"For I do not think it below me or my art to acknowledge, with respect to the cure of fevers and other distempers, that when no manifest indication pointed out to me what should be done, I have consulted my patient's safety and my own reputation, most effectually, by doing nothing at all. But it is much to be lamented that abundance of patients are so ignorant as not to know, that it is sometimes as much the part of a skillful physician to do nothing, as at others to apply the most energetic remedies, whence they not only deprive themselves of fair and honorable treatment, but impute it to ignorance or negligence."

We conclude these extracts with a picturesque description. hysterics" in a man.

It is a case of "the

"I was called not long since to an ingenious gentleman who had recovered from a fever, but a few days before he had employed another physician, who blooded and purged him soundly, and forbade him the use of flesh. When I came I found him up, and heard him talking sensibly. I asked why I was sent for, to which one of his friends replied with a wink, wait and you'll see. Accordingly, sitting down and entering into discourse with the patient, I perceived his under lip was thrust outward, and in frequent motion, as happens to peevish children, who pout before they cry, which was succeeded by the most violent fit of crying, with deep and convulsive sobs. I conceived this was occasioned partly by his long illness, partly by the previous evacuations, and partly by emptiness; I therefore ordered him a roast chicken, and a pint of canary."

In making these selections we have done our author great injustice, partly from having to give them either in Swan's translation or our own, and thereby losing much of the dignity and nerve-the flavor, or what artists would call the crispness of the original; partly also from our being obliged to exclude strictly professional discussions, in which, as might be expected, his chief value and strength lie. We know nothing in medical literature more exquisite than his letter to Dr. Cole on the hysterical passion, and his monograph of the gout. Well might Edward Hannes, the friend of Addison, in his verses on Sydenham, thus sing :

"Sic te seientem non faciunt libri
Et dogma pulchrum; sed sapientia
Enata rebus, mensque facti
Experiens, animusque felix."

It would not be easy to over-estimate the permanent impression for good, which the writings, the character, and the practice of Sydenham have made on the art of healing in England, and on the Continent generally. In the writings of Boerhaave, Stahl, Gaubius, Pinel, Bordeu, Haller, and many others,

he is always spoken of as the father of rational medicine; as the first man who applied to his profession the Baconian principles of interpreting and serving nature, and who never forgot the master's rule, non fingendum aut excogitandum, sed inveniendum, quid natura aut faciat aut ferat." He was what Plato would have called an 'artsman," as distinguished from a doctor of abstract science. But he was by no means deficient in either the capacity or the relish for speculative truth. Like all men of a large practical nature, he could not have been what he was, or done what he did, without possessing and often exercising the true philosophizing faculty. He was a man of the same quality of mind in this respect with Watt, Franklin, and John Hunter, in whom speculation was not the less genuine that it was with them a

means rather than an end.

This distinction between the science and the art or craft, or as it was often called the cunning of medicine, is one we have already insisted upon, and the importance of which we consider very great, in the present condition of this department of knowledge and practice. We are now-a-days in danger of neglecting our art in mastering our science, though medicine must always be more of an art than of a science. It being the object of the student of physic to learn or know some thing or things, in order to be able safely, effectually and at once, to do some other thing; and inasmuch as human nature cannot contain more than its fill, a man may not only have much scientific truth in his head, which is useless, but it may shut out and hinder, and even altogether render ineffectual, the active, practical, artistical faculties, for whose use his knowledge was primarily got. It is the remark of a profound thinker, that "all professional men labor under a great disadvantage in not being allowed to be ignorant of what is useless; every one fancies that he is bound to receive and transmit whatever is believed to have been known."

