INTRODUCTORY LECTURE BEFORE THE ALBANY MEDICAL COLLEGE, OCTOBER 1, 1839, By DAVID M. REESE, M. D. INTRODUCTORY LECTURE BEFORE THE ALBANY MEDICAL COLLEGE, DELIVERED OCTOBER 1, 1S39. BY DAVID M. REESE, M. D. PROFESSOR OF THE THEORY AND PRACTICE OF PHYSIO. PUBLISHED AT THE REQUEST OF THE CLASS. ALBANY: PRINTED BY J. MUNSELL, 58 STATE STREET. 1839. Dr. Reese, At a meeting of the Students of the Albany Medical College, Mr. J. V. I*. Qnack- enbusli was called to the chair, and Mr. T. H. Reynolds appointed Secretary, and the fol- lowing resolution adopted: Resolved, That a committee be appointed to wait upon Dr. Reese, and request for publi- cation his Lecture delivered on Tuesday evening, Oct. 1st. We the committee, in behalf of the class, respectfully ask of you the same. Yours, with sentiments of high fcSpcct, ROBERT KELLS, FRANCIS N. SILL, E. W. TROTTER. Gentlemen, I gratefully acknowledge your kind and respectful notice of my late Introductory Lecture; and though not written with a view to publication, I do not feel at liberty to de- cline a compliance with your request. I therefore place the manuscript at yourdisposal. With great respect, Your obedient servant, D. M. REESE. Oct. 3, 1839. INTRODUCTORY LECTURE. Gentlemen, The position I now occupy, and that of my colleagues in the Faculty of this school of medicine, is very different from that under which it became my duty to open the college on the occasion of the Introductory to my last course of lectures. Then we were collectively and individually volunteers, and might be regarded as adventurers, in the business of medical instruction; and our personal reputation was all the hazard we incurred, and even this upon our own responsibility, and subject to the censures of many for our temerity. No other individual, no other body of men were committed with us in the untried experiment upon which we entered, and save the kindly participation of our few friends and patrons, residents of this ancient city, we were en- gaged in an enterprise without patronage, and al- most without sympathy. But in common with many of our professional breth- ren in the empire state, we had clearly perceived and deeply felt the lamentably low state of medical lite- rature among us; and without allowing ourselves needlessly to speculate upon the causes of what we 4 all deplored, we resolved upon an effort to raise the standard of professional education in this state, by attempting the organization of a new medical school. And profiting by the lessons taught us by the history of the past, we were not content with the project of a new school, but we determined that it should be founded upon a new principle, new to this state, new to our country, but one adapted to our national cha- racter, and conformable to the genius of our liberal institutions. Hence, instead of commencing our work by ap- pealing to the state treasury, as others have done; before we had demonstrated the feasibility of our plans, or given evidence of our fitness to execute them; we resolved to try what could be done by in- dividual enterprise, and to exhibit, in the sight of all men, that our claims for public patronage were to be founded only upon our contribution to the public be- nefit. Nor indeed had we the courage to ask, even for adoption into the family of the state, by the legal recognition which an act of incorporation bestows, until we had first opened the college, collected and arranged the physical facilities for our work, and actually commenced our several courses of instruction. Nor was our confidence in the wisdom and justice of our rulers at all shaken, by their repeated refusal to charter projected medical schools, after the expe- rience they had in relation to the sickly and perpetu- ally needy circumstances of those, which had already shared so largely of the public treasury. We felt an assurance, that we had only to put forth our collect- 5 ive energies for the establishment of our new school, and our new principle of organization would com- mend itself to their sense of propriety and duty. Nor were we disappointed, maugre all the resistance made by rival schools, for a charter at once inde- pendent and libera], has crowned our honest efforts, and we now therefore stand before you, commissioned by the authority of the state of New-York, empow- ered in conjunction with our trustees and curators, to confer all the rights and immunities of our profession upon our meritorious pupils. The new principle by which our organization is distinguished, is that of opening these halls of science for popular instruction and improvement, and encour- aging the non-professional laity to cultivate at least the rudiments of the physical sciences. Nay more, all the ignorant empirics and quack pretenders to medical knowledge, are free to come within this our temple, where the fountains of medical science are unsealed for the common benefit of all; and we thus offer them inducements no longer to impose upon the credulity of the vulgar, no longer to trifle with human health and life, by applying remedies of which they know nothing, to the vital organs of which they know less. For this novel and unique feature in our plan, we have been reviled, and even derided, by those who would fain affect a monopoly of professional