A* INTRODUCTORY LECTURE, DELITERED AT THE OPENINO OF THE THIRTY-FIRST SESSION, OF THE MEDICAL COLLEGE OF OHIO, NOVEMBER 4th. 1850, BY JOHN BELL, M. D. PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE IN THIS INSTITUTION, AND LECTURER ON CLINICAL MEDICINE, IN THE COMMERCIAL HOSPITAL OF CINCINNATI. CINCINNATI: PRINTED AT THE DAILY COMMERCIAL OFFICE. 1850. Cincinnati, Nov. 9, 1850. At a meeting of the Students of the Medical College of Ohio, held Novemher 9th, Mr. T f Swaney was called to the Chair, and Sol. L. Greene appointed Secretary. On motion it was unanimously Resolved, that a Committee of three he appointed to wSt on Prof. Bell, and solicit a copy of his address for publication. Whereupon the following gentlemen were appointed, viz : following g ^ ^ ARoNg> Taog_ k_ w_ j^^^ A_ Wj Keagan> T. J. SWANEY, Chairman. Sol. L. Green, Secretary. / CORRESPONDENCE. Cincinnati, Nov. 9, 1850. Prof. Bell, Dear Sir : In accordance with the desire of the Students of the Medical College of Ohio, we, the undersigned, were appointed a Committee, to solicit a copy of your very excellent In- troductory, for publication. A compliance with the above request, will meet the approbation of the entire Class. Yours, Respectfully, JOHN J. ARONS, THOS. R. W. JEFFRAY, J Committee. To Prof. J. Bell. A. W. REAGAN. Cincinnati, Nov. 11, 1850. Gentlemen : I have been honored with your letter^>f the 9th inst., in which you ask, on the part of the class, for a copy of my Introductory lecture, with a view to its publication. Gratified as I am by this early mark of confidence in my opinions on the relative position, attributes and range of Medicine, and on the duties of those who profess to teach it, I cheerfully comply with the wish of "the entire class," so kindly conveyed by you, and I place the manuscript of my lecture at your disposal. I remain, Gentlemen, Very respectfully, Yours, JOHN BELL. To Messrs. John J. Arons, Thos. R. W. Jeffray, ^ Committee. A. W. Reagan. '•} * <• i INTRODUCTORY LECTURE. My associates of the Faculty of the Medical College of Ohio, have deputed me to address you, gentlemen of the class, and fellow citizens of Cincinnati, on the occasion of the opening of the regular course of lectures in this institu- tion. Waiving personal feelings and considerations in the dis- charge of this temporary trust, I may be allowed merely to allude to the fact of our meeting each other for the first time. Still I cannot call myself a stranger among those whose greet- ings of welcome are heard almost as soon as the tones of affectionate farewell from kind and long attached and cher- ished friends have died away. The voices in my new and old homes are in different keys, but both breathe harmony. In other parts of the world, he who should cross a mountain range, like the Allegheny, and descend a noble river, like the Ohio, would find himself transferred to strange lands, among a people whose language, laws, manners and customs are entirely dissimilar from his own. Even when the language is the same, as in Germany or Italy, he would meet in a few days, sometimes in a few hours travel, differences in gov- ernment and industrial progress, which place the inhabitants of the respective sections far apart, and utterly estranged from each other. The Tuscan has, for example, as little sympathy for a Neapolitan or a Sicilian, as a Frenchman for a Cossack or the Don. How different the state of things on 0 this side of the Atlantic. Lofty ranges of mountains, wide rivers, and the greatest differences in climate and productions of the soil are forgotten in the community of language, lit- erature, political, and social institutions, and pervading tone of manners. We pass from the Atlantic coast to the Alle- gheny mountains, we descend the Ohio and Mississippi to its confluence with the ocean; or we traverse the great valley, cross the Apalachian range and travel to the Pacific, every- where meeting our countrymen, and everywhere seeing the same flag waiving in the breeze, as at once an evidence of nationality and a pledge of the charter of our common liberties. During this long traverse, we pass, indeed, from one sover- eign state to another; but we are not, as in the old states of Europe, reminded of our having reached the boundary line, by a call for passports or vexatious examinations of our clothes and books by custom-house officers. Next to our gratitude to God for the revelation of his word, ought to be our thankfulness to him for such rich and hitherto unexampled privileges as this glorious Union insures to us. Turning aside from a contemplation of this sublime pros- pect, which goes beyond " all Greek, all Roman fame," I would ask your attention, while taking a rapid survey of the relations of Medicine to the world of thought and action in which we five. The present age is described to be one of progress. It is equally remarkable for abrupt transition and sudden change. New views are taken of political economy; new discoveries are made in the sciences and the arts; new ex- periments attempted in religion and morals. Emigration is now doing more than war and conquest ever accomplished, in occupying vast territories, forming new states, founding cities and spreading the buz of commerce, and the doubtful music of manufactories, from innumerable centres. On this continent, and more especially into these United States, Eu- rope pours out her people—the Irish, the Scotch, the English, the Germans, the Dutch,and the French, to whom, of late years, 7 are added the Norwegians, the Poles, and the Hungarians. The plastic power of our government and institutions, and the prevalence of our language, insure a certain degree of homogeneousness among these numerous and originally di- verse elements ; but they are not quite sufficient to efface cer- tain peculiarities of opinion, prejudice and literature, with a no small share of ignorance and credulity. Even the indolent Mexican and the recently awakened Peruvian and Chilian, and the hitherto passive Chinese, have ventured into the current of emigration, and joined the savage Indian, and the eagerly inquiring American and European, in