STRICTURES ON SOME OF THE EFECTS AND INFIRMITIES OF :ellectual AND MORAL CHARACTER, IN STUDENTS OF MEDICINE: AN INTRODUCTORY LECTURK, DELIVERED IN THE UNIVERSITY OF LOUISVILLE, November 1st, 1847. BY DANIEL DRAKE, M. D. PROFBSSOR OF PATHOLOGY AKD THE PRACTICE OF MEDICINE. PUBLISHED BY THE CLASS LOUISVILLE, KY. PRENTICE AND WEISSINGER 1847. Sfe^ft; 0 tf STRICTURES ON SOME OF THE DEFECTS AND INFIRMITIES OF INTELLECTUAL AND MORAL CHARACTER, IN STUDENTS OF MEDICINE: AN INTRODUCTORY LECTURE, DELIVERED IN THE UNIVERSITY OF LOUISVILLE, November 1st, 1847. BY DANIEL DRAKE, M. D. PROFESSOR OF PATHOLOGY AND THE PRACTICE OF MEDICINE. PUBLISHED BY THE CLASS LOUISVILLE, KY. PRENTICE AND WEISSINGER. 1847. INTRODUCTORY LECTURE. Young Gentlemen : As you have come together in this Hall, from the mountains of Virginia to the wilds of Missouri, and from the Upper Mississippi to the banks of the Alabama river, it cannot be, but there are among you, spe- cimens of almost every variety of intellectual and moral character, found in the extensive and diversified region within those limits. With these peculiarities, you are to sit down side by side, and listen to lectures, which by their very adaptation to the tastes of some, will be unimpressive to others; while, in reference to the whole, they may fail to prove useful, in consequence of infirmities and defects in yourselves, which you should if possible correct at the very beginning of the session. While prosecuting your studies, in the offices of your respective and respected preceptors, these peculiarities, and, too often, these defects were unconsciously cherished; for, until we compare ourselves with others, we do not know to what extent we differ from them, nor how far we have departed from the models which should ever stand before us. The time has now arrived, when you may make the comparison,-and each will find around him, individuals who are strong on points in which he is weak; while he in turn will present excellencies, which they ought to imitate. The opportunity for this reciprocal amelioration of character and habits. is one of those advantages which can no where be had, but in medical schools, and can scarcely be too highly valued. The primary object of this lecture, is to aid you in the improvement which may be derived, from studying these excellencies and im- perfections of mental character and deportment, by directing your atten- tion to faults and infirmities, which may be fairly assumed to exist among you, the correction of which is not more indispensable to success in tlw acquisition of elementary knowledge, than to your honest advancement on the path of fame and fortune. But as some of you are young, and have just commenced the study of medicine, others farther advanced, and destined to be candidates for graduation at the end of the session; while many expect to enter on the practical duties of the profession after s single course of lectures; and as the varieties and degrees of your pre- 4 paratory education are equally diversified, it follows, that the task I have undertaken is beset with difficulties, and cannot be successfully performed without a willing and sustained attention to all that I may say. In coming up to its execution, I shall throw you into groups, and leave it with each to class himself in such of them, as a candid and searching self examination may direct. Should some of you find yourselves in sev- eral I hope you will not despair, for the first step towTards placing our feet on the right path, is to discover that we are in the wrong; as a consciousness of sin, is an indispensable prerequisite to repentance and a better life. My first, appeal is to the best among you. I'll try my 'prentice hand on them, and thus prepare it for more difficult undertakings. How many of you belonging to this group, is known only to Him, who counteth the thoughts of man as He numbereth the stars of Heaven, and weigheth his spirit as in a balance. To us, at this time, it signifies nothing, to know how many can legitimately claim admission—but it does signify much, that no student should, by an over-estimate of his genius, learning and moral temperament, place himself in its elevated ranks, when his claims are not well founded. The students who of right constitute the group I am now addressing, require to be admonished, almost as much as any others. By sound faculties of mind, ample opportunities, and habits of diligence and sobriety, they have reached high relative distinction,—in many in- stances without being conscious of it, for their studies were solitary. They will now mingle with less favored brethren; and under the compari son, may relax in their efforts, and begin to let themselves down;—there is death in this relaxation. Young gentlemen! The men who carry forward the world, do not grad- uate their efforts by any reference to those, whom its great Author de- signed they should lead on. If they look down, it is not to select an eligi- ble place among those below them, but to give an eneouraging glance—to beckon inspiringly—to shame the laggard, and cheer the weary! Such is your mission, and in