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ANNUAL  ADDEESS
CANDIDATES
   DEGREES AND LICENSES,
              IN THE

MEDICAL INSTITUTION OF YALE COLLEGE,

         JANUARY 20, 1847.
BY RUFUS BLAKEMAN, M. D.,
 MEMBER OF THE BOARD OF EXAMINERS.
  NEW HAVEN.
WILLIAM H. STANLEY, PHINTER.
     1847. 
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ADDRESS.
  Gentlemen:
       I am called to address you at a period of your lives,
probably more interesting and momentous than any through
which you  have as  yet passed.   Hitherto your career has
been circumscribed within that vestibule of life, which leads
to the more exciting  scenes, in which you will soon mingle
and participate.  You have now arrived at that threshhold,
from which another grade will introduce you as actors on a
stage, of which you  have been only Spectators.   Although
you have doubtless been occasionally associated with the
actors in these scenes, yet  their cares and  responsibilities
were not yours; nor  were  the difficulties,  which  occasion-
ally perplexed and embarrassed them, sensibly felt by you.
It is not to be presumed that  during such intercourse, you
could have acquired  that discipline, which a more immedi-
ate interest would be likely to impart, or such as emergen-
cies, to which you will now be subject, must necessarily im-
pose upon  you.  It is incident to your present stage of pro-
fessional life to be buoyed up by the confidence of hope, and
many of you may regard success in the untried field before you
as hardly problematical.  Such zeal and confidence, when
predicated upon a just estimate of character and qualifica-
tion, afford a guaranty of success.   But in  connection with
these buoyant  anticipations let  it occur to you,  that many
have commenced their professional career with hopes equal-
ly sanguine, who have failed to reach their anticipated goal.
They  encountered  difficulties, which their fancy sketches 
4
failed to delineate, and which therefore became  stumbling
blocks, over which  their hopes  were prostrated.  It is
therefore no unfriendly hand that points you to these diffi-
culties, that you may be prepared, if not to avoid, at least
to meet and encounter them without being disconcerted.
  Permit  me then,  as having preceded you, to  allude to
some of the embarrassments which are (I may say) the nat-
ural offspring of the  medical profession; while at the same
time I suggest the  kind of preparation which  is required
successfully to meet the emergencies incident to its practice.
Your time has hitherto been employed in preparation for the
extended  theatre before you.   Your  associates in similar
pursuits have been the indulgent spectators of your actions
and progress.   You have been employed in the investigation
of the intricacies of organic structure, with its wonderful
manifestations.   Its derangements, constituting the greatest
variety of diseases with their causes, have  been portrayed,
their different phases noted by the delineation of the symp-
toms characterizing each; and  your  attention  has been di-
rected to the agents reputed as efficacious for their removal.
In your progress thus far, you  have had as ready counsel-
ors, the illustrious dead, and the distinguished living, to aid
and direct you in the difficulties  occurring in the  investiga-
tion.   But far different are the relations which you are here-
after to assume.  Notwithstanding the same aids may be ac-
cessible, emergencies will not unfrequently occur, to meet
which all your acquirements will need to be available.  Cases
will often present, where neither books nor counselors will
be at hand to direct or sustain your decisions.   In such cases
the spectators of your actions will most probably be, either
those having the deepest interest in their results,  who will
be  ready  to bestow  applause or censure, as they may judge
your conduct merits, or a more indifferent public, who will
scrutinize all your acts, with the view to determine whether
you are entitled to their confidence and support.   Occasions
will occur, when it may be in your power to exhibit the tri- 
5
umphs of science in its contests with  disease, and the con-
sequent alleviation of human suffering.  In such.case  you
will obtain a rich reward, as well from the indulgence of your
own benevolent emotions, as from the tribute of gratitude
which both patient and friends will most likely bestow.
But alas! on the  other hand, you will too  frequently meet
with instances, where with all  the resources of the healing
art, you will be able to impart to the sufferer and solicitous
friends little beyond the melancholy solace, that your utmost
efforts will probably effect no more than a prolongation of
diseased existence, or an alleviation of suffering during an
inevitable progress to the tomb.  Occasionally diseases  will
embarrass you, by the complexity or obscurity of their symp-
toms, such as your reading or knowledge of the animal func-
tions will afford but an imperfect guide for the  development
of their character or location.  In such cases you will be
compelled to a prompt investigation of temperament, idio-
syncrasy, or  the   peculiarities  of nervous structure on the
living page before  you, for a satisfactory explication of their
phenomena.  Not unfrequently will all your  resources be
taxed, and the moral and physical energies of your charac-
ter be called in requisition, in  cases of imminent peril to
your  patient, where anxious  friends are noting  each word
and action of your features, to  derive therefrom your decis-
ion, upon which impends either hope, or despair.  In such
emergencies your embarrassment will generally  be propor-
tionate to your available resources.  But previous to the ac-
quirement of a degree of discipline, which experience  can
alone impart,  (unless endowed with  an  overweening self-
confidence, which is indicative of superficial acquirement,)
they will tend to discourage and disconcert you.
