Critiques and Addresses by Thomas Henry Huxley

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Well, now, gentlemen, I am sure my colleagues in this examination will
bear me out in saying that I have not been exaggerating the evils and
defects which are current--have been current--in a large quantity
of the physiological teaching, the results of which come before
examiners. And it becomes a very interesting question to know how all
this comes about, and in what way it can be remedied. How it comes
about will be perfectly obvious to any one who has considered the
growth of medicine. I suppose that medicine and surgery first began
by some savage, more intelligent than the rest, discovering that a
certain herb was good for a certain pain, and that a certain pull,
somehow or other, set a dislocated joint right. I suppose all things
had their humble beginnings, and medicine and surgery were in the same
condition. People who wear watches know nothing about watchmaking. A
watch goes wrong and it stops; you see the owner giving it a shake,
or, if he is very bold, he opens the case, and gives the balance-wheel
a turn. Gentlemen, that is empirical practice, and you know what are
the results upon the watch. I should think you can divine what are the
results of analogous operations upon the human body. And because men
of sense very soon found that such were the effects of meddling with
very complicated machinery they did not understand, I suppose the
first thing, as being the easiest, was to study the nature of the
works of the human watch, and the next thing was to study the way the
parts worked together, and the way the watch worked. Thus, by degrees,
we have had growing up our body of anatomists, or knowers of the
construction of the human watch, and our physiologists, who know how
the machine works. And just as any sensible man, who has a valuable
watch, does not meddle with it himself, but goes to some one who has
studied watchmaking, and understands what the effect of doing this
or that may be; so, I suppose, the man who, having charge of that
valuable machine, his own body, wants to have it kept in good order,
comes to a professor of the medical art for the purpose of having it
set right, believing that, by deduction from the facts of structure
and from the facts of function, the physician will divine what may be
the matter with his bodily watch at that particular time, and what may
be the best means of setting it right. If that may be taken as a
just representation of the relation of the theoretical branches of
medicine--what we may call the institutes of medicine, to use an old
term--to the practical branches, I think it will be obvious to you
that they are of prime and fundamental importance. Whatever tends to
affect the teaching of them injuriously must tend to destroy and
to disorganize the whole fabric of the medical art. I think every
sensible man has seen this long ago; but the difficulties in the way
of attaining good teaching in the different branches of the theory, or
institutes, of medicine are very serious. It is a comparatively
easy matter--pray mark that I use the word "comparatively"--it is a
comparatively easy matter to learn anatomy and to teach it; it is a
very difficult matter to learn physiology and to teach it. It is a
very difficult matter to know and to teach those branches of physics
and those branches of chemistry which bear directly upon physiology;
and hence it is that, as a matter of fact, the teaching of physiology,
and the teaching of the physics and the chemistry which bear upon it,
must necessarily be in a state of relative imperfection; and there is
nothing to be grumbled at in the fact that this relative imperfection
exists. But is the relative imperfection which exists only such as
is necessary, or is it made worse by our practical arrangements? I
believe--and if I did not so believe I should not have troubled you
with these observations--I believe it is made infinitely worse by
our practical arrangements, or rather, I ought to say, our very
unpractical arrangements. Some very wise man long ago affirmed that
every question, in the long run, was a question of finance; and there
is a good deal to be said for that view. Most assuredly the question
of medical teaching is, in a very large and broad sense, a question of
finance. What I mean is this: that in London the arrangements of the
medical schools, and the number of them, are such as to render it
almost impossible that men who confine themselves to the teaching
of the theoretical branches of the profession should be able to make
their bread by that operation; and, you know, if a man cannot make his
bread, he cannot teach--at least his teaching comes to a speedy end.
That is a matter of physiology. Anatomy is fairly well taught, because
it lies in the direction of practice, and a man is all the better
surgeon for being a good anatomist. It does not absolutely interfere
with the pursuits of a practical surgeon if he should hold a Chair
of Anatomy--though I do not for one moment say that he would not be a
better teacher if he did not devote himself to practice. (Applause.)
Yes, I know exactly what that cheer means, but I am keeping as
carefully as possible from any sort of allusion to Professor Ellis.
But the fact is, that even human anatomy has now grown to be so large
a matter, that it takes the whole devotion of a man's life to put the
great mass of knowledge upon that subject into such a shape that it
can be teachable to the mind of the ordinary student. What the student
wants in a professor is a man who shall stand between him and the
infinite diversity and variety of human knowledge, and who shall
gather all that together, and extract from it that which is capable
of being assimilated by the mind. That function is a vast and an
important one, and unless, in such subjects as anatomy, a man is
wholly free from other cares, it is almost impossible that he can
perform it thoroughly and well. But if it be hardly possible for a man
to pursue anatomy without actually breaking with his profession, how
is it possible for him to pursue physiology?

