AN ADDRESS delivered before the TRUSTEES, FACULTY, AND STUDENTS OF the MEDICAL DEPARTMENT OF the WESTERN RESERVE COLLEGE. BY A. A. BLISS, ESQ. WITH THE VALEDICTORY ADDRESS, IN BEHALF OF THE FACULTY, TO THE GRADUATING CLASS, FEBRUARY 25th, 1846. BY PROF. ST. JOHN. I* PUBLISHED BY REQUEST OF THE GRADUATING CLASS. CLEVELAND: YOUNGLOVE'S STEAM PRESS. 1847. i7 4 THE MISSION OF THE PHYSICIAN, HIS DUTIES—HIS RESPONSIBILITIES—HIS PLEASURES. I speak of the Mission of the Physician—of his duties, his respon- sibilities and his pleasures. The theme has none of the attractions of novelty, and no recom- mendation other than its intrinsic importance, unless it should be con- sidered novel to select a subject with any reference to its practical consequence. There is no one word in the language that will convey to the mind a full and clear idea of the Mission of the Physician. It is perhaps not the fault of the language, for it cannot reasonably be demanded that a syllable should embody the sentiments of a volume, or that the ideas of an age should be concentrated into the limits of a word. Truth should be loved and sought after for its own sake : it is lovely in itself. The solution of a difficult problem in mathematics may be desirable not merely for the reason that the result accomplishes a prac- tical object, but that at the end of the process truth is developed. There is sublime enjoyment in the clear perception of truth itself, in the search after Nature's hidden laws and the development of those laws. Many of the most wonderful and important discoveries, in the different departments of science, have been made when perhaps the discoverer had no thought beyond the ultimate truth thereby developed. Yet, however ardently we may admire the philosopher in his search for abstract truth, our sense of appreciation at once kindles when we view these truths applied to the benefit, and brought into subserviency to the use, of man. The original discovery of important principles in science, and the application of those principles to the service of mankind, are not always the product of the same mind. Abstract truths already developed, are often seized upon and rendered practi- cally tributary to human happiness. When the glittering point is seen, reaching towards the heavens from the tops of our dwellings, every one knows that this is to preserve us from the terrible effects of electricity, and that we owe this power of preservation to the genius of Franklin. Yet how few, comparatively, know that he is yet more renowned among philosophers for the discovery that lightning and electricity are identical; without which previous discovery, the theory of the lightning rod would never have entered his conception. And towards whom is our admiration the most profound:—Davy, in his Laboratory, searching for some unknown chemical law, or Davy the 4 inventor of the Safety Lamp. That there is caloric in an iceberg, is a truth beautiful in itself; but to the mariner shipwrecked in the Polar Sea, how mean that truth appears, without power to extract warmth for his frozen limbs. It is the philosophy of the Utilitarian, that all action should tend to the greatest good of the greatest number, and that all knowledge should contribute to the same result. With whatever propriety this doctrine may be repudiated, in many of the departments of study and action, it is believed to be the true philosophy in its relation to the study and labors of the physician. His efficiency depends in a great degree upon his acquirements in the different departments of scientific knowledge. With the mechanism of the human body he should be as familiar as with the outward seeming of the face of his friend. The hand, how wonderfully made ; the elegant proportions and per- fect adaptation of the limbs ; the convolutions of the brain ; the eye, from which the mind looks out from its in-dwelling; the delicate net-work of nerves ; the beautiful tracery of veins and arteries; the coursing of the blood. And with the vegetable kingdom,—every tree and shrub, every plant and flower : not content to appreciate their beauty and be regaled by their fragrance, but to know the substances of which they are composed—the particular combinations of those substances, and the relations those combinations bear to the use to which it is desirable to apply them. A knowledge of the science of Chemistry is not only useful, but indispensable to the physician. A familiar acquaintance wilh its wonders is his very life. In short, in all the departments of science, his researches cannot be too extensive —his knowledge too profound. Knowledge like this, is a fountain from whose pure waters his draughts cannot be too long nor deep. And why is this knowledge necessary to the physician 1 Is it simply from the satisfaction it affords him to search out the truths such know- ledge developes 1 Is it from the sublime enjoyment he is supposed to feel in searching for hidden things-^-in seeing what Omniscience has hitherto only seen—in exposing to the clear gaze of the human in- tellect truths sufficiently glorious to be familiar to the counsels of Infinity—in unfolding beautiful and terrible mysteries ? Why is the term physician used in connection with the necessity of this know- ledge? Why more necessary to him than to any other man ? Is it not because the very term implies a particular course of action— certain duties to be performed by him to whom the term can properly be applied. If the term implies an obligation to perform certain duties, this obligation implies the importance of the requisite qualifi- cation for the full and complete performance of those duties. Why then, again, is this knowledge necessary ? Is it not for the purpose of qualifying him for the discharge of the high duties he has taken upon him ? This knowledge, then, in his case, is acquired for the use he can make of it—to purposes of good. It is not to him a mere abstraction. It is not to enable him to dream his life pleasantly away, because to him it is more joyous to dream than to sleep and not to dream. No, this knowledge is acquired for the use that can be made of ft—to fit him for what he has to do. 5 What> then, is the mission of the physician ? Although there is no word that expresses it fully, yet it is shadowed forth more clearly, than by any other, in that word, 30 much abused by theorists, and too little regarded by all, UTILITY. I speak of some of the duties of the physician ; not the speci^c du- ties incident to his ministrations, but of the nobler labors, that relate to his qualification for those more specific. The physician should be a student. The spirit of the age is, per- haps, unfavorable to the close application of the studious mind ; still, it is emphatically an age of progress, in almost all departments of knowledge. Philosophy is carrying its researches every where, min- gling lessons of wisdom with its lofty speculations. Science, if not adding new conquests to its long list of triumphs, and unfolding new glories, is making its way towards the more perfect appreciation of the masses. Art, if not guided by the inspirations that are em- bodied in the Venus and the Apollo, is struggling for the ideal con- ceptions that gave Phidias to posterity. Not only are the arts and sciences apparently advancing, but public education, societies for the promotion of knowledge, the spirit of invention and discovery, manu- factures, facilities for rapid communication and familiar intercourse, navigation, and all things useful and beautiful, excite the attention of the world, and seem to prosper by the labors for their advancement. But, by the side of this astonishing progress, there is a spirit of rash innovation—a seeming desire to blot out the past—the evident posses- sion of wild and bewildering ideas on almost every subject—a daring, restless inquisitiveness—a discontent—a disposition to hasten all events —a reluctance to submit to the ordinary course of things, that is un- favorable to calm meditation and to clear and steady thought. There is a spirit also that seems to be woven into the very texture of the public mind, that looks upon tumult and conflict with emotions of pleasurable excitement. The tramp of armed hosts—the caparison of the war-horse, and the plumes of his rider—the glittering para- phernalia of the field—the shock of onset and the peals of victory— seem to delight the public heart: a delight that can alone be turned into mourning by the harvest of bitter fruits, yielded to the lips of those who seek glory for their country in the din of arms. Although in some of these characteristics there is much of good, much which, if rightly directed, would tend to the highest happiness of the crea- ture ; yet the evils of this state of things are manifold, and manifest themselves in a thousand different forms. These evils no where appear more clearly, than in their tendency to prevent thorough education—rigid mental discipline. The people seem too busy, to think clearly and steadily, to in-estigate thoroughly and fully. Hence is created a paradise for quacks in education. Their nostrums are everywhere vended and everywhere taken, by those who vainly hope that when they come out from the bewildering influence of the dose, to find themselves perched upon the summit of human knowledge, or at least hanging upon some point far up the craggy path. The rapidity with which knowledge is frequently at- tempted to be communicated, if indicative of nothing else, may be of 6 > he rapidity with which the teacher acquired his. He, having perhaps entered the portals of some public institution, found himself imme- diately passing out at the rear, with an accelerated momentum—a new motive power of peculiar significance having been applied on the passage. The diploma of an institution like this, and the parchment of the initiated into the mysteries of the legal profession, are too often made to serve a purpose for which they were never intended, to wit : to furnish clear evidence that to the possessor, it is a certificate that he has in truth finished his studies. This was never their proper office.