  You hardly  need  to be informed that the public, ^pon
whose opinion you are more or  less dependent, have a deep
interest in your character; nor that their  confidence will be
cautiously  bestowed  in a  matter  of such  vital concern-
ment as that of life and health.  All candidates for public 
6
favors,  in their novitiate, encounter  obstacles from  this
source;  but lapse of time is sure to remove them, where ad-
equate  genius  and qualifications are  not wanting.   The
young artisan must expect to witness a  preference manifest-
ed by the public, to the more experienced in his occupation.
In the learned  professions, the young  legal practitioner is
constantly reminded that public confidence is bestowed upon
his seniors in experience;  and in the clerical profession, al-
though the youthful preacher often by his powers of eloquence,,
attracts popular applause, yet in matters of more grave inter-
est, a preference is usually manifested for the counsel of the
more  experienced  divine.  If therefore, in the arts and the
other professions, experience is the passport to public confi-
dence, you need not be surprised or disappointed,  should it
be cautiously extended to the young and inexperienced  phy-
sician, however extensive maybe his acquirements.  While
such embarrassments await the young beginner in other pro-
fessions, as well as the medical, it is  not to be concealed
that they attend the  latter in a far greater degree.  This is
unquestionably to be explained, as well from the vital inter-
est which the public have in the results of medical practice,
as from the abstruse sciences which constitute the basis of
our profession, of the undefined character of which  they
are not without some knowledge.  It is an undoubted fact,
that wrhile the professions of law and theology  are based up-
on principles which are obvious  to the reason  and common
sense of mankind  generally, those on which physic is found-
ed, are in a great  degree undefined deductions  from the vital
and physical laws, the intricate nature  of which is too subtle
for complete comprehension by the human mind, even in
its most mature state, and which at most, are discoverable
only in their a  posteriori results.
   While therefore, in common with other professions, you
are to expect difficulties which await youth and inexperience,
there are those which are the specific offspring of medical
science, which will frequently  perplex and embarrass you. 
7
It has ever been the misfortune of the  medical profession,
that the laws governing the animal economy  are  less sus-
ceptible of definition, than those regulating inorganic matter.
Notwithstanding a profound  intricacy  veils  the  intimate
character of the latter, yet such is the  uniformity of their
phenomena, that the physical sciences dependent upon them
have been made to attain a comparative degree of exactness,
while those of  life, upon which  medical science is  based,
have not hitherto yielded a like uniformity in  their results.
The principles therefore governing medical science, must
be considered as deductions from long observation, rather
than from an  intimate acquaintance with the laws of the an-
imal or organic economy.  While affinity, gravitation, elec-
tricity, &c, have each yielded, in a degree, their phenomena
to the  philosopher, the principle of life evades pursuit, by
its  ever  varying and novel operations.   Although  many
of the important laws of life have been revealed, still, the
nature of life itself remains obscure .and incomprehensible.
Were the manifestations of life as simple and uniform, as
are those of the physical  laws, the  physician might now
boast of principles as exact as those  claimed  by the chem-
ist, and natural philosopher.  But in view of  all the multi-
plex varieties presented by organic nature, it is hardly to be
presumed that  its intimate relations will ever be thus ac-
curately unfolded, or be made the subject of exact demon-
stration.
  Such being the state of the medical profession relative to
the sciences upon  which it  is founded, it is not surprising
that the principles by which it is governed  should be less
definite than  those of the  other professions;  nor  that  the
fluctuations to which it has  been subject in the different eras
of its history, should have  occurred; or even that the  un-
blushing pretensions of empiricism should mislead the public
mind, in a science which, least of all, it is adequate to com-
prehend.  It is this subject  of medical  principles—those
principles which are recognized by every honorable and well 
8
educated physician—which I would here  strenuously urge
as worthy your attention, especially at a time like the pres-
ent, when the public mind, perhaps more than at any other
period, is distracted by the various systems presented for its
consideration.   We have too frequently been stigmatized by
those possessing a limited acquaintance with medical science,
(yet of some standing  in literature,)  as a  profession want-
ing those standards, by which those receiving a medical
education are enabled to regulate their practice, with all the
precision and uniformity of the other learned professions.