quest of gold, in the valley of the Sacramento. There might the ethnologist pursue his studies with the advantages that a naturalist would be supposed to enjoy in a Zoological Gar- den. The two collections differ, however, in this respect, that while the human varieties gather gold for themselves, the brute ones are brought together in order that their exhibition may procure gold for their keepers. One of the marvels of the times is the transmutation of so many metals and all kinds of the products of nature and art unto gold, by the aid of gainful trade and manufactures. The dream of the Philoso- pher's Stone is now realized in the multiplied applications of mechanical ingenuity, of which, not the solitary alchemist, but rather every industrious operative, reaps his share of the fruits. Even from the animal deemed unclean by the Jewish legislator, and equally prohibited by the Arabian impostor, is now evoked—a spirit, which, leaving behind its grosser ten- ement, becomes the genius of wealth and social refinement, set off with artistic elegance. While these changes are going on in the material world, others not less remarkable, but of more equivocal benefit, are taking place in the world of thought and sentiment. Old opinions and usages are becoming obsolete, and are condemned without inquiring into their inapplicablencss to the existing order of things. The deference once paid to age and station 8 is passing away as an old fashion, like that of the dress of those whom we unceremoniously thrust aside. "The old man eloquent" is listened to as people listen to music which breathes of other days, but the impression is evanescent, and leaves behind no lesson of wisdom and of prudence. Like the rapid stream eager to loose itself in the ocean, "----still pursuing, still unblest, We wander on nor dare to rest." In our eager haste we seem not to be aware that our chil- dren, with the increased impetus acquired by continual pro- gress and innovation, will magnify our example, by driving us off the field of action, while they contemn our advice and ridicule our fears. The discoveries made in science, which are positive ad- ditions to our available knowledge, are too apt to be con- founded with the speculations of intellectual and ethical phi- losophy, and the theories of political economy and govern- ment. We thus attempt to unite dissimilar and discordant materials, and persuade ourselves that we are able to lay a foundation for social and political regeneration—a very Uto- pia. We experiment in moral with more freedom, but cer- tainly with less method than in physical philosophy; for while in the latter, failure is attended with loss of material and time, in the former, it is productive of disturbance and derange- ment in the whole fabric of society and government. In the material world we do adventure somewhat, but seldom with- out careful inquiry into the efficiency and safety of the means employed for the gratification of our wants and the enlarge- ment of our pleasures. When, for example, we propose to ourselves to visit transatlantic regions, we ascertain, before- hand, whether the ship or the steamer, according as we select the one or the other, be staunch and well built, whether the rigging and sails of the former, or the machinery of the latter, be new, the captain competent, the engineer thoroughly in- structed in his duty, and the steersman sober. All the re- 9 quirements of science, all the experience of art must be com- plied with. We ailow of no paradoxes in the fashion of sail- ing and steering; such as forcing the vessel stern foremost, or trying how near she can be brought to a lee-shore. The most confident assertions, unsustained by previous trials, will not persuade us that it is a matter of entire indifference, whether the pressure of steam be much or little, the boiler of copper or of iron, the water fresh or salt; nor will all our admiration of genius and bias, in favor of the largest charter of individual freedom of action, as well as of freedom of opinion, induce us to consent to place the control of the machinery and the rate of speed under a blind, or an insane, or even a so called practical, but yet ignorant engineer. That water will drown and fire burn, and that if we are projected with force against a hard body we shall be the sufferers in limb, if not in life, are truisms which we are not hardy enough to deny, not- withstanding all the promised protection from cork jackets, life preservers, fire proof washes, and gum elastic armour. How different their creed and conduct, when men enter the domain of ethical and intellectual philosophy ! They dread explosions of steam boilers and of the fire-damp of mines; but they can sport and toy with a pestilent heresy which will convulse society and sever them from all that makes life val- uable, even if it does not lead, in the perturbations to which it gives rise, to the destruction of life itself. They can trust themselves to blind or ignorant guides, vile pretenders, in re- ligion or morals, and to persons without education or know- ledge of the past or experience of the present, who boldly promise to cure them of their bodily ills. Soul and body will be periled while imbibing the poison of infidelity, or wander- ing in the limbo of vain and fantastical opinions. The true is neglected, almost despised, in the mad chase after the new; and the harmonies of creation are thought to be tame and spiritless in comparison with the rocking of the earth- quake and the rumblings that precede and accompany the 2 10 eruptions of the volcano. Benevolence, herself, is forced too often to abandon her quiet and unostentatious habits, and to walk abroad accompanied by the braying of trumpets and the waving of flags, with many boastful devices. Noise is made the exponent of sense, and motley is the garb of wis- dom. To be the leader of anew sect in religion, with abun- dant ignorance of scripture and theology, or of a new party in politics, with equal ignorance of history and political econ- omy, and a disregard of the written constitution of the land; to found a school in literature with