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ADDRESS
BEFORE TEE
MEDICAL SOCIETY OF THE STATE OE NEW YORK.
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By DANIEL P. BISSELL, M. D., of Utica, President,
DELIVERED FEBRUARY 3, 1864.
[Reprint from the Transactions of the Medical Society- of the State of New York, 1864.]
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ADDRESS
BEFORE THE
MEDICAL SOCIETY OF THE STATE OF NEW YORK.
By DANIEL P. BISSELL, M, D,, of Utica, President.
DELIVERED FEBRUARY 3, 1864.
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          ALBANY:
VAN BENTHUYSEN'S STEAM PRINTING HOUSE.
             1864. 
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ADDRESS.
Gentlemen of the Society:
  In the address which it becomes  my duty to read  before the
Society this evening, I shall present some thoughts and facts on
Medical Progress.  In attempting  to do this, it will be neces-
sary for me  to confine myself to a small  part  only of that vast
field which the mention of my subject opens up to view.  For a
full and complete  examination of it I have neither the time nor
the ability.  I am  aware too that much of  what I shall say will
be tame and common place to you gentlemen of the Society; but
to those not familiar  with medical science and literature, who
have honored us by their presence, and perhaps to  others who
may read the record of our proceedings, it may not be altogether
void of interest or information.
  Let me confess here  that I am conscious  of a certain pride of
profession, when I reflect that among such a body of  men as are
collected before me, the word progress does not awaken in a sin-
gle mind a sense of suspicion or of disapprobation.   The dead
past has many lessons for us, but it imposes no law.   Its prece-
dents do not constrain our reason, nor do its  statutes limit our
action.   The records of medical knowledge are still open, and
the achievements of the " divine art" are to-day more than ever
manifest.  We do not merely yield to progress and accept it on
compulsion,  we cultivate it, we welcome it from every source, we
believe in it as a necessity, and as the highest  utility.
  Upon this point  I know we are grossly misapprehended by the
unthinking portion of the public.   They persist in imagining us
to be a sectarian  body, with a doctrinal  system, and tests of
membership.  They suppose us to maintain  a regular  practice, to
be jealous of all innovations, and that we  wage unceasing war
upon all who would bestow benefits on mankind in  a new and
better way.  But we must never tire of impressing it upon the 
4
 public mind that legitimate medicine  has not and  cannot have
 any exclusive dogmas, and that it  does not confine  itself to any
 exclusive agents or class of agents in  the treatment of diseases.
 On the contrary, we  declare  those, and those only, unscientific
 and open to the suspicion of  quackery, who found their practice
 on doctrinal formulas, or who limit it to certain agents or methods
 of treatment.  Such a test  commends itself at  once to a sound
 common sense,  and a right knowledge  of the  unity  of nature
 under all her various forms.
   We know that the  laws of  disease in  man are only a part of
 those laws  by which he exists as an organized being; that the
 laws of his organization are but a part of those which belong to
 all organized matter;  and that  these still cannot be  separated
 from those chemical and  mechanical laws  which  pervade all
 nature, and the systems of worlds.
   These noble conceptions  of science, which form  the basis of
 our  medical knowledge and practice, are  indeed among the best
 results of progress; and the knowledge that the laws of disease
 are  connected with all other natural laws, if it has  reduced  in
 some respects our hopes in regard  to the  cure  of  pathological
 states, it has also improved our etiology and diagnosis of disease,
 and  is guiding us to a more perfect system of therapeutics.  Our
 medical  philosophy, so to  say, is not that proud  and  boasting
 thing which blind experience would make it.   It is neither expe-
 rience alone, nor abstract reason; but it is experience  tested by
 rules and analogies, or universal law.   We cannot say that " like
 cures like," for that like never exists in nature;  neither  can ex-
 perience alone make a law unto itself, nor afford  safe data for
 rules of practice.
   I am well aware that a rigorous following out  or  application
 of scientific ideas has  led into a medical  skepticism  some of the
 best  minds  in our profession.   But the  great majority of our
 members have been able to pause within the limits which rational
 experience  and common sense seem to prescribe.