learning, and who arrogate the exclusive possession of the ar- cana of the art of healing, as though science did not repudiate so fanciful an aristocracy. “ Salus populi, 6 suprema lex,” is the distinguishing motto of our noble science, and should be written upon our portals. Quackery will ever flourish, while the sovereign peo- ple are taught to regard physicians, either as mystics, magicians, jugglers, or practitioners in the arts of witchcraft. Credulity and superstition will be ever busy in multiplying empirics, and increasing their victims, so long as dark and mysterious secrecy is made to be characteristic of medicine. But let the professors in the various departments of medical science adapt their discourses and their publications to the popular eye and ear; let their instructions be sufficiently accessible to the public to inculcate upon the popular mind enlightened and correct views of the true nature and extent of the physical sciences, and the invaluable resources of the healing art; and the nation and the world may thus be rescued from self immolation, in the vortex of charlatanism and impos- ture. If the entire community could be impressed with correct information in physiological and pathological science, the empiric would himself be shocked at his own temerity, and if he have remaining any vestige of moral sense, or even of manhood, he would be impel- led to abandon the craft by which he has his gains, or to seek that knowledge which can alone prepare him for the conflict with disease and death. And, if gene- ral information could be diffused through the public mind, touching the intricate and complicated structure of the human frame, the number and importance, of delicate and vital organs, the laws of life in health 7 and disease, the deleterious and deadly results of me- dical agents applied to the living fibre injudiciously or indiscriminately, and the salutary potency of a skil- ful adaptation of remedies to the organic and func- tional disturbances of health; the swarms of empirics in our country, would find “their occupation gone,” for popular ignorance is the pabulum vitce of quack- ery. For illustration, let the enquiry be made, who would entrust his valuable watch for repair, to the black- smith who shoes his horse ? What mariner would go to sea in the ship built by his tailor ? Or, what lady would commit her piano or music box, the inestimable gift of love or friendship, when either were out of tune, to the repairing hand of her shoemaker? To propose these questions, is to answer them. And yet is it not surpassing strange, an anomalous paradox in this age of wonders, that ladies and gentlemen of re- finement, education, accomplishments, and fortune, aye and of high intelligence too, exhibited on all other subjects; do nevertheless commit their stomachs, livers, lungs and brains to the hazardous experiments of men, whose ignorance would forbid their employment in the most menial offices ? And whence have we this strange anomaly? Is it because of a wide-spread mis- anthropy which leads to an indifference to the value of health and life ? Assuredly not. These very per- sons, are those most anxious about their health, most sensitive in view of its loss, many of whom are ready to give quackery itself a “world of wealth for an inch of time.” But the mystery is nevertheless easily 8 solved. The public generally, are well informed touch- ing the intricacy of a watch, a ship, a piano and a music box, and the mass of the people are sufficiently enlightened, to know that none but the skilful hand and practised eye can safely meddle with such com- plicated machines. But is the human body less in- tricate? Is the structure of man less delicate and complicated ? Are blood-vessels, nerves and vital tissues in the living body, more safely handled by rude hands, and subjected to medicinal or poisonous agents, than are the wheels of a watch, the ropes of a ship, the keys of a musical instrument ? Certainly not; but then the latter are subjects ojDen to the sen- ses, appreciable to every capacity, and popular curi- osity in relation to these forms of mechanism, has ne- ver been repressed, nor has an air of inexplicable mysticism been thrown around them by those who practise these arts. Every one knows that any one may be a watch maker, a ship builder, or a musical instrument maker, who will give time and patience to the work, and all know equally well, that none can safely undertake such employments, without having previously and regularly learned them. And this is the source of the correct notions on such subjects which every where prevail. But such is lamentably not the fact in regard to our noble science. The popular mind is a tabula rasa in all that appertains to the healing art. An impos- tor has only to proclaim that hemlock is a mineral, and that castor oil is made of dead men's bones, and other than those confessedly children and fools are 9 shocked with the intelligence. An ignorant clown has only to lay aside his awl and his waxen thread, for roots and yarbs, and thousands are ready to be- come the lap-stones on which he may hammer out his fame and fortune; if he only take the title of botani- cal, or Indian doctor, and boast of vegetable remedies for all incurable diseases. The more ignorant he is