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DELIVERED AT THE ANNUAL COMMENCEMENT
V
1
GEORGETOWN  COLLEGE
Br Thomas Antisell, M  D.,
PROFESSOR OF MILITARY SURGKRY, PHYSIOLOGY, AND HYGIENE.
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    WASHINGTON, D. C.
ifBSON BROTHERS,  PRINTERS
         18(54.
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DELIVERED AT THE  ANNUAL  COMMENCEMENT
GEORGETOWN    COLLEGE.

           By Thomas Antisell, M. D.,
   PROFESSOR OF MILITARY SURGERY, PHYSIOLOGY, AND HYGIENE.
     WASHINGTON, D. C.
GIBSON BROTHERS, PRINTERS,
          1864. 
                                    Georgetown, D. C,  March 3, 1864.
SIR —
  The undersigned, on behalf of the Students of the Medical Department of
Georgetown College, appreciating the value of your Valedictory delivered  this
day, respectfully request a copy thereof for publication.
                             Very respectfully,
                                   J. M. D.  FRANCE,
                                   K. D.  WRAV,
                                   FRANK S. WALSH,
                                   SAMUEL HOLMAN,
                                   EI)\V. S. THOMPSON,
                                   EDW. MORAN.
THOMAS  ANTISELL, M.  D.,  Professor  of  Military  Surgery, Physiology.
                             and Hygiene.
Committee.
                                    Georgetown, D. C, March 4,  1864.
GENTLEMEN,—
   In compliance with your request I have the honor to forward the copy of
the Commencement Discourse, and  at  the  same time  to express  my  sense of
the honor conferred, and the gratification which it affords me  in learning that
you have deemed it  worthy of publication, and remain, Gentlemen,
                                  Your obliged,
                                           THOMAS  ANTISELL.

To Messrs. France, Wray, Walsh, Holman, Thompson, and Moran,
                             Committee of the Class of Session 1863-4. 
                        ------000------


Gextlemex of the Lkaduatixu Cla^s of 18(58-4:

   Having devoted the allotted period of Medical Study, and
fulfilled all  the requirements of the Medical  Faculty, and
having been subjected to a series of examinations  intended
to test the  amount of your knowledge, you  have now re-
ceived the  highest  honor it  is in the power of this or any
University to bestow- the degree of Doctor in  Medicine.
   All scholastic connection between the Faculty and the late
student now ceases^ and your time, talents, and opportuni-
ties are to be occupied with  the  battle of life  on  becoming
the members of so honorable and liberal a profession.
   While, to the Professors, this is but the return of another
season in which a few young men are added to the ranks of
practice, to you it is an epoch surrounded with circumstances
which never presents itself to you again, and on this account,
in accordance with time-honored custom, a member  of the
Faculty addresses you with remarks pertinent to the occasion.
   You will be called upon  to perform very serious duties  in
life.   You become the guardian of the race, ushering weak
and puny humanity into the busy world, watching over the
childish and  adolescent years ; upholding manhood from the
destructive influences around ; and when you can no longer
preserve life, it is yours to alleviate the sufferings which ac-
company the shuffling off of this mortal coil.
   You have social duties, also, to perform.  You will advise
the public in all matters relating to health.  You are to aid
the law in deciding points of almost metaphysical subtlety
regarding aberration of the  mind ; and you have the regu-
lation of the hygienic conditions of  armies, fleets, and even
of the whole  nation.
   It  is scarcely possible to conceive of duties  more serious
than  these ;  duties which, to perform well, needs the culti-
vation of all your powers for a life of integrity and usefulness.