I get every year those very elaborate reports of Henle and
Meissner--volumes of, I suppose, 400 pages altogether--and they
consist merely of abstracts of the memoirs and works which have been
written on Anatomy and Physiology--only abstracts of them! How is
a man to keep up his acquaintance with all that is doing in the
physiological world--in a world advancing with enormous strides every
day and every hour--if he has to be distracted with the cares of
practice? You know very well it must be impracticable to do so. Our
men of ability join our medical schools with an eye to the future.
They take the Chairs of Anatomy or of Physiology; and by and by they
leave those Chairs for the more profitable pursuits into which they
have drifted by professional success, and so they become clothed,
and physiology is bare. The result is, that in those schools in which
physiology is thus left to the benevolence, so to speak, of those
who have no time to look to it, the effect of such teaching comes
out obviously, and is made manifest in what I spoke of just now--the
unreality, the bookishness of the knowledge of the taught. And if this
is the case in physiology, still more must it be the case in those
branches of physics which are the foundation of physiology; although
it may be less the case in chemistry, because for an able chemist a
certain honourable and independent career lies in the direction of
his work, and he is able, like the anatomist, to look upon what he
may teach to the student as not absolutely taking him 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 must be confined to two or
three centres.

Now let me add one other word, and that is, that if I were a despot, I
would cut down these branches to a very considerable extent. The next
thing to be done beyond that which I mentioned just now, is to go
back to primary education. The great step towards a thorough medical
education is to insist upon the teaching of the elements of the
physical sciences in all schools, so that medical students shall not
go up to the medical colleges utterly ignorant of that with which they
have to deal; to insist on the elements of chemistry, the elements of
botany, and the elements of physics being taught in our ordinary
and common schools, so that there shall be some preparation for
the discipline of medical colleges. And, if this reform were once
effected, you might confine the "Institutes of Medicine" to physics
as applied to physiology--to chemistry as applied to physiology--to
physiology itself, and to anatomy. Afterwards, the student, thoroughly
grounded in these matters, might go to any hospital he pleased for
the purpose of studying the practical branches of his profession. The
practical teaching might be made as local as you like; and you
might use to advantage the opportunities afforded by all these
local institutions for acquiring a knowledge of the practice of the
profession. But you may say: "This is abolishing a great deal; you are
getting rid of botany and zoology to begin with." I have not a doubt
that they ought to be got rid of, as branches of special medical
education; they ought to be put back to an earlier stage, and made
branches of general education. Let me say, by way of self-denying
ordinance, for which you will, I am sure, give me credit, that I
believe that comparative anatomy ought to be absolutely abolished.
I say so, not without a certain fear of the Vice-Chancellor of the
University of London who sits upon my left. But I do not think the
charter gives him very much power over me; moreover, I shall soon come
to an end of my examinership, and therefore I am not afraid, but shall
go on to say what I was going to say, and that is, that in my belief
it is a downright cruelty--I have no other word for it--to require
from gentlemen who are engaged in medical studies, the pretence--for
it is nothing else, and can be nothing else, than a pretence--of a
knowledge of comparative anatomy as part of their medical curriculum.
Make it part of their Arts teaching if you like, make it part of their
general education if you like, make it part of their qualification for
the scientific degree by all means--that is its proper place; but to
require that gentlemen whose whole faculties should be bent upon
the acquirement of a real knowledge of human physiology should
worry themselves with getting up hearsay about the alternation of
generations in the Salpae is really monstrous. I cannot characterize
it in any other way. And having sacrificed my own pursuit, I am sure I
may sacrifice other people's; and I make this remark with all the
more willingness because I discovered, on reading the name-of your
Professors just now, that the Professor of Materia Medica is not
present. I must confess, if I had my way I should abolish Materia
Medica[1] altogether. I recollect, when I was first under examination
at the University of London, Dr. Pereira was the examiner, and you
know that "Pereira's Materia Medica" was a book _de omnibus rebus_. I
recollect my struggles with that book late at night and early in the
morning (I worked very hard in those days), and I do believe that I
got that book into my head somehow or other, but then I will undertake
to say that I forgot it all a week afterwards. Not one trace of a
knowledge of drugs has remained in my memory from that time to this;
and really, as a matter of common sense, I cannot understand the
arguments for obliging a medical man to know all about drugs and
where they come from. Why not make him belong to the Iron and Steel
Institute, and learn something about cutlery, because he uses knives?

[Footnote 1: It will, I hope, be understood that I do not include
Therapeutics under this head.]