fulfilling it, you work out your, otvn destiny. That destiny, properly understood, is to make yourselves great and good, in pro- portion to your higher participation in Heaven's natural gifts; to plant your- selves on the lofty and unsheltered terrace, where the towering pine plays with the pure breezes of the upper air, and the oak of a thousand sum- mers, dyes his leaves in the rainbow. If you do not rise to this relative distinction, you may glitter in the sunbeams of prosperity for a moment: but your very names will vanish from the firmament of the profession, as the colors of the beautiful bow fade from our admiring view, and leavp nothing to mark their place in the sky. o I must pass on to group second comprehending those who have already attended two courses of lectures, but wisely resolved to wait on a third, be- fore offering themselves as candidates. The dangers which beset the members of this group, ai'e not a few. While those whom I have just addressed, rely on their genius—these rely on their opportunities; but as genius untaxed is unproductive, so opportunities un- improved are barren. A student of this group often says—if others can graduate on two courses of lectures, certainly I may pass through my third, without labor or anxiety. Here, again, is a downward tendency, and woe to him who takes it. Much that was learned the first year—im- perfectly learned as it too often is—has to be learned anew in the third: much that would have been studied with intensity in the second, was passed carelessly over, because a third course had been decided on; and much that might have been learned in the last vacation, was postponed to the coming session. Such is the condition I fear, of almost every individ- ual in the group I am now addressing. And is it a condition to justify in- dolence, or inspire confidence in the future? Far from it! All common sense cries far from it! Experience proclaims aloud the same decision, and prudence weeps over the fatal delusion! Alas for the youth in his third session, who may turn a deaf ear to their warning voices, when thus united. A third group is composed of gentlemen somewhat advanced in life, who have entered on the practical duties of the profession, before graduating. Many of this class have a commendable skill, in the application of common remedies to common diseases. They have earned a merited reputation, within their limited spheres of practice, and in the honest opinion of their confiding patients, could scarcely be spared from home—could scarcely need the advantage of a second, or even one university course. Who is proof against such beguilements? Who can rise superior to the siren voice of his own self-love, mingled with the honest flattery of grateful friends? I will tell you. Not the victim of vanity or self-conceit—not the man whose vision is bounded by a horizon of recipes and infallible nos- trums—not the man who has been accustomed to measure himself by him- self, or by the empirics who may have infested his neighborhood; but the man of humility and self-examination—the man who has not only estima- ted impartially his capabilities and acquirements, but had the mental vis- ion to see evidence of a world beyond and around the circumscribed orbit in which he was moving—who from a small number of facts and a limited acquaintance with principles, has been able to infer the existence of many more; who, to borrow an illustration from geology, has found in the rolled pebbles of his path, an evidence that there are, somewhere, rocky strata from which they had been detached. Such is the middle-aged student, who has risen to a just estimate of the magnitude, of what he has under- 6 taken when he enters the university for the purpose of graduating on a single course of lectures, or on a second, long after the first. He will per- ceive and admit, that there are a multitude of elementary truths, which he has not studied; that his knowledge of anatomy is most limited; that he is equally deficient in the rudiments of chemistry, that he has not studied the natural and pharmaceutic history of the medicines he has suc- cessfully prescribed; that physiology has not revealed to him her world of living mysteries; and he will anxiously realize, that the time is passed by, for an easy and successful study of these rudiments—the appropriate duty of earlier years. Happy would I be, could I assure him, that his anxieties are groundless—that his task will be light—that he may trust to his years—may rely on his experience! I can utter no such counsels. They would be false and fatal. He should know the worst, and prepare himself accordingly. He has engaged in an enterprize from which he can- not withdraw—in which failure will bi-ing disgrace, while success will but place him on the same platform with his juniors. My only panacea for this touching condition, is industry—systematic, courageous and tireless industry. There is, young gentlemen, a fourth group, larger I fear than either of those which have been presented, who have commenced the study of medicine without due preparation. All such, labor under two disadvan- tages. 