In a spirit of true prophecy, Bichat says, "We have arrived at an epoch in which pathological anatomy should start afresh." For, as the a.n.a.lysis of the organs had led him to the tissues as the physiological units of the organism; so, in a succeeding generation, the a.n.a.lysis of the tissues led to the cell as the physiological element of the tissues. The contemporaneous study of development brought out the same result; and the zoologists and botanists, exploring the simplest and the lowest forms of animated beings, confirmed the great induction of the cell theory. Thus the apparently opposed views, which have been battling with one another ever since the middle of the last century, have proved to be each half the truth.
The proposition of Descartes that the body of a living man is a machine, the actions of which are explicable by the known laws of matter and motion, is unquestionably largely true. But it is also true, that the living body is a synthesis of innumerable physiological elements, each of which may nearly be described, in Wolff"s words, as a fluid possessed of a "vis essentialis" and a "solidescibilitas"; or, in modern phrase, as protoplasm susceptible of structural metamorphosis and functional metabolism: and that the only machinery, in the precise sense in which the Cartesian school understood mechanism, is, that which co-ordinates and regulates these physiological units into an organic whole.
In fact, the body is a machine of the nature of an army, not of that of a watch or of a hydraulic apparatus. Of this army each cell is a soldier, an organ a brigade, the central nervous system headquarters and field telegraph, the alimentary and circulatory system the commissariat. Losses are made good by recruits born in camp, and the life of the individual is a campaign, conducted successfully for a number of years, but with certain defeat in the long run.
The efficacy of an army, at any given moment, depends on the health of the individual soldier, and on the perfection of the machinery by which he is led and brought into action at the proper time; and, therefore, if the a.n.a.logy holds good, there can be only two kinds of diseases, the one dependent on abnormal states of the physiological units, the other on perturbations of their co-ordinating and alimentative machinery.
Hence, the establishment of the cell theory, in normal biology, was swiftly followed by a "cellular pathology," as its logical counterpart.
I need not remind you how great an instrument of investigation this doctrine has proved in the hands of the man of genius to whom its development is due, and who would probably be the last to forget that abnormal conditions of the co-ordinative and distributive machinery of the body are no less important factors of disease.
Henceforward, as it appears to me, the connection of medicine with the biological sciences is clearly indicated. Pure pathology is that branch of biology which defines the particular perturbation of cell-life, or of the co-ordinating machinery, or of both, on which the phenomena of disease depend.
Those who are conversant with the present state of biology will hardly hesitate to admit that the conception of the life of one of the higher animals as the summation of the lives of a cell aggregate, brought into harmonious action by a co-ordinative machinery formed by some of these cells, const.i.tutes a permanent acquisition of physiological science.
But the last form of the battle between the animistic and the physical views of life is seen in the contention whether the physical a.n.a.lysis of vital phenomena can be carried beyond this point or not.
There are some to whom living protoplasm is a substance, even such as Harvey conceived the blood to be, "summa c.u.m providentia et intellectu in finem certum agens, quasi ratiocinio quodam;" and who look with as little favour as Bichat did, upon any attempt to apply the principles and the methods of physics and chemistry to the investigation of the vital processes of growth, metabolism, and contractility. They stand upon the ancient ways; only, in accordance with that progress towards democracy, which a great political writer has declared to be the fatal characteristic of modern times, they subst.i.tute a republic formed by a few billion of "animulae" for the monarchy of the all-pervading "anima."
Others, on the contrary, supported by a robust faith in the universal applicability of the principles laid down by Descartes, and seeing that the actions called "vital" are, so far as we have any means of knowing, nothing but changes of place of particles of matter, look to molecular physics to achieve the a.n.a.lysis of the living protoplasm itself into a molecular mechanism. If there is any truth in the received doctrines of physics, that contrast between living and inert matter, on which Bichat lays so much stress, does not exist. In nature, nothing is at rest, nothing is amorphous; the simplest particle of that which men in their blindness are pleased to call "brute matter" is a vast aggregate of molecular mechanisms performing complicated movements of immense rapidity, and sensitively adjusting themselves to every change in the surrounding world. Living matter differs from other matter in degree and not in kind; the microcosm repeats the macrocosm; and one chain of causation connects the nebulous original of suns and planetary systems with the protoplasmic foundation of life and organisation.