   Under the light of improved  medical  science, heroism in the
 practice of medicine has given place to a more rational mode  of
 treatment, and nature and art are now united and combined  in
 conducting  diseases to favorable  terminations.  The purely ex-
pectant treatment should only be adopted when the practitioner
fails  to comprehend the true pathological state or lesions which
he is called  on to correct.  It is, when life is at stake, better  to 
5
do nothing  than to  do wrong.  Nature always attempts to pre-
serve life, and if man had not transgressed the laws of his physi-
cal being, the vital force alone would often be his best physician.
But when be transgressed the laws of his moral nature his soul
was sick, and blood was shed to heal it.   So too, the violation of
the laws of  his physical organization brought disease upon him,
which it  sometimes requires blood to remove.  The amount of
blood to be  taken, or the remedies used, and the manner of taking
it away must always be left to the  enlightened judgment of the
practitioner.
   The law  of the human mind, which compels a sick  person to
believe in remedies to cure him, is as  universal as any purely
natural law, and we are forced to believe that it has some legiti-
mate end, from the very fact of its existence.   How pathological
processes can be changed by the agency of medicines we at pre-
sent but imperfectly understand;  but that the difficulty of this
problem has little to do with our practical duties, may be boldly
maintained.
  It is, however, when we turn from the general principles upon
which  medicine is  based, to any one  of  the numerous special
sciences cultivated with reference  to it, that the sure marks of
progress are manifest.
  Pathology, a knowledge of which in the present  day is essen-
tial to the title  of doctor, and all  important  to the practitioner
of medicine, is  of comparatively recent  date.  In the history of
medicine we go back to Hippocrates, who lived more than four
hundred years before the Christian  era,  as  its distinguished
founder.  Previous to his day medical science cannot be said to
have had more  than a shadowy existence. He confined himself
to the study of the various phenomena of disease,  their succes-
sion and terminations, and seems to have  fully  appreciated the
superior value of facts over opinions, yet  he  had but little idea
of the structure  of  the human  body, and  less knowledge of its
functions.   As  illustrating his knowledge  of anatomy and phy-
siology, he considered the brain a sort of gland, which exuded a
viscid  fluid.  Hippocrates, however, is not the only  investigator
who has mistaken the structure and functions of this organ.  His
successor, Polybius, was no more learned, neither were Sy/ennesis
or Diogenes.  Aristotle indulged in a wider range of speculation,
but his ideas  of anatomy, physiology and medicine were rude,
vague, erroneous and fanciful.   'Dtwloo   and  Praxagoras but
                             Muclu 
6
 echoed the ignorance of those who  preceded them;  the latter,
 however, felicitated himself on the discovery that the arteries
 were air tubes.
   It is asserted that Erasistratus and Herphilus, in the school of
 Alexandria, 320  years before Christ, actually examined human
 bodies.  However  the works of Celsus  and Morinus, in the first
 century, do not show material progress.   Galen, of Pergamus, in
 the second century, was perhaps the first of the ancient authors
 who possessed  any proximately  accurate anatomical knowledge
 or ideas of physiology.  His works enumerate the names of the
 brain and sutures of the head nearly  as at the present day.  He
 also divided the vertebral column into cervical, dorsal  and lum-
 bar, discovered some of the muscles and their uses, and set forth
 that arteries contained blood instead  of air in the living animal.
 He  further  asserted the brain to be the source of the nerves of
 sensation, and the spinal cord of those of motion, and traced the
 distribution of most of both classes.  He  described the brain
 and its investments, the lungs, pleura, heart, and pericardium,
 and abdominal organs with tolerable accuracy.  He was the first
 to introduce vivisection with the view of determining  the func-
 tion of organs, and  to take advantage of accidents and diseases
 in men to obtain the same end.  In  two  instances he  was  en-
 abled to observe the motion of the  heart, though  he did not
 reach the idea of the  circulation of  the  fluid in it.   He, bow-
 ever, gave medical science a foundation  which after-ages of
 ignorance did not entirely destroy.   Soraneus, in the same  cen-
 tury, would seem to have examined human bodies, as he described
 with considerable accuracy the female organs of generation.
   From this period to the 13th century we find medicine envel-
 oped in ignorance, superstition and mystery, and the  office of
 the physician connected with that of priest.