1st. They have not the power of acquisition which a knowledge of language imparts. 2d. They have not the advantage" of habits of ap- plication. Great, indeed, are the embarrassments under which such a pupil prosecutes the study of the difficult sciences, which make up the profession of medicine; and deeply will he be mortified, day by day, to see those who sit by his side, display a clear comprehension of what to him wears a discouraging aspect of darkness and doubt. Things not well understood, are not long remembered; and crude ideas, like crude aliment for the body, do not impart nourishment and growth to the mind. I would gladly offer a word of encouragement to the members of this group, but what encouragement can I give, without being unfaithful to the duty I have undertaken? To themselves they must look—on themselves must they rely. Their prayer for help will not avail, unless they keep their own shoulders to the wheel. They must study words as well as the ideas which they represent; they must note down in the lecture room, the terms they do not understand, and at night consult their faithful friends—the dictionary and lexicon— for those definitions which lie at the foundation of medical, as of all other science. They must comprehend, that knowledge cannot be gained with- out systematic and sustained attention—that it is not the bee which flies most fleetly from flower to flower, but the one which penetrates deepest 7 and remains longest, in the nectared corolla, that stores its cells with honey. They must learn the great and momentous truth, that habits of study can only be acquired by application—that he who floats upon the surface, will never learn to dive and bring up the pearls, that lie far down in the dark and deep waters beneath him. Encouragingly, however, would I say to all the students of this group—do not be without hope—every succeeding day, if you do your duty, the obstacles to your progress will lessen, your vocabulary increase, your powers of analysis strengthen, your adhesiveness to a difficult problem become more pertinacious, your methods of study more systematic, and your acquisitions more copious. We must advance to a fifth group. There are among you, many who feel themselves under the necessity of going into practice after at- tending a singb course of lectures. I deeply regret, as I hope they do themselves, that there should be such necessity, for the benefits which medical schoo's may confer, can be but partially acquired in a single ses- sion; and here I feel it my duty, publicly to declare, that no one ought to commence the study of medicine, without first consulting the cost, and ascertaining that he has means adequate to an ample course of study. Now what advice shall I give to the members of this group? Shall I tell them, to direct their attention on practical subjects, and load their portfolios with rules and recipes? By no means, for no advice could be more inju- dicious: No recipe for making an empiric could be more skilfully de- vised. All experience proves, that when young men commence their ca- reer with practical labours, they are prone to neglect theoretical investiga- tions. They become men of precepts, instead of principles. They may. in certain lines of practice, be adroit and successful; but cannot depart from the beaten track, and when new or unexpected difficulties arise, they are thrown aback, or grope their way in a darkness which the light of science only can dispel. I say, then, to the members of this group, bestow your attention on the primary branches—the first elements. Make yourselves good anatomists; for if thoroughly acquainted with the structure of the >ody, you may afterwards become good skilful surgeons by your own un- assisted efforts; but if you begin with operative surgery, your labors will be uncertain, and your advancement bounded by the narrowest limits. I would say, study chemistry, pharmacy, the natural history and modus operandi of medicines;—you may soon learn to apply them to the cure of diseases, and at last range through the whole nosology; but if you begin with the practical application of medicines, the properties and habitudes of which you do not understand, you will permanently enrol yourselves in the ranks of empiricism. I would say, devote yourselves to physiolo- gy, pathology, and pathological anatomy—to the functions of the organs, to the general or elementary types of morbid action, and to the corres- s ponding forms of morbid structure; and you will then find the study of particular diseases an easy task, while any attempt to acquire that kind of knowledge, without the requisite rudimental attainments, will be fatally abortive; for the most intense application, will only establish in your memo- ries an association between certain symptoms and certain recipes. Now, anatomy, chemistry, and pathological structure, without which you can- not understand physiology, pathology, or the preparation of medicines, can only be studied with success in a medical school; and I might, there- fore, earnestly exhort all who intend to commence the practice after one course of