VALEDICTORY ADDRESS TO THE GRADUATING CLASS OF THE PHILADELPHIA COLLEGE OF MEDICINE, DELIVERED ON SATURDAY, MARCH 1, 1851, y BY FREDERICK A. FICKARDT, M. D., Professor of Obstetrics and Diseases of Women and Children. PUBLISHED BY THE CLASS. PHILADELPHIA: G. S. HARRIS, PRINTER, 119 NORTH FOURTH STREET. 1851. CORRESPON DENCE. Philadelphia, March 1, 1851. Professor F. A. Fickabttt, M. D., Dear Sir :—On behalf of the Graduating Class of the Philadelphia College of Medicine we respectfully request of you a copy of the eloquent and instructive Valedictory Address delivered to them by you this day at Commencement; and we take leave to say that we hope you will accede to_ their wishes, in which we most cordially join. Very respectfully and truly, Your friends and servants, MURD. MURCHISON, M. D., Tenn. CHAS. B. FOSTER, M. D., Geo. EDWIN T. EDGERTON.M. D ,SC. H. W. C. FOLK, M. D., S. C. CHAS. T. BOCOCK, M. D., Va. W. S. ERNST, M. D. Pa. JOHN DICKSON, M. D„ Pa. CHAS. E. COX, M. D., Ala. J AS. BYNUM BELL, M. D., Geo. JOSEPH HERITAGE, M. D.,Pa. W. W. FOLK, M. D., S. C. ALEX. R. SHAW, M. D., Pa. THOMAS T. TURNER, M. D., Geo. Philadelphia, March 2, 1851. Messrs. Murchisojt, Edgertoh, Bocock, akd others, Gentlemen:—Your polite note of the 1st inst. is received. I have to thank you for its kind expressions, and accede with pleasure to its request. When in years, and perhaps in distant places, your eyes fall upon the visible Address, then, I beg you, to remember me. That its simple but sincere teachings may be of ser- vice to you is the cordial wish of Very truly, Your friend and servant, FRED. A. FICKARDT, M. D. ADDRESS. Gentlemen and Graduates of the Philadelphia College of Medicine : I greet you to-day with no ordinary emotions. The President and Faculty have placed in your hands the Diploma of the Institution, by virtue of which you will go forth from this hall and take your equal and honorable rank among your Brethren of the Profession, a Profes- sion at once elevated and humane, whose duties you have nobly chosen as your walk in life. To-day your Faculty part with you after a long and interesting as- sociation, and are finally severed from you by the diligent and credi- table completion of your various practical and scientific studies. I will not deny, gentlemen, that your marked attention to the Lec- tures of the Course has elicited the liveliest pleasure on the part of your Teachers ; and that their efforts to benefit you by their instruc- tions, have been cheered and lightened by your close application. By this conduct you have won the esteem of your Faculty and given them the pleasing hope that your future will be brilliant with a zealous and successful cultivation of our Science. I am thankful to my colleagues for this opportunity of declaring my admiration at your industry and high moral and gentlemanly bearing, for no Class ever passed through a Medical College with a more stain- less reputation, and of also expressing my personal acknowledgments of your uniform and very acceptable courtesy. From this day you are travelers on the great journey of Medical Science ; and from hence you pass, staves in hand, on your mission to the relief of Humanity. It is fit then that we should feel an in- terest in you ; and I desire to assure you in the name of your Faculty that their best wishes follow you ; and that they will rejoice at your success, and sympathise with your trials and struggles on the way. It is a saying, gentlemen, with our countrymen, that " the price of 4 Liberty is eternal vigilance. " The price of Knowledge is eternal thought; and to acquire Knowledge is now your sacred duty. Do some of you say—Have we not graduated 1 Ah ! gentlemen, that graduation, honorable as it is to you, and much labor as it has cost you, is but the first fair step upon your path. Let none deceive them- selves. Your weightiest study has just begun. You have learned the elements with us, but with yourselves lies their wide and various application and extension. "We have given you the key-facts, but their vast and wondrous, their mysterious and solemn chambers you must explore alone. In your libraries, at the side of the sick, the suffering and the dying, alone, at all times of day and night, you must arrange, combine and apply them ; and still by faithful study multiply your vital store. Oh ! what a labor ? Oh ! what a glorious privilege and power! How sublime to heal the sick, the lame, the blind, the deaf; to still the aching brain ; to soothe the throbbing heart; to banish burning fever ; to stay disease ; to stand by the bedside of the father, the mother, the husband, the wife, or the child, and arrest the very uplifted hand of Death ! Oh ! this is noble, and worth the double of your toil ! Who then will not labor for it ? Who, to achieve this magnificent benevolence, this grand capacity in Medicine, will not dili- gently read, study and reflect, and sift and weigh and judge 1 Press on then, Graduates ; time past, time present, and to come, are open before you. Seize on their revelations with eager hands and complete the work you have so worthily commenced. Let nothing discourage you. As you advance on your way brighter scenes and greater facilities will open upon you ; the rugged road will become