   Being, as we trust, prepared for this duty of  life, it is not
proposed before this goodly assembly to lecture you on any 
                           4

strictly professional topic ;  and  on the present occasion 1
shall, therefore, occupy your attention by laying before  you
a historical sketch of the method of Education  in  Medicine
at various periods of civilization, and especially  in what con-
sist the true doors of knowledge in your day.  If we have
improved  in old  times in our art it is certainly due to the
accumulated information of the past which has been laid be-
fore us : it was the duty in  that time to study the past.  If
we desire to improve in our day, it is not by the study of the
past, except as a matter of history, but rather by an awa-
kened attention to the improvements of the present.   If we
look back  into the dim vista of an almost fabulous historical
period,  we  find, among the  early  European  nations, as
among  all  barbarous  people, disease  looked upon  as the
visitation  and  punishment  of an  Offended  Deity.   They
believed the world  to be peopled  with picturesque  deities
who inhabited mountains, vallies, and  groves—spirits who
made the  fountain bubble up, or presided over the  growth
of the tree—fawns, dryads,  hamadryads, and nereids.   To
propitiate these  gods  was the only means by which it was
then considered possible to be cured ; and it was the practice
of the sick to visit the heathen temples  and appease  the an-
ger of the god by an offering,  or present a gift  in return for
their recovery.   Along with the gift was handed in  a writ-
ten statement of the symptoms of the disease, with the mode
of cure, which was  hung up on the walls of the temples of
.Esculapius, and  thus was initiated a history of disease or of
medical cases.   Crude and full of error and of superstition
these were no doubt, but still it was the only means then
existing whereby a knowledge of the approach of disease and
of its results could be obtained.
  By degrees the  temples  of  iEsculapius,  or Asdepions,
multiplied, and  the Votive Tablets,  as  these histories were
called, were preserved  for inspection  and consultation by
those who were  supposed to suffer similarly.   The  priests,
who preserved these, were the first physicians.   By  degrees
a set of men, not in the priestly office, made it their business
to consult the tablets, and the earliest method of teaching
was that  where the pupil, accompanying the  teacher,  con-
sulted the Votive Tablets of  those patients  who  had been
cured of disease.
  This  practice  gave a certain experience  to  the teacher,
who gradually drew a practice  round  him of patients  who
came to the Asclepion or temple to consult  him.  In time
each  Asclepion  had its renowned  physician who collected
pupils around  him ; and the Asclepion, in  its mode of in-
struction, resembled very much the modern dispensary prac- 
tice,  where the pupil, after  seeing  a  patient  within  the
building, visited him afterward at his own home until cured.
This mode of teaching lasted  nearly 800 years in Western
Asia and Europe from the time of Hippocrates B. C. 400 to
the period of the  destruction  of the  temples (in which  the
Asclepions were included) at Bvzantium under the reign of
Theodosius in 390  A.  D.
  The Christian spirit of these times was evinced  even in the
closure and destruction of the  temples of the gods.  As  the
Asclepion  had been of acknowledged benefit to humanity,
some  substitute for it had to be  supplied, and  public build-
ings were set apart for the reception of the sick coming from
a distance to consult the  physicians of the cities  ; and thus
commenced the formation of  the  institutions approaching
but not fully corresponding to  the modern hospital.
  During this long period of Asclepion instruction a gradual
change had been going on in the mode of acquiring medical
knowledge.  The  Ptolemies  in African Alexandria were
patrons of all the  art and  science of their day.  Learned
men were invited by them to that city, which  soon  became
one of the shining beacons in the civilization of the Medi-
terranean shores.   Besides  the  large libraries  established
there the Museum  was formed  by Ptolemy Philadelphus, in
which four faculties were taught—Mathematics, Medicine,
Literature, and Astronomy.   The  most  eminent teachers of
that day in Medicine were to be found there, and opportuni-
ties for anatomical instruction  were afforded.  To make  the
education more complete, the Serapion, or temple of Serapis,
corresponding in some degree to the  Greek Asclepion, was
established near the Museum, in  which the sick were  re-
ceived, and persons were admitted to study disease ;  and we
have thus in Alexandria  developed the more complete mode
of instruction, consisting of that given in the  Museum or
College and that  given  in the  Serapion, corresponding to
clinical practice.
  Here a great and manifest improvement in the mode of
teaching was  added by Africa to  the more simple Asiatic
instruction.
  When  the followers  of Mahomet (A. D. 638) entered  Af-
frica by Egypt they overthrew  the worship and the temples
of Isis ;  and, in an unguarded  moment, the Museum was
demolished, the  school of instruction  scattered abroad, and
a library said to have been consumed  in the strife.  The
conquerors strove to replace the ruin, but notwithstanding
the zeal for learning and science displayed by the Arabs, Alex-
andria never recovered her literary position, and the dicta of
Galen, the speculations of Democritus, and the metaphysics 
6
of Aristotle ceased any longer to be  the chief  sources of
Medical instruction.