However unjust this charge, its effects have been to depre-
ciate legitimate medicine in public estimation, and to lessen
that confidence to which it is justly entitled,  and through
which alone its greatest usefulness can be attained.   This
would be an unsuitable occasion, even were it not unneces-
sary, for those (like yourselves) who have acquired medical
science,  to  attempt its vindication from  such  unfounded
charges; yet to repel  the odium, it is proper to state, what
no one acquainted with its true character will deny, that med-
ical science  is based upon principles, which, if not as exact,
are nevertheless received,  recognized and  relied upon, by
learned  physicians, no less than are those of the other sci-
ences.   It would seem,  at a time like the present, when
empiricism in every shape is obtruding its hydra forms, for
the»purpose  of deluding the ignorant and the credulous, that
a necessity exists for our profession to unite in support of its
recognized principles,  in order  to  establish a character, by
which the public may be able to discriminate between legit-
imate medicine, and   the  baleful systems  of  empiricism,
which like the famous misletoe, their authors strive to sustain,
by obtaining an adhesion to the  sturdy trunk of medical
science.
  For the purpose therefore of fixing your attention on these
important facts, and thereby securing your concurrence in a
work so important to  the reputation of our  profession, I
will refer you to its history  for  proof, that at no period has 
9
the general character of true medical science been subject
to the vacillations, by which its traducers labor to disparage
it.  Such history will show, that a uniformity of principle
and  practice  has characterized the  medical  profession,
throughout  the different ages, from that  of Hippocrates
to the  present period.   The  venerable father  of physic
was led by inductive reasoning, as strenuously to embrace
the antiphlogistic treatment of febrile diseases, as do  the
great body  of  the profession at this  period.  His exalted
reputation appears to have established this rational method
among  the  Greeks of his  own, and the succeeding ages.
His  writings,  with  the additions made by his Roman suc-
cessors, Celsus and Galen, became the standards of medical
literature, and  were the guides of practice for a period of
more than fifteen hundred  years succeeding the era of the
distinguished Coan.
   During the  dark ages succeeding the downfall of  the
Roman  empire, in which the epidemic disorders of the im-
agination had  operated  nearly  to the extinguishment of
all the  sciences, we  find  the  rational system  of  Hippo-
crates  preserved and practiced by such distinguished phy-
sicians  as Arabasius,  Numesius,  JEtius, Paulus and some
others.
   After  the entire subversion of the Roman State,  med-
ical  science,  less  depreciated than the  other  sciences,
passed  to the  Arabians, with whom the Hippocratic prin-
ciples flourished, and became improved,  in the  hands of
the distinguished Serapion,  Rhazes, Avicenna,  Albucasis
and  others.   After  being  fostered  there  for a time, it
found  another  refuge  at  Salernum in  Naples; and  on
the revival  of  literature, it  commenced a  general expan-
sion, under the  influence of such Universities as Montpe-
lier, Paris,  Bologna,  Padua, Milan, Pavia  and Placenza.
It is unnecessary to trace the course of legitimate medicine
as exhibited by its historjR  as you are doubtless familiar
with its  progress in the hands of the celebrated fathers, who
                            2 
10
cultivated and improved the science, from the seventeenth
century downward.
  If medical science, during the earlier eras of its history,
failed to attain that degree of exactness of which it now can
boast, it at least has  the merit of establishing for itself prin-
ciples of practice,  which are generally  recognized by the
profession in its present comparatively advanced state.  It
is true  that quackery  and empiricism have ever been the
baleful excrescences of the medical  profession,  and that
they have ever beguiled the public mind, in a degree propor-
tionate to the ignorance  and superstition prevalent  in the
different ages,  and  to the  character and influence of the
promulgators of their systems.  Thus the atomic theory was
the formidable rival of regular  practice in Greece and
Rome, by means of the powerful influence of the Epicure-
an school of philosophy.  The  chemical theories  of the fif-
teenth century, through the efforts and influence of the celebra-
ted Paracelsus, Van Helmont, and others, dazzled the  world
for a season, and led the credulous and sanguine, even  of the
medical profession, to anticipate, not only  that its agents
would be  made effective to antagonize all diseased action,
but that the vital  changes constituting senility were  likely
to be  resisted,  thereby  acquiring for the organic fabric a
degree of earthly  immortality.  During  the   depression of
literature in the dark ages,  astrology, by presenting a  facile
pathway for evading the stubbornness of reason and fact,
for a time  led  astray a large  portion of mankind, in pur-
suit of the  illusions  presented by its magic lens.  But the
re-actions of a rational  science dissipated the dreamy  infat-
uation,  and left it existence only with  the  ignorant and
superstitious.