* And he who would receive them with such a spirit, is not a worthy recipient of the benefits intended to be conferred. They are only given as testimonials that the possessor is thought worthy to enter upon the threshold of a life of study. That he is prepared to com- mence the career of a student, and not that that career is ended. A life of study is a life of toil and slow progress. The hill of science is a hill of difficulty. There is no railroad communication to its sum- mit, by which passengers can be delivered at the other end of the track at so much a head. It cannot be reached by the aid of the steam-whistle, and amid the confused rattle of machinery. Neither can the lightning carrv the rich products of those bright fields, to the rale below, upon magnetic wires. A tariff of prohibition hems its riches in. It is only by the slaw process of days and nights of toil— by arduous and continued labor—-that the end can be attained. Al- though a process of toil, yet around the hopeful and persevering traveller, ten thousand joys are clustered. The refined society, and the kindly sympathies of his fellow travellers, cheer him on. How his heart leaps at every step in his progress gained! With what ex- tacy he stands triumphant upon some jutting rock, which, from be- low, seemed an impassable barrier to his higher ascent! And at every resting place in his pilgrimage, he discovers the sculptured monu- ments of those who have gone before him. Here are the trees and shrubs, still blooming, that they have planted, and the rich fruits of their labors hang melting to the taste. All along up, the richest ores shine from the hill side. An emerald here and there lies embedded, and the pure diamond, like the radiance of the evening star, sparkles upon the vision. Upon the very thorns that pierce his feet, roses bloom ; and from every jutting rock plants shoot out, with flowers of every hue of beauty—redolent with the perfumes of Eden. The physician should be a student. Not content with the mere ex- amination of the text-books, and with the ordinary acquirements these books and his other teachings furnish; it is not of these I would speak. He should acquire habits of reflection and close observation. He should study Nature in her thousand forms. These habits once- acquired, the labor itself will be joyous ; for " There is a spirit within us, which arrays ,; The thing we dote upon with colorings, " Richer than roses, brighter than the beams " Of the clear sun at noonday, when he flings 7 " His shower df light upon the Peach, or plays " With the green leaves of June, and strives to dart "Into some great forest's heart, and " Scare the Sylvan from voluptuous dreams. But more particularly I remark, he should study the philosophy of the human mind. Not the volumes of Locke, Reid, and Stewart merely, (and these should not be neglected,) but he should study as none but the physi- cian has opportunity—in connection with health and disease—with all the vicissitudes of its earthly dwelling, under all the phases of its existence, in this temple not made with hands. What mind is, the Infinite has not revealed ; and what its essence is, is of but little moment, compared with the phenomena attending its acting state. In prying into the mystery that envelopes the nature of the soul, conjecture will be the starting point, and endless conjec- ture the field of our labors. We can reasonably believe that it is not Fire, as was the theory of Zeno; or Number, according to Zenoc rates j or Harmony, as was believed by Aristoxenus ; or the Lucid Fire, the creator, of all things, according to the Chaldean philosophy. The philosophers of Alexandria taught the existence of two minds, the sensual, and the intellectual. Whatever view we may take of these wild theories, or of pthers equally fanciful, the phenomena of mind, as developed wherever mind exists, remains of practical importance. We can have no consciousness of the operation of the mind, ex- cept throrgh the organism of the body. We may believe, as we do, that it may exist separate from, and independent of, the faculties of this frame of dust, but we can have no consciousness of such an ex- istence. Therefore we know nothing of its phenomena, except in this state of dependent existence. Our earliest knowledge of the creation of the human mind, is the revelation that the Almighty breathed into the human body the breath of life, and man " became a living soul." The mind is this " breath of life," breathed from the lips of the great " I am," into the body already created for its recep- tion. It is that " breath of life," breathed into no creature but man, that constitutes him " the image of God." I would, therefore, urge the study of this mystical union between flesh and spirit, and the relations that union bears to the physical con- dition of man. This is a subject, the investigation of which has, as yet, borne no relation to its importance. It meets the physiologist and pschycologist in every step of their progress. It bears the most inti- mate relation to the welfare of man, in all ages, in all places, in all circumstances. If I had the trump of an angel, I would proclaim it. If I had the power to mould mind, I would turn more of the philoso- phy of the day into the channel of this investigation. It is not the intention here, of course, even to enter the threshold of the subject. It is so vast in extent, that the thought of its vastness is painful to the strained intellect. But, by this investigation, how many of the men- tal ills of life may be relieved—how many of its painful mysteries explained. The world has always been divided, in this relation, into 8 two classes—the deceivers and the deceived. The deceivers have derived their power for harm, from their superior knowledge of the subject of which we are speaking; and the deceived their liability to be duped, from their ignorance. The mysteries of the ancient mythology, and the no less mysterious rites and ceremonies of more modern superstitions, intended to enslave the mind, are founded, to a great extent, upon a knowledge of the relations which exist between mind and matter. The illusions of ghosts and spectres, the ten thou- sand terrible fantasies the ignorant mind conjures up, stories of mys- terious forms and signs, of supernatural appearances, demonology and witchcraft, may all be explained by an attainable knowledge of these relations. The tendency to give credence to the mysterious and su- pernatural is, perhaps, even now, more prevalent than is generally supposed. There are multitudes in almost every community, upon whose minds the light of knowledge has but faintly beamed, whose day dreams are haunted with mysteries of fearful portent, and whose nights are rendered gloomy by visions of warning. The thou- sand coincidences of life, which even to the tutored intellect seem curious, strike the ignorant, the timid, and superstitious, with wonder and awe. Reason will exclaim, -----------" Can such things be, And overcome us like a summer cloud, Without our special wonder." The only reason why this age is less swayed by delusions than the past, and civilized nations than nations of barbarism, is, because the laws of mind, in relation to the body, are more clearly understood. The vale of ignorance lies behind and below us, while we are strug- gling along up the mountain of truth : a cloud hangs over the valley, the sun light is upon the mountains. But the physician should not only study, generally, the relations between body and mind, and their bearing upon the physical condi- tion of man, but more particularly the influence of the mind, in its different states, upon the body, and the influence the body exerts, in its various conditions, upon the intellect. It is to knowledge derived from investigation here, more than to any other source, that he owes his power. His main object in the pursuit of his profession should be, to cure the ills of the body—to restore health where disease has rioted. How can he do this, without a knowledge of the means best calculated to produce the result % Has the mind any influence on the body, in dis- ease % If so, that influence must be either for good or evil, either tending to render successful the ministration of the physician, or to defeat all his efforts. The best adapted medicines, in the formulary of the apothecary, may be given, yet, with the mental influences unfavorable, the patient will continue to linger and languish. How important, then, a thorough knowledge of these mental influences. That shame mantles the face with blood; that fear blanches the cheek, and renders it bloodless; that anger swells the features, and fills the blood vessels, almost all understand. But it is not only the 9 violent exercise of the passions, and the more intense action of thS mind, that produces its effects upon the body, but it is believed that every mental emotion has a corresponding