smooth, and all its Alps subside before your growing and mightier knowledge. Be bravely aware of your position and your powers. Gird up your loins—summon up your courage—bend all your ener- gies to the task and resolve to conquer. Success, gentlemen, demands the cultivation of your intellectual faculties. How ? By one great overshadowing Rule : Think for yourselves. Read, hear, gather opinions, but think for yourselves. Swear by the words of no man. It is our own thought which de- velops the higher reflective and creative powers of the soul, and makes the passive memory vigorous by its deep impressions. It is our thought only which gives us a true substantive and independent pro- perty in general or particular Science. All other knowledge is facti- tious ; a borrowed stock in trade, a superficial prosperity of intel- lectual possession, fugitive in character and unreliable in crises. 5 But a beautiful or important thought won from the hard soil of facts by " the sweat of our brows, " is our own ; and being logically pos- sessed in all its parts, becomes a living idea, endowed with our own spirit life, and available to every purpose of its knowledge. In such thoughts men have faith;—for such they toil;.—with such they achieve their triumphs ; and through such their memories become immortal. Genius is god-like, talent is admirable, wealth gives facili- ties, and refined education is excellent, but neither the one nor the other can supply the place of your own thought and your own in- dustry. Remember then, gentlemen, that you hold in your own hands your own destinies. With regard to Theories and Systems let nothing sway you to the surrender of your own judgments. Do not fall into the common weakness of supposing one System perfect and all others totally false. You will learn, as you grow more experienced, that each has truths and untruths, merits and demerits, although not, perhaps, in equal ratio. Acquaint yourselves with all, and thus perfect your know-? ledge, and extend your catholicity of truth. You are the honorable Graduates of the oldest and best System of Medicine in our view. But shall you on that account close your eyes to all other systems ? Will you exclude yourselves and your patients from the benefits of all other reaches of remedial experience and thought ? I am persuaded you will not. Search, gentlemen, for facts, and discarding the tyran-* ny of theories, variable as the wind, embrace the truth wherever you find it. Thus free you will reap a harvest of golden ideas. Your Practice will be comprehensive, pleasant and curative, and yourselves truly " Doctors, " or learned^ in Medicine. Next, gentlemen, a high morality is essential to give full effect to your attainments. Integrity is the basis of all lasting reputation and usefulness, and commands alike the confidence and respect of friends and foes. " Do as you would be done by, " is the great and controll- ing rule. This covers all morality-^all honesty—all love—all duty —all truth ; and not only satisfies Earth but applies itself to Heaven, Observe the pure teachings of this rule, and your reputations will brighten in the eyes of men ) your influence will be enhanced, and your studies and Profession illustrated, Let me point out to you, however, one snare which may entang7e your feet unawares ; a pit into which many of the Profession fall— yet not more than others. I allude to the treacherous habit of the use of stimulant drinks. The severities, the irregularity, the trials and exhaustions, the cold* the wet, the hunger, the travel by night, and the 6 sleepless vigils of Medical life, present but too many and strong temp- tations to receive the temporary support of Alcohols. The hospitality of the people, too, increases the evil—misjudging friends, who thus drug the bowl of life with sorrow, shame and death ! It has been my sad experience to behold many of my early medical acquaintances thus cut off in the flower of their lives, in the midst of their useful- ness, and more than once, in the full view of the most cheering prospects. I cannot easily comprehend how Medical men shall permit usage of this sort to blind them to its dangerous tendencies, and the poisonous character of their draughts. The systemic unfitness of Al- coholic liquors ; their everywhere rejected presence in the economy; their irritant and excitant action ; the injurious states of the brain and abdominal viscera they induce ; the serious organic lesions, and addi- tional risks of recovery from sickness or accidents attached to their frequent imbibition, are so many daily evidences of the impropriety of their use. They are moreover perilous in another and to the Profession, ex- ceedingly grave point of view. The essential sign of Alcoholic ex- citation of the nervous mass is disturbance of that mental equipoise which is sanity. Excitation carried to intoxication is craziness; whilst at any marked perceptible point short of this, it is l'mited delirium. Figure to yourselves, gentlemen, a Physician in one of these condi- tions, leaning over the sick couch of a fellow creature, holding with unsteady hands, and considering with unsteady mind, the delicate and important scale of life and death; while Death, himself, perhaps, peers through the