of the learned lumber of the schools, or even of his mother tongue, the more confidence is reposed in his skill, especially if he be the seventh son of the seventh daughter, or profess to have obtained his larnin by inspiration or immediate revelation, whether from ce- lestial or infernal agency. Superstition and even re- ligious fanaticism are thus made tributary to the pub- lic delusion, and multitudes become the victims of the stupid experimentalist upon popular gullibility. The reason of the prevalence of such impostors, and the source of their success, are both found in the fact that even in this age of light and intelligence, when the teachers of all other sciences are employed in simplify- ing every other species of knowledge, and rendering it the common property of all, Medicine, and every thing appertaining to it, is locked up in mysticism and obscu- rity, unapproached and unapproachable by the popu- lar mind. Our books are filled with hieroglyphics and symbolical language, like those used for the pre- servation of the occult sciences, in ancient times, by the professors of astrology and the black arts. Our professed teachers of medicine have, to a lamentable extent, employed obscure technicalities, neologisms, and unintelligible mysticisms, so that their pupils have 10 been in need of a vocabulary of jaw-breakers even while listening to their lectures. The general reader has been thus repelled from the sealed books written for the ostensible purpose of making every man his own doctor; and the popular mind has been taught to regard our science as a system of magic, its teach- ers wizards, and its practitioners as having dealings with the devil or some of his imps. When they are sick, and one of these miracle mongers with wig and cane, has shaken his head and looked wise, they have trembled with fright, lest Death and his pale horse, should suddenly appear in sight. In answer to their inquiries, when they have the courage to make them, in relation to their disease or its remedies, they have listened to some Latin or Greek technicalities, or been enlightened by the use of anglicized neologisms still more unintelligible. A veil of inexplicable mystery has thus been thrown over the entire subject, and a thousand tricks of the trade have been employed to terrify and affright the populace. So also in relation to our medical schools, their doors have been hermetically sealed against the populace. And, although a favored few have been allowed a peep into the dissecting room, or by special grace been al- lowed to look at a human skeleton, yet the public at large have been led to suppose that within their walls some awfully terrible affairs are ever enacting. Little boys are trained up with horrible apprehensions, so that in passing by a medical college they have to whistle to keep their courage up; and shut their eyes, lest ghosts and hobgoblins should dance before their vision. 11 Now all these vulgar errors have been perpetuated, by the reprehensible policy of the profession ; and the public mind has thus been beclouded and deluded, un- til confidence in our art has been shaken, and medical men have to a great extent been regarded by the po- pulace as mystics, and no more respect is felt for such than for other conjurers and mountebanks. The remedy for these deplorable and humiliating evils, is natural and easy. Let our museums of ana- tomical specimens be thrown open to public in- spection, without any other than necessary and be- coming restrictions; let our halls of medical science be accessible to all who choose to visit them, and to profit by the knowledge communicated by lecture or otherwise. In other words, let the public mind be en- lightened in relation to the true character of our science, its progressive improvement and advance; the zeal, and industry with which it is cultivated in every department; the rational and becoming manner in which practical anatomy is pursued; and the im- portant uses of the dead to the living, which is the only and all-sufficient justification for human dissec- tion ; and a medical college will no longer be a mon- strum, horrendum in public estimation, but what it is and ought to be, a seminary of learning, a temple of science. Thus will teachers and practitioners of the healing art come to be regarded as students of nature, and public benefactors. The public, thus prepared to appreciate the justice of our claims to superior at- tainments, by witnessing our industry and zeal in the cultivation of medical science, will also be pre- 12 pared to award us their confidence in times of peril to their health and lives from the inroads of disease, and quackery would thus be shamed out of countenance and banished from the abodes of civilized man. That there is no invincible repugnance to the culti- vation of practical anatomy, and physiological science among any class of the community, is apparent, from the fact that their rudiments are taught in most of our modern colleges and academies, and even in the high- er female seminaries of learning, which abound in our country. But I am happy in having it in my power to appeal to the enlightened audience before me, in proof of the correctness of my position. In this city of Albany, many of you have listened to the instruc- tions of