This subject of art and science is hinted at, with his usual sagacity, by Plato, in a very singular passage in his Theatetus :— Particulars," he says, are infinite, and the higher generalities give no sufficient direction in medicine; but the pith of all sciences, that which makes the artsman differ from the inexpert, is in the middle propositions, which, in every particular knowledge, are taken from It would not be tradition and experience.”*

*Being anxious to see what was the context of this remarkable passage, which Bacon quotes, as if

easy to convey in fewer words, more of what deserves the name of the philosophy of this entire subject, and few things would be more for the advantage of the best interests of all arts and sciences, and all true progress in human knowledge and power, than the taking this passage and treating it exegetically, as a divine would say, bringing out fully its meaning, and illustrating it by examples. Scientific truth is to the mind of a physician what food is to his body; but, in order to his mind being nourished and growing by this food, it must be assimilated -it must undergo a vital internal change must be transformed, transmuted, and lose its original form. This destruction of formal identity-this losing of itself in being received into the general mass of truth--is necessary to bring abstract truth into the condition of what Plato calls "the middle propositions," or, as Mr. J. S. Mill calls them, the generalia of knowledge.* These are such truths as

verbatim, in his advancement of learning, we hunted through the Theaetetus, but in vain. We set two friends, thorough-bred Grecians, upon the scent, but they could find no such passage. One of them then spoke to Sir William Hamilton, and he told him that he had marked that passage as not being a literal translation of any sentence in Plato's writings He considered it a quotation from memory, and as giving the substance of a passage in the Philebus, which occurs in the 6th and 7th of the forty-two sections of that Dialogue. Perhaps the sentence which comes nearest to the words of Bacon is the last in the 6th section, beginning with the words οἱ δὲ νῦν τῶν ἀνθρῶπων σοφοι. The τὰ δὲ μεσα αὐτοὺς ἐκφευγει οf which he speaks, seem to be equivalent to the middle propositions."

*The following we give as a sort of abstract of an admirable chapter in Mill's Logic on "The Logic of Art:"-An art, or a body of art, consists of the rules, together with as much of the speculative propositions as comprise the justification of those rules. Art selects and arranges the truths of science in the most convenient order for practice, instead of the order most convenient for thought-science following one cause to its various effects, while art traces one effect to its multiplied and diversified causes and conditions. There is need of a set of intermediate scientific truths, derived from the higher generalities of science, and destined to serve as the generalia or first principles of art. The art proposes for itself an end to be gained, defines the end, and hands it

over to science. Science receives it, studies it as a phenomenon or effect, and, having investigated its causes and conditions, sends it back to Art, with a rationale of its cause or causes, but nothing more. Art then examines their combinations, and according as any of them are or are not in human power, or within the scope of its particular end, pronounces upon their utility, and forms a rule of action. The rules of art do not attempt to comprise more cond, tions than require to be attended to in ordinary cases i and therefore are always imperfect.

have been appropriated, and vitally adopted, by the mind, and which, to use Bacon's strong words, have been "drenched in flesh and blood," have been turned in " succum et sanguinem;" for man's mind, any more than his body, cannot live on mere elementary substances; he must have fat, albumen, and sugar; he can make nothing of their elements, bare carbon, azote, or hydrogen. And more than this, as we have said, he must digest and disintegrate his food before it can be of any use to him. In this view, as in another and a higher, we may use the sacred words,-"That which thou sowest is not quickened except it die: except a corn of wheat fall into the ground and die, it abideth alone; but if it die, it bringeth forth much fruit;" for as it is a law of vegetable life, that a seed does not begin to pass into a new form, does not begin to grow into a plant, until its nature is changed, and its original condition is broken up, until it "dies" in giving birth to something better,-so is it with scientific truth, taken into or planted in the mind-it must die, else it abides aloneit does not germinate.

Had Plato lived now, he might justly have said, "particulars are infinite." Facts, as such, are merely so many units, and are often rather an encumbrance to the practical man than otherwise. These "middle propositions" stand midway between the facts in their infinity and speculative truth in its abstract inertness; they take from both what they ne d, and they form a tertium quid, upon which the mind can act practically, and reason upon in practice, and form rules of action.

