VALEDICTORY ADDRESS Cjje (irahaimg jJCIass MEDICAL DEPARTMENT 1 1 GEORGETOWN COLLEGE. SESSION 1860-'61. By THOMAS ANTISELL, M. D., Professor of Chemistry, lexicology, and Physiology. WASHINGTON: HENRY POLKINHORN, PRINTER. 1861. 1 VALEDICTORY ADDRESS ^C|e (grataating dtas^ OF THE MEDICAL DEPARTMENT OF GEORGETOWN COLLEGE. SESSION 1860-'61. By THOMAS ANTISELL, M. D-, Professor of Chemistry, Toxicology, and Physiology. WASHINGTON: HENRY POLKINHORN, PRINTER. 1861. CORRESrONDENCE. Washington, D. C, March 5,1861. Prof. Thomas Antisell, Dear Sir: We, the undersigned, members of the Graduating Class of the Medical Department of Georgetown College, Session 1860-61, having been much interested in the Valedictory delivered by you on the 28(h of February, ult., take this opportunity of soliciting a copy of the same for publication. Very respectfully, I Your obedient servants,1 LOUIS C. HOOTEE, J. M. BINCKLEY, W. W. HAYS, A. R. BARRY, chas. Mccormick, pHARLES ALLEN, W. H. GARDNER, J. H. PORTER. Mehical Department of Georgetown College, Washington, D. C, March 6, 1861. Gentlemen: It affords me much pleasure in complying with your request, containing so flattering an appreciation of the merits of the address; and with well-wishes for your success, I remain yours, very truly, THOMAS ANTISELL. To Messrs. J. H. Porter, W. H. Gardner, Chas. Allen, Chas. McCormick, A. R. Barry, W. W Hays J. M. Binckley, and L. C. Hootee, Members of the Gradmtinff Class of 1860-61. ADDRESS. Gentlemen of the G-rajjuating Class of 1861: The Diploma which each one of you has just now received, is to the world a proof of conformity to the rules of this Institution, and while it declares you to be the possessor of that amount of profes- sional information which justifies our College in giving you its high- est honor, it should never convey to you the idea that your medical education is completed. You have received from us the institutes, the principles of the art, you are going abroad into the world to practice. Society, that great hospital, lies before you, and whether you frequent her upper or her lower wards, always bear in mind that to practice rightly is also to learn. In the pursuit of your profession, you will soon perceive that it has a two-fold character or function. One of which is that of simply curing disease as it presents itself among members of the community. To this phase of your art, your education has been more specially directed, as being that which renders you immediately useful. The other function of your profession is that of preventing disease. This aspect has no relation to an individual, but is occupied with masses of men, as an army or navy, a city or a district; it involves an appreciation of all of the circumstances in any way injurious to life. This is not so immediately useful to you, but is of vastly larger impor- tance to your fellow man; it is at once a new and a higher branch of the art, and no full and effective system of instruction has as yet been adopted, although partial efforts have been made to teach pre- ventive medicine in our colleges and schools, and yet this necessity of attention to this subject is imminent, owing to the new organiza- tion of society which has sprung up in this century. The world at large is still imbued with the belief of the universal application of the maxim — "They that are whole need not a physician, but they that are sick," an apothegm perhaps only true where applied to a sparce population following agricultural pursuits. 4 A due realization of the peculiarities, mental and social, of our day, will better enable you to comprehend the duties and the difficul- ties which surround your professional career. Within the present century, the discovery of steam and its appli- cation to locomotion, has increased commerce, enlarged the bounda- ries of travel, and, by removing the dangers, has enormously increased the number of travelers. Railways by tens and steamers by the hundred convey our population (and not ours only, but that of all the enlightened world) by the million to and fro from one end of the national domain to the other. In a short space of time we rush from the Lakes to the Gulf; from Vancouver's Island to Panama, and from Aspinwall to Boston or New York. Every fortnight, irrespective of season or temperature, we perform a journey, without much fore- thought, which our immediate ancestors before undertaking, willed their property to their friends and their souls to an over-ruling pro- tector. In times of war we have seen large masses of men thrown sud- denly, by steam agency, upon distant shores, whose climatic condi- tions were essentially different from the country left behind; a few years ago Europe sent 150,000 troops to the Crimea and 30,000 paid the penalty of the journey. Friends and acquaintances of all of us have left their homes to reach warmer latitudes, and when we have heard of them, it was that they sickened soon after arrival and ultimately died. Is it inevitable that travelers must paylthe penalties of death ? Are they or are they not capable of resisting the conditions which surround them ? And cannot medical science meet this evil arising out of these new transitions? Such is one of the questions for your consideration and solution. Within this century machinery has superseded hand labor, steam has been applied to that machinery which has been concentra- ted in favorable localities, and towns and cities have sprung up with a mushroom-like rapidity. The concentration of labor and the con- sequent consolidation