatment on a rational basis, and the same consciousness of the ennobling effect of uprightly pursuing its duties. It would be absurd to say that he himself was not borne upon a wave which began elsewhere; it would be unjust to think that he was not foremost in urging the movement on. are eager for them, use them frequently |