   The university of Bologna, established in the 12th, in the 13th
 century had so far advanced as to divide its professors into phy-
 sicians, surgeons, physicians for  wounds,  barber  surgeons  and
 oculists; and Mondine, in this institution in 1315, dissected two
 bodies of females, and in the following year a third. He divided
 the  body into three cavities, the upper or  head containing the
animal members, the lower the natural, and the  middle or thoracic
the spirital.   Mondine here made one step in advance, he believed
the blood flowed from the heart to the lungs.
  Monta^, who died in 1460, made 40 dissections, and Mathew- 
7
de-Gradibus, in 1480, dissected and represented truly the ovaries.    /
Benevieni, of Florence, still later, and Ve/salius in the 16th cen- (v/  y
tury,  following Montagan/ gave continued interest  and great tfl / X,
impulse to anatomical study, and began to foreshadow pathologi-   /   /
cal anatomy.  Benevieni is said to have made 117 dissections, and
to have  sought  to  illustrate medical  theories by the results of   *
these post mortems.   In Ve/salius we have presented the first
comprehensive and  systematic work on anatomy.   Through cen-
turies the superstition of the times prevented the examination of
human bodies ; comparative anatomy  gave but uncertain ideas,
and the knowledge of diseased conditions was entirely out of the
question.
   With the revival of literature, science and  art, the study of
medicine revived, and step by step we can note its progress.  In
1619  Harvey  announced the grand discovery of the circulation
of the blood, and laid the foundation for deeper physiological and  /
anatomical research.   Bartholin, Willis, Malpighi, LeeuwenMck, /'  '^
Ruysch, Wm. Hunter,  distinguished names, now appeared 'upon
the stage, and we have not only discoveries but the commence-
ment  of the study of structures  and organization.  Malpighi, in
this period of medical progress, made  the first investigation into
the skin and secretory glands. Embarrassed by the minute exami-
nations required in the study of  structures, Leeuwenhock recom-  &,
mended the use of the microscope.  Ruysch, the most eminent
man  of bis time directed  attention to morbid as well as normal
anatomy in bis numerous dissections, and introduced plates, thus
fixing and continually recalling morbid conditions, and leaving
behind him the record of bis observations  and investigations in
a form impossible for words to impress.                n
   In  1679 Bonet, of Geneva, published his Sepulchre turn, which
was a general resume of all previous  medical  knowledge, but in
which he made few observations or generalizations.  Up to this
period medical writers produced only curious and isolated facts
in diseases, and all opinions were tinctured with the gross super-
stition of their times.  But a new  era is approaching in which
we have  Valsalva and bis  illustrious  pupils,  Santorini and
Morgagni.
   Morgagni, who in 1682 was a doctor of medicine at the age of
nineteen years, published his first work on  anatomy in 1706,
which at once gave him a rank witb the first teachers and learned
doctors of bis day.   He was the first to establish pathological 
8
anatomy on the sure basis of scientific facts, and may be con-
sidered the father of pathological science.  His long life was
spent in the most  extended and patient investigations, while he
also continued in the active practice of his profession.  He made
no less than 600 dissections, and while thus extending and per-
fecting anatomical knowledge, he directed his efforts  to the veri-
fication or refutation of the existing theories of medicine, which
up to his  day  rested on the superficial and  uncertain foundation
of symptomatology.   He brought the symptoms observed during
life, which he  carefully recorded, to this test.   His great works
on the origin,  cause  and nature of diseases, were  not published
until near the close of his life, and he embraced in them his vast
erudition, the  result of his observations from an extended prac-
tical experience, and the most  careful investigations; all under
the guidance of  a  ripe and impartial judgment.
  From this time  physiology and  pathology began to assume a
place in the schools  and in the profession proportional to their
importance.  About the same  time Boerhave founded the  first
school at  Leyden,  where Haller received  his instruction.  The
latter, afterwards, at Gottingen, poured the  inspiration  of bis
transcendent genius into hitherto  dark fields of research, and
gave signal and enduring impetus to the study of the constitution
of the tissues, and  of the functions  of the varibus  parts  and
organs of  the human body.  These investigations, commended
by Malpighi, Leeuwenback  and  Ruysch, received fresh interest
when touched  by the^iving power of this illustrious teacher and
observer.   He dissected, in the seventeen years he was professor
at Gottingen, 400  bodies, and published many beautiful anatomi-
cal  and physiological plates, as  the result of these studies.