my able colleague, the Professor of Anatomy, and to those of his preceptor, the Professor of Sur- gery; both of whom, have for a number of years been most laudably engaged in this, and neighboring cities, in cultivating a taste for these pursuits. You know with what interest their large classes have thronged the lecture rooms in which both these gentlemen have taught practical anatomy, and collateral sciences. The former of these gentlemen, many of the ladies of this and neighboring cities, have heard lecture, with a human body upon the table, while in full view of the promiscuous audience, he has dissected and de- monstrated the beautiful and complicated structure of muscles, tendons, blood-vessels and nerves, while the fixed attention and breathless silence of all, has intel- ligibly spoken his eulogy. And it is due to Professor Alden March, who in all coming time, must be view- 13 cd as the father and founder of this college, to award him the honor of having long and zealously labored for this new principle of adapting medical instruction to the popular mind. With his co-laborer Professor Armsby, they have nobly triumphed over professional and prevalent prejudice, and the latter has not only reconciled the feelings of the non-professional to wit- nessing human dissection for scientific purposes, but very many of his auditors have been so interested in his dignified and courteous manner of conducting it, that they have been almost persuaded to bequeath him their own bodies for similar purposes. For the prevalent and almost universal ignorance of the community in relation to human health and life, and for the consequent mischiefs of quackery, our pro- fession are therefore, to a great extent, responsible; and the mantle of secresy which we have so long been accustomed to wrap about our science, is essen- tially empiricism itself. If the teachers and practi- tioners of any other science, were to attempt similar exclusiveness, and arrogate the possession of a mono- poly of its art and mystery, creating a privileged or- der, a fictitious aristocracy of knowledge, assuming to exclude the popular mind from prying into its secrets, the result would be the same. Suspicion, distrust, and jealousy, would lead to resistance, and ultimate contempt for such pretensions, nor would it be possi- ble in this land of freedom and republican equality of rights, to control the thirst for knowledge, which is characteristic of our age and country. Hence the monopolists of any science, would find 14 themselves unable to retain the public confidence; they would be supplanted in popular esteem by the merest pretenders to the same kind of knowledge; and the most absurd, unphilosohpical, and dangerous errors would be propagated and embraced by the mul- titude. Such is memorably the case with medical science. On no subject is the popular mind less in- formed, and in no other department is there so fruitful a field for imposture and fraud. The laws for the suppression of quackery only multiply its agents and victims, w hile the remonstrances of medical men are regarded merely as the idle and interested declama- tion of mercenary mystics; for in the language of Lord Bacon, “ in the opinion of the multitude, witch- es, fortune tellers, and conjurers, have always held competition with physicians.” A brighter day will dawn upon our country and the world, only when the restrictions upon knowledge shall all be taken off, and medicine like other sciences, shall only seek the public confidence by demonstrating to the popular mind, its necessity, importance, and utility. No longer is mankind to be governed either by pompous pretensions, by force or fraud. They who secure and retain popular favor and confidence, must do so by frank ingenuousness, and throw open their opinions, their conduct, and their claims, to the sun-light of free inquiry, and unrestrained investiga- tion. Thus may we commend ourselves to the com- mon sense of our contemporaries, and command their homage and respect, not to ourselves but to the ma- jesty of truth. 15 Such, gentlemen, are the sentiments of those who have founded, and who sustain the Albany Medical College. And in conformity with such views, I ap- pear before you in the department which I have the honor to teach. When, therefore, I propose to in- struct you in the Theory and Practice of Medicine, you are not to expect of me, that I make pretensions to an intuitive or inherent acquaintance with subjects of which you are ignorant, and that I am about to re- veal to you the explanation of mysteries in which 1 have been enlightened by inspiration. Let me disa- buse your minds thus early, if you have fallen beneath the reign of popular delusion. I have never been a favorite with the gods, nor has any superhuman affla- tus ever visited my intellectual organization, constitu- ting me an oracle of ultimate appeal. And let me, moreover, admonish you, that though others may make good their pretensions to professional qualification by intuition, or hereditary descent, I have not obtained the knowledge I propose to impart to you by absorp- tion, or any other mysterious or inexplicable process. My colleagues will all make the same concession, and we therefore pretend not to speak ex cathedra from the professor’s chair. Whatever