influence on the system. If the bodily sensations, produced by every mental exercise, could be faithfully analyzed, it would appear that, at the flitting of a thought through the mind, there is a corresponding sensation. But it is to the imagination, more than to any other faculty of the mind, that we are to look for a healthful or deleterious influence upon the body in cases of disease. The world is full of facts, and your own observation has furnished you a full share of them, to show that the imagination alone can produce the most fatal diseases, as well as counteract the ravages of those already produced, It detracts nothing from the efficiency of this mental influence, nor from its claims upon our consideration, that upon it empiricism has founded all its triumphs. The power which a knowledge of this principle in mental philosophy has given, has enabled it to build up a system for itself, the practical operation of which, although in many instances effective of good, demonstrates that a perverted exercise of a power to do good, is more to be deprecated than a want of that power. The fact that quackery makes use of this power to accomplish its purposes, only renders it the more needful that science should wrest it from the dominion of the quack, and shape it into subserviency to its own great ends. If, then, it is true that mental exercise is so potential for good or evil, in cases of diseased action, the importance of acquiring the power to control, and give direction to, these exercises, will be at once ap- preciated. The physician who has acquired this power, has become almost omnipotent in his ministrations. His first object should then be, to obtain this power. This cannot be done simply by the scientific knowledge his course of study furnishes, nor by the abstract study of the different systems of mental philosophy, but by the practical ap- plication of principles thus acquired in the close observation of the case before him. Neither can it be obtained by mere desire, nor by the exercise of the will. It can alone be conferred by the mind, upon which it is to be exercised. If the prostrate form is at all times ap- proached with cheerfulness, kindness, and courtesy—if the stiffness too often associated with professional demeanor, is mellowed down by the exercise of kindly sympathies, an emotion of the sufferer's heart is created, of which confidence is the appropriate definition, which at once seats the physician upon his throne of power. The patient should have confidence in the skill of the physician, and in all the means used for his restoration, and if possible, be inspired with the cheer of hope. " Cease every joy to glimmer on the mind, But leave, ah! leave, the light of hope behind." This point gained, and the victory is achieved. It is not to be wondered at that the invalid, his mind weakened by disease, should waver, and at times, without reason, halt in his confi- dence ; nor that the utmost patience and forbearance is requisite on 10 the part of the physician, that the whims and caprice df a Weak in* tellect do not sway him from the kind and courteous bearing that should always be entertained towards the object of his attention. Of the details of the physician's study, 1 do not propose to speak ; and if the suggestions already made, seem stalo and common place, it may be an apology, that it is not the aim of the speaker to give ut- terance to novel truths, but to strive to impress upon the mind the great practical importance of truths already familiar. I speak of the responsibilities of the physician. How shall they be estimated ? The responsibility attached to the performance of a particular course of duty, always bears a relation to the nature of the duty to be performed. We have only to consider the duty of the physician, to find a rule for the measurement of his responsibilities. The assumption of the discharge of these duties, implies an obliga- tion for their faithful performance, and this implies the necessity of the qualifications requisite for such performance. Who shall bear these responsibilities 1 Who shall assume the labor, with a con- sciousness that he is unfitted for the task 1 Some idea may also be formed of the responsibility attached to the performance of a particular course of conduct, by the contemplation of the results of right or wrong action in the premises ; and the responsibility of the individual who assumes the performance of a duty, may be in proportion to the magnitude of the consequences re- sulting from the duty. If faithfully performed on the one hand, the greater or less amount of good flowing from it; and the greater or less amount of evil, resulting from an unfaithful performance. Thus, the responsibility of the physician may, to some Cegree of certainty, be measured by a consideration of the immense good a skillful dis- charge of his duty brings to mankind, and the incalculable evils that ignorance and quackery may inflict. 1. The physician is responsible to himself. For what was man made 1—a little lower than the angels; his breath of life from the lips of the Almighty : placed upon the beautiful earth, with dominion over every living thing that moveth upon it. For what was the exquisite mechanism of the human body created 1 the soul upon its throne within, with its strong arm of guidance upon the complicated machinery? Has man no duties to himself ? Then he has none to his race, nor to his God. The obligation of duty to others, implies a duty to one's self. His duties to himself specifically, are those of the highest preparation for the performance of his general duties. The magnitude of his general duties, implies the strongest obligation to the duty of self-preparatfon. And, as the right performance of the du- ties of the physician depend almost entirely upon his preparedness for their performance, a glance will show us the magnitude of the results that would flow from a want of that preparation ; and as his responsibility may be measured by these results, the truth that he is responsible to himself will be clearly seen. 2. He is responsible to the sick. The duties and responsibilities of the physician to the diseased are, perhaps, more readily appreciated them in any other relation. 11 As a penalty for the violation of those physical laws, framed in wis. dom, for the regulation of the body, disease has crept into the system. I his, if permitted to riot unchecked, will result in dissolution. The physician assumes the task of conquering this disease, in its rapid and seemingly triumphant march towards this result—of restoring health and vigor to the weakened frame. Not unconditionally and beyond contingency, has he assumed this task ; but he has assumed to do all that untiring diligence, and such skill as it was his duty to have ac- quired, can do. W7ith this engagement upon him, he must not shrink. The wasted object of his ministering labors, with the pulse fluttering at the wrist, and the tremulous breath upon the lip, looks to him as the controller of destiny. The living watch with anxious eyes, and whispered enquiries, the result of his ministrations-; for to them, it is the restoration of joy and gladness, or the severance of tie& that liken the realities of earth to the bliss of Heaven. With such duties assumed, what are his responsibilities? If life, with all its joys, and death, with its lamentations,(to the living at least,) hangs upon his skill, how tremendous are the consequences attached to the performances of his duties % If, then, his responsibilities can be measured in any degree, by the results of his labor, who can esti- mate the weight of his responsibility to the sick ? 3. He is responsible to those in health. By common consent, he is placed on duty to guard the avenues by which disease may enter into the citadel of the system. The enemy is continually lurking about the outworks for an opportunity to enter. If there is a dilapidated portion of the wall, it will be discovered and surmounted. The post of the physician is the post of honor. He is Upon duty not only to guard the avenues of entrance, but upon the ramparts to repel the foe. His labors are arduous and continuous, and honorable in proportion as they are skillful. But what are the riches within the fortress that he assumes to guard ? They are the treasures that are embodied in the moral, intellectual, and physical interests of a world—all the varied interest of a life, multiplied by the lives of the race. By a convention with mankind, he has engaged to guard these in- terests. When the enemy stealthily finds an entrance and makes an attack, the physician is detailed from the post of previous duty to a combat with the foe. The struggle may be long, and the result doubt- ful. The enemy, in his virulence and perseverance, avails himself of every want of skill in his adversary ; and if at any moment he is at fault, or off his guard, the sword of the enemy triumphs. And although the blanched cheek, the pulseless temple, the wasted form, the dust to dust returning, herald the thousand triumphs of the com- mon foe, yet, but for the hosts that go forth to battle with their armor on, their weapons burnished, and wielded with exquisite skill, the thou- sand triumphs of the fiend would be ten times ten thousand, until the blast of Death would wither the green earth, and human life shrink away to the God who gave it. If, then, the duties of the physician to the community in health, 13 are such as are here indicated, and if his responsibility bears any re* lation to results, how vast will that responsibility appear ? 