of population leads to the propagation and development of disease quite distinct from that of a rural population. The vicissitudes of fortune in cities are so extreme, and the struggle for existence so laborious, that the nervous tension of the community is often more than it can bear, especially when the physical and moral development lags so far behind the intellectual endowment. The necessity of counteracting the evils of human consolidation has led to sanitary improvements, and preventive medicine first appears 5 in this connection under the name Hygiene. Now, preventive medi- cine, reviewed in all its relations, is as yet only in its infancy. To your generation will be entrusted, the care of observing and co-relating all the phenomena and to lay the broad foundation of this largest branch of medical science; it is fortunate that with the necessity, the means is also present. The present mode of teaching medicine solely from observation, commenced by Hippocrates and practiced by Galen, but thrown aside by the tendencies to disputation and the love of authority peculiar to the dark ages, is that which is in conformity with the habits of observers of other branches of nature; and that love for and devotion to the investigation of the external world which has led to the nu- merous developments in the useful arts, is that which provides the remedy for their too keen and injurious pursuit. One of the healthiest signs in the history of modern thought, is the increasing turn toward a minute and reverent study of nature. It is in part, perhaps, a reaction from the over-concentration and indivi- dualism which were the characteristics of the last century, and the commencement of this present. We cannot doubt that the greater use of the observing powers, and the disposition to be more occupied by the facts of the world about us, pervades our literature, our art, our theology, and our science. Indeed, it would seem as if this progress, commencing from the inner recesses of experimental investigation, had not only brought out great results for science itself, but had per- vaded the tone of general thought, and that at an epoch of unex- ampled advance in the discovery and explanation of physical phenomena, the mind of society had as it were gained a tinge of this general and observant and watchful spirit; that where formerly it raised theory and framed system, it is now content to wait in rapt attention for the revelation of fact, for the evidence of purpose, and to labor with earnest faithfulness to elicit germs of a new truth by the closer searching of the means at its disposal. The great current of human thought which had for centuries before traveled in the maelstroom circle of speculative reasoning or abstract history and poetry, is now directed along the ever-varying path of organic life, and the result of this out break of eager and inquiring interest in the present and external nature, is the enthusiastic welcome which has ushered in the Cosmos of Humboldt, and the " Origin of Species," of Darwin, which finds responses in breasts even but slightly acquainted with Natural History. Nor is this interest limited to science. In the lighter field of fancy and of art we have the same tendencies displayed 6 in the works of Ruskin and of Kingsley, in a healthy tone, and that of Bronte in its sickly melancholy. Yariously is it displayed by each. All of them are full of the minute observation of life. These conditions of society and modes of thought, peculiar to our day, bring with them necessary deviations from health, which de- mand removal, and since these deviations are solely produced by the social condition, it lies within the power of medicine to indicate the means whereby they may be prevented ; and this, as we have already stated, is the new demand which modern society makes upon you. Your duty is not confined to the preservation of individual life, but extends to the life of the community, to the preservation and prolongation of human life in the broadest sense. What is life ? When Bichat defined it as the sum of the functions by which death was warded off, he nearly approached the true statement. Man is but a composition of tissues and parts, held together in a certain structural form, which is apparently always a forced and temporary one, since that form and structure is ever tending to return to sim- pler forms and more permanent conditions. There is such a force of this kind acting on our frames to destroy it, that we build over again portions of our bodies fourteen times in the year. " Such is in fact," says that great physiologist, referred to, " the mode of exist- ence of living bodies that everything surrounding them tends to their destruction." It is external nature which ultimately overthrows life; were there for every external injurious influence an internal repara- tive organism, " an answering process or act," then, indeed, would life be the highest conceivable both in degree and length. But the force of resistance is not equal to the force of degradation, as is shown by what is called the wear and tear of existence. The environ- ments of life (climate, nourishment, and manners) are continually act- ing upon us, and acting unfavorably. As we begin to live we begin to die, and extinction would be the result did not man possess, to a limited extent, the power of adapting his frame to these environments. Just as a plant sends its roots in one direction towards its fluid nourish- ment and twists and gnarls itself until it overcomes the obstacles