MEDICAL DEPARTMENT ®s(sm©@i?WKj sisaiog DELIVERED AT THE SMITHSONIAN INSTITUTION MARCH 25, 1856. BY _S JOHNSON ELIOT, M.D., PROFESSOR OF ANATOMY. 3 WASHINGTON: HENRY POLKINHORN, PRINTER. 1856. -T^;' A VALEDICTORY GRADUATING CLASS MEDICAL DEPARTMENT DELIVERED AT THE SMITHSONIAN INSTITUTION MARCH 25, 1856. BY JOHNSON ELIOT, M. D., PROFESSOR OF ANATOMY. %%/^0{ ,. WASHINGTON: HENRY POLKINHORN, PRINTER. 1856. Washington, D. C, Mareh 28,1856. XhtAH Sir r— The undersigned, in the name of the Graduating Class of the Medical Department of Georgetown College, request for publication a copy of your Address delivered before (hem on the 25th inst. C. GIRARD, J. H. JORDAN, F. S. BARBARIN. Prof. Johnson Eliot, M. D, Washington, D. C, March 31,1856. Gentlemen :— Your note of the 28th inst, requesting a copy of the Address delivered to the Graduating Class of the Medical Department of Georgetown College, is received. Although not designed for' publication, it is, nevertheless, at your service. Very Respectfully, Your obedient servant, JOHNSON ELIOT. C. GlRARD, M. D., J. Hammer Jordan, M. D,, F. S. Barbarin, M. D. ADDRESS. Gentlemen Graduates : The happy hour has at length arrived; a period anticipated through anxious and toilsome months ; you are to realize all that fancy, in her happiest mood, has presented to your imagi- nations. This evening, gentlemen, you have reached the goal of your first ambition; years of hope, expectation and application are now to be rewarded by a public acknowledgment of proficiency, which, while it consummates your success, terminates your col- legiate term, but not your studies, and receives you as worthy members in a vocation equaled only in its usefulness by its honorable associations. You are this evening legally consti- tuted Doctors in Medicine; and while you receive the merit, you must prepare to bear the high responsibilities connected with its honorable and active prosecution. The time is yet fresh in my memory when I, as a graduate, occupied a similar position, enjoyed the same anticipations and experienced the same exhuberance of joy now expanding within your bosoms ; well do I remember the occasion, and it is needless to express how deeply and truly my present feelings harmonize with yours, feelings which, once experienced, can never be forgotten. This is not a moment to pass enconiums upon your abilities or qualifications for the discharge of the duties pertaining to your chosen sphere. The diploma just received from your president is a sufficient acknowledgment of our confidence in your professional capaci- ty, and of the high estimate we entertain of your characters as gentlemen. Believe me, when I add, that though the honor be- stowed is exalted, it is, nevertheless, richly deserved. The cir- cumstances attending your graduation are in the highest degree interesting and auspicious. You have received your testimonials of merit in the presence of an audience eminently refined and 6 intelligent; you are honored by the presence of the fashion, elite and beauty of the metropolis. You have received your award in the hall of an institution, under the immediate eye of the first of American philosophers, where the learned and re- spected of the land have displayed the results of their investi- gations, experience and study; a hall consecrated to genius, where literature, the arts and sciences have made their abode. Under these happy auspices we may well congratulate you, and associate the present with your future successful career and eminence. In accordance with an excellent and honored usage, we must be permitted upon this, the last occasion we shall have the privilege of addressing you officially, to impress upon your memories a few words of advice, which we trust, if attentively reflected upon, will add materially in leading you to success in after life, and thus, while we dissolve the tie existing between preceptor and pupil, we in friendship beg your earnest atten- tion. The profession you have this evening so openly embraced is an ancient, an honorable and useful one. Of the antiquity of our profession we might say much ; we might entertain you for hours with incident, both grave and amusing, connected with the period of its infancy, and draw for your edification and instruction lessons of deep import and interest; but this is needless; enough to say that coeval with the ills and sufferings of men your profession originated, and a merciful desire to ameliorate the infirmities of humanity instituted its first pre- cepts. Originating at the period in which it did, the good combined with the evil, the real with the imaginary and super- natural, without science to guide its course, or even truth to its investigators, its development was necessarily slow, its course devious and uncertain. History probably presents no parallel in the progress of the sciences approximating that of medicine ; the vicissitudes through which it has passed in arriving at its present useful and elevated position, is a subject of medical literature unques- tionably familiar to all of you; sufficient to remark, that al- 7 though mingled with error, superstition and prejudice, it has slowly dissipated the error which fittered its infant steps and retarded its early progress; and yet far from maturing, it is sufficiently advanced in its development to assure us that if the principles which have thus far sustained and directed its progress be systematically and untiringly persevered in, they will lead to its ultimate perfection and grandeur. The principles to which we refer are at the foundation