lectures, to devote themselves to those branches. Reading and experience, with such preparation, will soon give them an enlighted facil- ity in practical labors, and place them far in advance of him who enters on those labors without preparation. The next and sixVn group is composed of those who, throughout their whole pupilage, are altogether intent on practical matters, although their time and means may be adequate to a prolonged course of study. A student of this group will pass by the natural and pharmaceutic history of a medicine, its chemical incompatibilities with other medicines, its modus operandi or physiological effects, and look only to its application in the cure of diseases. Another will aim to make himself an operative surgeon, without first making himself a good anatomist. Another, will recoil from pathology, and give attention only to the symptoms and treatment of dis- eases. AVhile the members of this group agree in bestowing paramount attention on practical matters, there is much diversity in their motives. Some have a governing instinct towards practical labors, and overlook the means of their successful performance. In no other country, does this in- stinct exist in so high a degree as our own. So far from being limited to the medioal profession, it is an Americau trait, and shows itself in all the pursuits of life—in agriculture, the mechanic and fine arts, engineering, commerce, and legislation; and, yet each of these has its philosophy or fixed principles; and, cataris paribus, he who knows them best, is best fitted for their practice. But another portion of this group shrink from the study of matters not practical, through sheer indolence and irresolu- tion. Their motto is—do nothing to-day which can be put off till tomor- row; they have no thought of devoting twelve hours a day to study, and never wrestle with a difficult proposition, but steal silently round it, as a cowardly general takes a by-road when he arrives at a fortress, and leaves it unconquered in his rear. To such students all minute and accurate de- scriptions in anatomy, all explanations of complicated experiments in chemistry; all pathological generalizations, and all inductive reasonings, offer perplexities, under which they either sink into listlessness or fall asleep. Still, they would not willingly leave the University as empty in 9 mind as they entered it, and, therefore, lazily, turn their wavering atten tion towards practical matters; thus, to speak figuratively, filling the pockets of their minds with small change, which, on returning home, they can jingle in the ears of the people, who sagely judge, that so much could not appear on the outside, if the inside were not filled to overflowing. The advice appropriate to the two divisions of this group, must be differ- ent. To the former I would say,—seek to find a reason for all you under- take, and in proportion to its correctness will be your success in practice: To the latter,—seek some other employment, and when you have found one in which mental indolence is no obstacle to success, you will not dis- appoint your destiny. The annunciation of the seventh group will, perhaps, startle you. It comprises those who have unfortunately engaged in the study of medicine, without possessing powers of mind adequate to that extended and difficult undertaking. Every memory is not retentive, every judgment, is not ac- curate, every understanding is not analytical—I mean, sufficiently so to enable the individual, successfully, to grasp the principles of the several sciences, which the physician should learn. But what criterion shall I offer ? Who can give the diagnosis of that feebleness of intellect, which renders the task of the medical student hopeless ? Must it be left to the decision of the ballot box, or to the more fatal veto of society ? These are the common tribunals, but no medical student should allow his fate to be thus postponed and pronounced. He should carefully and candidly study his own intellectual character, and compare himself with his fellow-stu- dents,—selecting those above and not those below him. He should frame an answer to every question propounded in the lecture room, and bring it to the touchstone of what the professor shall declare to be the truth. He should, from time to time, write down his knowledge of particular sub- jects, and examine his compositions, or submit them to the criticism of candid and qualified friends: finally, he should review his medical knowledge, as it exists, unuttcred, in his own mind, and ascertain whether his views are as clear and his conclusions as satisfactory, as they are on common topics. By these methods, and a confiding reliance on the opin- ions of those who understand both his own character and that of his un- dertaking, he may, almost infallibly, arrive at a correct decision. When this decision is unfavorable to his aspirations, it will present at least two degrees. It will either declare ultimate success impossible, or improbable. In the former case, I take it for granted, he will retire from the study at the end of the session ; but should he