im- peding it, so has man, in the course of time, produced natural modi- fications of his structure, which have, as their normal result, the final adaptation of the organism to the climate in which he lives. Thus certain typical characters of race are produced, transmissible heredita- rily, which constitute the varieties of the species. Alter the envi- ronments, and the race is altered to a slight degree, and if this alter- ation be rapidly effected or extensive in its nature, the race may not 7 be able to accommodate itself to the altered condition, and although it may not be annihilated, it will undergo such a diminution of vital- ity, such a degeneration from the normal type, as to abridge the mean animal life, and to render that of the individual much more precarious. Now, of those unfavorable environments, I shall only on the present occasion call attention to two: the one being a condition of climate, and the other of social position. " Climate," writes Dr. Forry, " constitutes the aggregate of all the external physical circumstances appertaining to each locality in its relation to organic nature." The influences of climate are shown by the diseases produced, and while there are many diseases common to all climates, there are many also which are peculiar to each local- ity. On elevated mountain regions malarial diseases are absent, as also yellow fever, cholera, and phthisis, which at 4,500 feet elevation is almost unknown, while on low and tropical sea-shores all of those are common. The diseases which produce the great sickness and mortality in hot summers and in tropical climates are fevers, dysentery, hepatic disease, cholera, and phthisis. When it is recollected that, unlike many of the most fatal dis- eases of northern climates, the whole of these maladies are of that description which all investigators, in recent times, unite in proving to be either removable or mitigable by vigorous and liberal meas- ures of sanitation, the medical man cannot but feel, amid the many disappointments which attend his labors, that, whenever he succeeds in carrying into operation any one Hygienic law, he begins to exer- cise the greatest of the Almighty's gifts to man—the power of arrest- ing death. As we pass from these warm and malarious regions to those where the rain-fall is more equally annually diffused, the malarial diseases disappear and typhus takes its place; and proceeding still further north to the colder localities, where winter predominates, typhus no longer occurs, but gives place to catarrhs, influenzas, ery- sipelas, and pneumonias of great severity. Malaria is the climatic environment which acts unfavorably on our people through the whole country; never before was a virgin soil so suddenly and extensively cultivated as happens in our West- ern States, and never, therefore, have malarious influences so affected a people. It is for you to prepare yourself for this condition. The perniciousness of the marsh poison, and its greater or less nox- iousness, according to season, climate, modification of soil, and social 8 condition of the people, are facts universally admitted ; wherever it abounds the human race degenerates. " There are parts of France," says Montfalcon, "so malariously fatal that every inhabitant suffers from it from his birth; scarce has he quitted the bosom of his nurse ere he languishes and gets thin and dies before his seventh year; or he vegetates on, cachectic, edematous, subject to putrid and malig- nant fevers, autumnal remittents, until the miserable being is scarcely able to fight against the diseases which convert his life into a pro- longed dying—he rarely reaches his fiftieth year."* " We do not live " said one of the miserable inhabitants of the Pon- tine marshes, to a stranger astonished that existence could go in such an unhealthy region. " We do not live—we die." We are told by Dr. Nott, that among the inhabitants of our Southern States, there is no acclimation against the endemic fevers of the rural districts, and that those who live from generation to genera- tion in malarial localities, become thoroughly poisoned, and exhibit the thousand protean forms of disease, which spring from this insidi- ous poison. He thinks also that the so called acclimation of negroes, has been overrated, and that they never, so far as his observation goes, become proof against intermittents and their sequelae. Thus it is the care of the health of the negroes in slavery, which even keeps them in such health, for while they have increased ten- fold in the United States, those of the British West Indies have di- minished in the proportion of five to two. According to Dr. Dowler, the imported negro, every where, except within the limits of the United States, tends to extinction. Even the Liberian experiment, is no exception to this general statement. During 32 years the num- ber of colored persons sent to Liberia, amounted to 7592, which number was reduced to 7000 at the end of that time, f So that even the colored race, it appears, has no immunity How much worse, must it fare with the white population, who after all are but northern Europeans, acclimated during tenor twelve gener- ations. Because man possesses in a limited degree the faculty of adapting himself to a climate different from that in which he was born, it by no means follows that this power is without limit; in other words that man is cosmopolitan—an opinion very generally entertained. On the contrary it is with great difficulty, and at great cost, that man * Morel on the degeneration of the human race, page 618. t Noith American Med. Ohir. Rev., September, 1857. 