4. But he is not only responsible to himself, to the sick, and to those in health, but to Him who alone can crown his mission wilh success^ And how insignificant his responsibility, in every other relation, com- pared with the one in which we are now considering it; All that goes to make it up in every other particular, is but an accumulation of re- sponsibilities to the Author of his being. Of what worth will his labors be, without the aid of Him who has created the adaptation of all that he administers to produce the desired end? What virtue can there be in the means the physician uses, except what the Creator has planted there ? All his labor, and all his skill, are but the use of means in his hands for the accomplishment of a given object. Is he prepared to make the best use of those means ? Can he apply them as they alone are adapted to be applied ? Has he searched out the se- cret of God's design in creating their adaptations ? Has he opened the book of Nature, and gathered from its pages all the truths at his Command ? Although the mission of the physician is one of toil, his duties ar- duous and perplexing, and his responsibilities such as an angel might faint to bear, yet, amid his toils and duties, and in the very sense of his responsibilities, there are joys that can be exceeded alone in the fullness of fruition. 1 speak, then, of the pleasures of the physician. Rich pleasures are furnished him in the pursuit of knowledge gen- erally. But I would speak more particularly of the pleasures of knowledge derived from the peculiar studies necessary to the physi- cian. In speaking of such peculiar studies, it is not intimated that the physician may not derive pleasure from investigation in the whole range of human knowledge. The whole volume of Nature is before him. All discoveries in the wonderful world of Nature and Art, are accessible to]him as to others, and a knowledge of these discoveries may become a source of enjoyment to him as well as to others. But beyond this, and in addition thereto, the peculiar duties of the physi» cian make requisite the pursuance of peculiar studies, from which may be derived peculiar pleasures. It is of these 1 would speak. Nor is it intimated that the pleasures derived from these peculiar studies may not be enjoyed by all. The physician has no monopoly in any department of knowledge. And although his investigations are usually, to a certain extent, in a direction where those of other interests in life are not, yet the investigation more usual to him may become so to others, and the joys he derives therefrom, be participated by all. The • difference is only, that the active duties of life demand of the physician thorough investigation in particular branches of knowledge, to fit him for a proper discharge of those duties. Of such knowledge it is proper to speak as the peculiar knowledge of the physician, and of the pleasures derived from it as his peculiar plea- sures. Of course, it is presumed that the physician will become fa- miliar with the details of anatomy, of animal and vegetable physi- ology, and of chemical philosophy, in its various relations. Such 13 knowledge as is here indicated, is absolutely essential to the discharge of his duties, and its acquisition a source of exquisite enjoyment. How wonderful are the truths developed in the study of anatomy and animal physiology ! Anatomy relates alone to the bodies of the dead, physiology to the functions of the living. The one examines the minutest portions of the body in death, the other considers it in the fulness of life and vigorous action. Anatomy is not only im- portant as it throws light upon the nature of many of the ills that flesh is heir to, but it is the principal means by which truths in physi- ology are developed. Without the opportunity to dissect in detail the bodies of the dead, the functions of the living could only be im. perfectly ascertained. Who can contemplate the wonders of the human frame without amazement ? And who would be ignorant of the truths that constitute those wonders ?—its exquisite machinery ?— the perfect structure of all its parts ? if we suppose ourselves upon some elevated point, with a beautiful landscape, of vast expanse, spread out before us, of barren mountain and verdant plain, of cities, with their hum of enterprise, of winding streams and village spires, of flocks upon the hills and lowing herds in the valleys, of tilled and waving fields, and " green old woods," how exquisitely beautiful is the truth, that the exact image of every object upon which our vision rests, is drawn by the Deity, with the pencil of light, within the human eye. This is not fancy, but fact. The image is penciled there. Every ray of light that strikes the vision, from every object in this area of a thousand square miles, is concentrated in that small space, and there leaves its impress. The eye Takes in at once the landscape of the world, At a small inlet which a grain might close. How feeble, and compaialively contemptible, are the highest efforts of human genius. The mechanism of the bones and muscles, and iheir perfect adap- tation to the uses to which they are applied. There is scarcely a practical principle in the whole science of mechanics, of which the skill of man avails itself, that was not originated by the Creator and applied in the frame work of the human body. And what human machinery could exercise the mere mechanical functions of the body, and last a single day ? Look at the vast power of the muscles. If a man lifts a weight of two hundred pounds, with the weight upon his jaw, the muscles Temporalis and Masseter, exert a force of fifteen thousand pounds. If ne lifts twenty pounds upon the last joint of his thumb, the muscle that bears the weight exerts a strength of three thousand pounds. If an ordinary man leaps two feet from the ground, the muscles that are active in that operation, exert a force of three hundred thousand pounds. This may seem incredible, but it has been demonstrated. And the heart, at every contraction that forces the blood from the arteries into the veins, exerts a power of over one hundred thousand pounds. And how fitted to excite wonder is the philosophy of the circulation of the blood ! How it rushes from the 14 heart, with the force of an engine, into the arteries, that spread them- selves into every minute part of the frame, and taper out till they be- come invisible; and from the arteries into the veins, which, in their origin, are also invisible, and thence back again into the grand reser- voir—the human heart! And this operation is continually performed, and the whole process completed as often as ten times every hour. And how beautifully constructed are our organs of respiration ! Of equal necessity to the circulation of the blood through the veins and arteries, is the circulation of air through the lungs. The internal structure of the lungs is lined with a membrane of a thousandth part of an inch in thickness, but of fifteen square feet of surface. On this membrane innumerable veins and arteries are distributed, through which the whole blood of the system is propelled. At every inspira- tion, forty cubic inches of air is taken into the lungs ; every minute, eight hundred cubic inches; every hour, forty-eight thousand ; and every day, one million one hundred and fifty-two thousand. This air meets the blood distributed upon the lungs, a part of its oxygen is absorbed by it; and thus the blood is fitted for the purposes of life, while the air that has lost a portion of its oxygen becomes un- fitted for use, and is immediately exhaled. And the philosophy of digestion—of that substance within us, capable of dissolving every animal and vegetable body, and fitting it for purposes of nutrition ; of sensible and insensible perspiration ; of the theory that more than half that we consume, passes away through the million of pores in the glands of the skin by insensible perspiration. And how beauti- fully distributed are the organs of sensation : the soft white nerves shooting out from the brain, and spinal marrow, into the system, with infinite variations, until they terminate in an infinite number of points on the surface of the body. Anything outward, that is adapted to pro- duce a sensation, must be sent from the surface along these delicate lines to the brain, where the sensation is produced; and in answer thereto, the brain sends back, by the same courier, its message to the muscles and limbs. By the commands of the will through the nerves, a hundred muscles are put in motion, all acting harmoniously at the same instant. The nerves are braced, the bones turn in their socket, and the whole animal machinery is in play, with a beauty and harmony that an infinite mind could alone originate. And in the eloquent lan- guage of another: "What an immense multiplicity of machinery must be in action, to enable us to breathe, to feel, to walk. Hundreds of bones, in diversified forms, connecled together by various modes of articulation; hundreds of muscles to produce motion, each of them acting at least in ten different capacities; hundreds of tendons and ligaments to connect the bones and muscles ; hundreds of arteries to convey the blood to the remotest part of the system; hundreds of veins to bring it back to its reservoir, the heart; thousands of glands, secreting humors of various kinds from the blood ; thousands of lac- teal and lymphatic tubes, absorbing and conveying