  The general prevalence and popularity of  such systems,
together with the monstrous and absurd superstitions which
have occasionally  perverted the religious instincts of man-
kind, strongly evince the exislence of  an  element in the
human mind, which  leads it more  readily  to grasp  at the 
11
mysterious and incomprehensible, than to embrace  princi-
ples susceptible  of demonstration.    This trait is  by no
means of modern manifestation, as Galen complained that
his patients were  more obedient to the incantations of di-
viners, than to his prescriptions.  Pliny though not a phy-
sician, alluding to the proneness which the ignorant manifest
for a belief in the miraculous powers of medicine, remarks,
"minus  credunt quce ad salutum pertinent, siintelligunt.v
We need not therefore  be  surprised,  that in a science like
that of medicine, where the manifest recedes into the un-
known, and the physical become blended with the more sub-
tle and  mysterious vital  laws, the  unprincipled  should,
in lieu of the labor of attaining science, entrench themselves
within the  marvelous, and pander to such propensity, with
the view to acquire popular fame and  fortune.
   Although illusion  and  error  have  thus occasionally ob-
scured the  path of true  medical science, yet its undeviating
progress through successive ages, and  the general recogni-
tion of its  merits by the intelligent of this enlightened pe-
riod,  afford conclusive  evidence, that it is based upon that
truth  which it is the aim of the human  mind to attain.  It is
only requisite therefore, to effect the suppression of empirics
and their delusive systems, that its principles should be pro-
mulgated in such manner, that society may be able to com-
prehend  and appreciate them.   This  allusion  to medical
history is made, to impress upon your minds the importance
of duly estimating principles, which have been so eminently
tested  by time  and experience;  and  likewise to warn you
against giving heed to innovations, which pretended reform-
ers of its elements, from motives of  interest  or notoriety,
are perpetually laboring to establish.   Such history  sho vs
that  in all ages,  from Hippocrates  to the  present time,
our profession has  not been without  men distinguished for
learning and  genius,  who,  notwithstanding the  hallucina-
tions which at times nearly  suppressed all the true sciences,
sustained and transmitted the same general principles which 
12
were deductions from their reason and experience—the same
which at this period are recognized as guides to our profess-
ion, both in the investigation and treatment of diseases.
  Ithas been stated that the antiphlogistic method of treating
diseases of an inflammatory character, was that practiced by
the Coan sage, and the fathers who succeeded him.  It may
be added that universal experience has established this as a
dogma of modern practice, from which few  deem it safe to
depart.  It is a remarkable  fact, that notwithstanding the
conflicting theories of diseases of this character, which have
at different periods prevailed in the recognized schools, such
as those of Boerhaave, Cullen, &c, few of their authors pre-
sumed to question the principle by their practice, although
with individuals its application might vary in degree.   The
same may be said regarding the sedative, and the tonic  treat-
ment of nervous affections,  and those of  general debility;
and if conflicting practice occurs among members of the
profession at this time, such  originates mostly in diseases
whose causes are  obscure, rather than from diverse views of
treatment, where such causes and character are obvious.
  I presume, gentlemen, it is  unnecessary to inform  you,
that notwithstanding the acquirements which have enabled
you to sustain the ordeal through which you have passed,
a vast  field still  remains for you to explore.   It will still
require  much patient industry  to acquire the mass of  facts,
which your predecessors have  stored for  your benefit; and
it is likewise due the  profession to which  you belong, that
you direct your investigations  to the further  discovery of
the still intricate laws of life,  and their manifestations both
in health and disease.   I have  remarked  that it is scarcely
to be hoped, that a complete knowledge of the vital agencies
can ever be attained, for the reason that their subtle  opera-
tions cannot  be made  objects of sensible  demonstration.
But the improvements in this  field  already  made, admit a
hope that the day is not far distant, when  the physician will
be able as rationally to define the general  laws  which con- 
13
trol his prescriptions, as the chemist to define the physical
agencies which regulate the affinities of inorganic matter.
It is not however contended, that the same uniformity of re-
sults can  probably be  obtained from the  operation of the.
vital, as the physical laws, in consequence  of the complica-
ted nature of organic  structure, and the combined  influen-
ces which these laws exert upon it.  But  in view of a field
so manifestly susceptible of improvement, it becomes the
duty of all, whose qualifications fit them for the task, to
withhold no efforts which may lead to new  and valuable dis-
coveries in this science.
   Your advancement to membership  in the  profession evin-
ces that you are esteemed adequate to the assumption of its
duties, and that you  are adjudged  competent  counselors to
your fellow men, in matters  pertaining to life and  health.