amount of know- ledge any of us have acquired, and hope to impart to others, has been obtained in the school of nature, by diligent, laborious, patient and persevering study and investigation into her mysteries. We have interro- gated nature,—and waited for her responses. These we have collected, compared, combined, and treasured up for our own use and yours. The human body has 16 been the laboratory in which we have pursued our study, and our investigations have been directed to that body in all its mutations from infancy to old age, in health and disease; and not content with our re- searches during life, we have entered the domain of death, and from the last remnant of mortality we have sought to extort the secrets of nature, that we might benefit the living. But while the human body, living and dead, has been our laboratory, the books of ancient and modern authors have served as our appara- tus. The three kingdoms of nature have been ex- plored for the materials of our experiments,—analysis, synthesis, and laborious ratiocination have been our processes; and our mechanical and chemical, physio- logical and pathological observations, have only been limited in their extent, by the mysterious laws of vi- tality, and the opportunities which our short lives have afforded, consecrated to this school of nature as they have been from our youth. And now, having trod this wearisome path before you, for your benefit, we collectively consent to begin again de novo, and, having the advantage we have derived from a life devoted to the pursuit upon which you have just embarked, and prepared to impart to you for your aid and encouragement all that we have learned in this school of nature, we now become your companions in the study and investigation of na- ture’s laws, in health and disease; and by a division of labor among us, we hope to conduct you prosper- ously through the intricate and complicated labyrinths with which, our experience and opportunities have 17 rendered us somewhat familiar. We invite you to fol- low us, admonishing you that close and diligent study, patient investigation, persevering toil, and an unsatis- fied soul still thirsting for knowledge, will be your destiny at every step, while constant progression in the acquisition of professional learning and qualifica- tion, must be your reward. We have no kind or de- gree of knowledge which we have not attained by the same arduous labor, nor have we any which you may not acquire in the same way. And after you shall have been taught the rudiments of sound profes- sional learning by our instrumentality, we shall be af- flicted and disappointed if you do not hereafter excel us in all that is valuable and useful, in proportion to your increased and increasing advantages, facilities, and opportunities. For this result we shall diligently labor, and we confidently ask your undivided atten- tion and co-operation. It will be my individual duty, in the department as- signed me, to inculcate upon your minds the great leading and fundamental principles upon which all correct and judicious medical practice is founded; and without an acquaintance with these great principles, you will be but empirics at best, of whatever extent may be your other attainments. These great prin- ciples include the laws of life, organic and functional, normal and abnormal, as modified by morbid agents, and as existing in the integrity of health; the in- tensity of vitality in the different structures and tis- sues of the body, primary and secondary, with their several individual and relative dependence and sym- 18 pathies; the varied and ever varying phases of mor- bid action, under deleterious influences, affecting the solids or fluids, together with the indications for or against the interference of art, and the true province of medication in all the multiplied modifications of dis- ease, to which the various organs of the body are sub- ject. Hence you may perceive the abstract as well as re- lative importance of the chair of “ Theory and Prac- tice of Physick” in a medical school, since it includes those branches of knowledge without an acquaintance with which, all your other acquirements will be vain. And though I would not invidiously or arrogantly magnify my office, yet I would have you estimate this chair in its true character. It is the great condenser, in which is to be concentrated the entire product of the processes of elaboration, conducted by my col- leagues in their several departments. For while each of them will instruct, interest, surprise and delight you with valuable and necessary truths, absolutely essen- tial for you to know, it is here that you are to learn the application of those truths to the actual business of your profession. They deal in the abstract, but here you are to contemplate the concrete. They will impart knowledge in generals, so to speak, in gross, we must descend to particulars, to the minute details of actual practice, and in this department we are to deduct the tare from the gross, and obtain the net product of all their instructions; for their speculations and facts can only be valuable or useful as they sub- serve practical purposes, and may be safely estimated 19 only by the ratio and proportion in which they are tributary to the theory and