an oversight of the canons of Aristotle and the " Ars Poetica" of Horace, which shall be Shaksperian only in its extravagance, and Miltonic only in its obscurities, are spectacles of no uncommon occurrence in these changeful days. Happily for the world, however, while this spirit of inno- vation and revolutionary change is abroad and rampant, an- other spirit of a milder character and subdued mien pursues its walks in many lands. This, which may be called the genius of retrospection and conservatism, stops ever and anon to look around, as if to ascertain the distance, and to note the distinguishing features of the road that has been traveled. It is both quiet and reflective: it invites to study, and in its frequent pauses seems loth to turn away from the contemplation of the men and scenes of other and remote times. It might be supposed to say, "Knowledge, methinks, in these disordered times, Should he allowed a privilege, to have Her Anchorites, like poetry of old." ******* " Living to God and Nature, and content With that communion.'' Each of these spirits shows itself in a literature of its own. That of the restless and the revolutionary one has been al- ready partly sketched. It need not be farther noticed, beyond a mention of its frequent sins against.the canons of taste, the principles of ethics, and the creed of religion. Its convul- 11 wive movements are obtruded on our notice, as evidence of strength; its grimace is made to pass for vivacity: it w.elds stage thunder and illuminates with lucifer matches. In the company of the genius of retrospection, we walk the streets of Thebes and of Memphis, we enter through the majestic pyramidal gateways of the temples, and feast our eyes with the sight of their forests of prodigally sculp- tured columns and entablatures. We are witnesses to the pa- geants of the Pharaohs, and the imposing ritual of the priests. We watch the labors of the agriculturist, are intro- duced into the workshops, and initiated into the private fife of the men, and the mysteries of the toilet of the women of ancient Egypt; for all of this is pictured on the walls in the interior of the pyramids and the labyrinth. In strolling through the open streets of Pompeii, and the subterranean ones of Herculaneum, we are able, with the assistance of our friendly genius, to mix with the people with whom they were once crowded, and,on entering the houses, we almost converse with their ancient occupants. Their furniture, their ornaments of house and person, their culinary apparatus, and their instruments of surgery are placed before us in their actual embodiment, in the museum of Portici. More than all beside—the land and cities of Palestine, where Isaiah denounced and Jeremiah mourned, in the lan- guage of prophecy and accents of poetry, where the Saviour taught and performed his miracles, and sympathized with hu- man griefs and sufferings, have been surveyed and measured almost step by step. In the study of the topography, climate, and productions of the soil, of Palestine, we have learned to reconcile apparent discrepancies in the Sacred Writ, which had once furnished materials for infidel doubts and shallow criticism. Greece becomes once again ''living Greece." The nar- ratives and descriptions of Herodotus and Thucydides are expanded into additional life by fresh and illustrative fea- 12 tures, and we fancy ourselves spectators of the battles of Marathon, of Salamis and Plataea, and follow with an in- terest that never tires the growing ascendency of Athens, "the eye of Greece," not merely in political power but still more, in oratory, philosophy, poetry, and the plastic and other imitative arts. Her "fierce democracy" now worship- ing genius and worth, now driving them into exile or destroy- ing them by poison, could look up with a feeling of pride that kings might envy, at the Parthenon, the sanctuary of their presiding deity, the crowning glory of the Acropolis, around the base of which were clustered other temples, devoted indeed to an absurd worship, but like that of Minerva, constructed with an architectural skill, and decorated by the kindred arts of sculpture and painting, in a style which has served as a standard and a model to all succeeding ages. Still guided by the genius of retrospection, as it speaks through the pages of Niebuhr and Arnold, we learn to sepa- rate the myths and legends from the true records of ancient Rome, and are fain to give up, but not without regret, the romance for the reality of history. We next follow the bar- baric streams which flowed with such resistless force over the worn out soil of the Roman empire; and which left, by their recession, that fertile mould whence have grown up the various great families of the nations of modern Europe. We trace with a curiosity resembling that with which we turn over old family records, the progress of these people from barbarism to civilization; and we rest with peculiar interest on those ages, the mediaeval, which were ones of transition from anarchy and ignorance to one of beginning order and restoration of learning—the period of sublime edifices raised for religious worship, of illuminated missals and prized manuscripts of classic lore—a period of a not learned priesthood, and of an unquestionably ignorant laity. More than one founder of an illustrious house, the Montmorenci not excepted, was unable to write his own name; a stamp of his signet ring or of the 13 hilt of a dagger serving in its stead. This illiterateness is not thought to dim the brightness of their escutcheon; and why should similar deficiency be deemed a stigma or treated in terms of ridicule, in the case of an adventurous commoner who becomes the architect of his own fame and fortune. To the period just noticed, succeeded that of incipient commercial unions and enterprizes—the rising importance of the towns as checks on baronial tyranny—collegiate founda- tions, ponderous tomes of endless commentary and disqui- sition, both polemical and metaphysical, and learned pre- lections, as heavy as the books and as little instructive as they. But I will not continue these retrospective