Your professed avocation will hereafter be to labor for the
preservation of the vital  machine,  when  assailed by  the
perils of disease to which it is made subject.   These trusts
and responsibilities you cannot possibly discharge, nor can
you even escape the charge  of criminal  delinquency,  with-
out incessantly laboring to acquire, and make  available, all
the means which science has furnished  for the attainment
of this important object.  It is a lamentable fact, that  suc-
cess in the medical profession is not always proportionate
to the qualification of its professors.   But notwithstanding,
I will venture to affirm, that no conscientious member, pos-
sessed  of  an ordinary knowledge of the vital fabric, with its
complicated structure, can with confidence hold himself out to
the public as a practitioner, without being furnished with the
ordinary means, which modern science affords, for the correc-
tion of its derangements.   It may be, and doubtless is true,
that  a public unenlightened  in medical  science, may not be
able to detect  the deficiences of the physician; that it
may exonerate him in cases of evil inflicted by his misjudg-
ments, or even applaud where  censure would be  justice.
But let it be borne  in mind by you, that while the intelligent 
14
 hold such  unmerited laurels  in  derision, a  scrutinizing
 moral sense within will not fail to scourge  such delinquent,
 for grave errors, which result from a want  of that  knowl-
 edge, which industry might have supplied.  Ever then bear
 in mind,  (and this I would address as well to the under-
 graduates as to the graduates,) that hours spent in untimely
 amusements,  by the student or  practicing physician, will
 not only be the subject of future regret, but must be attend-
 ed  with danger to those whose lives may be entrusted to
 their charge.
  Such then are the relations and responsibilities which you
 assume, by the reception of the  honors of  this Institution.
 It may not therefore be deemed  inappropriate, particularly
 to define some of your implied obligations and duties, which
 you  owe both the public, and the profession of which you
 are now members.   By these honors the public are virtual-
 ly informed, that you are  worthy of their  confidence and
 patronage in your profession, and that you  possess a moral
 character to which they may with confidence entrust  their
 dearest interests.
  But, gentlemen,  permit me to  admonish you, that this
 announcement  to  the community  will  not  be  realized,
 that  its vital interests will be hazarded, and  that you will
 bring dishonor upon your instructors, and  those who  have
 decided favorably  of your  attainments, should  you  per-
 mit  your  industry, in  the field  of science,  to terminate
 with your  pupilage.  It is  not  to  be presumed, however
 arduous may have  been  your efforts of investigation and
research, that during this  short period, all the archives of
medical literature could possibly have  been explored, and
 made available. Nor was this made the condition upon which
your present advancement was to depend.  The object de-
signed by such term of preparation is  rather the acquire-
ment of the principles of medical science, and their appli-
cation  to  its  practice,  than the accumulation  of all the
facts and phenomena upon which  they are based.  With 
15
such essentials it is decided that you are furnished.  But as
before stated, it will be deemed a culpable dereliction from
that duty, which you owe the public, the profession and your
own reputation, should your opportunities not be devoted to
the increase of your stock of knowledge from such books as
embrace the mass  of experience of your predecessors and
cotemporaries, and also  by a patient analysis of such dis-
eases and their  phenomena, as your own observations may
supply, to endeavor to advance the interest of your profes-
sion,  and likewise that of the public, whose welfare is in no
small degree connected with  your improvement.
   No individual physician, however great his abilities and ac-
quirements, can without  culpability disregard the principles
of practice generally recognized by the profession; nor can es-
sential innovations be adopted, without hazard to his reputa-
tion, and peril to those who may be seduced by his novelties.
It becomes every physician to reflect, that his limited observa-
tion and experience are not adequate authority to allow a  ha-
bitual disregard of general medical opinion, relative to the in-
vestigation and treathient of disease.  This  is a prerogative,
which all pretenders to the healing art assume, and which
unrivaled they  should be permitted to enjoy.  It is to be
regretted, that the medical  profession  numbers  among its
members, those  who arrogate the introduction of new prin-
ciples in medicine, which are claimed as  deductions from
data supplied by  individual  experience and observation.
These often announce themselves to the public as reformers
of the elements of  medical  practice.  But the  object of
such  cannot  be problematical, nor  can  the  position of
that physician be an object of envy, who can descend into
the arena with the quack, and basely contend with  him for
the prize, which  awaits superiority in the art of deluding
the ignorant and credulous.   It is such recusant members
of our profession, and not the mere pretenders, who most
degrade  the  medical  profession in  the estimation of  the
community. 
16
  The intelligent  portion of the  public  are, for the most
part, inclined  to vindicate  medical science,  and to give
their  influence  to  its support.   Although  not intimately
acquainted with the elements of the science, they are en-
abled, from analogies  supplied by the sciences with which
they are familiar, to appreciate the advantages of a med-
ical  education.  But when such witness individuals pos-
sessed of these advantages, disclaiming its essential  princi-
ples, and rearing new dogmas of their own, upon which their
novel practices  are based—their  confidence in the healing
artbecomesessentially weakened, and empiricism is too often
charged by them upon the entire profession.   It is not surpri-
sing  therefore,  that with  such views and  opinions, their
labors and influence should be less active  in our behalf, than
they would be, could there be witnessed  a union of all edu-
cated  physicians in  the support of  principles, by which all
unswerved by interest are governed.   Such evils too man-
ifestly exist, for which no  other  remedy will be adequate,
but that of a  united effort of the honorable portion  of the
profession, with the view to effect a divorce from the unprin-
cipled, who have unfortunately gained a nominal rank among
them.