  On the destruction of the Alexandrian School, Medicine
took refuge with the wandering and exiled Jews.  After the
destruction of Jerusalem the empires adjoining were flooded
by Jewish schools.   The educated Jews  settled in  Alexan-
dria ; and, after the Arab conquest, they kept up the Greek
teachings wherever they went.  But their influence was lim-
ited in time, although spread over the then civilized earth.
Nor were they alone in this work, for, driven out of Con-
stantinople,  the  Nestorian  Christians  carried  away  with
them, and became the depositaries of, the Old Greek Medi-
cal  Science.  " Its great names they revered.  They collected
with the utmost assiduity whatever works remained on Medi-
cal  topics, whether of a Greek or Alexandrian origin, from
the  writings of Hippocrates, called with affectionate venera-
tion by his successors, ' the divine old man,' down to those
of the  Ptolemaic school." *
  These Christians, being more educated than the surround-
ing heathen in  their Medical Practice, were  associated with
the  Jews ; and with these people, by their contact with the
Arabs, spreading into Mesopotamia and  Syria, taught that
wonderful people the value of Greek and Alexandrian Medi-
cine.   But they mingled Oriental Philosophy with their in-
struction ; they inculcated planetary influences and  the doc-
trine of indwelling  and animating  spirits  in everything,
whether living or lifeless, ideas that can  hardly  yet be ex-
tirpated  by the light of a nineteenth century Christianity.
The tendency of the human  mind, when  in its uneducated
condition, to refer all cause and effects not otherwise explic-
able, to the action of powers and influences more than earth-
ly—omne ignotum pro mirabile—is remarkable.  To  do away
with this Hippocrates labored with energy.  When  philoso-
phy first left the temples of the  gods  it declared  that every
thing was either water, air, or fire.  We smile, perhaps, now
at the  seeming childishness  which declared  it, but  it was a
great advance in its day, and by pointing out that an excess
or deficiency of any of these elements constituted disease, it
aimed  a blow at the connection of the worship of the gods
with Medicine, which it never recovered in Greece.  Among
the practical Romans  planetary  influences  supplanted the
anger of the gods as causes of disease.   A passage in Aulus
Gellius, in his  " Attic Nights," tells us that the muscular
fibre grew larger, oysters  grew fatter, and the eyes of cats
fuller as the moon increased, and that they dwindled in like
manner on its wane.
* Draper's Intellectual Development, passim. 
7
   Still later in time the belief in demons, witches, and vam-
 pires superseded the trust in the gods and led to charns,
 amulets, and incantations to preserve humanity from diseases.
   This  excess  of spiritualism  has infused  itself in  Chris-
 tianity under the form of a belief in special  providences and
 of the direct interference of the Deity in the  order of nature.
 This opinion in our own times appears sometimes ludicrously
 put.  Thus Professor Gross, in his American Medical Bio-
 graphy, in describing Dr. John Godman, one of the Medical
 celebrities of the day, states that,  being of the highly unct-
 uous school of Christianity, he was prevented from studying
 Medicine  by the special interference of the Divine Ruler of
 Events,  but  that he  afterwards  reverted to that  pursuit
 through the friendly interposition  of Dr. Davidge.
   Indeed  we are yet scarcely rid of charms and amulets, and
 we have a temple of Isis in every  city, where the  spirits of
 the living and  the dead  can be raised up and interrogated,
 or the soul of  a  table or piano may be so  disturbed as to
 make them take on the power of locomotion.
   The inquiring and   energetic   Arab  adopted   Medical
 Science, and, with  the zeal  of new believers,  pushed for-
 ward its  improvement -with rapidity.   They wTould try and
 disentomb the  deific essence out of every object  in nature
 worth investigating ; they experimented with every thing ;
 they acted on them with acids, which they  themselves pro-
 duced ; they tortured them with fire to draw the spirit out of
 them, and thus Alchemy  was the origin and the first steps in
 the development of our modern Chemistry.  The Arab would
 not only investigate, but he would teach.  When  the Abas-
 sides Caliphs moved to Bagdad they established a school of
 Medicine there, and the world-renowned Har^mn Al Raschid
 not  only  increased  their number  in  the  dominions of the
 faithful, but he wrote to  Charlemagne in Europe, as being a
 wise man  and  powerful monarch, advising him to cultivate
 learning by the establishment of schools, advice which that
 monarch  speedily adopted.