glances, for which, brief as they are, time fails me. It may be said, how- ever, in conclusion, that never in any former period of the world, have the same searching and persevering examina- tions been made in history, biography, political economy, forms of government, and the relative duties and obligations of rulers and people as at present. Mankind is now studied under new aspects, and with a rigid revision of former facts, and a rejection of cherished speculations. The seed, long since sown in the invention of printing and the discovery of America, has germinated into vigorous plants with abundant efflorescence; but the full fruit is yet to be gathered. After drawing these contrasted pictures of the influences now operating on the human mind, wTe naturally ask: Is Medicine also swayed by them ? Is she now driven impetu- ously forward into almost revolutionary extremes, then vacil- lates and remains nearly stationary, while casting a long and lingering look around, as if loth to abandon her old ties and associations? Rich in her endowments and ministered to by so many attendants in the shape of natual history, chemis- try, physics and mental philosophy; deriving her healing agents from earth and sea and air, fight and electricity, the productions of the vegetable, animal and mineral king- 14 doms; curiously observing the effects of the social system, in the various phases of civilization, and the modifications im- parted by differences of religion and government, and the pursuits of agriculture, commerce and the arts, how can Medicine fail to sympathise with most of the movements that are taking place in the world of nature and art. Although constantly called to witness scenes of gloom, and to relieve deformity and the contortions of disease, her aspirations, strengthened by her kinswoman Hygeia, are ever towards the fair, the beautiful, the good. Amid ruin and decay, she is still intent on reconstruction in harmonious proportions. Her standard, the sound mind in the sound body, implies a continual longing for the freshness of corporeal beauty, ani- mated by purity of thought and elevation of soul—the being, in fine, such as was first seen when sent fresh from the hand of its Creator in Paradise. Medicine, in her desire to realize this fair vision, some- times forgets the rules of severe logic, and, wandering from the path of induction, manifests a faith which, however esti- mable it may be in a religious sense, as inculcated by the apostle, is not a guide to safe conclusions in the study of vital phenomena and therapeutics. Sometimes, wdien lis- tening too readily to the plausible representations of her scientific aids, she is turned away from the line of reason and fact; as when at one time chemical, at another mechanical philosophy adduces its affinities and movements, as those which give rise to, if they do not actually constitute the inti- mate changes and physiological processes of the living body. As well might we attempt to explain the workings of the hu- man mind by algebraical formulas, or reduce the institutes of law to mathematical problems. Medicine is harassed by a spirit of innovation and change, through those who profess consanguinity, but who act a very unnatural part towards her. They are ignorant of her history and of the claims on the world's gratitude of the 15 men who, in successive ages, have brought genius and learn- ing and laborious and conscientious observation and patient trials and ingenious experiments, to illumine her path and to strengthen her in her ministrations. These pretended relatives, from chaos sprung, frequently usurp her offices, and affecting a reform, use a jargon, which, although not without Greek roots and Latin vocables, is as remote from common English as its reasoning is from common sense. These persons denounce that which they are too indolent to learn, if not too ignorant to understand. They assert that legitimate medi- cine is deformed, whereas it is they themselves who are aw- ry ; and that she is inconsistent and obscure, because, in fact, they will not give themselves the trouble to take up the clue to her course. Their rule would seem to be, to con- demn first and to assign reasons for their judgment afterwards. They are determined to sacrifice medicine, and to cut short her remonstrances in the same way as in the apologue of the cook and the barn yard fowls. On his putting the ques- tion, in what fashion they would like to be served up for the table, they replied, " May it please you, we would rather not be served up at all." "Oh!" rejoined the Solon of the kitchen, "you wander from the question." The same impatient ignorance which would thus maim and disfigure if not actually destroy medicine, is manifested in the attempt to introduce a hybrid brood in her place. Like the poet who wrote a descriptive poem first, and then visited the spot which he had described, these innovators first manufacture systems in medicine, and in ethics too, and then set about collecting facts and reasons for the support and elucidation of their vagaries. They seem to forget, that doubts and scepticism in one road do not excuse us for un- limited credulity in another; and yet we sometimes meet with scoffers at revelation and miracles, who give credence to medical and social theories which are as absurd as they are impracticable. 