9 adapts, or attempts to adapt himself to the climate and other influ- ences of lands, removed from that of his birth. This point of practical value, both to the physician and the economist, demands your seri- ous attention. " Can any one race of men live and thrive in any climate ? " asks Dr. Robt, Knox,* a competent authority on ethnology. " Travel to the Antilles and see the European struggling with existence, a prey to fever and dysentery, unequal to all labor, wasted, and finally perishing and becoming rapidly extinct as a race, but for the con- stant influx of fresh European blood. European inhabitants of Ja- maica, of Cuba, Hispaniola, and of the Windward and Leeward isles, what progress have you made since your first establisment there— Can you say you are established? Cease importing fresh European blood, and what will be the result? Your pale wan and sickly off- spring would in half a century be unproductive. Face to face with the energetic negro race, your color must alter ; first brown and then black. But look at Hayti; with a deepening color, vanishes civi- lization, the arts of peace, science, literature, abstract justice. The European then cannot colonize a tropical country, he cannot identify himself with it; hold it he may with the sword, as we hold India, and as Spain once held Central America, but inhabitants of it in the strict sense of the word, Europeans cannot become. ***** Withdraw from a tropical country the annual fresh influx of European blood, and in a century its European inhabitants cease to exist." * * It may be advanced that this is an extreme case; i. e., the sudden translation of men thirty degrees nearer the Equator than their origi- nal dwelling-place. But how can the point be proved better than by an exhibition of the extremes? Look at the Panama Railroad, a structure not much more than fifty miles in length, built, not with the sweat of honest toil, but actually with the blood of laboring men. At points along the road are the lines of graves where hundreds of poor laborers, suddenly taken from a northern climate, have paid the debt of nature, either after a few days residence in many cases, or a few weeks in others. The tempting bait of a better pay drew an unacclimated race to certain and to speedy death. Had one of the petty despots of the locality, so abused or despoiled the same number of men, upon some imaginary political offence, that death occured to all, the world would have exclaimed against this wholesale slaughter; but it was not so; it was in the cause of commerce, for the benefit of * Knox, Races of Men, a fragment, p. 107. 10 the world, for the progress of civilization, that this road should be built, then death proved a fact well known, that the power of the individual man to resist climate is but slight. Inter-tropical regions are not necessarily fatal to man, unless man contravene the laws of his organization. And what are these ? That in individuals in which one class of organs are called upon to perform but a light duty and that in a slow manner, you cannot suddenly increase the work or quicken its rate of action without great and even fatal injury. The exemption of the natives of India from the bad effects of a tropical sun is shown to depend on the extreme thickness of the scarf skin; and a great error is committed when we attempt to acclimate an inhabitant of the temperate zone by exposure to that luminary. The immunity of the Indian has been the work of many generations. In endeavoring to acclimatize an inhabitant of our Northern States, the work of many generations is attempted to be effected at once. The man of the temperate regions whose heart and lungs perform their functions actively and fully, while the skin and liver are com- paratively at rest, cannot suddenly transfer the rapidity of metamor- phosis of tissue from the lungs to the skin, from the heart to the liver, without shortening his life. In machinery, do we expect to attain fine rapid movements and slow movements by the same mechanism; or, do we expect that a machine not used to the transition from rapid to slow movement, will perform it without disarrangement or fracture of some of its parts. If men change their dwelling place many degrees from north to south, the lifetime of a single individual is not sufficiently long to complete acclimatization; it takes many lifetimes, and if the original colonists have traveled too large a portion of the total distance, the offspring may be so feeble and degenerated that colonization may not perhaps be effected at all. From France to Algiers is but a short distance. The mean temperature of the south of France is only a few degrees less than the Algerine coast, and yet, the mortality and sickness of French emigrants has been so great, that some able and thoughtful men of France have despaired of doing more with it than making it a military province, rather than a fruitful colony of the mother country. The advance of a people from a cold to a warm latitude must be so slow that the circulating vessels may be accommodated to the different quantity of fluid which they may contain, and that the mus- cular and nervous system may diminish in volume; this modification becomes hereditary, and transmissible if slowly made, and arrests 11 itself within determinate limits, finishing with the result of adapting the constitution of the later generation to the climate in which he is necessitated to live. Evart