practice. You will perceive that I betray some degree of anxi- ety that you should not undervalue my department, and I frankly admit that such is my purpose, and I would fain thus early indoctrinate you into its just ap- preciation. For I am not insensible of the peculiari- ties inseparable from my chair, which give greatly the vantage ground to the other departments, especially among superficial students. I have no brilliant ex- periments with which to dazzle your vision; no im- posing apparatus to attract your attention; no prepa- rations, models, casts, drawings, or machines, with which to pursue my demonstrations, elicit your curi- osity, and thus challenge your admiration. The in- trinsic nature of my department is such that it will not admit to be taught through the eye. My appeal is through your ears, to your intellect, and my success will depend upon your attention, your reflection, and your memory. It will be my duty to conduct you di- dactically through the wide field of pathology, with the collateral branches, of hygeine, etiology, sympto- matology, diagnosis, prognosis, prophylaxis, and the- rapeutics* In these several departments, the only demonstrations I can possibly furnish you, will be clinical, at the bedside of the sick, or the illustrations derived occasionally through the courtesy of the pro- fessor of anatomy from post mortem examinations. In all other respects my course must necessarily be didactic, and will I hope be distinguished by perspi- cuity and logical accuracy, when it becomes at any time theoretical. To lead you to habits of thinking, close and connected thinking, and prompt you to in- vestigate for yourselves, to read diligently, to study perseveringly, and thus profit by the instructions and demonstrations of my able colleagues, will the result which will be sought in my department. The importance of the subjects which will pass in review before us, will entitle them to your patient and close attention, especially as it will not be in my power to summon to my aid any auxiliary attractions, such as those which will add interest and fascination to the other branches taught in the school. I do not despair, however, of convincing you that the theory and prac- tice of medicine, is a department by no means devoid of interest, but one fruitful of that kind of information, without which, you can never become accomplished or able physicians. By the interest you individual- ly take in the course, and the attention you bestow during its progress, I shall be able to judge with tole- rable accuracy, long before we reach the green room, how many of you are preparing yourselves adequately, for the arduous duties and trying responsibilities of our noble profession. To aid you, I propose weekly to conduct an examination of the class by way of reca- pitulation and review, and in this way be enabled to amplify topics of interest, and illustrate what may have been obscure or ambiguous. For your own sakes, for the sake of the character of the college and especially for the sake of the public, whose health and lives are shortly to be committed to your guardianship, I conjure you to give yourselves to diligent attention 21 and study, without which, no man ever became hon- ored or honorable among physicians, and without which, our hopes of your future eminence and success will be vain. This college opens wide its doors, to all who seek to acquire medical knowledge, and who are ambitious to excel among their contemporaries as physicians of sound learning, and solid practical infor- mation. Our trustees and patrons have liberally pro- vided physical facilities for the student in this spacious building, of which we are justly proud. Our faculty are not deficient in zeal, industry or enterprise, and of some of their number, it is not vain boasting to af- firm, that both as practitioners and teachers, their es- tablished character entitle them to public confidence. And we have embarked our all in this work, with the united resolution that neither time, toil, nor money, shall be spared to elevate the character of medical literature here, and contribute all that in us lies, to ad- vance the cause of medical education in our state and country. Nor will we be satisfied, unless the Albany Medical College shall acquire a reputation worthy of this ancient city, creditable to the state, and honorable to the profession. Thus only will the hopes of its friends be realized, and thus alone will our perma- nence and success be commensurate with the views of its founders, and the ambition of those who now constitute its faculty. And as this exaltation is one which can only be reached, by our individual and col- lective merit, we have the highest possible motives for exertion, and shall be continually impelled by a sense 22 of weighty responsibility. Should we fail in attaining our wishes, we shall retire from the professorships we hold, and give place to others, more capable, and therefore, better adapted to secure success; for we shall never relinquish the position we have assumed that this empire state should have within its own bor- ders, one medical college deservedly great, rivalling any other in the nation; nor shall we relinquish our oft repeated opinion, that Albany is the city which can and will sustain it.