Sydenham, Hippocrates, Abernethy, Pott, Hunter, Baillie, Abercrombie, and such like, among physicians, are great in the region of the "middle propositions." They selected their particulars-their instances, and they made their higher generalities come down, they appropriated them, and turned them into blood, bone, and sinew.

The great problem in the education of young men for medicine in our times, is to know how to make the infinity of particulars, the prodigious treasures of mere science, available for practice-how the art may keep pace with, and take the maximum of good out of the science. We have often thought that the apprenticeship system is going too much into disrepute. It had its manifest and great evils; but there was much good got by it that is not to be got in any other way. The personal authority, the imitation of their master-the watching his doings, and picking up his practical odds and ends-the coming

under the influence of his mind, following in his steps, looking with his eyes, accumulating a stock of knowledge, multifarious it might be, the good of which was not fully known till after-years explained and confirmed its worth. There were other practical things besides jokes learned and executed in the apprentices' room, and there were the friendships for life, on which so much, not merely of the comfort, but the progress of a physician depends. Now everything, at least most, is done in public, in classes; and it is necessarily with the names of things rather than the things themselves, or their management, that the young men have chiefly to do. The memory is exercised more than the senses or the judgment; and when the examination comes, as a matter of course the student returns back to his teacher as much as possible of what he has received from him, and as much as possible in his very words. He goes over innumerable names. There is little opportunity even in anatomy for testing his power or his skill as a workman, as an independent observer and judge, under what Sir James Clark justly calls "the demoralizing system of cramming." He repeats what is already known; he is not able to say how all or any of this knowledge may be turned to practical account. Epictetus cleverly illustrates this very system and its fruits"As if sheep, after they have been feeding, should present their shepherds with the very grass itself which they had cropped and swal

* Professor Syme, in his Letter to Sir James Graham on the Medical Bill, in which, in twelve pages, he puts the whole of this vexed question on its true frooting, makes these weighty observations:-" As a teacher of nearly twenty-five years' standing, and well acquainted with the dispositions, habits, and powers of medical students, I beg to remark, that the system of repeated examinations on the same

lowed, to show how much they had eaten, instead of concocting it into wool and milk."

Men of the "middle propositions" are not clever, glib expounders of their reasons, they prefer doing a thing to speaking about how it may be done. We remember hearing a young doctor relate how, on one occasion when a student, he met with the late Dr. Abercrombie, when visiting a man who was laboring under what was considered malignant disease of the stomach. He was present when that excellent man first saw the patient along with his regular attendant. The doctor sauntered into the room in his odd, indifferent way, which many must recollect; scrutinized all the curiosities on the mantelpiece; and then, as if by chance, found himself at his patient's bedside; but when there his eye settled upon him intensely ; his whole mind was busily at work. He asked a few plain questions; spoke with great kindness, but very briefly; and, coming back to consult, he said, to the astonishment of the surgeon and the young student, "the mischief is all in the brain, the stomach is affected merely through it. The case will do no good; he will get blind and convulsed, and die." He then in his considerate, simple way, went over what might be done to palliate suffering and prolong life. He was right. The man died as he said, and on examination the brain was found softened, the stomach sound. The young student, who was intimate with Dr. Abercrombie, ventured to ask him what it was in the look of the man that made him know at once. "I can't tell you, I can hardly tell myself; but I rest with confidence upon the exactness and honesty of my past observations. I remember the result, and act upon it; but I can't put you, or, without infinite trouble, myself, in possession of all the steps." But would it not be a great saving if you could tell doctor. young others?" said the

66

"It would

be no such thing; it would be the worst thing that could happen to you; you would not know how to use it. You must follow in the same road, and you will get as far, and much farther. You must miss often before you hit. You can't tell a man how to hit; you may tell him what to aim at." "Was it something in the eye?" said his inveterate querist. "Perhaps it was," he said goodbut don't you go and blister every man's occiput, whose eyes are, as you think, like his."

*This is very clearly stated by Dr. Mandeville, the acute but notorious author of the Fable of the