  About the time of the  establishment of the school at Bag-
 dad  the  dissensions among the Mussulman leaders  drove
 them into Africa, and the Emir Abderahman having reached
 the modern Morocco passed over into Spain, and, by easy con-
 quests, brought a large  portion of its  fair  lands under his
 rule; he fixed his capital  at Cordova, and having established
 the practice of opening a school and a hospital in connexion
 with every Mosque,  he at once enlightened that country; he
founded a Medical  School at Cordova, which drew pupils
from and furnished  teachers to a large  portion of Western
Europe :  these  teachers were Jews and Arabs, who  were  in 
8
direct communication with Alexandria and Bagdad.  Medi-
cal authors were translated, and  Medicine never was more
energetically cultivated nor more honorably pursued than
under  the  rule  of the Arabs,  which, extending from  the
Caspian Sea to the borders of Portugal, made Arabian Med-
cine an enlightened and a popular science over an extent of
three thousand miles.
   Here is a picture of the  life of a fashionable and prosper-
ous Jewish physician of the  twelfth century,  given in a  let-
ter of the Rabbi Mosch Ben  Maiemon, a native of Cordova,
but afterwards practising at  Cairo. " I reside," he writes to
a friend  "at the Egyptian capital, and  am in terms of  the
greatest  privacy with the  Grand  Sultan, whom, in the  dis-
charge of my duty, I visit daily morning and evening ;  and
when he or any  of his sons  or  the ladies of the harem  are
unwell I remain in the palace the whole day.  It is, besides,
my duty  to visit  the principal state officers in  their illnesses.
When  I  go to the Court in  the morning and meet nothing
new  to detain me, I return at mid-day to my own house, which
I find  full of Jew  and Gentile nobility and commonalty,
judges and merchants, friends, and even some  who are no
friends, awaiting me.  As soon as I arrive  I  salute them
civilly, and beg  them to allow me to take some refreshment;
and  then leaving the table, I busy myself with inquiring in-
to their ailments, and direct the necessary remedies.  Many
there are who are obliged to  wait until night b&cause the at-
tendance is so numerous that I am occupied with them  the
whole afternoon  ; and sometimes I am so worn out and over-
come with  drowsiness that I drop over asleep  while convers-
ing,  unable to utter another  syllable."*
  The  school at  Cordova had a library of 250,000 volumes,
furnislied by  the  Emir Alhakem 2d,  and so famous  had its
teachings become that in other cities of the Moslem dominion
in Spain  new hospitals and schools were established, and so
valuable  was  this two-fold mode of instruction felt to be that
when Cordova surrendered to the Christians in 1226, and  the
Moors Avere finally driven  from  Spain, the schools of Medi-
cine  remained  and  prospered for nearly three centuries
longer (1512.)   The sway of Arabian Medicine was exerted
for eight hundred years, and, while we cannot praise it  too
highly on account of the  learning of its teachers, and  the
mode of  teaching by experiment and illustration, peculiar
then to that  school, we should perhaps hardly regret that
the causes which led to its  introduction into Europe were
the causes which led to its  abandonment and decav.    The
* Brit, find For. Med. Rev.»vol. xxvii. 
0
migration of the Arab into Africa brought it into Europe ;
the migration  of  the  Turks  to  Constantinople  drove it
out.   When  a weak monarch of a dissolving empire called
upon  Mahomet  2d to  secure him in the possession of the
capital of the Eastern kingdom of European civilization the
warlike Arab entered Byzantium and destroyed the last re-
mains of the  Greek empire of the East (1453 A. D.)
  The Greek learning and the Christian hospitals which had
been established in that city then suddenly disappeared ; the
learned  men  emigrated into the more westerly kingdoms of
Europe, joined the schools which  had been connected with
the monasteries  and abbacies in Italy, France, and  Spain ;
and the schools of Charlemagne, founded at the  advice of
the Arab, became  the  future University of France—the ri-
vals of the schools of  the  Caliphs, the successful rivals by
reason of a purer teaching.