nutriment to the circulating fluid; millions of pores, through which the perspiration is continually issuing; an infinity of ramification of nerves, diffusing sensation through all parts of this exquisite machine; and the heart, 15 at every pulsation, exerting a force of a hundred thousand pounds, in order to preserve all this complicated machinery in constant opera- tion. The whole of this vast system of mechanism must be in action, before we can walk across our apartments." Yet, "were a single pin of the machinery within us, and over which we have no control, either broken or deranged, a thousand movements might instantly be interrupted, and our bodies left to crumble into the dust." "How precious are thy wonderful contrivances concerning me, O God. How great is the sum of them. I will praise thee, for I am fearfully and wonderfully made. Marvellous are thy works, and that my soul knoweth right well." And of vegetable physiology, of the functions and structure of the living plant. An investigation into the nature and properties of vege- table life, must necessarily be made by the physician ; and any one who has glanced at the investigation, knows that it unfolds a world of beauties, a world of wonders. There is no plant, no shrub or flower, that has not properties worth searching out. And what an infinite variety in the vegetable kingdom ! Of the millions of plants, no two are alike. They have different odors, different hues, different details in their formation. The humblest evidence of vegetable life that creeps along the surface ; the vine, whose tendrils cling to the forest giant; the stately tree, that the woodman spares not, as well as the gentle flower that blooms at its roots—all possess their characteristics, their peculiar properties. The microscope has discovered in the bloom upon our summer fruits, a paradise of flowers and gigantic forests, with walks and perfumed avenues, where insect life can fan the sun- beam with its golden wings, and make sweet melody with its little songs; and if, perchance, there need should be, lurk as securely in some deep recess, as the lion in his native jungles. The whole circle of vegetable life is full of delights to the heart impressed with a sense of the beautiful, and to such a heart, in every stage of the investigation, there are recourses bursting forth with joy : from the investigation of the smallest microscopic shrub, upon a surface of mould, to the oak that crowns the hill, or the stately cedars that tower on Lebanon. Is there, then, no pleasure in studies like these ? And it will not be un- derstood, that it is supposed, that any of these facts are communicated to ignorant ears, but simply for the purposes of illustration. Of the necessity of the study of the science of Chemistry, or of the pleasures afforded by the study, I need not speak. There are in- ducements to a thorough investigation of this science, that do not exist in the investigation of almost any other ; among which is the fact, that the science is yet in its infancy. It being yet in the early stages of its progress, more brilliant discoveries are yet to be made, and richer fruits reward the labor of the student. In many of the departments of philosophy, important principles are discovered, which, from their very nature, show themselves to be ultimate discoveries. Like the solution of a mathematical problem, the result is a demonstration that the ultimate truth is found—that it cannot be improved upon, added to, or subtracted from. This is true of many of the principles in natural philosophy, and it is a truth also in aome of the details of the science 16 of chemistry; but the general principles of the science are considered by all chemists as almost in a transition state, at least in a state of progress. Many of its most important principles are taken as true, not because they are known to be true, but because they have not as yet been discovered to be untrue. It is a part of the province of chemistry to ascertain the ingredients of which all matter is com- posed—to discover those elementary substances which, when united, form the bodies of matter we observe; and also to ascertain the laws by which the union and separation of these elementary principles may be regulated. All ordinary matter is supposed to be a compound of certain elementary principles, united together to form the substances we observe. What those elementary principles are, is for chemistry to discover. A body that has been analyzed and decompounded, until a substance is found remaining, that resists the power and skill of the chemist further 10 decompose it, this substance is called an element, and the only evidence that it is an element, consists in the fact that chemistry has hitherto been unable further to decompose it. Not but that the science, in its progress, may yet be able to do so, and thus prove that the elementary principles of our present limited know- ledge, will be compound substances in the light of future discoveries. In fact, such discoveries are so confidently expected and hoped for, that the votaries of the science are ever on the alert, their vision strained towards every quarter of the world, hoping to see streaming into the heavens a blaze of light, that shall be to the chemical world what the splendors of the Borealis are to the polar skies. If such discoveries are made, and from the nature of the case, can reasonably be expected to be made, what a field for the persevering and ardent student. The pathway is open before him, he has but to enter; and although the brilliancy of a new discovery may not place a crown upon his brow, yet the riches already scattered may be appro- priated, as well as the fruits already garnered by the reapers before him. But I must no longer dwell upon the pleasures of the physician, as derived from these departments of study. 1 have merely hinted at some of the resources of enjoyment, in this relation. The imagina- tion of the hearer can fill out the finer pencilings of the picture. But the physician has pleasure in the peculiar opportunities the practice of his profession furnishes for the observation of nature. I know, and who does not, that the life of the physician is a life of toil, in all seasons, in all hours. The mandates of professional duty he must be ready at all times to obey—whether to the halls of wealth or the hut of poverty—whether in the gloom of midnight or in cheer- ful day—whether he rides beneath the smiles of the sunlight or in a battle with the tempest. Yet, to the mind rightly tutored, all these things may be made tributary to his enjoyment. With a mind jaded and a body worn out with fatigue, he sinks upon his bed, blessing " the man who first invented sleep," hoping to rest until the "Time the morn mysterious vision brings, While purer slumbers spread their golden wings." 17 But perhaps ere the moment comes, that " gentle sleep" first finds him, and with " soft oppression" seizes his " drowned sense un- troubled," the calls of duty summon him from his rest. With a mind irritated by fatigue, and a disposition to murmur at his lot, he goes forth in the quiet hour on his errand of duty. What, think you, are the glorious visions that greet him ? The sluggard, who remains in the arm3 of "nature's soft nurse," until the night is chased away, and who, like the immortal Panza, " never desires a second sleep, because the first lasts from night till morning, cannot tell what those visions are. The still, frosty air plants the rose upon his cheek, gives an unu3ual sparkling to the eye, sends health and vigor through the frama, and the exhilaration of redundant life lo the animal spirits. In his going forth he finds nature attired in her robes of utmost beauty, to greet him in her halls. The fresh dew-drop congeals on the grass, and every blade is tipped with chrystals, and the earth for the time proudly shows to the stars the splendors of her jewelled covering. And there are not only glories beneath him, hut he reads the firma- mant! The azure vault is thickly set, with gems of the night gleam- ing and coruscating—the lyre of Orpheus breathes music to the starry spheres—the daughters of Pleione, with their diamond crowns, are the chosen queens of the astral heavens ; while the sword of Orion, drawn and flashing, guards the throng. And there are none of the ordinary phenomina of the heavens that he may not observe. The motions and relations of the heavenly bodies—the wonders of the planetary system—fhe little kindlings of the smallest meteor, as well as the gorgeous electricity of the arctic sky, which, to the eye of superstition, has seemed like armed hosts, marshaling in the heavens, with their blood-red banners streaming. And not only does he ob serve the wonders of the night, but what is more pregnant with beauty than night and morning blending together. A faint light first heralds the sun in his coming towards the gates of the morning, and then, as is beautifully said, " He first opens a little eye of heaven, and sends away the spirits of darkness, and gives light to acock, and calls up the lark to matins; and by and by, gilds the fringes of the cloud, and peeps over the eastern hills, thrusting out his golden horns, like those that decked the brows of Moses, when he was forced to wear a veil, because himself had seen the face of God." But he has not only opportunities to observe nature in the night season, and as the morning cometh, but in the light of day, all the beauties of the outward world are spread out before him. If