of the structure which we now en- trust to your guardianship; in the honor of its protection and elevation you are now equal participators. The substructure in medicine, laid by our forefathers, was not based in vain. Upon their labor has arisen a stately monument commemorative of their industry and devotion. Succeeding generations have not been unmindful of the sacrifices they made for us, and have acknowledged their worth by advancing the enterprise thus no- bly begun. Every period since their time has added something to its stability and progress. To no particular era, to no one people exclusively, belong the credit and merit of its elevation; all have contributed, all have given their mite towards its erec- tion, and to all we award the merit of its fair proportions. Perfect as this great work appears, it is nevertheless unfinished, and great responsibility rests upon yourselves and contempora- ries throughout the world, not only to preserve its integrity, but to add to its improvement. From each of you we expect something; let the contribution be ever so small, be it only aa a single grain of sand to the increasing mass, you will so far have discharged your duty and realized the reasonable expecta- tions of those who have enlightened your path and placed you in the road to distinction and worth ^remembering that to ele- vate it, you ennoble yourselves, to enrich it you enrich and pro- mote yourselves. But you may inquire through what means are we to become contributors to this great undertaking, and render ourselves worthy members and followers ? To this in- terrogatory, I will briefly reply. By persevering application and study, close observation and untiring industry; let no op- portunity pass, however trival, without endeavoring to produce something useful and practical; let the principles inculcated, 8 and the teachings of your oollegiate course be viewed in detail, and contrast them with your own observations and experience. Return annually to your text books ; do not simply read, but study them, for unless you keep your attention constantly en- gaged with their contents, facts, and important facts, will pass into oblivion, and thus you will be deprived of half your pow- er to be efficient. Anatomy, chemistry and physiology I earnestly commend to your attention. The first-—the Alpha and Omega of your science—must not be neglected; pursue its study with enthusiasm and devotion. Confine yourselves not alone to human structure, but extend your observations into the subordinate classes of animal creation. Study comparative anatomy; for surely there is nothing ffhich has been created unworthy of your attention. Compare the very lowest grade of animal organization with the highest, the simplest with the most complex; and trace, step by step, the development of structure, the adaptation of organ to organ, and their functional application—to man the most elevated, perfect and noble work of the Creator. In chemistry you possess the very key to na- ture's laboratory; what would the physician, what would the man of science do without its knowledge ? To the chemist wo owe an immense debt of gratitude. It is through his instru- mentality that medical agents, before unknown, are discovered and classified; every article of the materia medica possessing remedical powers must be submitted to his scrutiny and analy- sis before it is reoeivod into the codex; your own intelligence will point to the indispensable necessity of cultivating thoroughly a science from which such results are to be obtained. If anatomy and chemistry furnish such ample means for in- vestigation, how admirably does the science of physiology ena- ble us to apply them in the elucidation of the most mysterious functions. The anatomist and chemist present to us the mate- rials for study. By anatomy we become acquainted with struc- tural formation and physical condition—we locate, describe and examine organs. Chemistry teaches us their ultimate consist- 9 encies and affinities. To physiology we award a higher, and I might with propriety say a spiritual office (as compared with mere description). It is to the science of physiology that we owe our knowledge of the functions of animal organization, the intimate and varied changes it undergoes in health ; it indeed embraces within its ample folds the true philosophy of medi- cine, in short the very vitality of our science. A familiarity with physiology enables us to define the boundaries of patholo- gy ; to know when normal ceases, and abnormal action com- mences. To retain the knowledge you have already acquired must not limit your ambition, but to acquire more must be your daily du- ty and pleasure. Independently of your authors and own ob- servations, I would suggest to you another means of seeking in- formation—a channel through which an inexhaustible current of facts of a highly practical character ever flows—and it is a means fortunately within the reach of all. I refer to the mi- croscope. It is almost incredible, even to a medical man when he examines and estimates the progress that has been made in medicine and its collateral branches, through the instrumental- ity of this valuable implement of science, how much every de- partment of medicine has received of valuable contribution from its application; all have been greatly benefited, but none more so than anatomy and physiology. To use this instrument in order to derive profitable and accurate information requires a degree of skill only attained by practice and experience ; you must be familiar with it in detail; and to avoid