in his Digest of Vital Statistics of the European (English) and Native Indian Armies, asserts that the European divisions in the Province of Bengal have to be renewed every 10J years, in Bombay every 13^, in Madras 17, and in India proper 13 J years; while the native soldier lives his allotted term. Can anything show more vividly the inability to be readily acclimated ? Mr. Ronald Martin, in his work on the Influence of Tropical Climate on European Constitutions, has established the fact of the degrading influence of an East Indian climate on the European race. The idea must be abandoned that the mortality of tropical climates is due to sweeping epidemics, and their unhealthiness to causes, against which, some years residence gives comparative security, rather, than to the slow unceasing influence of a power which no acclimation of a single life overcomes, and which seems in league of unending hos- tility with the native, against the foreigner who has invaded his shores. Mr. Martin, himself, quotes Twining, who states that after careful inquiry, he was not anywhere able to find a sample of the third genera- tion, from unmixed European stock. They believe that such is not to be found in any part of India, and least of all in Bengal proper: so that European civilization, by Europeans themselves, in tropical cli- mates, is a dead letter. Now, if we accept this as a true statement of fact, which I believe it to be, it is wonderfully at variance with the conventional theories of the day. The notions involved in the terms humanitarianism and progress, which, besides including steam machinery, steam locomotion, and magnetic telegraphs, also takes in Minie Rifles, and Dahlgren Guns, wars of races in India and China, periodic shooting of Caffirs at the Cape of Good Hope, extermination of the Australian and New Zealand aborigines, removal of the red man from regions where his food abounds in plenty to districts where he must either starve or steal, and mercilessly warring on him because he prefers the latter; —constitute the "progress of the age"—a term, now the war cry of a vast party, booming above the voice of the world's ever-rolling waves. Whenever we hear this cry of progress attributable to super- iority in race, as historians we may remember that there has been many dominant races on the globe, and that a conquering race neither implies a permanently enduring race, nor a God-chosen one. Another degenerative influence at work upon existing society, is the continued strain of the human mind in either finding out the 12 means of existence or of satisfying the social demands of his position in life. "Notwithstanding the enormous intellectual advances made during the present age, there probably never was a period * * * when happiness and contentment were less generally diffused through- out the different classes of society. The increasing tendency to the concentration of wealth in the hands of a few, necessarily produces discontent among the many, while the incessant striving after social elevation, as one of the results of a diffused education, the intensity of competition, * * * the love of display, the introduction of for- eign vices, and the frequent faithlessness of men holding important trusts, have all united to engender a state of feeling in the highest degree injurious to the mental condition of the community"*—a con- dition which often terminates in insanity. The question as to the increase of insanity is one upon which au- thorities differ and of which it is very difficult to form an opinion. Statistics are advanced in support of both positions, and it may be that, as in the case of moral crimes, the apparent increase may be due to the fact that the cases are now made public by our papers, and that more attention is paid to them. But certainly new causes have sprung up in the wear and tear of the great battle of life, too often carried on without regard to any consideration but the gratification of an ever-restless ambition, which leads men of every capacity and degree to sacrifice present happiness in the fierce struggle for wealth and pre-eminence. The increasing civilization of the age, of which we constantly hear such complacent commendation, is not without its se- rious drawbacks, and society thus pays for its advantages by the greater selfishness of its members and by the prevalence of a lower morality. The curability of insanity depends, in a great degree, on the causes which produced it. Where the causes are of social origin, hu- mane and enlightened treatment, by developing again the intellect, will produce many a cure. " Gentle as angels' ministry The guiding hand of love should be, Which seeks again those cords to bind Which human woe hath rent apart— To heal again the wounded mind And bind anew the broken heart. The hand which tunes to harmony The cunning harp whose strings are riven, Must move as light and quietly Forbes. 13 As that meek breath of summer heaven Which woke of old its melody ; And kindness to the dim of soul, Whilst ought of rude and stern control The clouded heart can deeply feel, Is welcome as the odors fanned From some unseen and flowery land Around the weary seaman's keel."