  In 1788  Desault opened  in the  Hotel Dieu, the first surgical
clinique, and carried pathology into this department  of medical
science.  In this now widening  field we have other names  cotem-
porary and in  rapid succession,  which truly adorn and illuminate
the history of  their times, and shed their light down to the  pre-
sent. Bichat, who  gave to physiology still higher rank;  c/rvisart, y
who introduced morbid anatomy, with dissections, int/his lee-/
tures, and by his careful physical examinations of disease  at the
bed-side, gave renewed emphasis and importance to clinical study;
Dup^trjm, his  illustrious pupil,  who, inspired by such a  master
in the doctrine  of pathology, at length demonstrated that the
physiological laws of nutrition applied to diseases,  witb the 
9
modifications which special conditions imply, and opened up the
subject of abnormal products; Wm. Hunter, who in  1754 began
his great work on "the  anatomy of the gravid uterus," which
was completed in 1775, and at once placed him in the front rank
of the anatomists of his time, and  who also established his
anatomical  museum and school in  London, which gave new im-
pulse to the study of anatomy ;  Broussais, author of the doctrine
of inflammation; Laennec, with  his  vital investigations into
phthisis and the introduction of auscultation and percussion ; and
then and since, a host of great men in our  profession, too  nume-
rous to mention in such  an address as this.
  In 1846 we have the first work of that most distinguished and
accomplished pathologist, Jtokitansky, who in learning and labor  / 2?
must always remain the wonder and admiration of men.  A man/
who has based his views and discoveries upon the most thorough
examination  of symptoms during  life, the widest professional
learning, verified and  fortified by the examination of a larger
number of human bodies than any other known pathologist.  We
ought also to mention Bennett, of Edinburgh, Paget, of London,
Todd and Bowman, Virchau, of Germany,  and Clark and Dalton^//y
of our own country;  ana jmat brilliant star, now  rising in the
medical world,  Brown-Sequard.
  An address, embracing even an outline of the developments of
medical science, with  the theories advanced and the discussions
thereon, of the past  150 years, would  not only be  beyond the
ability of the speaker, but would stretch into volumes.
  From the time of Ruysch to the present, medical science has
been largely indebted to the engraver, and iconographic patho-
logical anatomy has grown more and more important. We now
no more think of trusting to the memory or verbal description of
morbid appearances than we would think of doing away with the
record of symptoms and  treatment, and resorting to oral teaching
alone to transmit knowledge.   All must be  recorded.  A work on
anatomy, physiology or  pathology, to be complete, must not only
describe but it must represent.   This department of medical sci-
ence has its embryotic  existence in the dark ages, in the rude
representations of disease, suspended in the  temples of Esculapius,
that the gods might see and heal.  Its development and  realiza-
tion are due to the efforts of Ruysch and others of his day, and
innumerable works since, and  its  perfection  is seen in the very  ^
recent and incomparable work of Ltebert.                       0/

                              / 
10
   But may we not venture to say that the engraver may yet dis-
 appear in this department, under advancing art, and that the sun,
 with its unerring fidelity to nature, true beyond the power of the
 eye  or genius of man, will be called upon to create another era
 of advance, and that we may have photographical anatomy; when
 we  shall  have  the actual  description  or representation of the
 disease, taken in a moment, representing every point, in the pro-
 gress of disease or investigation.
   As the  laws of the vital  functions in health come before those
 in disease, so progress in physiology was necessary before any
 advance in pathology could be made;  and what  mind is there
 capable of grasping, without some effort, the advancement made
 in the physiology of the nervous system alone, within a compara-
 tively short period of time.  From Haller to Draper, and  Paine
 and Dalton of our own day and country, it would  need volumes
 to record  the patient and oft  repeated experiments, the careful
 observations and  the acute analogies which have occupied and
 filled this important space in medical progress.