not do the same in the latter case ? My deliberate judgment is, that he should. I admit that some would thus be diverted from the profesion, who might at last become as respectable as many now in it; and, even, that a few would be turned off, in whom thy 10 ratio of mental development might, under continual application, he so im proved as to secure ultimate distinction; still, it is better, both for the in- dividual and society, that he should err on the safe side. It is in vain to ar- gue, that the successful practice of the profession does not call for high intel- lectual powers;—it is an aggression on the dignity of our noble calling to come into its ranks unprepared ;—it is treason to society to seek, without deserving its confidence ;—it is degrading to the individual, to place himself in a path, on which he will not be able'to advance by the force of his legitimate qualifications ; when, on some other, he might earn a livelihood, and, by appropriate and honest endeavors, render himself useful and respectable. An eighth group must now receive attention. It is made up of those who lack punctuality ; who come late to the lecture room, or leave it before the lecture i9 over ; or from trifling causes loose a lecture, or even a day. I might dwell on the obvious indecorum, of entering or leaving the room in such a manner, as to disturb the professor or divert the attention of the class ; and urge, that as medicine is a polite and refined profession, all stu- dents should diligently cultivate good manners; but I can place punctuali- ty and regular attendance, on much higher ground. The acquisition of science is by undeviating progress according to fixed laws. It may be slower or faster, but the law of continuity is still the same. Every step must be trodden. Every subsequent must have its antecedent. It is, in fact, a chain of cause and effect—of premises and conclusions—and no- thing can be omitted without vitiating all that follows. You have heard of the wonders of the magnetic telegraph—swift as the lightning of heaven- unerring as the thunderbolt when it descends upon the proud spire of the doomed temple. But divide the conducting wire, and the silent mes- sages which it was transmitting are annihilated : substitute for any part of if, an imperfect conductor of electricity, and the delivery of the message becomes slow, uncertain, and unsatisfactory. In the former, we have an emblem of ignorance—in the latter, of error:—a proposition wanting, or a falsehood interposed between truths, which it cannot logically connect. Now the teacher, when faithful to his high calling, advances from fact to fact, from theorem to theorem, and every pupil should follow in his foot- steps. But how can he do it, who is oil-n absent? who enters the lec- ture room after a proposition has been discussed? or leaves it, while an- other is undergoing analysis? or absents himself for a day and then rejoins his fellow travelers on their march, quite ignorant of all they had passed through in his absence ? In a certain sense he keeps in company, but is not in mental companionship, with his fellow students; and when he reaches the examination room, is either fatally ignorant, or encumbered with a confused burden of isolated truths, which he is unable to demonstrate ; and of errors, which he cannot even intelligibly express. 11 We come to a ninth group, whom I would fain omit to admonish, but duty forbids. It is constituted of students whose social feelings lead them into society, during the session. In all other respects, their instincts and deportment as students, may be unexceptionable. It is difficult to declaim or argue against the indulgence of this sentiment-in itself so amiable and even praiseworthy. For that very reason, however, it is the more neces- sary, to warn those in whom it is strongly developed, against the conse- quences of its indulgence. Conscience, or refined moral taste, may protect us against vicious temptation; but they are powerless in reference to al- lurements which are in themselves innocent, and yet, indulged under cer- tain circumstances, may prove highly detrimental to some important and cherished interest. Youth is the age in which we form our manners- and equally that, in which we enjoy, with the highest zest, an intercourse with congenial society. Moreover, when a student comes from the coun- try or a distant village, into a city, at a season of the year when fireside and drawing-room socialities are epidemic, and he knows that his teach- ers, and all with whom he has official intercourse, are more or less parties to them, he naturally feels as if he were treated with neglect in not being invited to participate. Such is the plausible strength of this temptation ; and yet, I say, unhesitatingly, it ought to be resisted. The loss of an eve- ning is, in itself, too insignificant to be noted; but the social sympathies awakened by it, may be franght with disastrous results; for it may remotely occasion the loss of many more. Invitations may multiply—the circle of enjoyments rapidly enlarge—the interest deepen—and, before the young man is aware of