  I confidently trust that I now  address no individual, so
wanting in self-respect, as to  permit any temporary interest
whatever to seduce  him to the  repudiation of principles,
eminently  established  by time and the  experience  of the
illustrious  of our  profession.  But permit  me to  reiter-
ate the too obvious fact, that the standard  of professional
character is essentially depreciated with  the public, by the
conduct of such unworthy members,  who in  their prac-
tices vie with  the ignorant pretender, in the  arts  of chi-
canery, for the base purpose  of reaping the  fruits which
popular credulity proffers to such recreancy.   Although ex-
ceptions of this character exist, yet the body of the  profes-
sion, with which you have, in a degree, embarked your for-
tunes  and your reputation, is honorable and  high-minded. 
17
 These will cordially greet you as brethren, and will readily
 proffer  their  aid  in promoting your professional  interests,
 provided your characters are such as to gain their confidence
 in your professional integrity.
   Our profession  claims a rank equal with the other learn-
 ed professions.  For the purpose therefore of securing such
 rank with the community, it is requisite that a professional
 self-respect be manifested, by exhibiting to it evidence, that
 honor with integrity is the  governing principle  among its
 members.  It has been remarked, that the  nature of med-
 ical science is such,  that  the  public cannot be  expected
 fully to comprehend its elements.  It can hardly be  hoped
 therefore, that their confidence and respect  can be secured
 for  its  professors, unless  they  harmoniously unite in the
 support of the principles, upon which they  claim their pro-
 fession is based.   Should all, who like yourselves are in the
 incipient stages of professional life,  resolve to effect such
 elevation of the standard of medical character, the work at
 no distant period would with certainty be accomplished,
 and it  is even probable that most of you  would live to
 enjoy such auspicious result.
   In view of  these facts,  it will become you at all  times,
 in vour professional  intercourse, to  act  with circumspec-
 tion before  a  public, which is liable,  from  mis-conception,
 to mis-construe your actions and motives.   While  you dis-
 card those members of the profession, who become recre-
 ant to its principles and honor, you ought to observe  a cau-
 tion, lest such differences of opinion as may occur on minor
 points, in your associated practice, be so mis-construed as to
 appear the result of a science, which  affords no fixed data
 for the guide of its professors.
   Medical science is for the most part based upon the ex-
 perience of the past and present generations of physicians.
 Consequently a medical education is  the  acquisition  of the
 facts thence derived.   But a caution is requisite,  that repu-
ted facts be not too hastily received, however confidently ad-
                            3 
18
  vanced, or however distinguished maybe the authors advan-
  cing  them.  The  physician who hastily  embraces novel
  theories  or opinions, or who is  ready to abandon remedies
  tested by time and experience, for reputed improvements
  the merits of which are known only by the  confidence with
  which they are exhibited by their authors,  must expose his
  patients to  the hazards of a desultory  practice, and also his
  own reputation to the charge of instability and indecision,
 which if less odious, is little less dangerous than confirmed
 empiricism.
   I would by no means urge upon you the necessity of being
 bound implicitly by the trammels of authority; for in a science
 like that of medicine, in which so much remains to be  discov-
 ered,  it is your duty, as its cultivators, patiently to explore
 its fields for their hidden  resources, and  cautiously to adopt
 whatever you may discover  as valuable, or whatever may
 have been  tested as such, by the investigations of your co-
 laborers in  the same interesting field.
   I would be understood in the preceeding remarks as stren-
 uously urging,  that in all  your  investigations and  practice,
 you ought to bear in mind, that you are devoted to a science
 having recognized principles, whose dictates you cannot ha-
 bitually disregard, without incurring the  charge of temerity
 towards those entrusting life  to your care, or without dero-
 gation from the character of the  profession, whose  honor
 and interests you are bound in all your conduct to sustain.
   You require not to be reminded, that your honorable com-
 petitors have rights, which in all circumstances it is your
 duty to respect. Nor, that in the conflicting interests which
will occasionally occur between you and  them, professional
 honor ought ever to be held sacred and inviolate.  By adopt-
ing this as a principle, you will ensure  the respect of all
honorable brethren; which, in addition to a profitable and
elevated  social intercourse, will acquire  for you their valu-
able assistance  and counsel, in emergencies where such may
be required. 