curtain with him, and prepares to strike the fatal blow through his wandering judgment. Were angels allowed to inter- pose would they not cry hold ! And will not you prevent such scenes, such outrage and such woe 1 As conservators of the general health constantly discountenance Alcohols as a drink. The word and example of the Profession is mighty in Hygiene. Banish them from your Practice except as ar- ticles of Materia Medica. Many times it is worse than death to pre- scribe them. Again, gentlemen, if you wish to move steadily amidst the storms of life, and preserve a cheerful composure under its vicissitudes, let mc earnestly advise you to entertain a lively sense of the presence, the goodness and providence of God. Everywhere about us, gentlemen, are the evidences of God. The works of Creation on their grandest or minutest scale, from the shi- 7 ning and immeasurable magnificence of the stars and planets, in whose vast and numberless combinations suns, constellations and systems roll and revolve on revolving suns and systems, until imagination withdraws from before the immensity of their Infinity, down to the animalcular wonders of a drop of water, or the feathery miracles of the dust of a butterfly's wing, all profoundly inspire the soul with the greatness, the wisdom and power of Go«!L " Thou art, Oh God f the life and light Of all this wondrous world we see ! Its glow by day, its smile by night Are but reflections caught from Thee: Where'er we turn Thy glories shine, And all things bright and fair are Thine.w It amazes- me, gentlemen, to hear it charged that the Profession is Atheistical. In the concise language of an able demonstrator of Anatomy " the Anatomist who is an Atheist is a fool." No man may warily scan the coursing arteries, the returning veins, the intelligent nerves, the receiving and forcive heart, the vivifying lungs, the crowning brain, the thousand surprising arrangements of bones, and muscles, and tendons, and pulleys, the precise and won- derful adaptive action of parts, direct and indirect, the miraculous conformation of those subtle organs whereby we receive the rays of light, the vibrations of sound, impressions of odors, taste and touch, and yet refuse his solemn assent to a Great Intelligent First Cause. Nor can any survey the various functions of the body and nervous centers, from the meanest, if there be any mean in the wise design, to the loftiest exercise of the god-like faculties of thought and speech, without feeling upon his heart the invincible impress of Divine crea- tion. I repeat, no man, having " mens sana in corpore sano" can be a true Physician and remain that blot upon the human intellect, an Atheist. Do not suppose, gentlemen, that I forget our Medical relations. I desire only to leave upon your minds favorably, principles too often overlooked, which are yet of primary importance to your happiness and success. As to the Rank of your Profession, assume that it is equal to any Arrogating to yourselves nothing that is offensive to others, permit nothing offensive from them. In deeds of wide and fraternal humanity, in devotion to the sick 8 and suffering; in that true heroism, braver than the soldier's, that faces death without glory; that unattended, encounters the plague, the cholera, the small-pox and a multitude of loathsome and infectious diseases, the Profession wears a crown of laurels forever green. Should the prestige of names be challenged, point without fear to Hippocrates, the " Father of Physic," whose genius and wisdom re- formed the curative Medicine of the World; to Galen, his great dis- ciple, and to Celsus ; to Harvey, who first demonstrated the course of the blood; to your learned Sydenham, your celebrated Linnaeus, your Boerhave, replete with science, your comprehensive Haller, your illustrious Van Swieten, your zealous Jenner, whose discovery of vac- cination checked the decimation of the civilized world; your admira- ble Cullen, your Scarpa, and Hey, and others, that brilliant host of operators on the eye, whose names should be written in light; your Hunter, your Dessault and Larrey, whose surgical achievements are beyond price; your skillful Baudelocque, your Denman, your phi- losophic Good, your intelligent Arnott; and in brief, to come nearer home, your Shippen ; your Wistar; your patriotic Rush and gallant Warren ; your Physick; your Hosack; your Dorsey and McClellan: your James and your Dewees. These are but a few of that bright array your Profession may boast as its sons and jewels ; nor is there an equal body of men, in any Profession, who form a fairer constellation above the intellectual horizon, or shine more luminously upon the science, the humanity and happiness of mankind. In your intercourse with the community take a right position and maintain it. The respect of the world is desirable, and important to you. The world respects those who respect themselves, and those only. " Make no enemy nor lose a friend." Nothing is more varia* ble and extraordinary than the revolutions of a life-time. So singu* larly are the affairs of men blended together, that none knows at what point, or at what moment, he may need the good offices of another, or have reason to regret his hostility. Such is human life and the