  It is remarkable of Saracenic  Medicine, as it is called, that
there  never was infused  into it any of the religions of the
Crescent.   When  the  Moslem conquered  he wras generous:
he ceased to persecute.  The spirit of toleration was of the
most  liberal character  in  .Moorish Spain, and  the medical
teachings of the Arabs, after eight centuries of residence,
preserved the evil  traces  of its Asiatic and Alexandrian ori-
gin. ^  As before stated, the poly theism of Mesopotamia, the
pharisaic spiritualism of the Jew, and the indwelling dasmon-
ology of Africa were combined in the school of Medicine of
Spain.  From all  such  ideas as these the followers  of Ma-
homet turned away with disgust, yet, having nothing better
to offer, they permitted the teaching ;  but when the Greek
learning was thrown back on Europe in the fifteenth century,
and when printing had been just adopted,  the teachers of
medicine saw at once the superiority of the old  Hippocratic
medicine over Galen and Avicenna, and from that time for-
ward, even in the schools of Spain, the old school prevailed in
doctrine while the  Arab method of teaching was  incorporated
therewith.
  Hippocrates had taught that the immediate causes of dis-
ease lay not in the anger of an offended Deity but in the hu-
man constitution ;  that the latter was liable to change by
exposure to external agents ; that it was modified by climate,
season,  and mode of life, and not by visitations of a Superior
Power.   He  separated Pagan Theology from .Medicine, and
taught his disciples to examine the frame itself for mutations
of health ; he taught them blood alterations ; blood poisons:
critical  days and  expectations of cure within  the system.
How different this from the Syrian notions of diseases being
produced by  the entrance of spirits and devils into  the sick ; 
10
 of exorcism and the capability of controlling  the evil spirit
 of a disease by the more powerful influence of a planet!
   Hippocrates  never troubled  his followers with the nature
 of disease ;  he  described rather the course  and the termina-
 tions of the illness than busied himself with imagining rul-
 ing influences.   The revival of his  mode of teaching in Eu-
 rope happily gave a new impetus to medicine by making men
 more solicitous  about the outer aspect <jf nature rather than
 busied with her inner movements.   The arbitrary conceits of
 the Galeno-Arabian  school were banished from science, and
 replaced by the surer harvest to be gathered from actual ob-
 servation  as directed  toward  the  development of abstract
 truths or laws.
   I cannot quit the subject of  the influence of  the Arabs on
 Medicine, and  the improvement in  the  mode  of teaching
 adopted by them without contrasting that people with those
 whom they conquered ; and  what  a  lasting benefit to hu-
 manity their invasion of Spain has been.
   When the Moors crossed over the  Straits of Gibraltar they
 found the natives of  Spain, like those of the rest of Europe,
 sunk  in barbarism hardly  emerged from  the  savage state,
 uncleanly in person, benighted in mind, inhabiting huts, in
 which it was a mark of wealth  if there were bulrushes on the
 floor  and  straw mats  against the  wall ;  miserably fed on
 beans, vetches,  roots, and  even the bark  of trees ; clad in
 garments of untanned skin, or, at  the  best, of leather, pe-
 rennial in durability but not conducive to personal purity, a
 state in which the pomp of royalty was sufficiently and satis-
 factorily manifested in the equipage of the  sovereign, an ox
 cart, drawn by  not less than two yokes of cattle, quickened
 in their movements by  the goads of pedestrian  serfs whose
 limbs were  wrapped in wisps of straw: such was the people
 who were conquered.*
   On the other  hand the Mahommedans, when they entered
Spain brought with them all  the luxuries  and the "tastes of
 Asia; they built splendid palaces of a noble architecture,
 with polished marble balconies and orange gardens attached;
courts  with cascades of water ; shady retreats for the heat
of the day ;  retiring rooms, vaulted with stained glass, over
which streams of water trickled; walls and floors of exquisite
 Mosaic ; fountains of quicksilver in apartments ventilated by
air drawn across flowers ; hypocausts or  air furnaces for win-
ter ; walls adorned with arabesques  and paintings ;  chande-
liers of colossal  size hanging from the ceilings ; pilasters of
verd antique crusted with lapis lazuli ; furniture of sandal
* Draper's Intellectual Development of Europe. 
11
and citron wood, inlaid with mother of pearl, ivory, silver,
and gold ;  vases of rock crystal and Chinese porcelain ;  Per-
sian carpets on the floor ; warm and cold water pipes in mar-
ble bath rooms ; whispering galleries for the women ; play-
courts for the children, and grand libraries for the master
himself.  The Khalifs of Cordova were the patrons of learn-
ing, and set an example of refinement  strangely in contrast
with the condition of the native European princes.
  Cordova under their rule, when at its highest prosperity,
boasted of more than two hundred thousand  houses, and
more than a million of inhabitants. After sunset one might
walk through it in a straight line for ten miles  by the light
of the public lamps at a time when for  700 years after there
was not so much as a public lamp  in London.   Every street
was paved ; nor was this  civilization  confined to one  city.