16 The enlightened and conscientious seeker after truth, he who would carry with him a knowledge of the past to aid him in his future inquiries, although he no longer goes up to the temple of Epidaurus, nor is enrolled among the Asclepiades, nor acknowledges allegiance to the school of Cos, will still find cause to hold fast to those golden precepts and practical maxims, which, sifted and scrutinized and added to from age to age, for the long period of twenty-three hundred years, be- ginning with Hippocrates, and coming down to the present time, now constitute a rich treasury from which he can free- ly draw for the relief of mankind from both bodily and mental ills. Aye, still more ! he will draw from it with the purpose of elevating the standard of humanity. Thus supported, the truthful inquirer will be neither discouraged nor bewildered by extremes and excesses, extravagances of creed and prac- tice, solecisms in logic and oversight of facts, the measured vanity of the regular sciolist and the immeasurable boasting of the irregular innovator and ignorant charlatan, mysticism masquerading in the garb of science, and absurdity reduced to system. However much he may be displeased at the un- productive and misapplied learning of some of his own order, he will not, on this account, find an excuse for tolerating, still less countenancing, and, worse than all, abetting the ignor- ance of one out of it. But, whilst we would advocate an intelligent conservatism, and deprecate change for change sake, and would yield a reasonable deference to station when ennobled by services, and to the dictorate when obtained by knowledge and learn- ing, we must not, at this time, claim a weight and authori- ty for the professor's chair, beyond that which is the mead for thorough and conscientious teachings. It gives no char- ter for crudities of thought, nor even for speculations, how- ever subtle, which are not germain to the matter under con- sideration. It authorises neither paradox nor personal nor collegiate vaunting, nor the pouring out a torrent of words in 17 place of a flood of ideas. But, neither does it excuse its occu- pant for a blind adherence to whatever is ancient. Science cannot be taught, on the one hand, in the equivocal language of the Delphic oracle, nor on the other, exhibit itself in the mummer's speech and gesture—declamation without earnest- ness, and vivacity without grace. We must not let it be said that a professor is not a teaeher, as it has been sometimes said that generals are not always gallant soldiers, nor divines theologians. Office, in too many cases, is far from being coincident with real distinction, fame, and extended usefulness, although it ought to be a proof of their attainment. Hippocrates and Celsus and Galen, in an- cient times, and Sydenham and Heberden and Mead, and the two Hunters, and Darwin, and Bichat, and Louis, in later times, have not been chronicled as professors in any college ; and the same may be said of others who rank with them among the most original thinkers, and the largest contribu- tors to medical science. The influence of Broussais waned, when, somewhat late in life, he was authorized to don the professor's gown and cap in the University of Paris. He had previously been a private lecturer for some years. In making these observations, I cannot be suspected of an intention to depreciate the order of which I have been lately made a member. My aim is to enforce a proper pride, a feeling of self respect, growing out of a consciousness of ability and attainments, among the great body of the profes- sion, and to persuade them that their mission is not the less praiseworthy nor are their services less eminent and deserving of reward and gratitude, although they may never obtain the titular honors of the professorship. We have been chosen from among them—we not unfrequently return to them, not sorry to escape from the cares of office and to enjoy once more the ease and freedom of private station. We, also, feel ourselves amenable to their opinions, when expressed with a deliberation and knowledge which ought to belong to a truly cultivated profession. 3 I is The duty of a professor consists in his presenting exist- ing knowledge in a clear and concise manner, rather than in attempts, especially those of an impulsive and erratic kind, to extend its boundaries. His ambition ought to show itself in imparting useful and safe principles, rules for the govern- ment of his hearers in the probable emergencies of profes- sional life. But the duty of prior preparation rests with the preceptors at home, as that of future development and strength and usefulness must rest writh the students them- selves. There are three parties deeply interested in medical education, who, although they have not co-ordinate power in the premises, must act with harmonious purpose. These are, the students themselves, their private preceptors, and their collegiate teachers or professors. The usefulness of the last must be in a great measure dependent on the satisfactory relations which the first two of these parties have maintained with each other. You cannot be insensible, my young friends, (for by these terms I may now venture to address you, gentlemen, of the class,) to the advantages which you have enjoyed, during your noviciate, from the early lessons of your preceptors, in prac- tical pharmacy, minor surgery, and an observation of the diseases incident to your respective neighborhoods. Certain- ly not profitless has been your quiet reading and your med- itation on what you have read. Opportunities have been fur- nished to most of you for looking around on Nature and taking your first lessons in botany and vegetable physiology, indigenous Materia Medica, mineralogy, geology and meteor- ology. A formidable body of science this, if its several parts were to be formally taught, but really pleasant and easy in occasional, though irregular lessons—outlines merely. A single plant with its technological divisions—a single speci- men of natural history with indication of its place in the re- ceived classification, from the hand of your preceptor, aided by reference to an elementary book on the subject, will often 19 suffice to awaken in your minds a lively perception of the qualities, relations and harmonies of the productions of na- ture—constituting pleasant study at the time, and profitable, when it becomes part of the entire series hereafter. Let not your preceptors be deterred from the duty of ad- vice and guidance by a fear, it may be a keen perception, of their own deficiencies. They are entitled to the privileges of the parental office, which, for a season, they are called upon to fulfil towards you, among which that of themselves learning while they teach is ever recognised. Why should they not act on this occasion in the same manner as a lovely woman who resolved on teaching her two little nieces botany. Although