his condition, his mind may be so diverted from the foun- tains of instruction, that he may at last perish from lack of knowledge. But this is not the whole. The energy of social feeling which character- izes the period of life under consideration, is designed by the Creator to promote the matrimonial union of the sexes, and when the youn°- man yields himself up to the society of those of his own age, he is in imminent danger, of having the sentiment of conjugal love awakened in his heart Thus, before he is aware of his true situation, he has, perhaps, become more solicitous for a marriage license than a diploma; and begins to indite love letters before he can write recipes! It requires but a slight knowledge of human nature, to foresee the results of the conflict which is now begun. We have a case of what John Hunter called incompatible actions, and one must speedily give way. Your own hearts will tell you which is doomed to defeat; while an experience still more limited than yours, would enable you to estimate the bitter fruits of substituting, in the midst of your pu- pillage, a love of sex for the love of science. I pass, with less embarrassment, to a tenth group—allied, yet remote. Its motley ranks comprehend the votaries of dissipation—"the ring-streak- 12 cd, speckled, and spotted"—the gross and sensual, in whom the insatiable appetites and propensities devour the moral sentiments, the love of know- ledge, and the aspiration to that "good name which is better than precious ointment." It would be waste of time to prove, that the members of this group are not devotees to that delightful assemblage of sciences, which makes up the profession of medicine. Yet, all do not deserve the censure and disgust, which it would be affected charity to withhold from a few. Many should be regarded with pity and tenderness, for they are the vic- tims of a companionship with master spirits in vice, and to them only shall I address myself. They do not move forward, in a career of dissipation, so much from inherent impulses, as from a fatal admiration of those to whom they look up, and a feeble resolution against the seductions of good fellowship. Are there any such in this class? Look into your own hearts, young gentlemen, and give the reply. A candid confession would, I fear, bring out a longer catalogue than could be seen without deep and painful emotion. And what shall be said to them ? Why, that they are candidates for the same ruin to which their leaders are hastening on ; and that, too, without the base apology of uncontrollable desire, or insatiable appetite. To be thus led away is so contemptible, that even pity herself can scarcely drop a tear of compassionate sorrow. And, still, she would not abandon those who have not become fixed in the practice of imitative dissipation; but exhort them to fly from the dangerous company of the dis- solute, and cleave to that of the virtuous. She would pray for their de- liverance, and console herself with the hope, that He who has commanded us to "remember our Creator in the days of our youth," will, in mercy, hear and grant her prayer. The last group to which I shall refer, is made up of bullies and despe- radoes. Youth is not less the period of dissipation than of touchiness and combat. Many young men live under the influence of all these tendencies; but some, although addicted to pleasure, are still pacific, while others in- cline to bullyism, without dipping into dissipation. It is one of the best signs of the times, that the number of the quarrelsome has greatly fallen off from what it was in the early part of this century and previously; and in proportion as love of science, morality, refinement of manners, a sense of religious obligation, and a just estimate of the true character of the phy- sician and the gentleman, shall take deeper hold of the minds and hearts of our students, will be the decline of insult and aggression. The age of chivalry placed refinement of manners on the basis of fear. Men were led to act courteously towards each other, through the dread of being held personally responsible for every violation. The sword was the avenger; and all who chose to defy its power, were at liberty to treat those around them in any manner, which their arrogance and other evil passions might 13 suggest. The most respectable young man was, then, not he who culti- vated his mind and purified his heart from every foul and ferocious pro- pensity, but he who was most ready and dexterous in plunging a dagger into the bosom of him who should give the slightest offense;—albeit, none might have been intended, and the innocent offender perhaps his dearest friend. It is delightful to know, that this relic of barbarism lingers in the bosom of so few of the young men of the present generation—that the hereditary diathesis of blood-thirstiness, has so nearly run out—that the moral sentiments have begun to triumph over the animal passions—and that a law of kindness is so rapidly superseding that of violence. This happy amelioration, has so greatly reduced the number of those who take delight in quarrelling, or find pleasure