Granada, Seville,  and Toledo were the  rivals of Cordova.
At  this time not  even a  palace  in Christian  Europe had
either a window or a chimney.  Loop-holes let in the light:
a flag-stone on the  floor  was the fire-place ;  the  soot and
colly begrimed the faces of the occupiers  of the apartments,
and a low doorway, under which  you  stooped on entrance,
was the only door  or protection from the  cold.
  In Spain the Arabs established manufactories of silk, cot-
ton, and linen ; all kinds of textures from looms, ornamental
jewelry and filigree work ; they planned ornamental gardens,
artificial fish-ponds, and aviaries of rare birds.
  They were cleanly to a fault.   They taught Europe the
habit of changing  inner garments.  In fine, whether in peace
or war, in letters or in science, the Arabs left their impress
of refinement,  which  has  been handed  down  to  our  day.
They regulated their agriculture by law, and introduced new
plants into use;  to  them, along with  a thousand  other
things,  we owe the introduction of cotton, sugar, rice, and
silk, gunpowder, and artillery, and, above all, the mariner's
compass.
  One can scarcely look  on these  two  pictures without re-
gretting the course of events which ended in rolling this
people back  again into Africa, and without wonder at the
result.   Their civilization disappeared  along  with them-
selves, and that part of Europe occupied by them relapsed
into its primitive  barbarism, from which  it has  not yet
wholly recovered.
  Since the days of Moorish .Medicine  down  almost to our
own time, the methods of teaching have not altered. They
are still those of the college and the hospital—they are es-
sentially Saracenic, oral and demonstrative.  In our time an
additional method  of instruction has crept in. 
12
    Absorbed in the old system of teaching, and listening ex-
  clusively to the lecturer, a careless  observer may forget the
  new power which  has sprung up in our midst since the com-
  mencement of this century, and bids fair to alter in a re-
  markable degree the science of medical teaching.  That revo-
  lution is impending, has already begun ;  but with so  silent
, steps advancing Ave  may perhaps under estimate  its  extent
  or importance.
    Time was as yesterday to a few of us in which the  influ-
  ence  of  the periodical press  on the state  and progress of
  Medicine was so fitful and equivocal as to be hardly worth
  the labor  of editing ;  bulky volumes were  produced occa-
  sionally,  which adorned  the  shelf  of  the  possessor.   The
  labor of years of experiments was delayed in publication until
  the whole was completed and published as one work.   The
  quarterly, monthly, and weekly medical serials had not  as
  yet appeared.   It was  not deemed  reputable for  a man  in
  large practice to come  before the world as an editor or con-
  tributor to these periodicals.  When Mr. Wakley first started
  the Lancet in  London the  proceeding was looked upon as  a
  ruse whereby power might be obtained by an individual for
  his own advantage, and not as a means of educating medical
  men to the standard of the day—just as at the present time
  we should look upon the efforts of that physician who desired
  to succeed in his profession by entering the common council
  or joining a church society.  The medical press, thirty years
  ago, hardly produced articles of daily or hourly necessity.
  Its reading did not run in lines  of direction useful to  prac-
  tical  men.  The teachers and lecturers held aloof from it.
  and hesitated to take advantage of the additional influence
  which this publicity gave them over the medical mind.
    But this mighty never-ending engine of man's most en-
  during labor  is irresistible in its effects.  Fed by hundreds
  of able minds in  our  profession, and directed in  its  move-
  ment by the most skilful  of our master craftsmen,  it has
  become more  influential than the school, because more uni-
  versal in its teaching.  Who is he now who never reads,  or
  ignores the journals, but the most audacious of idlers or the
  veriest of simpletons.
    The finest medical minds do  not  hesitate  to  publish, for
  they know that the mass of practising medical men are their
  pupils for the time, and willing  to receive their instruction,
  provided  it is brought  home to them.  A Cooper, a Velpeau,
  or a Gross, a Watson, a Rokitansky, or  a Clark, can thus
  address the whole  world of practitioners as it were, and thus
  the press  adds another link to the chain of medical brother-
  hood  which binds the  profession together  over the  whole 
13
civilized globe.   Could the most eloquent of teachers in the
halls  of our  colleges attain  one tithe  of that usefulness?