herself ignorant of the subject, she set about her task with such hearty good will, that she carried on learning, as regarded herself, and teaching, as regarded them, concur- rently and successfully. When, advancing to the next stage in your studies, you place yourselves under our care and, in a measure jurisdic- tion, we can only hope for your credence in our teachings, by our proving ourselves worthy of your confidence. We must show that we have done our best to prepare ourselves for our part; that we appear before you, not merely as men with scholastic and collegiate titles, who may have eagerly clutched the professor's chair, or by intrigue and extrane- ous influence have been invited to a seat in it; but as honest and industrious teachers, still students in the large accepta- tion of the term, and keen observers of the progress of medi- cal science. By our position in a great city, our collective organization, museums, and various illustrations and facili- ties for teaching practical anatomy, and by hospital and conse- quent appliances for teaching clinical medicine, we are placed in the possession of means for imparting medical knowledge, and for advancing medical education beyond the reach of private and individual tuition. Your own duties, gentlemen, in the relations which you hold, both to your former and present preceptors, are readily 20 understood, and will, we fondly hope, have been, and con- tinue to be, duly appreciated by you. They consist in a docility which is often most conspicuous in the most ingen- uous and independent minds, in a methodical and persever- ing industry, and an intentness to turn to account present opportunities, as if, and the supposition is generally verified by the fact, they would never recur. Thus advancing, step by step, with a modest, but assured, tread, you will gradually climb the steep ascent, until you reach the summit, there to hold converse with the master spirits who have given dignity and fame to your profession in by-gone days. The time is past when one great school, as that of Alexandria, in ancient, and of Leyden, Montpelier and Edin- burgh, in modern times, attracted universal regard, and was the recognised centre of knowledge, and the dispenser of pro- fessional titles and fame. In our own country, the University of Pennsylvania enjoyed, for awhile, this enviable eminence; but, of late, it has been outstripped by its young and vigorous rival, the Jefferson Medical College ; and it now lives, in part, on its former reputation, which, like the vanity of ancestral fame, is a very flatulent diet. It is the oldest school in the United States; but this is rather equivocal praise, as it reminds us of the remark of Montesquieu, in reference to the Univer- sity of Paris, that " it is the oldest of the King's daughters, so old indeed that it is beginning to doat." Medical schools are springing up among us with an im- promptu rapidity equal to that of the birth of Minerva from the head of Jupiter; but here the comparison, it is to be feared, ceases, for the good natured legislators, who bring medical colleges thus suddenly into life, have not the power to invest them, at the same time, with the mantle of wisdom. At the present rate of increase, a man of proper professional pride will soon write his -own epitaph in nearly the words of Piron, the witty Frenchman, who, in order to show his disdain of the French Academy, desired that the inscription on his tomb should ran thus: " Here lies Piron, who was nobody, ■z\ not even a member of the Academy."* So our medical Piron will soon write for himself: "Here lies Doctor Quiet, who was nobody, not even a Professor." It is not enough for a school to have gone through a pro- cess of organization—charter, trustees and faculty—unless it be quickened into active functional display, by talent, in- dustry and learning, and be sustained by continued and com- bined exertions, so as to reach the highest point of medical in- struction, while disseminating the best principles of ethics. Each school must now have aspirations similar to those of one of Napoleon's marshals, who, annoyed at the continual babble of the descendants of the old noblesse, returned emigres, and followers of the Bourbons, about their ancestors, exclaimed, with some pettishness : " I, too, will be an ancestor." A right noble ambition that—to be the head of an illustrious family, by one's own labors and worth. With increase of numbers come competition and rivalry— by which, in many instances, the public is the gainer—as we find in commerce and the arts ; but in the business of educa- tion, good results are not by any means, so evident. Men are better judges of the value of material than they are of intel- lectual products; and they find out much more readily the best market, and the best manufacturers and mechanics, where they can sell and buy to the greatest advantage, than the best college, and the best school for the instruction of their children. They cannot be persuaded to buy flimsy, albeit cheap textures, because they have a flashy color, or are set off with gilt or silver fringe; but, at the same time, they are easily persuaded to encourage educational institutions, and private instructors, whose chief recommendations to them are cheapness and the railroad rapidity with which they hurry their pupils through the course of their so-called studies. You have heard it said that there is no royal road to geometry. *Ci-git Piron, Q.ui ne futrien, Pas-meme Academecien. 