in making the more pacific or feeble stand aside, when they may choose to select a certain path, that but few among you can be referred to the group of desperadoes. To those few I would say, if you have the courage and the high and quick sense of honor which you claim, it is inconsistent with your pretensions, and unworthy of your arrogated dignity, to impose upon, or provoke a quarrel, with fel- low students, who have adopted a different theory of the duties and dig- nity of human nature—who aim at subduing their violent passions, and seek to elevate their moral feelings, and their sense of justice, over all the gross or grovelling principles of their nature. To enter into combat with such an one, is not the way, honestly, to earn the distinction which chivalry professes to regard as desirable. That reputation can only be achieved, by success in equal combat; but the combat is never equal, where one of the parties has inflamed those passions which he holds in common with wild beasts and savages—while the other has cherished those which, universally adopted, would spread peace and joy over the whole earth. Gladly would I persuade such of you as delight in browbeating and bullying, to take higher views of the end for which you were created; I beseech you to study the nature of human excellence, and follow out to their le- gitimate, their unfailing results, the various sentiments and passions, which sway the heart of man and mould his destiny; do this faithfully, and you will perceive and feel the truth of all that I have said; that whieh now seems beautiful to you will appear deformed, and much which you now enjoy will become disgusting—but your happiness will increase, and a brighter and nobler destiny open to your purified vision. Young gentlemen: I must now address you in the aggregate. There are some sinister biasses of character which American students gen- erally—most certainly those of the West and South—possess to a much higher degree than they are aware. 1. Most of them think of the profession too much as a tradesman thinks 2 1-1 of his store, or a mechanic of his work shop. The ordinary tradesman does not trouble himself with the study of the great principles of political economy—he thinks only of filling his shelves from the nearest market, with such articles as he knows, from experience, will be called for. He never attempts to fathom the great sources of supply, or follow the streams on which are distributed, throughout the world, the products of agricul- ture and the arts, in which he deals—he knows nothing of the balance of trade, or of the laws which govern the circulation of those universal re- presentatives of all property—gold and silver coin. Such an one is only a store-keeper: he can never, justly, be called a merchant. He lacks comprehension, and is destitute of economical science. The mechanic or artisan, in his work shop, manipulates with tools which have been in- vented by others ; applies mechanical powers according to rules, investi- gated and proposed by abler men ; or squares the foundation of an edifice by a problem in geometry, which he does not understand ; the dyer weighs and measures out chemical agents, of which he knows but little, and deposits in his cloth a coloring matter, thr; composition of which is to him a pro- found secret. Now, it is a humiliating fact, that a large proportion of our students aim at no higher excellence than this in medicine; and aspiring to nothing more, they attain to nothing more. Were I, discreetly, to study popularity, I should not venture on these plain truths. I am sure they are unpalatable, and so arc many of our most valuable and precious medicines ; but as we do not hesitate to prescribe them freely, notwith- standing our patients dislike their smell or taste, so I shall not, on the pre- sent occasion, deal in homoeopathic doses: and will, therefore, add, that this low estimate of the necessary acquirements of a physician, is a great cause of the lamentable progress of quackery in all parts of the country. Too many members of the profession present themselves, before discerning men, in that deficiency of learning and science, which sinks them to the level of the pretenders of their neighborhood, and destroys the landmarks which should for ever separate science from empiricism. 2. Having formed this low conception of the nature of the profession. its effect on their application is most disastrous. Under the perpetual ad- monition of their teachers in the univerity, they may, while there, apply themselves with some degree of diligence; but the false theory, that they have a light task only, before them, is forever recurring and forever relax- ing their intensity. It is a law of the human mind, to graduate its efforts by the object in view. If a young man attempt to leap over a chasm, ho conforms to this law. He judges of its width, and exerts himself accord- ingly. If he think it five feet across, he makes one degree of effort—if ten, another—if fifteen, a still greater. Should he have overrated its width, he has only expended more strength than was required, but is rewarded