19
   It is remarked by Berkely, that " few men think, yet all
have opinions."  There is no condition in which men are or-
dinarily placed, where thought is more requisite, than it is for
the physician, whether engaged in reading, in the investiga-
tion of disease, or in his medical prescription.   No physician
is justified in prescribing energetically for a malady, without
an opinion formed of its seat and character;  which opinion
ought  to be a well  grounded deduction  from a thoughtful
investigation of its phenomena.  Not unfrequently diseases,
especially those of  organs more intimately  connected with
life, by reason of the extent of their sympathies, will assume
a  complexity which  is embarrassing,  rendering  accurate
diagnosis extremely difficult.   But in the  present advanced
state of pathology, there  are comparatively  few affections,
whose origin and character  may  not be discovered by the
intelligent and observant physician.  He who, without such
careful analysis  of the phenomena of diseases of this de-
scription, as may enable him to judge of their nature, shall
resort  to the exhibition of the heroic class of remedies, will
often have occasion to  repent  his rashness,  by  being com-
pelled to witness results  detrimental to  his patients,  and
which  will be likely  to prove disastrous  to  his reputation
and mental quiet.
   Chorael remarks, that " to do good is the second law of
therapeutics, the first being not to do harm."  This remark
is worthy of adoption as an axiom for the  profession, as ex-
pressive of its chief object, which should ever be borne in
mind by the physician, in  his administrations for health and
life.   In all cases of doubt and perplexity regarding perilous
disease, let me counsel you, to permit no unworthy pride to
conceal, from those interested in the result, your embarrass-
ment;  nor let the jealousy, lest a  professional  competitor
should share with you the credit of a contingent favorable
termination of a case, restrain you from obtaining  such as a
counsellor.  Although in  case of a happy issue, such may
share  with you the laurels, yet in the event of an opposite 
20
result, he will afford  you relief, by assuming a  portion of
the responsibility.   That pride is reprehensible which would
conceal from your patient, or his friends, your perplexities,
lest their acknowledgment should expose  your professional
fallibility;  and that selfishness is most unworthy of profess-
ional character, which permits a grudge,  should a profess-
ional brother participate with  you the credit, and happi-
ness, of having  contributed  to the alleviation  of human
suffering.
   As the possession of elevated  principles of honor, and the
attainment of a respectable degree of science, can alone en-
title a physician to the favorable consideration of  his breth-
ren of the profession;  so  an irreproachable moral character
is requisite to secure for  him the respect and confidence of
the community, upon whose esteem he is at all times depend-
ant.  It is incident to the medical man to witness more of
the phases of human character,  than falls to  the  lot of the
generality of men.  Disease is an agent which divests char-
acter of the artificial disguises which conceal  it, in a degree,
from the public view.  With such divestment it is presented
to the observation of the physician.   In such condition his
relations to the afflicted and distressed often  constitute him
a ready and suitable confidential counsellor, in matters other
than those of a professional nature.   But that physician is
unfit for such associate office, who is deficient in any consid-
erable degree in the moral virtues.
   No scientific attainments  will compensate for  the want of
correct moral principles.  Without these, you cannot acquire
that entire confidence of the community,  which will enable
you to  develop a character for usefulness,   or attain  that
rank which the public are ever ready to award to cultivated
intellect.  Your advantages have been such, that more will
be required  of you by the community, than from  those who
 have been less favored.   Your foibles, if such exist, will be
 more severely  discussed and  criticised;  or on  the  other
 hand, your virtues, if made active, will not fail to exercise 
21
a more general influence  with the society of which you  are
members.
  Permit me then to enjoin upon you, thatwhile you cultivate
science with the view to alleviate physical evil and suffering,
you  do  not neglect that  moral  discipline of yourselves,
which is requisite, not only to make you the physician, with
whom  the public may with confidence entrust their health
and their lives, but  also upon whom they may rely as safe
counsellors, in all matters which concern their  private inter-
ests, or  the good of civil society.
  Although you are to  assume your  station  in society as
physicians, and in that capacity to perform the specific duties
of medical men, yet the  public will have  other claims upon
you, which  you are at no  time to disregard.   You  will be
presumed competent advisers in matters relating to the gen-
eral welfare of society, and your standing will require that
such aid be cheerfully rendered in all cases where it may be
required.
  The peculiar intercourse, which the  physician holds with
the various ranks of the community, qualifies him often to
render more efficient aid in matters pertaining to its welfare,
than can possibly be effected by others.   His  necessary ed-
ucation, his more general acquaintance, and the confidence
ordinarily reposed in the medical adviser, naturally  acquire
for him an influence, which others, though possessing supe-
rior endowments, rarely attain.  The duty then will devolve
upon you, on  passing the threshold where you now stand,
to assume,  not  only the responsibilities  of the physician,
whose professed avocation is the preservation  of health  and
life, but you are  also to become  the citizen, whose duty it
ever is to be vigilant for the civil welfare of the community;
and to  render assistance in  sustaining its institutions  and
burthens, to a degree proportionate to  your ability and qual-
ification.