rendering your- selves ridiculous before your cotemporaries, you must be fully acquainted with the discoveries of others before you attempt to claim any as your own. Medicine being a liberal profession, its followers should be characterized by liberality of feeling and action; strict honor and integrity should mark their course in every transaction of life. Daily experience teaches us that he who conducts him- self in strict conformity with the principles of honor, will ulti- mately attain every reasonable desire. In your intercourse 2 10 with your professional brethren, be scrupulously exact, yet for- bearing; be to them the "very mirror of courtesy," never permitting their professional fame to rest under a momentary shadow, for none better than medical men can appreciate the circumstances under which imputations are cast, and the grounds upon which they are sustained. The differences of opinion which will always exist between gentlemen upon medical topics, should never be considered legitimate grounds for dissention or ill-feeling, and so long as their views are controlled by the dic- tates of conscience, they are to be respected. Of course we do not include in this category, the wild theories of the igno- rant, designing, or eccentric. Never permit prejudice to sway you in examining a theory, even though its principles conflict with your most cherished views, and be in direct opposition to those which you have always considered orthodox. Recollect that from every system of medicine some truth may be drawn, some fact elicited, some idea conceived, that under proper guidance may lead to highly valuable results, and this without for an instant compromising either the integrity or stability of that which you really know to be correct. Your position in regard to those who may require your services, is one of ex- treme delicacy, and the greatest circumspection is needed on your part in discharging your duties to them with honor and fidelity. You are introduced into families, frequently under the most painful and trying circumstances; implicit confidence is placed in your integrity; you hold the two-fold position of friend and physician; you become acquainted with their do- mestic afflictions and troubles, a partaker of their happiness and joys, and not unfrequently your counsel is sought by them upon subjects entirely foreign to your profession. Con- fidence thus reposed, it is needless to say, gentlemen, cannot, under any circumstances, be violated. While upon this topic, I might, however, give you a word of caution; never be the voluntary depository of confidence. Secrets under the most innocent circumstances, are dangerous to comfort, the possession of them, by enlisting your sympathy, may lead you to violate the rigid rules of professional etiquette, 11 and possibly defeat the ends of justice. Never volunteer your services. Upon this point I desire to be well understood. Casualties and emergencies are direct calls upon your humanity, and are never to be disregarded; under such circumstances discharge your duty faithfully, and then relinquish your posi- tion, unless especially desired to continue your attentions. In the event of this being the wish of the individual or his friends, perform your duty conscientiously, both to the sufferer and the medical gentlemen whom you may have displaced. By adopt- ing this rule in your intercourse with the community, you will avoid much anxiety, and in some instances, mortification. Never forget that the poor and lowly have preferences in selecting their medical advisers, as well as the elevated and wealthy, and al- though they may have confidence in your ability and skill, nevertheless circumstances may have induced them to prefer another. When this is done, never permit your feelings to be wounded ; remember how dear a boon health and life is to all, and be not piqued with any endeavor on their part to preserve it. In your practice never permit your presence to be the cause of the slightest embarrassment to those who have the dearest interest in the sufferer at heart, upon the most delicate intimation that full and sincere confidence is not reposed in you; remove the apprehension at once, by withdrawing from the responsibility, for I cannot imagine a less enviable position than that of a physician thus placed. It shackles his judgment, and renders his ablest efforts unavailing and inoperative; indeed it so circumscribes his field of action that he cannot justly and consistently perform his duty. To "fcombat disease is sufficient, without having the additional duty of inspiring confidence. If the utility of a vocation bears any proportion to the necessity of it when required, certainly we may, without egotism, place the profession of medicine in the first grade of value. We all acknowledge, under pressing circumstances, its importance, and appreciate the efforts of its followers; but to render yourselves useful, you will have to be deprived of many of the comforts and pleasures that are attached to other vocations; you are, 12 really, without obtrusively soliciting public patronage, the ser- vitors of the unfortunate sufferer, ever ready, ever willing. The profession of medicine is by no means a lucrative one, though occasionally fortunes have been amassed in its pursuit; these, however, are exceptions. If any of you have selected it solely with a pecuniary view, disappointment surely awaits you; and I would advise you to abandon the cause at once, ere the pursuit has commenced. Rest assured that the same study, reflection, and application, bestowed