But do not suppose that, after all these deductions, there would not
be ample room for your activity. Let us count up what we have left. I
suppose all the time for medical education that can be hoped for is,
at the outside, about four years. Well, what have you to master in
those four years upon my supposition? Physics applied to physiology;
chemistry applied to physiology; physiology; anatomy; surgery;
medicine (including therapeutics); obstetrics; hygiene; and medical
jurisprudence--nine subjects for four years! And when you consider
what those subjects are, and that the acquisition of anything beyond
the rudiments of any one of them may tax the energies of a lifetime,
I think that even those energies which you young gentlemen have
been displaying for the last hour or two might be taxed to keep you
thoroughly up to what is wanted for your medical career.

I entertain a very strong conviction that any one who adds to medical
education one iota or tittle beyond what is absolutely necessary, is
guilty of a very grave offence. Gentlemen, it will depend upon the
knowledge that you happen to possess,--upon your means of applying it
within your own field of action,--whether the bills of mortality of
your district are increased or diminished; and that, gentlemen, is a
very serious consideration indeed. And, under those circumstances, the
subjects with which you have to deal being so difficult, their extent
so enormous, and the time at your disposal so limited, I could not
feel my conscience easy if I did not, on such an occasion as this,
raise a protest against employing your energies upon the acquisition
of any knowledge which may not be absolutely needed in your future
career.

IV.

YEAST.

IT has been known, from time immemorial, that the sweet liquids which
may be obtained by expressing the juices of the fruits and stems
of various plants, or by steeping malted barley in hot water, or
by mixing honey with water--are liable to undergo a series of very
singular changes, if freely exposed to the air and left to themselves,
in warm weather. However clear and pellucid the liquid may have been
when first prepared, however carefully it may have been freed, by
straining and filtration, from even the finest visible impurities, it
will not remain clear. After a time it will become cloudy and turbid;
little bubbles will be seen rising to the surface, and their abundance
will increase until the liquid hisses as if it were simmering on
the fire. By degrees, some of the solid particles which produce the
turbidity of the liquid collect at its surface into a scum, which
is blown up by the emerging air-bubbles into a thick, foamy froth.
Another moiety sinks to the bottom, and accumulates as a muddy
sediment, or "lees."

When this action has continued, with more or less violence, for
a certain time, it gradually moderates. The evolution of bubbles
slackens, and finally comes to an end; scum and lees alike settle at
the bottom, and the fluid is once more clear and transparent. But
it has acquired properties of which no trace existed in the original
liquid. Instead of being a mere sweet fluid, mainly composed of sugar
and water, the sugar has more or less completely disappeared, and it
has acquired that peculiar smell and taste which we call "spirituous."
Instead of being devoid of any obvious effect upon the animal economy,
it has become possessed of a very wonderful influence on the nervous
system; so that in small doses it exhilarates, while in larger it
stupefies, and may even destroy life.

Moreover, if the original fluid is put into a still, and heated for a
while, the first and last product of its distillation is simple water;
while, when the altered fluid is subjected to the same process, the
matter which is first condensed in the receiver is found to be a
clear, volatile substance, which is lighter than water, has a pungent
taste and smell, possesses the intoxicating powers of the fluid in
an eminent degree, and takes fire the moment it is brought in contact
with a flame. The alchemists called this volatile liquid, which
they obtained from wine, "spirits of wine," just as they called
hydrochloric acid "spirits of salt," and as we, to this day, call
refined turpentine "spirits of turpentine." As the "spiritus," or
breath, of a man was thought to be the most refined and subtle part
of him, the intelligent essence of man was also conceived as a sort
of breath, or spirit; and, by analogy, the most refined essence of
anything was called its "spirit." And thus it has come about that we
use the same word for the soul of man and for a glass of gin.

At the present day, however, we even more commonly use another name
for this peculiar liquid--namely, "alcohol," and its origin is not
less singular. The Dutch physician, Van Helmont, lived in the latter
part of the sixteenth and the beginning of the seventeenth century--in
the transition period between alchemy and chemistry--and was rather
more alchemist than chemist. Appended to his "Opera Omnia," published
in 1707, there is a very needful "Clavis ad obscuriorum sensum
referandum," in which the following passage occurs:--

"ALCOHOL.--Chymicis est liquor aut pulvis summe subtilisatus,
vocabulo Orientalibus quoque, cum primis Habessinis,
familiari, quibus _cohol_ speciatim pulverem impalpabilem ex
antimonio pro oculis tin-gendis denotat ... Hodie autem, ob
analogiam, quivis pulvis teuerior, ut pulvis oculorum cancri
summe subtilisatus _alcohol_ audit, hand aliter ac spiritus
rectificatissimi _alcolisati_ dicuntur."