The schools of Paris, of Edinburgh, of Tubingen, Dublin,
and Giessen of Munich and Vienna have in their turn  at-
tracted  crowds of hearers by  reason  of the celebrity of the
teachers ; but the utility and renown of such localities are of
limited  extent and duration, while the  journals of our day
collect and preserve  the most  valuable current  information,
carry it to our very doors and offices, and deposit it for future
use.  The press, then, is  a  teacher  and a chronicler of no
mean power.   In order  to contrast fully these two modes of
instruction, that by the press and  that from the theatre, let
us suppose that one or other of these be suddenly suspended
in its operations, and what would be the result?
  Suppose that in this country one or two of the most emi-
nent  medical  schools closed their  doors, or even  should  all
the Medical Colleges of  the country do so, what effect would
it have on Medical practice ? The profession for its education
would fall back on the practice of sixty  years ago, when the
pupilage was  more extended  and  its results more valuable
than  now ; and  if then able  surgeons and physicians were
developed  under its influence how  much  more  at  present
when by that occurrence of no collegiate teaching, the Medi-
cal press would  still further augment its utility and supply
the deficiency.
  If every lecture-room  were at once and finally closed upon
its class, journals and hospital practice remaining, would any
harm come of it? would learning  and instruction  cease?
would there be one teacher, one pupil the less ?   The talent
shut out from the lecture-room would show itself  as usefully
and more extensively by the  opportunities of publication ;
and it is  most certainly true  that  the collective interests of
Medicine would  not suffer,  and  that  the  public at large
would more likely be the gainer.   Perhaps to the pupil it
would be a large gain.  The money paid to teachers now
would  then  go for  purchase  of books, plates, microscope,
chemical apparatus  and other appliances ; and always sup-
posing him well inclined and well directed  the absence of a
school would be no loss to him.
  On the other hand, give us all  the existing schools and
take  away the medical press, and who are reached by our
teachings? Students chiefly.  A few practitioners perhaps in
early life would return for some special  light or benefit ; but
the large mass of medical practitioners, occupied fully with
their daily duties, unable to attend, and having  nothing to
recall or renew  their education now  slipping away from
them, by degrees would, at  the close  of their life, be less 
14
useful members  than at the  beginning.   The  individual
Physician would not be benefitted, and the public would cer-
tainly be  the loser by the lowered  standard of the Medical
attendant.
  The teachings of Medicine are,  then, accomplished by the
joint aid of the Hospital, School and the Press ; nor is  this
conjoined  mode of education peculiar to Medicine ; it is found
creeping in and  intruding in  arts and in religion.  The
preachers  of our day are continually deploring the apathy of
congregations and the paucity ©f listeners to their discourses;
the press has become their rival also ; and since the public
may sit at the feet of a Chalmers and other illustrious dead,
at their own firesides, they may  possibly  prefer  their pro-
ductions to unwinnowed and tame  discourses of the living
preacher—discourses such as the Rev. Robt.  Hall  had in his
mind when he uttered his famous stricture upon the preach-
ers of his  day:   "The best passage,"  said he,  "in many a
sermon  is the passage from the pulpit to the vestry."
  While there  are some  branches  of Medical  instruction
which can best be learned in  the  theatre and by oral in-
struction,  as Anatomy  and Chemistry, and some by close
observation in hospital, as practical  Medicine and Surgery—
there are  yet others which can, perhaps, with more advan-
tage be mastered by the student in his room and from books.
" Art is long and life is  short," says Celsus ; and our stu-
dent  life  is shorter still.  It is not possible to teach more
than  the  mere elements  of some departments of Medical
knowledge, and some have to be omitted altogether.   Some
parts of Medical  learning are  not  at all embraced  in  the
curriculum, such  as Insanity, and until very lately Hygiene
and Medical police.
  By stepping in to supply the deficiency  in education, the
press, then,  has  to some extent become the  rival of the
school, and has taught many branches hitherto confined to
schools both more effectively and  economically.   But has it
vet  superseded the school? Far from it.   Within this cen-
tury, too,  has been adopted from Europe a system of clinical
instruction, the instruction at  the bed-side,  the most valu-
able, the most practical of all, which cannot yet  be taught
in books.  And  perhaps it never will supersede oral instruc-
tion.  As medicine advances mechanical and physiological
appliances come  to  its  aid, and  as the use of  these imply
skill in manipulation their use is  so much additional neces-
sity for the occupation of the teacher ; no amount of descrip-
tion will teach  the use  of the  stethescope practically—the
laryngoscope, opthalmoscope, or the microscope.