upon almost any calling, either of a professional, mercantile, or mechanical character, would yield you more munificently, and at the same time, with an infinitely less degree of anxiety and vexation. If you have selected it through a desire for its study, or better still, through an inclination to be beneficial to your fellow-men, you should render yourselves in every way worthy and accept- able, and a word on this subject may not be inappropriate. Many physicians starting out in life make their first essay to become popular, not in a medical but social light, and attach themselves to every club and society into which they can ob- tain admission. Daily experience unfolds to us the truth, that a popularity based upon such a frail foundation, is of the most ephemeral character, and passes away not unlike the changes in fashion. Merit, true merit, based upon the solid support of the knowledge you possess, is the only sure footing for a repu- tation, independently of the desire to patronize it, remains sta- ble, though circumstances, fortunes, and times may change. I would advise you, gentlemen, under no circumstances, to enter the political arena. If you are politicians you cannot be phy- sicians ; the two vocations and their influences are antago- nistic ; their affinities are incompatible; they never can be combined advantageously to yourselves or to those with whom you are professionally associated. I have never yet heard of an eminent political physician, or do I expect ever to hear of one, and I think I may safely challenge the country to produce one. The physician has no more to do with poli- tics than a theologian has, with the latter; all admit the inap- propriate association. Follow your vocation ardently and truly, 13 and you will have quite enough to occupy your attention with- out meddling in the affairs of State, beyond an expression of opinion. I trust sincerely, gentlemen, never to hear of your names being enrolled among candidates for a political advance- ment. In a pecuniary view, I must remind you of the old and familiar adage, that "Charity begins at home." You labor for bread, you must have it, your profession is to be your support, it is to be your all, and while it will always sustain you liberally, it may never enrich you. Be liberal, be generous to all, but not to your own injury; when you render services, demand your fees, and endeavor to obtain them, but never place it in the power of any to say that you have taken from the poor man his last dollar; divide with him, share with him, but never oppress him. Gratuitous services you must ever render to the indigent; indeed, you have no right to deny them your advice under proper circumstances, inasmuch as you have assumed the posi- tion of almoners, you must sustain the character honestly. If you have that confidence in the power of your profession which you should have, to relieve suffering and preserve life, upon what principle can you refuse your attention to them when solicited ? Life is desirable to all, even to the poor, friendless, and destitute; to repulse them you degrade yourselves as men and christians, and add but another pang to their woes. Ser- vices of this character you owe to the world, necessarily from your position, but does not the world owe you something in return? I might occupy pages upon this subject, viz: the ob- ligations the community are under to the profession, but I will not do so on this occasion, I will merely express it in two words: charity and forbearance. What profession receives more and deserves less censure than that of medicine ? Every individual, however learned or ignorant, believes himself capa- ble of passing judgment upon medical men, and scarcely ever fails to express opinions upon their relative merits and de- merits. It is really amusing to see what trivial circumstances will ingratiate the unworthy and ignorant and lower the meri- torious and skillful in the estimation of the community. The 14 most absurd and unreasonable rumors are believed eagerly, and adduced as testimony against them, and maintained with perti- nacity for years, greatly to their injury and discomfort. A very brief experience will, however, enlighten you upon this point, enough to add that you have but little to expect from the pub- lic, and rest assured that what you receive by way of remune- ration, will be obtained only by assiduous labor. The diploma conferred upon you this evening is not a nomi- nal honor; the source from which it emanates should ever be to you a subject of legitimate pride and gratification. Read it attentively, and mark its language. You are declared by it learned and honorable; let your professional career sustain the first declaration, and under no circumstances forfeit your claims to the second. Remember its device is symbolic of its charac- ter, and wherever civilization holds sway, where religion is cherished, where science and literature are cultivated, there its value will be acknowledged and respected. This evening, gentlemen, we present you to the world with the endorsement of the Alma Mater, be careful never to vio- late the high trust thus reposed in you. Permit me, in conclusion, to extend to you the greetings of my colleagues. By them I am requested to acknowledge the many pleasant hours passed in intercourse with you, and to express to you the deep regret they experience in separating. Of your success in professional life we shall always be happy and pleased to hear. In misfortune you can rely upon our sympathy, advice, and aid. In their name I bid you farewell. \m