From this point of view, pathology is the a.n.a.logue of the theory of perturbations in astronomy; and therapeutics resolves itself into the discovery of the means by which a system of forces competent to eliminate any given perturbation may be introduced into the economy.
And, as pathology bases itself upon normal physiology, so therapeutics rests upon pharmacology; which is, strictly speaking, a part of the great biological topic of the influence of conditions on the living organism, and has no scientific foundation apart from physiology.
It appears to me that there is no more hopeful indication of the progress of medicine towards the ideal of Descartes than is to be derived from a comparison of the state of pharmacology, at the present day, with that which existed forty years ago. If we consider the knowledge positively acquired, in this short time, of the _modus operandi_ of urari, of atropia, of physostigmin, of veratria, of casca, of strychnia, of bromide of pota.s.sium, of phosphorus, there can surely be no ground for doubting that, sooner or later, the pharmacologist will supply the physician with the means of affecting, in any desired sense, the functions of any physiological element of the body. It will, in short, become possible to introduce into the economy a molecular mechanism which, like a very cunningly-contrived torpedo, shall find its way to some particular group of living elements, and cause an explosion among them, leaving the rest untouched.
The search for the explanation of diseased states in modified cell-life; the discovery of the important part played by parasitic organisms in the aetiology of disease; the elucidation of the action of medicaments by the methods and the data of experimental physiology; appear to me to be the greatest steps which have ever been made towards the establishment of medicine on a scientific basis. I need hardly say they could not have been made except for the advance of normal biology.
There can be no question, then, as to the nature or the value of the connection between medicine and the biological sciences. There can be no doubt that the future of pathology and of therapeutics, and, therefore, that of practical medicine, depends upon the extent to which those who occupy themselves with these subjects are trained in the methods and impregnated with the fundamental truths of biology.
And, in conclusion, I venture to suggest that the collective sagacity of this congress could occupy itself with no more important question than with this: How is medical education to be arranged, so that, without entangling the student in those details of the systematist which are valueless to him, he may be enabled to obtain a firm grasp of the great truths respecting animal and vegetable life, without which, notwithstanding all the progress of scientific medicine, he will still find himself an empiric?
Footnotes:
[1] _Discours de la Methode_, 6e partie, Ed. Cousin, p. 193.
[2] _Ibid_. pp. 193 and 211.
[3] _De la Formation du Foetus_.
[4] _Theoria Generationis_, 1759.
[5] _Anatomie generale_, i. p. liv.
XV
THE SCHOOL BOARDS: WHAT THEY CAN DO, AND WHAT THEY MAY DO.
[1870]
An electioneering manifesto would be out of place in the pages of this Review; but any suspicion that may arise in the mind of the reader that the following pages partake of that nature, will be dispelled, if he reflect that they cannot be published [1] until after the day on which the ratepayers of the metropolis will have decided which candidates for seats upon the Metropolitan School Board they will take, and which they will leave.
As one of those candidates, I may be permitted to say, that I feel much in the frame of mind of the Irish bricklayer"s labourer, who bet another that he could not carry him to the top of the ladder in his hod. The challenged hodman won his wager, but as the stakes were handed over, the challenger wistfully remarked, "I"d great hopes of falling at the third round from the top." And, in view of the work and the worry which awaits the members of the School Boards, I must confess to an occasional ungrateful hope that the friends who are toiling upwards with me in their hod, may, when they reach "the third round from the top," let me fall back into peace and quietness.
But whether fortune befriend me in this rough method, or not, I should like to submit to those of whom I am potential, but of whom I may not be an actual, colleague, and to others who may be interested in this most important problem--how to get the Education Act to work efficiently--some considerations as to what are the duties of the members of the School Boards, and what are the limits of their power.
I suppose no one will be disposed to dispute the proposition, that the prime duty of every member of such a Board is to endeavour to administer the Act honestly; or in accordance, not only with its letter, but with its spirit. And if so, it would seem that the first step towards this very desirable end is, to obtain a clear notion of what that letter signifies, and what that spirit implies; or, in other words, what the clauses of the Act are intended to enjoin and to forbid. So that it is really not admissible, except for factious and abusive purposes, to a.s.sume that any one who endeavours to get at this clear meaning is desirous only of raising quibbles and making difficulties.