  You are, gentlemen, about to embark your  fortunes with
that of a profession, such as I have  attempted to portray 
22
 to you;  which if it presents occasional perplexities  and
 embarrassments, also commends itself to your consideration,
 as  honorable and  elevated  in  its general  character  and
 objects,  and as possessing an interest with the public, un-
 equaled  by  any other,  holding temporal relations.  If its
 professors have not awarded to them that degree of honor
 and emolument, which some  in other learned professions
 often acquire in civil society,  they at least may be  assured of
 consideration with all  ranks of the   community, at times
 when disease and suffering render  apparent  the  futility of
 all  conventional distinctions.  A  writer of note  remarks,
 " the medical man is indeed a guardian angel of a family, a
 deity of  health.  If the profession is  not a lucrative one, it
 is a divine one."   Cicero says li nothing brings men nearer
 the Gods, than by giving health to  their fellow men."
  It is a profession (I may almost say) to which the instincts of
 man, have ever resorted for relief from bodily pain and infirm-
 ity, and upon which the hopes of humanity ever cling, when
 assailed  by the imminent perils of disease.  It is a profes-
 sion which can boast of more cultivators of the natural  sci-
 ences than all the others, and which acknowledges  no superi-
 or in its contributions to general philanthropy.  Sir William
 Blackstone remarks " the gentlemen of the faculty of physic
 have the character of general and extensive knowledge, a
 character which their profession, beyond others, has remark-
 ably deserved."
  With this profession, your  interests, your reputation and
 your honor,  are in a degree  identified.  Of its renown, or
 its obloquy, you will more or less  participate.  It becomes
 you,  therefore,  ever  to be vigilant for its welfare and its
honor; and  while you have a care  that it receives  no dero-
 gation from your conduct, your efforts ought ever to be  ex-
erted to correct its imperfections, and to elevate its reputa-
tion.   Bacon says " I hold  every man a debtor to his pro-
 fession, from the which, as men of course do seek  to receive 
23
countenance and profit, so ought they of duty to endeavor
themselves to be a help and ornament thereto."
   You are, gentlemen, about to dissever connections, which,
as the product  of an innate principle  of  human nature,
cannot be effected with  indifference.  You will soon  bid
adieu  to  these  quiet  and venerable  halls of science,  for
which some  of you have acquired  attachments, from long
and  interesting  association,  to a degree that memory will
hold them in affectionate regard, to the latest period of your
lives.  You are about to proffer the parting hand to your
distinguished  preceptors, who  have assiduously labored to
elevate you  to  your present position.   To these you have
incurred a debt of gratitude, which, if coin cannot cancel, it
is in your power  to discharge,  by a career  of professional
usefulness and respectability.  You leave behind your junior
confreres,  with   whom you have long held  pleasant social
intercourse,  who have yet to  toil through the  labyrinth
which you have passed.  These will not fail to be watchful
of your progress, for the  purpose  of directing  their own
course, when advanced  to the position which  you now
occupy.
   Your associates of childhood, to whom you are attached
by the more indelible ties of that susceptible and  disinter-
ested period, you will exchange for others  formed in your
new position, whose professions you can alone test by the
lapse of time, and the  influence of those conflicting inter-
ests which characterize a busy and selfish community.  But
above all, most of you will necessarily separate yourselves
from the domestic altar, where the germs of your character
received development; where the holy instinctive affections,
which originate parental and filial ties, became ripened into
those rational attachments, which no lapse of time, or vicis-
situde of life, will be able to extinguish.  From this shrine,
where  you have derived so much, and participated  so long,
of the purest sympathies of the human heart, you turn to  re-
ciprocate  comparatively  cold  formalities with  a society, 
24
whose greetings and professions are mostly but the effusions
of the selfish passions by which it is characterized.
  To such a crisis in your lives have you now arrived.  You
pass hence to assume your new relations, and  to act a part
in society, for which the past has been  a term of prepara-
tion.  The option is yours, whether that society, with which
you are to be associated, is hereafter destined to hail you as
its benefactors; or whether, in consequence  of evils which
it may receive from your hands, it shall have occasion to de-
plore the connection, and  to  repudiate you as  detractors
from its happiness and welfare.
  Go then, young gentlemen, to your respective  theatres
of action; and may prosperity attend  you in all the  contin-
gencies  which await you in the unrevealed future.  May
your career in life be such, that  when near its termination,
you may enjoy the retrospect of having lived for the benefit
of your generation.  May the cheering  prospect  then  be
yours, that for the good you have achieved in the field of
science, your names will  ever be  held in grateful remem-
brance by those who succeed you. 
 
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