   Ppwadhe discovery by Charles  Bell of the double functions of
 the  spinal nerves, followed by that of Marshall Hall, showing the
 reflex and independent powers of the spinal cord/  Then the func-
 tions of  the sensory ganglia, at the  base oif  the brain, were
 brought to light by Carpenter, and the unconscious action of the
 cerebrum  was  demonstrated by  Laycock; and now  we  have
 further explanations of the reflex  nervous phenomena by Brown-
 Sequard, and the functions of the cerebellum illustrated by Dal-
 ton.  Close  upon these discoveries  in  physiology, and attained
 by their light, has followed an improved knowledge of pathologi-
 cal states  or morbid changes.  Zeal, such as led S&kitansky, the J?
 great  continental  pathologist, to the  examination of 30,000
 human bodies has been evinced by numerous others in the same
 department of medical science, like Todd in England, iiebert  in (6)
 France, and our  own Clark, to the great  advancement of our 7
 knowledge of disease.
   By the powerful aid of the microscope and chemical tests, the
 very beginnings of morbid action have been traced to the pri-
 mary cells and molecules of organs.   In the nutrition, growth
 and  change  of these cells, we have a foundation for an etiology^
which  need no longer rest on the secondary and blended symp-
toms of disease, forcing us to disguise our real ignorance of mor-
bid action under the cloak of indefinite general terms 
11
  From these advances  in physiology, pathology  and etiology,
wo  come to  their practical  application through  diagnosis and
therapeutics.  Admitting that we have a cell pathology, though
as yet far from complete, to what extent has this influenced and
improved our treatment of diseases ?  I  fear we shall have to
confess, on considering this question, that our general practice
has not kept pace with the advance of that knowledge on which
therapeutics  is based.  This is owing chiefly to the fact that the
bounds of medical science have become so extended as to forbid,
except in a few cases, the perfect union of the scientific inquirer
and the general practitioner in the same person.   The practical
and the scientific, in our profession, are  thus necessarily, to a
great extent, separate ; and I need not tell you, my medical breth-
ren, that the bringing  together what the limited powers of human
nature tend  to divide, is one of  the chief  objects of this associa-
tion.
  Another reason why our practice does not fully correspond to
our advanced knowledge in the science of medicine, is founded in
the effect produced on  it by the popular ignorance and prejudices   .
of the times.  Many of us have  felt that the constant  appeals of'q/.q^t
quacks, of every  genus and species, to all  the/hkiiululo notions of
disease and  its treatment, have almost completely succeeded in
preventing  all true medical knowledge from gaining a foot-hold
in the public mind.  It is also true  that the necessity of adopting
our language as well as our practice in some  measure to  the
popular medical notions of the day, has  greatly hindered many
of us from keeping up  with the  advance of medical science.  To
acknowledge this humiliating state of things in our profession, is
partly to correct it, and I have  touched upon it for that purpose
only.
   Perhaps in  no department of medical  science  has there been
more marked  advancement and progress than  that  which com-
prises the investigation and treatment of cerebral and cerebro-
spinal  diseases.   These nervous affections, and  their name^ is
legion, which have their origin in disordered function, or in lesion
of  the'brain and spinal cord and their investing membranes, are
at  the present day much better  understood and more  successfully
treated than in former times.  This, however, does not result so
 much from the continued observations of these maladies, and the
 application  of remedial agents, as from  the aid  afforded in the
 true interpretation of symptoms  under  the increasing light of 
12
advancing  physiology, and the more accurate knowledge of the
anatomical structure and molecular action in health and disease
of the great central organs of nerve force.  The successful prac-
titioner of to-day cannot  satisfy himself with the study of dis-
eases merely by their symptoms, nor with their treatment, by the
remedies in use by his preceptor, or recommended in the lectures
to which he has listened in the medical school from which he re-
ceived his degree.  Sometimes before the ink is dry on the pre-
scription which he has written, some Dalton, or Todd, or Bow-
man, may have pronounced and proved  his physiological know-
ledge in error, or some Jkokitansky or Brown-Sequard may have
successfully upturned  the  views of pathology on which his pre-
scription rested.   The practitioner of medicine at the present
time must stand, not upon this narrow circle of ideas, but upon
the broad platform of general principles, looking upon and prac-
ticing  his profession as an art, awaiting  in faith and looking in
hope for the  dawn  of that day when not only the  deep founda-
tions but the whole superstructure of the edifice of medicine will
consist of ultimate facts and principles, cemented by an accurate
knowledge  of the  laws and  forces of the animal economy, both in
health and in disease.