22 There is assuredly no democratic road to science and learning. These rich prizes are not to be won by the acclamations of the multitude, nor by the votes of popular meetings. They cannot be obtained even by legislative enactment, nor by assumption of scholastic titles on the part of voluntary asso- ciation, nor by abbreviation of the period of collegiate studies, or the curtailment of college fees. All attempts to substitute extraneous aids for persistent and methodical study, during a somewhat lengthened period, under the guidance of regular and able, and conscientious teachers, are deceptive, if not fraudulent. They lower the standard of education and pro- fessional attainments; and, by the large alloy of ignorance and cant which they introduce into the current literature, they merit severer reprobation and punishment than are so promptly awarded to clippers and forgers of the current coin of the country. Is it to be wondered at, that, under the influ- ence of the dominant spirit of innovation and misrule, and without the restraints of sound learning, or even habits of study and reflection, that religion and medicine should be attacked by so many isms and pathies. Among these we look in vain for that love of truth manifesting itself in tru- isms, and of mankind which exhibits itself in genuine sym- pathy. It should be the aim of the different medical schools of the country, in a spirit of generous rivalry, to raise the stand- ard while increasing the means of medical education. They must carefully reject all the expedients to swell the number of their classes, which smack of the petty, and not always conscientious trafficker rather than the elevation of true science, and the sensitiveness of refined literature.. En- couragements held out to the illiterate, the unstable, and it may the be more unworthy still, to study medicine, are pre- miums given to ignorance and indolence. Many a good mechanic and thrifty farmer are thus lost in making them bad doctors. Genius requires no such hot-bed culture. It is a 23 vigorous plant and will grow in a scanty soil and a bleak atmosphere, and bear fruit under an ungenial sun. It will show itself soon enough to insure all needful aid, without its being debased by ostentatious and selfish patronage, and eleemosynary support. A few words on the obligations of Western medicine and the favorable circumstances under which Cincinnati is placed for medical instruction, and I have done. In speaking of the relative advantages offered in different sections of the Union, for the observation of diseases, and for acquiring a familiar knowledge of their nature and treatment, neither declama- tion nor satire should avail in determining the selection of the school. Inflated descriptions of superior benefits conferred by one, and depreciation of the merits of another, are in doubtful taste, and are as impolitic eventually as they are unjust at the time. Keeping within the prescribed limits, we cannot help see- ing and wondering while we look at the teeming products of western agriculture, and the untiring activity, and the extent of western commerce. We know the strong arm and devising head of western men, and soon have occasion to admire the lively mind, the readiness of adaptation to circumstances, and the graceful cordiality of western women. Let Western Medicine be known by equally significant marks, and it will be able to offer a fair and full exchange with the East, analagous to that which is used with in their commercial intercourse, and with, perhaps, the same differ- ence, in the fact of the West finding the abundant and rich staple, and shaping it to the gratification of needful wants, while the East may have some advantages in variety and ingenuity of manufacture and artistic exhibition. Even now, satisfactory progress has been made in the West, arguing still farther success. The cities of Cincinnati, Louisville and St. Louis, furnish means which have been already brought out for the successful teaching of theoretical and practical medi- 24 cine, equal to some of the cities on the Atlantic border. Were a detailed enumeration required this remark might, with some qualifications, (as in the instances of anatomy and clinical medicine and surgery,) be extended to smaller places, which have won for themselves a certain degree of reputation. The medical literature of the West manifests itself, for the most part, in journalism, the scattered and unequal efforts of wdiich we might wish to see concentrated on fewer points, with a gain of greater vigor and more direct applica- tion. It may be said of medical journals as of medical schools, in the United States, that, even though it could be showm that they have not been multiplied beyond the wants of the country, still, reference being had to the requirements of medical science, they ought to rest on a more generally recognized basis of learning, experience and method. Strong in their union and action under the same code, they would present an impregnable front against the assaults of preju- dice and empircism, while sending out continually men indoctrinated in the true faith, and ready for every emergency of council and action, where individual and public health are to be protected and diseases averted or cured. Writings of a more substantial character than those just alluded to, might be cited from the annals of western medi- cine ; but, for the present, I shall content myself with a men- tion of the latest as it will be, when completed, the most comprehensive of all. You anticipate me in the reference to Dr. Drake's Systematic Treatise on the Principal Diseases of the Interior Valley of North America. All the members of the profession in the valley have a direct interest in the use- fulness and success of the work : they, in common with his personal friends, must devoutly wish that the author and veteran teacher will be allowed health and leisure to complete it in a manner commensurate with the acknowledged merits of the first part now offered to the public. 