his heart is rightly imbued, he can talk with vegetable nature as with a familiar friend—he knows her qualities, and appreciates her thousand beauties; and he also knows that ——----" Nature never did betray The heart that loved her : 'tis her privilege, Through all the years of this, our life, to lead From joy to joy ; for she can so inform The mind that is within us—so impress With quietness and beauty—and so feed 18 With lofty thoughts—that neither evil tongues, Rash judgments, nor the snares of seliish men, Nor greetings where no kindness is, nor all The dreary intercourse of daily life, Shall e'er prevail against us, or disturb Our cheerful faith—that all which we behold Is full of blessings." He also has peculiar opportunities for the observation of nature as developed in the animal kingdom, and particularly as embodied in the form of man. To observe human nature successfully, it must not be done when the guises, that man generally assumes, are upon him. He must be the child of nature, not the offspring of art. Who looks upon man, in the variety of conditions that he is looked upon by the physician ? Who, like him, sees the heart, not only in the weakness of fatal disease, but intermediately, in all stages to the bloom of health ? Are there not lessons of wisdom here ? Is not the book open with lines of knowledge clearly written all through its pages? He that runneth may ruad ; and dull must be the mind that does not master its truths, and slothful the reaper who does not gather a rich harvest from such a field. The physician also has pleasure in the immediate duties of his prac- tice, and in the thousand incidents necessarily connected therewith. A volume might be filled with illustrations on this point. He has pleasure in the success of his efforts to relieve and make whole, in tne gratitude and confidence of those ministered unto, and in the many evidences of that gratitude and confidence, variously and unexpectedly furnished. He has pleasure, further, in the consciousness of well doing. If he is fitted for the position he occupies, and makes the best use of that position to benefit mankind, the consciousness of it cannot but afford pleasure. If he has labored diligently and faithfully to mitigate and alleviate the evils that sin has brought into the world—if he has driven anguish from the throbbing temple, and sorrow from the stricken brow —if he has put joy into the aching heart, and planted vigor in the fainting system—if he has chased away sighing and tears with the breath of ho^e, and smoothed ihe pillow upon which the departing soul yet lingers, and plucked the thorns therefrom—if, in looking back upon his field of action, he sees clearly the results of a life well spent, joys must be his, compared with which, the pleasures of pomp are the bitterness of ashes. And they are not such joys as are evinced in the sounds of merriment, or in hilarious noise, but joys that fill the soul, and whose fittest companion is ihe deep silence of the heart. And if, perchance, in addition to his ordinary duties, he has whispered the consolations of religion to the soul not yet beckoned away by hovering forms, and has fitted the immortal spirit for the glory of the seraphim, who shall snatch from him the crown of joy such a con- sciousness gives, or sneer at the beatitude that swells such a heart. The physician has pleasure, inasmuch as the practice of his pro- fession furnishes evidence of the being, and iillustrates the benevo- id Lence of the Deity. It is true, these evidences are everywhere fur* nished, and are written upon every living thing. " The heavens de- clare the glory of God, and the firmament showeth forth his handi- work." The gathering clouds speak His majesty. His praise is hymned in the rustling trees, and His goodness whispered in sweet music by every little insect that flutters in the sunbeam. But in addition to this general truth, the physician finds these evi- dences, and illustrations, in the details of his professional practice. He sits by the bedside of his patient, he feels the pulse, and examines certain phenomena which are called symptoms. To him they indi- cate disease. He administers his medicines, and a certain effect is produced. Can he tell how it is produced ? The frame-work of the whole science of medicine, is built up of observation. All the reason he has to think that certain medicines will produce desired effects, is, that the observation of successiue ages, goes to show, that as a general rule, such effects will be produced. Having produced such results, the same results will probably be again produced. But in answer to the inquiry, how these effects are produced, he answers nothing. Why is it that a few doses of white powder, administered to the victim of the ague, will hush the tumult of his frame, when before, his flesh quivered on every limb, and his bones almost leaped from their sockets? Why is it that opium, in gentle doses, will lay to rest the watchful nerves, and melt away the pains of the excited system, and when ad- ministered in excess, produce wild visions, and sometimes ecstatic dreams ? The mind that created the human system, created also the substance that produces the effect upon it. He not only created their separate existence, but the relations between them, and the influence those relations exert. The process cannot be accounted for, except, as the handi-work of God's omnipotent power. If it can be account- ed for in no other way, to this it must be attributed. The power of medicinal agents, in the preservation of life, cannot be explained on the principles of human philosophy. Here, then, is clear evidence of the being of God, and his benevolence is illustrated, in the miti- gation of the evils of life, the use of these agents furnish. With these considerations of his mission—his duties—his respon- sibilities and his pleasures—we are led to magnify the office of the physician, and to speak encouragement and hope to those about to enter upon his career. You have assumed the discharge of duties, toilsome in their performance, and bending with responsibility, yet sweetened with joys. Your responsibilities to yourselves, to those to whom you are called to minister, to the community and to God—call for the exercise of untiring diligence, and your highest intellect. With a commission from on high, you are to go to the abode of suffering ; either to alleviate the miseries of those, to whom the scenes of life are vanishing away, or by the exercise of skill, and duty well per- formed, to raise the drooping to vigorous life, and flush his pallid features with the hues of health. Or perchance, in the many vicissitudes of your career, in connexion with bodily ills, the intellect may become fitful, and falter in its powers; wildnes-3 may fasten itself upon the contorted brow, the glare of mania shine in the' eye, and reason 20 herself tremble artd quiver on her throne ; and her light, like the night- lamp by the bed of the dying, flicker, and faint, and die. With a torch kindled at the altar of God, you are sent to re-light the lamp of reason, and place it, burning, in the dark chambers of the mind. Go, then, to the work ! 'Tis the Divinity within you ! ! And if at the commencement of your career, discouragements should thicken around you, let the consciousness of duty, and the star of hope, lead you on. And if, even after you have entered for a time, upon the details of your manv duties, and the romance with which you may have in- vested them vanishes away, and their realities seem severe ; still, if the responsibilities you have assumed could give utterance, every voice would say—Press on—Press on ! and not, like the fabled Ata- lanta, linger in the race ; though to swerve you from duty and its re- ward, your whole pathway may be strown with golden apples from the gardens of the Hesperides. PROF. ST. JOHN'S ADDRESS TO THE GRADUATING CLASS. Gentlemen : The arrival of the day, which announces the com- pletion of your course of preparatory studies for assuming the privi- leges and responsibilities of an important profession, is an event of no small moment, whether viewed in reference to yourselves indi- vidually, lo the community with whom you are hereafter to mingle, lor good or for evil, or to those of us who are responsible for your professional qualifications, and in no small degree for your profes- sional deportment henceforth. After a laborious, and I trust profita- ble, course of mental training, the time has arrived when your con- nection with this Institution is about to be dissolved, and you are to enter into the more active scenes of life, and upon the discharge of high, responsible, and solemn duties. On such an occasion, a few words of caution, advice, and encouragement may not be inappropriate. And though I could have wished the duty of addressing them to you, might have been committed to some of my colleagues, whose enlarged ex- perience of its trials and its encouragements, might have borne more ample testimony to the high and ennobling interests that cluster around the relation of the physician; yet the duty assigned me, will furnish an occasion of assuring you of the affectionate interest of your teachers in your future welfare and success. 21 In behalf of a cause so full of promise to the hopes of philanthropy, the limits usually alloted to a discourse, might be not unprofitably occupied in sketching the influential relations of the physician with science, with sickness, with bereavement, with all the absorbing in- terests of society ; and in deducing from these multiplied relations, his comprehensive sphere of duty, and the magnanimous incentives which impel its performance. 