  If more than the  merest smattering of Chemistry be de- 
15
manded, the Student must place  himself under  a teacher,
lor no amount of reading can communicate that knowledge
which enters by the eye and appeals to that sense alone.
  The University of London was established about the com-
mencement of the second quarter of this century to  grant
degrees  of medicine to all  applicants who, upon examination,
came up to a  certain  standard  of education.   It mattered
nothing where the medical learning had  been obtained or
whether the candidate  had ever been inside the  walls of a
medical College.  He might have learned  his chemistry in
a mining  school,  and his anatomy in a zoological Museum,
or a school of art: the  information was  all that was re-
quired.  To students of  such a character the journals and
the press became their chief and  in some cases  their only
guides and educators.
  Another object which was hoped to  be accomplished by
the establishment of the University of London was the total
separation of classical learning from the curriculum of Medi-
cine.  The absurd waste  of three  or four years  spent on the
dead languages was  at once abolished in that institution ;
and last and not least the total separation of the educational
privilege from that of granting  diplomatas.  In this respect
many of our  Colleges  in this  country might imitate the
English example.
  Medicine is  an universal science—it is cosmopolitan, and
valued everywhere—and in its advancement, while we start
from the leaning handed  down through Greek, Roman and
Arab, we have received, and are receiving  yearly great and
wonderful  additions and improvements in our Godlike art
by the cultivation of the science  in every civilized tongue :
and fully to improve the advantages thus offered, is to be an
educated physician.   While it is  always a matter of regret
that an  ignorant man enters the ranks of the profession, the
proper nature  and extent or standard of education has not
been so  equally accepted.   Up to the second quarter of this
century  the classical scholar (as it is termed) was held to be
properly educated to commence medical studies ;  that is the
college degree in  Arts  was prescribed as the preliminary in
the old Universities ; but the immense development  of ex-
perimental science since 1840 has called for some  acquaint-
ance with  it rather than with  ancient classics in order to
understand medical science ; and if we desire to know in
good time what is actually going  on in Europe in medicine
or any other science, we  must read the journals  in the ver-
nacular, and thus the modern languages become of more im-
portance to the medical men than the dead.  I have always
thought that it would be  desirable if some amount of infor- 
16
 mation on these two subjects—that is. Experimental Philo-
 sophy and Modern Languages (French and German) were
 required of pupils before matriculation ;  and our Universi-
 ties ought to recognize this necessity by modelling a degree
 in philosophy which would imply the cultivation and teach-
 ing of modern science within their walls ; this degree might
 be required as a necessary preliminary to graduation in the
 Doctorate. Such a degree should imply a thorough English
 education, attendance on courses of experimental philosophy
 and a proficiency in French  and German languages ; and
 this I  believe to be the proper basis on which to raise  the
 medical curriculum.
  Gentlemen, it has been customary on occasions like this,
 in adding the last words, to  speak something of honorable
 conduct,  to  be  guided by  religious  feeling, of industry,
 which, in proportion as it is exerted, will produce its reward
 by  giving you enlarged and remunerative practice.   I omit
 the first of these because we have neither taught you ethics
 nor religion, and we  commit you in these  matters to the
 world and the guidance of your own hearts, and with re-
 gard to the second, the less that is said on that the better, as
 at the best they would be but the weak reflex of home taught
 truths and prayers.  The statement that success follows ex-
 ertion and crowns merit, is a dogma that cannot and  never
 will be true ;  it denies all earthly experience, it flouts a re-
 vealed hope, and it unteaches truth.  We can only tell you
 it is the duty of  life to work—to work that you may live—
 that without full store of knowledge you have slender chance
 of success, and that stocked with industry you are ever ready
 for  success;  and  that  there is also another law, the which
 neglected, greatly to succeed, is miserably and in truth  to
 fail.  We also  desire that  you will ever preserve a kindly
 regard for your past  teachers as your future friends, and
 guard the reputation of this University with a jealous eye,
 as being identified to  some extent with your own, that you
 will add  to its lustre by your own good name, which you
 will never be induced to forfeit, from a love of popularity, a
feeling of selfishness, or the hope of gain. 
 
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