25 Cincinnati, by her geographical position, wealth and popu- lation, offers advantages for a medical school not inferior to any city in the Union. The one now fully organized and so long under the direction of the State, by the means of intel- ligent Trustees, affords, in connection with a well-established hospital, every desirable facility for medical instruction. Proper pride and self-interest must alike incite the citizens of Cincinnati to foster an institution which, by its increasing reputation, will add to the fame she has already acquired in the arts, both of use and ornament. It will be recognized as a fresh gem in the queenly crown which now shines with the precious gifts of a Mitchell, in astronomy, and a Locke, in electricity and electro-magnetism. Secondary to its claims on public regard and countenance, in philanthropic and scien- tific points of view, but still meriting serious considera- tion, are the pecuniary benefits to the city which flow from outlay by the students of the school at the time, and the still larger expenditure subsequently, during the visits of themselves and friends, and the purchases and orders resulting therefrom. The home feeling and pleasant associations cre- ated, every year, by the residence, for some months, of hun- dreds of ingenuous and intelligent youths from all parts of the State, and from many neighboring States, cannot fail to excite a strong and perennial influence in favor of the city, both in a social and commercial aspect. The Commercial Hospital of Cincinnati affords means and facilities for obtaining a familiarity with clinical or bed-side medicine, superior to those which can be met with in some of our most populous cities. Your guides, the physicians and surgeons of that institution, who are also the professors in the Medical College of Ohio, will make it their business to put you, gentlemen of the class, in the path of independent and honest investigation of disease, and to deduce the in- dications of cure. You will not be taught by us, either in the Hospital or the College, (and in this respect we do not 4 26 differ from our professional brethren in other places,) exclu- sive or one-sided medicine. We shall not attempt to indoc- trinate you with allopathy alone, still less with homoeopathy or hydropathy alone. Sometimes, more generally indeed, our remedies will be given with a view to remove the disease, by inducing a series of actions antagonistic to those which con- stituted its symptoms, and so far we are allopathic practi- tioners. Sometimes, but less frequently than in the circum- stances just mentioned, we have recourse to medicines, or remedial measures, which produce effects seemingly anala- gous to the symptoms of the disease, and in this sense we practice homoeopathically. But then we give in all cases, where wo profess to give medicine at all, appreciable doses, not infintesimal and impossible ones, as the dilutions of homoeopathy are. The virtues of water for a drink in health and free dilution in disease, as well as for external use by bath, douche and fomentation, have been familiar to every well-read and experienced physician long before Priesnetz and Graeffenberg were ever heard of. In the selection of remedies and the study of their pre- cise adaptation to the stage and duration of the disease, and the constitution of the patient, a spirit of eclecticism has always been invoked; but not that spurious kind which con- sists in excluding at once entire classes from the Materia Medica, because forsooth, they belong to the mineral king- dom. These exclusives forgot that the substance of all others, which are not nutritive, the most congenial with the healthy living body, is a mineral—iron. It enters into the composition of healthy blood and its use is followed by de- cided renovation of the languid system, in its giving color to the pallid cheek, and animation to the functions ; and this in a more permanent manner than can be obtained by any vege- table whatever. The exception to the general proscription of mineral preparations which has, I learn, been made in favor of iron, wTould doubtless be extended by the same set, eclectic, so 27 called, in favor of others of the class of minerals, if extremes and excesses, abuses in fact, were not assumed by them to have been the measure and standard for their regular employ- ment by scientific physicians. These anti-mercurialists might know, that in cases of violent inflammation of the stomach and intestinal canal, calomel vis milder, safer and more efficacious than jalap or even their favorite podophyllum^ or May Apple. If it be a question of poisoning, by the injudicious and reckless use of active articles of the Materia Medica, the veriest tyro soon learns the fact, that such a result will more cer- tainly ensue from the use of Prussic acid or strychnia than from any preparation of arsenic or mercury; and that digi- talis and lobelia and tobacco call for more caution in their administration, and are liable to produce, by an over dose, more alarming if not fatal effects, than the salts of antimony, or of copper, or of zinc. As well might a certain set of diet- ists, calling themselves eclectics, allege that fitting nutri- ment of a vegetable kind could be obtained only from grains, to the entire exclusion of that furnished by the potato and other roots; or that rain water is the only fitting drink for mankind, and that river and spring water ought to be utterly forbidden for such a purpose. These propositions would not be a whit more absurd in hygiene, than the exclusion of mineral preparations is in medicine. If the former would cm-tail the supply of nutrimental food, even to the causing, at times, of famine, the latter would, with equal certainty, diminish the means of curing disease, and, so far would cause increase of mortality, and especially among those who are most exposed to disease and death—the hard working laborers in town and country, the often overwrought opera- tives, and the poorer classes generally; in fine the majority of mankind. Wretched mockery of science—spurious philanthropy- wilful occlusion of the senses, and refusal to use the reason- 28 ing faculties, that would substitute a part for the whole, by making us forego the employment, in their proper place, of all that nature supplies and art devises for the restoration of the weakened or diseased functions to their healthy condition. You, gentlemen of the medical class, will learn when to use, when to suspend the administration of remedies; how to make hygiene at one time an aid, at another a substitute for medicine, by your enjoining a suitable regimen, which shall embrace the judicious application of exercise, bathing, travel, and resort to mineral springs—appeals to hope with- out fostering delusion, and a confiding in Providence without pretending to perform miracles.