Similarly, Robert Boyle speaks of a fine powder as "alcohol;" and,
so late as the middle of the last century, the English lexicographer,
Nathan Bailey, defines "alcohol" as "the pure substance of anything
separated from the more gross, a very fine and impalpable powder, or a
very pure, well-rectified spirit." But, by the time of the publication
of Lavoisier's "Traite Elementaire de Chimie," in 1789, the term
"alcohol," "alkohol," or "alkool" (for it is spelt in all three ways),
which Van Helmont had applied primarily to a fine powder, and
only secondarily to spirits of wine, had lost its primary meaning
altogether; and, from the end of the last century until now, it has,
I believe, been used exclusively as the denotation of spirits of wine,
and bodies chemically allied to that substance.

The process which gives rise to alcohol in a saccharine fluid is known
to us as "fermentation;" a term based upon the apparent boiling up or
"effervescence" of the fermenting liquid, and of Latin origin.

Our Teutonic cousins call the same process "gaehren," "gaesen,"
"goeschen," and "gischen;" but, oddly enough, we do not seem to have
retained their verb or their substantive denoting the action itself,
though we do use names identical with, or plainly derived from, theirs
for the scum and lees. These are called, in Low German, "gaescht"
and "gischt;" in Anglo-Saxon, "gest," "gist," and "yst," whence our
"yeast." Again, in Low German and in Anglo-Saxon, there is another
name for yeast, having the form "barm," or "beorm;" and, in the
Midland Counties, "barm" is the name by which yeast is still best
known. In High German, there is a third name for yeast, "hefe," which
is not represented in English, so far as I know.

All these words are said by philologers to be derived from roots
expressive of the intestine motion of a fermenting substance. Thus
"hefe" is derived from "heben," to raise; "barm" from "beren" or
"baeren," to bear up; "yeast," "yst," and "gist," have all to do with
seething and foam, with "yeasty waves," and "gusty" breezes.

The same reference to the swelling up of the fermenting substance is
seen in the Gallo-Latin terms "levure" and "leaven."

It is highly creditable to the ingenuity of our ancestors that the
peculiar property of fermented liquids, in virtue of which they "make
glad the heart of man," seems to have been known in the remotest
periods of which we have any record. All savages take to alcoholic
fluids as if they were to the manner born. Our Vedic forefathers
intoxicated themselves with the juice of the "soma;" Noah, by a not
unnatural reaction against a superfluity of water, appears to have
taken the earliest practicable opportunity of qualifying that which
he was obliged to drink; and the ghosts of the ancient Egyptians were
solaced by pictures of banquets in which the winecup passes round,
graven on the walls of their tombs. A knowledge of the process of
fermentation, therefore, was in all probability possessed by the
prehistoric populations of the globe; and it must have become a matter
of great interest even to primaeval wine-bibbers to study the methods
by which fermented liquids could be surely manufactured. No doubt,
therefore, it was soon discovered that the most certain, as well as
the most expeditious, way of making a sweet juice ferment was to add
to it a little of the scum, or lees, of another fermenting juice.
And it can hardly be questioned that this singular excitation of
fermentation in one fluid, by a sort of infection, or inoculation,
of a little ferment taken from some other fluid, together with the
strange swelling, foaming, and hissing of the fermented substance,
must have always attracted attention from the more thoughtful.
Nevertheless, the commencement of the scientific analysis of the
phenomena dates from a period not earlier than the first half of the
seventeenth century.

At this time, Van Helmont made a first step, by pointing out that the
peculiar hissing and bubbling of a fermented liquid is due, not to the
evolution of common air (which he, as the inventor of the term "gas,"
calls "gas ventosum"), but to that of a peculiar kind of air such
as is occasionally met with in caves, mines, and wells, and which he
calls "gas sylvestre."

But a century elapsed before the nature of this "gas sylvestre," or,
as it was afterwards called, "fixed air," was clearly determined, and
it was found to be identical with that deadly "choke-damp" by which
the lives of those who descend into old wells, or mines, or brewers'
vats, are sometimes suddenly ended; and with the poisonous aeriform
fluid which is produced by the combustion of charcoal, and now goes by
the name of carbonic acid gas.

During the same time it gradually became clear that the presence of
sugar was essential to the production of alcohol and the evolution of
carbonic acid gas, which are the two great and conspicuous products of
fermentation. And finally, in 1787, the Italian chemist, Fabroni, made
the capital discovery that the yeast ferment, the presence of which
is necessary to fermentation, is what he termed a "vegeto-animal"
substance--or is a body which gives off ammoniacal salts when it is
burned, and is, in other ways, similar to the gluten of plants and the
albumen and casein of animals.

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