change-- able current of its events, that the despised and injured individual of to-day is often the strong and powerful man of to-morrow. This truth strikes all observant men as they review the drama of life ; and more than one, professional and lay, has bitterly repented the anger, the scorn or unkindness of irrevocable days. Toward your Professional Brethren be affable and frank. Sacredly adhere to the etiquette established among Physicians for the preserva* 9 tion of Professional harmony and good feeling. Let nothing induce you to forget the dignity of your calling in unworthy efforts ; or in remarks derogatory to the merits of those in competition with you. To hope, as some do, to build up a reputation on the defamation of a rival, is one of the most preposterous propositions with which the Med- ical heart ever deceived itself. That man only can erect to himself a solid and useful reputation, who to scientific attainments unites indus- try and a strict integrity of general and Professional conduct. To the Profession and humanity, gentlemen, you owe it, to be care- ful as to the qualifications of those you receive into instruction. Ac- cept none whose mental powers and attainments are unequal to the Profession ; nor any whose principles are opposed to its honor. As the homes of the Country are chiefly the sources of its social and mor- al principles, so are the Medical offices responsible for the men who issue from them. In the choice of your Medical armament receive only the most ap- proved and best medicines and of the purest sort. Refuse all cheap and doubtful drugs. In nothing is it more important to have reliable agents than in the sick-room, when perhaps a life hangs trembling on the efficacy of a single dose. With regard to the number of your medicines a proper understanding and control of established good remedies, will better promote your successful treatment than a too miscellaneous and multitudinous resort. A skillful artisan needs not many tools. Let your Diagnosis of disease be careful and comprehensive. In your medication be closely attentive to all circumstances of constitu- tion, temperament, habits of life mental and physical, idiosyncrasies, hereditary tendencies, age and sex. In the Practice of Medicine learn to look conditions promptly into shape, and form to yourselves at an early moment, clear and de- finite ideas of the diseases you encounter. To do this accustom your- selves to take in quickly all essential symptoms of cases, and as readi- ly to reject those not special, or merely associate. Be sparing of Prognosis. Disease varies as the changes of the day. In serious cases be neither arrogant nor despondent, but watchful and attentive, and ever as cheerful as circumstances will admit. Endea- vor to inspire your patients and those around you with confidence so far as is just. The words, the tones, the looks and conduct of Physi- cians are often as potent as their remedies. When occasion requires, be unwearied in the application of your best skill; and in dangerous contingencies refuse to yield your patients until beyond all reason- 10 able hope. None can infallibly tell when the dread fiat has gone forth from the Throne of the Almighty; or when it may be happily stayed. Often at the verge of life, when Nature's tide apparently stands still —at its lowest ebb—never to know reflux more—the ruby stream of being recommences a healthful flow, and the father, or the mother, the child, the sister, or the brother, the husband or the wife, already mourned as dead, is borne back to life, and home, and friends, and happiness again. To the poor be kind, and to their Medical wants assiduous. They sufficiently need sympathy and aid when sick. Look upon them as children of the Great Father who is in Heaven, and you will not fail of your reward. In the field of Surgery be prudent, rather than bold and fearless. Do not rush recklessly at every opposing obstacle, knife in hand. The scalpel is the last resort of the truly scientific Surgeon ; and is, not unfrequently, a tacit admission, either of the deficiency of the operator, or the inefficiency of the healing art. It is now universally agreed in the Profession, that steel-edged Surgery should be far more sparingly employed than formerly. Surgery is indeed a noble art— requiring various and precise knowledge, great discriminative powers, calm courage, and unwavering steadiness of mind and nerve. Thus mentally and physically accomplished the Surgeon occupies a proud position; nor can I commend to you a better exemplar than your own able and popular Professor. In that delicate and important department which relates to the gentler sex, let a generous courtesy and the most scrupulous honor and purity continually attest the esteem in which you hold woman, and the respect which is so eminently her due. Woman, tender, and physically weaker than man, yet supports the most painful and hea- viest part of the burden of life. In all the affections she is our superior. She is God's smile upon the Earth. As mother, sister, daughter, wife, or lover, we. cannot match her qualities. Without her essential traits, man would relapse into barbarism, and human nature shrink beneath a wintry and perpetual frown. I repeat then, be gentle to