by 15 fhe discipline and invigoration of his muscular system. Should he have underrated its breadth, he falls to the bottom, and crawls out, so mortified and discouraged perhaps, that he resolves on taking some new path. 3. And this brings me in the third place, to say, that a low estimate, and, consequent feeble prosecution of the science of medicine, is one cause, why so many relinquish it for other and very different pursuits. The best of all guar- anties for constancy in what we undertake is a high estimate of its magni- tude, and a corresponding devotion of our wnole heart, to its acquisition. Such a state of mind, will soon banish every thought of renouncing, what we have undertaken. It rises in value according to its cost; and we esteem it the more, for the difficulties which beset its pursuit. 4. In the fourth place, our students do not propose to themselves, that they will strive to enlarge the boundaries of our science. But why should they not? The American mind is not inferior in strength or invention to that of Europe. In the science of government—in jurisprudence—in elo- quence—in war—in agriculture—in the fine and useful arts, it has shown itself quite equal, often superior, to the European mind. Why is it, then, that we continue to look, almost exclusively, to our medical brethren on the other side of the Ocean, and not to cnrselves for discoveries and im- provements? France, Germany, Englar.-c".. Scotland, and Ireland, are re- spectively cultivating the profession, as if the duty of enlarging its boun- daries, rested on one only. The physicians of those several kingdoms, dfi not turn to each other with an eye of dependence-, but of emulation. In this coii::l:v, the reverse prevails. To acquire a tolerable know- ledge of what is done abroad, too often constitutes the sum total of the ambition of the best minds among us, while hundreds do not even aspire to that. It is time that we threw off the shackles of colonial dependence, and assumed a higher position. Once, like callow nestlings, we of neces- sity swallowed whatever our European nursing mothers dropped into our gaping throats ; but we are no longer unfledged, and should spread out our ^Towing pinions, and begin a life of independent activity. This resolution once taken, success would not be doubtful. But who should take it? — Those who are now in, or those who are aspiring to the profession? 1 answer, all, but especiallly the latter—you and your fellow student throughout the Union; —for the old are too inert, the middle aged too in- different, and a majority of both classes, too little prepared by early dis- cipline or lofty aspirations to enter on a career of glory. Our hopes, therefore, must rest on you more than your preceptors and seni- ors. Would to God, my young friends, that I could kindle in your hearts a flame of patriotic ambition, so intense as to burn up every germ of servile dependence on the physicians of the old world! Would that 1 could fill your imaginations with bright and bcaut'fnl visions of the future1 lli But should I do so, remember that the most glorious conceptions will not, of themselves, secure the objects which they embody. The conceptions of mind which tell on the progress of an individual, a class, or a nation, comprehend both causes and effects. The little child as eagerly puts forth its hands to pluck the flower which hangs beyond its reach, as that which blooms within its grasp. Experience tends to correct this constitutional error of infancy ; but in many minds the correction is so slow and imper- fect, that the man, in this trait of character, remains a child ; and while he indulges in captivating visions of excellence, which cost no effort, ne- glects the labors which alone can convert them into living realities. They who do not rise above this infirmity of our nature, will do nothing towards emancipating us from our unequal dependence on Europe. They who surmount it, will contribute to the foundation of an American profession. To this great and brilliant enterprise your alma mater now calls you— every one, the humblest not less than the highest, for all may contribute something. How happy would she be, to see every heart here, and in all the sister schools of the Continent, quickened into life, and filled with a moral courage equal to the task! Then, the question with the young as- pirant would no longer be—What saith the seer of other countries? but of our own, our beloved native land : then, improvement would roll on- ward, like a mighty river—deep and fertilizing as the Mississippi—trans- parent and uniform as the St. Lawrence! The fame of its waters would spread to other lands; and many of their young men would come and drink. American students as they traversed the ocean for the East, would then greet European students on their way to the West; and on reaching the schools of the old world, would feel no humiliation; but in the pride of a glowing patriotism, would be able to exclaim to those around them—"If we have sought the banks of the Thames and the Seine, your young men are treading those of the Delaware, the Hudson and the Ohio."