1 might hold up for your emulation the eloquent examples of those who, not satisfied with doing good themselves, have exerted all the influence of their ministry to inspire a love of it in others ; who, not content with being endowed them- selves with the true principles of wisdom, have endeavored, through the intimacy with which they were favored, to extend all useful truths ; and who, when it became their duty, have not hesitated to face danger, contagion and death. But interesting as the contemplation of pro- fessional life is, in the details of its duties, its motives, its trials, and its rewards, the present occasion precludes all, save casual allusion to this attractive theme. It will not be expected that I shall pronounce a labored eulogium Upon the profession which you have chosen, nor enter upon a discus- sion of the comparative necessity or importance of its various branches. Of the former, we trust an enlightened conviction pre- ceded your determination to engage in its pursuit; and for the latter, if our efforts in the lecture rooms, in enunciating and enforcing the principles of these branches, have not been successful in impressing a sense of their importance, I should deem the task impracticable on the present occasion. I have alluded to this day as completing your preparatory studies, but do not misunderstand me ; interpreted aright, you will perceive that it implies that your most important studies are only now about to commence, if you intend faithfully and conscientiously to fit your- selves for the serious duties which await you. I would have you carry with you hence, the distinct impression that this Institution, by this day conferring its honors upon you, only places you in favorable circumstances for the attainment of the yet higher honors—the con- fidence, approbation, and gratitude of your fellow-citizens, which are attainable only by unceasing devotion to your profession ; by doub- ling your diligence in the pursuit of knowledge; by a faithful and unwavering observance of every professional obligation. And here suffer me to say to you, in all kindness, however re- spectable may be your standing as scholars; however much, in the short period of your pupilage, you may have acquired from books; however deeply you may have drank at the fountains of wisdom, which the fathers in our profession have opened, still you are only beginners; you have only mastered the elements of professional science; you have only set your feet on the very borders of a broad field of learning, which lies spread before you. The youthful medical graduate, can make no mistake more fatal to his own success, and fraught with greater injury to the cause of humanity, than to suppose that study—close, laborious, unremitting study—is not essential in his profession ; that the acquisition of knowledge is to cease with the 22 reception of a diploma. It requires no prophet's ken, to predict with perfect accuracy the fate of that young man who rests satisfied with present attainments, and does not make it the great rule of life that everv day shall, in some way, be instrumental in increasing his stock of professional knowledge. He may, indeed, by a pleasing address, by artifice or misrepresentation, or by a bold and dashing impudence, secure a brief and evanescent popularity ; but he never can, in this way, lay the foundation for a good and permanent success. Lrenius may do much at first, but unaided by severe, patient, and untiring industry, it is but a poor heritage to its possessor ; and, like that spon- taneously inflammable, flickering gas of the marshes, the ignis fatuus, will in all probability, lead its deluded follower into inextricable dim- cullies. Tne importance of study in connection with professional reputation and success, is too little regarded ; and especially in this advanced period of the history of professional science, it is a great error in any young man, however commanding may be his talents, to suppose that he can rise above mediocrity without a thorough cultiva- tion of his intellectual powers. The general principles of the pro- fession—results, as they are, of the study, experience, and wisdom of successive generations—are, to a great extent, settled upon so firm a basis, that they are in very little danger of being overthrown, or ma- terially disturbed, by the dreamy speculations, or visionary theories of modern pretenders. Medical philosophy is a science, in the strictest sense of that term : classified facts, the result of the most rigid in- duction of facts gathered by the most careful experiment and accurate observation. Its practice involves processes of the most severe logic. Too long, for the interests of humanity, has it been believed that, while thorough intellectual culture and mental discipline were indis- pensable to success in other professions, the issues of life and death might dailv hang upon the inconclusive reasoning of an untutored mind, which has spent three years in undirected medical reading. But if an accurate memory and diligent reading, have furnished that mind with the requisite facts, is it not fitted for action ? By no means. Of what use would tho best furnished armory be to him who knew not how to discharge a single piece ? A mind filled to repletion with facts, without that skill in the use of facts, which is the resuli of men- tal discipline, is deplorably imbecile in all its efforts—an elaborate piece of machinery with no moving power. Every year is adding to the great amount of learning connected with the profession. It is idle to pretend, that there are not at this day valuable sources of information, to the examination of which the most industrious life is hardly equal, and without a familiar acquaint- ance with which, one of your profession cannot reasonably hope to secure the confidence and command the respect of his fellow men. A knowledge of diseases and their remedies, or an acquaintance with the writings of those who have been distinguished in the various de- partments of the profession, never has been and never will be attained by intuition. Nor can it be the work of a month or a year—it is the labor of a life. The last half century has produced a great change in the medical profession—it has opened new sources of instruction, 23 of the most valuable character, and elevated medical science to a high and dignified position. To the credit of the age, it may be said, more liberal views are entertained in regard to a medical education, and a thorough qualification for professional respectability and usefulness, than were formerly cherished. It is now a common sentiment that, while great pains are taken to secure the services of men of talents and learning in the ministry, and those of the ablest, most experienced, and skillful in the legal profession, it is unwise to intrust life and health to the guardianship of ignorant pretenders. With any other views than those which embrace the increasing responsibilities of the sta- tions you contemplate occupying, you will degenerate into the mere practitioners of habit and empiiicism. As you value, therefore, the lives and happiness of those who may be committed to your charge, and as you hope to pass through life with comfort and credit to your- selves, permit no opportunity to escape of attaining all the knowledge that is attainable by diligent and energetic study. Be assured, that the pleasure you will derive from the daily conviction that you are acting on the sure basis of conscious information, will be a source of perpetual enjoyment. But you have other duties to perform besides those of study and reflection ; and these are so many and so various, that they can hardly be embraced in the narrow compass of a brief address. To one duty, of no small importance, I briefly direct your attention : I allude to a systematic punctuality in meeting your appointments. It is not to be expected—indeed, it is not possible, that a physician should meet every engagement precisely at the time appointed; but a little attention to the arrangement of his business, methodically, will, in most cases, enable him to meet his arrangements at the appointed hour ; and a strict adherence to this rule, except in extreme cases, and when pre- vented by unforseen and unavoidable hindrances, will prove of great benefit in the whole course of your lives. System is the life and soul of business. Jt is said of an eminent physician in one of the largest commercial cities of the east, one who stood at the head of his pro- fession, that his mode of doing business was so perfectly systematic, and every professional duty so arranged, that he never found it neces- sary to be absent from public worship en the Sabbath, except when calied to visit a patient in an urgent case, who was not on his list on the morning of that sacred day. Your employers expect, and have a right to require, of you punctuality in the discharge of your duties; and the probabilities are very strong, that he who once fixes the habit of neglecting his appointments and consulting his own convenience, rather than the feelings and wishes of his employers, will find at no very distant day, that the sum total of service required at his hands, will impose no very heavy tax, either upon his time or his talents. In all your intercourse with men, and especially with your medical brethren,' courtesy, and