Reading the Act with this desire to understand it, I find that its provisions may be cla.s.sified, as might naturally be expected, under two heads: the one set relating to the subject-matter of education; the other to the establishment, maintenance, and administration of the schools in which that education is to be conducted.
Now it is a most important circ.u.mstance, that all the sections of the Act, except four, belong to the latter division; that is, they refer to mere matters of administration. The four sections in question are the seventh, the fourteenth, the sixteenth, and the ninety-seventh. Of these, the seventh, the fourteenth, and the ninety-seventh deal with the subject-matter of education, while the sixteenth defines the nature of the relations which are to exist between the "Education Department"
(an euphemism for the future Minister of Education) and the School Boards. It is the sixteenth clause which is the most important, and, in some respects, the most remarkable of all. It runs thus:--
"If the School Board do, or permit, any act in contravention of, or fail to comply with, the regulations, according to which a school provided by them is required by this Act to be conducted, the Education Department may declare the School Board to be, and such Board shall accordingly be deemed to be, a Board in default, and the Education Department may proceed accordingly; and every act, or omission, of any member of the School Board, or manager appointed by them, or any person under the control of the Board, shall be deemed to be permitted by the Board, unless the contrary be proved.
"If any dispute arises as to whether the School Board have done, or permitted, any act in contravention of, or have failed to comply with, the said regulations, _the matter shall be referred to the Education Department, whose decision thereon shall be final_."
It will be observed that this clause gives the Minister of Education absolute power over the doings of the School Boards. He is not only the administrator of the Act, but he is its interpreter. I had imagined that on the occurrence of a dispute, not as regards a question of pure administration, but as to the meaning of a clause of the Act, a case might be taken and referred to a court of justice. But I am led to believe that the Legislature has, in the present instance, deliberately taken this power out of the hands of the judges and lodged it in those of the Minister of Education, who, in accordance with our method of making Ministers, will necessarily be a political partisan, and who may be a strong theological sectary into the bargain. And I am informed by members of Parliament who watched the progress of the Act, that the responsibility for this unusual state of things rests, not with the Government, but with the Legislature, which exhibited a singular disposition to acc.u.mulate power in the hands of the future Minister of Education, and to evade the more troublesome difficulties of the education question by leaving them to be settled between that Minister and the School Boards.
I express no opinion whether it is, or is not, desirable that such powers of controlling all the School Boards in the country should be possessed by a person who may be, like Mr. Forster, eminently likely to use these powers justly and wisely, but who also may be quite the reverse. I merely wish to draw attention to the fact that such powers are given to the Minister, whether he be fit or unfit. The extent of these powers becomes apparent when the other sections of the Act referred to are considered. The fourth clause of the seventh section says:--
"The school shall be conducted in accordance with the conditions required to be fulfilled by an elementary school in order to obtain an annual Parliamentary grant."
What these conditions are appears from the following clauses of the ninety-seventh section:--
"The conditions required to be fulfilled by an elementary school in order to obtain an annual Parliamentary grant shall be those contained in the minutes of the Education Department in force for the time being.... Provided that no such minute of the Education Department, not in force at the time of the pa.s.sing of this Act, shall be deemed to be in force until it has lain for not less than one month on the table of both Houses of Parliament."
Let us consider how this will work in practice. A school established by a School Board may receive support from three sources--from the rates, the school fees, and the Parliamentary grant. The latter may be as great as the two former taken together; and as it may be a.s.sumed, without much risk of error, that a constant pressure will be exerted by the ratepayers on the members who represent them to get as much out of the Government, and as little out of the rates, as possible, the School Boards will have a very strong motive for shaping the education they give, as nearly as may be, on the model which the Education Minister offers for their imitation, and for the copying of which he is prepared to pay.
The Revised Code did not compel any schoolmaster to leave off teaching anything; but, by the very simple process of refusing to pay for many kinds of teaching, it has practically put an end to them. Mr. Forster is said to be engaged in revising the Revised Code; a successor of his may re-revise it--and there will be no sort of check upon these revisions and counter revisions, except the possibility of a Parliamentary debate, when the revised, or added, minutes are laid upon the table. What chance is there that any such debate will take place on a matter of detail relating to elementary education--a subject with which members of the Legislature, having been, for the most part, sent to our public schools thirty years ago, have not the least practical acquaintance, and for which they care nothing, unless it derives a political value from its connection with sectarian politics?