woman. Repay her trust with honor, and give to her sufferings your kindest sympathies. There can be no baser being than the Professional man who betrays the confidence of the sex : nor more unmanly than he who refuses the accord of his nature to her agonies. The man, I do not hesitate to say, who is deficient in respect for woman, or regardless of her honor, is unfit for the Practice of the great confidential trust of Medicine* 11 In the general pursuit of your Profession fix your aim. In this and perseverance lies the secret of success. Men who climb a moun- tain toil. Those who view the ascent and dream of Aladdin's Lamp, or the ring of the Genius, may dream, but when they awake they will find themselves at the bottom. The law of success in science is labor; and it is by the use of talents, not their possession, we rise in life. Do not diverge from the upward path. When some seemingly beautiful light shall dazzle you with its glare and fascination, some deceit of partisan politics, some meritricious lure of sudden wealth, or any other anti-professional temptation, turn from it as an ignis fatu- us that will mislead and lose you. Fix your sight on your pole star and press on. Never procrastinate. " Time is the stuff life is made of." An hour may be life or death to the patient: nor can you know in what direction the energies of practice may demand your presence in the next. " To-morrow is nowhere but in the fool's calender," and ceases daily to thousands. It is by the just employment of time and by judicious concentration of effort that great results are generally obtained. " How, " said a gentleman to another, celebrated for his vast labors, " do you accomplish so much—have you any plan ? " "I have, " was the reply, " when I have anything particular to do I go and do it." "How," said another, to one of our most eminent statesmen, " do you manage to do so many things ? He replied, " By thinking of one thing at a time. " In your money affairs be systematic and correct. Many excellent men fail of their mark by neglect of this point. Be prompt in your collections. " Short accounts make long friends, " and nothing more frequently and unpleasantly disturbs Physicians and families than an unwise postponement of settlements. Parties are prone to forget the many and important services rendered, and naturally take exception at amounts, which on earlier presentation, or with less accumulation, would have been held moderate and cheerfully liquidated. It is but just to families, and to yourselves to present your bills semi-annually. Exercise economy in the expenditures of your early years. Look forward to the attainment of a proper and comfortable independence, before you shall have passed the prime of life. Every Medical man should at forty years be reasonably independent, under common cir- cumstances of Practice. Beyond independence do not care too great- ly for wealth. 12 It is a mistake to suppose happiness can be purchased. Above that honorable and useful measure I have indicated, it is a question with well balanced and experienced minds whether riches are desirable. The private history of Astor, Girard, and McDonough does not ind>- eate great value in possession. Knowledge, wisdom and virtue, gentlemen, are worthier than wealth. They are fuller of fruition ; they approximate man nearer to God. And what shall interject itself as a barrier to the mighty and resolute will ?—what limit the knowledge of the earnest Soul ? Not anything, gentlemen! Little by little, steadily and with method, braced by thought and patient industry, temperance, integrity and reliance on Almighty God, move on and win the eminences of your Profession. The love of knowledge is a faculty of the soul. Not even death shall destroy it. The disenthralled Spirit released from the clogs and fetters of this temporality, the body; unearthed from this dull mould of clay which but restrains it, will find one of its chiefest joys in Eternity in knowledge. In that grand existence we shall be led like children, step by step, from one world to another, from glory to glory, from intelligence to still brighter intelligence, and learn to know all their wonders, until, at length, we are lost in the ineffable beatitude of knowing God. In conclusion, gentlemen, it remains but for me to ask your kind recollection of your Alma Mater. It is the intention of those you leave behind you to spare no effort to place the " Philadelphia Col- lege of Medicine," in all requisite appointments for a thorough and scientific course of professional instruction, on a basis inferior to none. In our labors we confidently expect the hearty and zealous co-opera- tion of every Alumnus of the Institution. With such a union of effort, your College now happily on the ascendant, must freely increase in honor and usefulness, and will before long take position beside the proudest of her Seniors. Gentlemen, in the name and behalf of the President and Faculty of your College I bid you an earnest and affectionate farewell. May your lives be happy, prosperous and useful; as citizens may you be eminent, as Professional men esteemed and honored, and as men enjoy the trust and affections of the community, and may the blessings of Heaven rest upon you here and hereafter.