a kind regard for the feelings of others, should govern your conduct. In the capacity of consulting physicians, avoid that low selfishness which sometimes prompts to an exhibition of opinions to the patient and attendants, from sinister motives; and remember that, if the attending physician is worthy of the confidence 24 of his employers, the business of the consultation is entirely between yourselves and him. Whatever acuteness of discrimination you may possess, in detecting signs and symptoms of disease, which a less critical or more superficial observer might fail lo observe, it is highly important that such a careful examination should be made, that the patient will feel entire confidence in your investigation. On the other hand, an excessive display of feeling, exhibited by a needless solicitude, and protracted, inexcusable examination of cases, for mere effect, should be avoided as one of those weak habits sometimes pos- sessed, but never wholly concealed, by physicians. Avoid all artifice and fraud in your professional conduct. Clandestine practice, what- ever the motive may be lor its adoption, should never be tolerated. Much of the prejudice which has accumulated against the profession, has arisen in a misjudged effort to effect the removal of disease, by the secret administration of some active remedy, to which there may be private or popular objections. There is much in the relation which will exist between your em- ployers and yourselves, directly and happily calculated to promote familiarity, to inspire confidence, and to cement the ties of friendship between the respective parties. The physician isadmiited freely into the very bosom of families in every walk of life. He is brought nearer, lhan any others, to his fellow men in their periods of weak- ness, sorrow, and suffering, both of body and mind. It is right that at such a lime they should be guarded from all contamination by the near approach of deception, impurity, and vice. It is peculiarly just that the physician of loose principles, and of corrupt practice, should be excluded fromthat unreserved, confidential intercourse, which must exist between the medical man and his patients. No such physician will deserve, or ordinarily obtain, the confidence of the community. In this ingenuousness of the heart, you will often be mode ihe reposi- tories of matters which are strictly of a personal or family character, and which never would be confided to the keeping of any other. In regard to this confidence, allow me to remark, that your honor is pledged to an inviolable secrecy ; and on all subjects with which you are made acquainted, either from the necessities of ihe relation which you bear to your employers, or from the friendship and confidence which may grow out of that relation, your lips should be hermetically sealed. That man is a disgrace to his profession, and guilty of the blackest treason, who can betray his trust in this particular. I can- not harbor a fear, gentlemen, that you will ever sport with the feel- ings of your friends, or with your own honor, at the hazard of your professional characters. Prize most highly the extent and variety of opportunity which your vocation will furnish for the exercise of an active benevolence. No one gives more real and arduous services to the public gratuitously than the philanthropic physician. The poor, who are always with us, and who, from their very poverty, are more apt to be sick, and to suffer more in their sickness, from the want of comforts and the ne- cessary struggle with their circumstances, draw largely on his time and his exertions. And, without boasting, we can truly say of our 25 fln^T * ' W fn l?Me ™e not cheerfu»y g^en, it is an excep- nlV hu6- fneral.ri,le- Jhe great Boerhaave ever regarded the poor as his best patients. Talents and industry may secure for you respect but esteem and confiding affection are the offspring of good will and benevolent action ; and if you have hearts that may be touch- ea by the kindlier sympathies of our nature, they will most frequently swell in unison with grateful emotions beside the pallet of straw or within the humble cot. Unless your future experience is to be wholly unlike that of all who have gone before you, you will find the practice of your profes- s.on beset with trials. Among the severest of these, you will place the proofs, perhaps daily rising around you, that integrity is by some accounted of little worth, taints are not duly appreciated, and merit is disregarded. Had the penalty of the fall of man been only sor- row disease, and death, and the physical man alone been contami- nated, your profession would have been practically divested of manv of its ills. Diseases would then, as now, have fastened upon the fairest': and the great destroyer would have gone on, gathering in counties^ numbers his fated victims, until the death of the last man announced that his commission had expired and his work was done. Bu' still your labor, and that of all the profession, would have been compara- lively light. True, we should have been obliged to study with ereat care into the nature and symptoms of disease, in all its Protean shapes ; an intimate acquaintance with the physical structure of man would have been no less important to the physician than it now is. The qualified, faithful, philanthropic practitioner, would have felt no less anxiety in regard to the result than he now feels ; and when, after putting forth all his well directed efforts, and exerting all his skill, he saw that all was vain—that the object of his care must sink under the wasting power of disease—he would have felt no less sympathy with the anxious group which encircled the bed of death, and were with agony awaiting the beating of the last pulse ; but when death had set his pale signet on the lips of his patient, he would have not only ihe consolation attendant upon the conviction that he had done his duty, but, in addition to this, the cheering assurance that justice would be done both to his motives and his conduct; that no misrepresenta- tions of either would be made; and that no tongue of malice or of envy would whisper the slanderous insinuation that his ignorance of the nature of the disease had prevented a resort to the appropriate remedies, or that his negligence in the treatment of his patient had hastened his dissolution. The trials to which you are to be exposed- trials from which no physician ever was exempt—will meet you, and you need no prophet's view to warn you of their approach. My object in mentioning a single one is, that though they may come un- bidden, they may not come unexpected. A poet, of undying fame, has said, "an undevout astronomer is mad;" and if a contemplation of the wonderful works of Nature be calculated to fasten upon the mind an abiding conviction of a great First Cause, and lead the soul to an intimate and hallowed communion with the divine Author of all existence, animate and inanimate, it 26 would seem impossible that an undevout physician should exist. Your studies lead you to an intimate acquaintance with man, the crowning work of the Almighty, so " fearfully and wonderfully made." And if to that knowledge, which few, except those of our profession, are privileged to acquire,—of this complicated, wonderful exhibition of power and wisdom—you add the myriad other proofs of the agency of a great First Cause,—of the wisdom, power, and benevolence, which are stamped on all his works—it would seem that skepticism should find no place in your minds. Let mo earnestly persuade you to cul- tivate in your own minds a firm belief in the doctrines of the Bible, and by all means encourage and strengthen ihe hopes of those who, in the hours of physical suffering, are sustained by its truths. Tne time has been, when skepticism and a denial of the truths of revela- tion, were considered evidences of superror discrimination, and when many misguided members of our profession advocated the doctrines of Voltaire and Hume. Those days are past, and a careful study of the truths of revelation and of science, and of the adaptation of the organs and functions of the body to sustain the immortal part, will at all times strengthen faith, for science and philosophy are in strict ac- cordance with the principles of the Christian religion. We are now, gentlemen, to part for a long season—we may never again meet to exchange friendly greetings—and although our paths may lead in opposite directions for earth, yet mutual interest will unite us in feeling, and your teachers will be no idle spectators of your career ; for at whatever point Providence may cast your lot, you will carry with you our sympathies and our warmest wishes for your pros- perity and usefulness. Let the whole tenor of your lives be in favor of the truth ; and as you are now to leave this Institution, which claims, and may justly pride herself in, you as her sons, may the blessing of Heaven go with you. And when, after the few short years alloted you on earth, and the mournful asterisk in the triennial shall announce that the last survivor of the class of 1846 is numbered with the dead, and gathered to his fathers, may it then be found that every individual, by a timely application to the great Physician, has been healed of his moral maladies ; and may we all meet in a world where all tears shall be wiped from all eyes, and sickness, sorrow, and death shall be known no more. In the name, and on behalf of my colleagues, I bid you, gentlemen, an affectionate—farewell.