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