Bernard moved out of his lodgings and set up house with two fellow medical students: Charles Lasègue (the future eminent neurologist and psychiatrist) and Casimir Davaine (who later made big advances in understanding the condition of Anthrax). With recently-acquired knowledge from the natural history curriculum, Bernard joined Lasègue and Davaine demonstrating biology by animal dissections at a nearby girls' school. It was modest employment which would help to repay his parents. It was also those dissections - but on bodies in the École Pratique - that set him on his first track to success: his technique was quite impeccable.
Bernard's clinical studies as an externe began in 1836, with lectures and much observation in the hospital wards and autopsy room. Gaining in confidence, he would untiringly question his teachers about this or that treatment. It was the period when blood-letting, la saignée was at last beginning to fall into disrepute, but he was soon identifying other medical practices and treatments for which no proof of efficacy was available. He could not hide his mounting Cartesian doubts.
The social life of Paris temporarily diverted him. Although never one for girls, he fell for a young lady with failing eyesight who was a patient in one of the hospital wards. His approaches were promptly snubbed, leading him to write to his friend Blanc, sadly and prophetically: "...I think I am destined never to be happy in love." And so he turned to appreciating Paris art - the wealth of painting that he found in its galleries and salons - and to the theatre, which he could hardly afford. No doubt he was still wondering about the future of his own two dramatic works.
He returned to his studies with more vigour and discovered that for a small fee, he could attend all the lectures that he wished at the prestigious Collège de France. In contrast to the boringly didactic lectures at the medical school, those at the Collège were excitingly innovative - and usually research-based.
He was particularly taken by François Magendie, who had abandoned surgery to become a hospital clinician, physiologist and more recently Professor of Experimental Medicine at the Collège. It was he who had identified the differing sensory and motor functions of the spinal nerve roots as they emerged between the vertebrae, and the phenomenon of recurrent sensitivity of these nerves. Magendie also had a healthy disregard for many treatments. As author of a major hospital formulary, his doubting attitude won Bernard's respect. It did not take him long to decide that he wished to walk in Magendie's footsteps.
If Magendie was to be his role-model, then the physician Pierre Rayer would be his mentor. Rayer had particular expertise in diabetes, and in kidney and skin disorders. He soon recognized Bernard's ability and lively mind, and welcomed him to more regularly attend his ward rounds. Through Rayer, Bernard also met intellectuals and so came face-to-face with new and controversial ideas. Perhaps it was through Rayer that he first heard Emile Littré (an ex-student of Rayer and a disciple of the philosopher Auguste Comte) speak of the positivisme which would begin to mould his own philosophy.
In 1839 Bernard sat for, but again barely passed his examinations as an externe - in 26th place out of the 29 who succeeded. He became an interne with the surgeons Velpeau, Falret and Maisonneuve, and later with Rayer. For a period he was also attached to Magendie's clinical service at the Hôtel Dieu. He soon made it clear that he also wished to be involved with his research activities. Not much later Magendie did indeed appoint Bernard as his préparateur (essentially a research assistant), and soon gave him permission to pursue an idea of his own.
During his human dissections, Bernard had always been puzzled by the tiny chorda tympani nerve that mysteriously connected the fifth and seventh cranial nerves. Using his delicate dissecting technique and both galvanic and chemical stimulation, he showed in some ten species of animal and birds that this nerve conveyed taste sensation from the tongue to the brain1,2. This work provided his very first scientific publication, of which he was justly proud. In this early series of experiments he incorrectly denied that the nerve had any effect on salivary secretion, and it was only eighteen years later that he showed that it indeed stimulated the salivary glands119.
Magendie had not been entirely happy about Bernard pursuing his own research ideas at the Collège. Accordingly, he found a cellar in the Cour de Commerce St André des Arts where he could do some of his experiments (by chance opposite the 'laboratory' where Guillotin had earlier performed rather sordid experiments on his new apparatus).
During his time as Magendie's préparateur, he helped his master assess the value of gelatin, which was readily extracted from animal bone-marrow. It was hoped that it might serve as a nutritional additive for the poor and the ill. Their studies showed that it had little, if any value: results which were vigorously, even viciously challenged by eminent proponents of gelatin. Following this introduction to nutrition - and to academic politics - Bernard also became interested in the way that carbohydrates were handled by the stomach. He made a signal discovery: that gastric juice modified dietary cane sugar so that glucose, its breakdown product could be absorbed into the 'economy' of the body.3,4 Together with further studies on gastric juice, he submitted this work in 1843TMB1 as his thesis for the degree of Doctor of Medicine.
The empirical treatments which Bernard had observed in the hospital finally convinced him that clinical medical practice was not be for him. He wanted to commit his life to research and thus establish fact - by proof: yet for this he would need a teaching appointment in a university department.
The research project which he chose for this important agrégation contest in 1844 - on the colouring matter of bloodTMB2 - was poorly received by his rather critical examiners (one of whom had unfortunately been a vigorous supporter of gelatin supplementation). They disapproved of his poor defence of the thesis, and also commented that his technique of presenting material was hardly one that would impress an amphitheatre full of medical students.
He failed the contest, and found himself facing the prospect of life as a village doctor: saying farewell to his academic colleagues - and more importantly - to his aspirations towards the discovery of truth in medical science.