I cannot but think, then, that the School Boards will have the appearance, but not the reality, of freedom of action, in regard to the subject-matter of what is commonly called "secular" education.
As respects what is commonly called "religious" education, the power of the Minister of Education is even more despotic. An interest, almost amounting to pathos, attaches itself, in my mind, to the frantic exertions which are at present going on in almost every school division, to elect certain candidates whose names have never before been heard of in connection with education, and who are either sectarian partisans, or nothing. In my own particular division, a body organised _ad hoc_ is moving heaven and earth to get the seven seats filled by seven gentlemen, four of whom are good Churchmen, and three no less good Dissenters. But why should this seven times heated fiery furnace of theological zeal be so desirous to shed its genial warmth over the London School Board? Can it be that these zealous sectaries mean to evade the solemn pledge given in the Act?
"No religious catechism or religious formulary which is distinctive of any particular denomination shall be taught in the school."
I confess I should have thought it my duty to reject any such suggestion, as dishonouring to a number of worthy persons, if it had not been for a leading article and some correspondence which appeared in the _Guardian_ of November 9th, 1870.
The _Guardian_ is, as everybody knows, one of the best of the "religious" newspapers; and, personally, I have every reason to speak highly of the fairness, and indeed kindness, with which the editor is good enough to deal with a writer who must, in many ways, be so objectionable to him as myself. I quote the following pa.s.sages from a leading article on a letter of mine, therefore, with all respect, and with a genuine conviction that the course of conduct advocated by the writer must appear to him in a very different light from that under which I see it:--
"The first of these points is the interpretation which Professor Huxley puts on the "Cowper-Temple clause." It is, in fact, that which we foretold some time ago as likely to be forced upon it by those who think with him. The clause itself was one of those compromises which it is very difficult to define or to maintain logically. On the one side was the simple freedom to School Boards to establish what schools they pleased, which Mr. Forster originally gave, but against which the Nonconformists lifted up their voices, because they conceived it likely to give too much power to the Church. On the other side there was the proposition to make the schools secular--intelligible enough, but in the consideration of public opinion simply impossible--and there was the vague impracticable idea, which Mr. Gladstone thoroughly tore to pieces, of enacting that the teaching of all school-masters in the new schools should be strictly "undenominational." The Cowper-Temple clause was, we repeat, proposed simply to tide over the difficulty. It was to satisfy the Nonconformists and the "unsectarian," as distinct from the secular party of the League, by forbidding all distinctive "catechisms and formularies," which might have the effect of openly a.s.signing the schools to this or that religious body. It refused, at the same time, to attempt the impossible task of defining what was undenominational; and its author even contended, if we understood him correctly, that it would in no way, even indirectly, interfere with the substantial teaching of any master in any school. This a.s.sertion we always believed to be untenable; we could not see how, in the face of this clause, a distinctly denominational tone could be honestly given to schools nominally general. But beyond this mere suggestion of an attempt at a general tone of comprehensiveness in religious teaching it was not intended to go, and only because such was its limitation was it accepted by the Government and by the House.
"But now we are told that it is to be construed as doing precisely that which it refused to do. A "formulary," it seems, is a collection of formulas, and formulas are simply propositions of whatever kind touching religious faith. All such propositions, if they cannot be accepted by all Christian denominations, are to be proscribed; and it is added significantly that the Jews also are a denomination, and so that any teaching distinctively Christian is perhaps to be excluded, lest it should interfere with their freedom and rights. Are we then to fall back on the simple reading of the letter of the Bible? No! this, it is granted, would be an "unworthy pretence." The teacher is to give "grammatical, geographical, or historical explanations;" but he is to keep clear of "theology proper," because, as Professor Huxley takes great pains to prove, there is no theological teaching which is not opposed by some sect or other, from Roman Catholicism on the one hand to Unitarianism on the other. It was not, perhaps, hard to see that this difficulty would be started; and to those who, like Professor Huxley look at it theoretically, without much practical experience of schools, it may appear serious or unanswerable. But there is very little in it practically; when it is faced determinately and handled firmly, it will soon shrink into its true dimensions. The cla.s.s who are least frightened at it are the school teachers, simply because they know most about it. It is quite clear that the school managers must be cautioned against allowing their schools to be made places of proselytism: but when this is done, the case is simple enough.