—Whittier. The term moral insanity, which Pritchard defines as a morbid perversion of the feelings, affections, and active powers, without any illusion or erroneous conviction impressed upon the understanding, "sometimes co-exists with an apparently uninjured state of the intel- lectual faculties." This impairment of the moral sense and feelings is a fit subject of medical inquiry, as its objects may be subjects for medical treatment. But in admitting that reason may lose her throne in a few indi- viduals who have given their passions unbridled extent, and where physical organization disables it from recovering its hold, you must not be led into the belief that every moral weakness is a morbid con- dition. The jdefence of moral insanity set up so frequently in our courts is one which you may be called upon to examine and inform a jury upon, whether there are a large number of persons of unaffected intellect in whom the governing power of the mind is so far enfee- bled that they are habitually incapable of resisting criminal influen- ces or vicious cravings, and who are consequently irresponsible for their actions. The law in almost all civilized countries has declared that no insane person shall be punished for any crime, and the fact of insanity is generally proven by competent testimony, in which our profession holds the most important position ; and there may occasionally float through your minds, as there does through the unprofessional, that there is some reality in the plea set up. It is well known and accepted by our profession that there is no insanity without a diseased brain: "a corporeal disease is the best and only true test of insanity."* If the brain and nervous system are in health, the mind can and does perform its functions, and no act performed by the volition of that mind should be separated from responsibility. Now, as the moral feelings and the intellect are both made evi- dent by the organ—the brain, it is obvious that when the brain is * T. M. Reese, in trans. Am. Med. Assoc'n, 1857. 14 attacked by physical disease, both judgment and moral sentiment will suffer. We can in no way separate intellectual operation from moral feeling, they work healthily together, and they become diseased together. The supposition that there exists a form of insanity which affects only the moral sentiment, and leaves the judgment free, has arisen among phrenologists who affect to have localized the seat of every mental perception and emotion, and would have us believe that these operations going on in different portions of the brain may be- come diseased without effecting the others. These false views have no foundation in fact: if you desire to benefit humanity, you will dis- card this pernicious philosophy from your thoughts, and resist the spread of such a dangerous delusion as that a man may be sane in his intellect, but insane in his moral sense. If such a plea as this be al- lowed to relieve a man from the responsibility of conduct especially vicious, you may reasonably ask where is the line of distinction be- tween crime and disease to be drawn ? " If it be said that the impulse to commit murder is the result of a disease of the moral pro- pensities, you will afford a ready and convenient palliation and excuse for the most heinous offences. Society will no longer be safe. The prospect of punishment will not deter men from crime. The person disponed to murder may reason himself into the act under the belief that he will be pronounced a moral maniac and thus escape the con- sequences. Do not hesitate to denounce such alleged cases of moral insanity as cases of moral depravity." * Hold the mirror boldly up to nature and show society that the cultivation of intellect alone, with- out a religious culture of the moral feelings, must produce an une- qually balanced mind; that in the same individual we may find the brightest coruscations of intellect with the greatest moral destitution, and that we are continually, by our condition of society, producing such one-sided individuals. The constant state of mental excitement, the rapid approach of prosperity, the tendency to follow pursuits only which lead to wealth, and to implant that education which points to fortune, the desire of the youth of both sexes to cultivate that read- ing which stimulates the happiness of the senses; our sensation novels, sensation newspapers, sensation operas, and sensation preachers, all evidence the love of excitement. An intellectual fermentation without a true ferment, turns every change into moral destruction, and hence it is that men guilty of the grossest infringements of the rights of man, committing acts which * Reese, ibid. 15 show a total absence of moral rectitude, are defended in open court, and often shielded from the punishment justly due to them, by the plea of moral insanity. Once acquitted, they receive the congratula- tions of their associates and become the heroes of romance. Their turpitude is rewarded and their course, thus approved by society, proceeds onward and downward, until checked by an opposition equally wicked—a private feud accomplishes what justice hesitated to perform—we are rid of a burden and gain temporary respite until the scene is repeated with a different dramatis personse. Gentlemen, in going abroad from this Institution, you carry with you the good wishes of all of those who have shared in your educa- cation. On the part of my colleagues, I present their earnest desires for your professional success; that you may enjoy the good esteem of your medical brethren, and above all, that you may possess that * * * jewel which no Indian mine can buy, No chemic art can counterfeit. It makes men rich in greatest poverty; Makes water wine, turns wooden cups to gold; The homely whistle to sweet music's strain. Seldom it comes—to few, from Heaven, sent; That much in little—all in naught—Content.