  In the study  of the  affections of the  brain and nervous centres,
the causation, pathology  and treatment of insanity have of late
received great attention.  In this department of medical science
and practice, we have not only progress but revolution.   An elo-
quent writer, Falret, in  describing the condition  of the insane
as it existed, not  many years ago, gives  the  following graphic,
and alas for humanity, truthful picture of this most unfortunate
class of the human race.  He  says:  " Considered alternately,
according to the manner of the times, as privileged beings, as
inspired  by Heaven, as possessed by  demons, as sorcerers and
heretics, and even as criminals, they were the objects of the most
absurd superstition, and  the most cruel  punishment.  We  find
them at first  shut up in the sanctuary of the temples, and often
mingling in their ceremonies; again, subject/to exorcism, to the (Si
rack, burned  at the stake; later, banished/to the most  obscure  /
and unwholesome corners of the country,  the hospitals, and even
the prisons—loaded with chains, crowded together or isolated in
cages like wild  beasts, and exposed to the curiosity of the public;
again, abandoned to themselves, wandering in cities and  in the
country, victims of the derangement  of  their ideas and senti- 
13
ments, these unfortunates disturbed the public repose, offended
good manners, and were according to the form and manifestation
of their  mental disease, objects of fear,  contempt,  ridicule or
absurd regard.
  In  this picture we  see  the condition  and treatment of the
insane for  many thousand  years.   Up  to the 18th century but
little  light had been shed upon its pathology or treatment;  and
indeed the views and ideas  pertaining to this subject can  hardly
be said to have taken form so as  to give  psychology a place in
medicine, until within  a little more than half a century.  If the
improvements in medicine had accomplished nothing beyond a
knowledge of the pathology and treatment of this form of disease,
we should even then be proud of  its achievements, but we  have
here  only  one department  of medicine in  which progress has
recently  been made.
  With respect to  its  literature,  there  were some books on the
subject of insanity, but twenty-five years ago there was no  peri-
odical in existance, devoted to mental disorders.   The American
Journal  of Insanity was commenced  twenty-one  years since, in
the New  York State Lunatic  Asylum, and was edited by the late
Dr. Amariah  Brigham, its first superintendent, who  died in the
asylum in 1849.  He was succeeded by the late  Dr. T. Romeyn
Beck, who like his noble predecessor in the editorial  chair, lived
and died in the cause of science and humanity.  Since the death
of Dr. Beck, which occurred in 1855, it has been edited  by the
medical  officers of this institution.  The establishment  of  this
journal was one of the first,  if not the  first, successful effort in
this  direction.  Since  its establishment, similar journals  have
been  brought out in France, England, Germany and in other
countries.
  This important branch of the medical profession has now fully
emerged  from the darkness which so long rested upon it.  Science
has rescued insanity from the domain of ignorance and supersti-
tion;  has placed it among the physical ills of life, a preventable
and curable malady, and has  at length triumphantly realized the
divine mandate, uttered two thousand years  ago, that the  lunatic
be "clothed  and in his right mind."   She has discovered with
aproximate accuracy the causes of the disease ;  has set forth a
clear  and distinct pathology, and in its  cure has  invoked the
noblest elements of  christian charity, and placed its treatment
in the hands of many of her  choicest sons. 
14
  It is with mingled feelings, in which those of pain and sadness
predominate, that I  touch  upon another branch of my subject.
None of us can forget that while we are devotees of science and
proud of our humane art, we are above all, American citizens.
As  such we mourn the fell blow, by which  the national body
politic, fresh from the glorious birth whose pangs are yet in the
memory of living witnesses, vital with the life breathed  into it
by heroic souls, and filled with the blood transmitted from gene-
rous hearts, is laid bleeding and prostrate by parricidal  bands.
Yet we must not repress a feeling of modest pride, in view of the
labor performed by medical men, in the vast field suddenly opened
up by a deplorable war, and of the  great  additions to sanitary
and surgical science which  have  been made during our present
struggle  for  national existence.   It is only by the  discovery of
imperfections that progress in any department is achieved.  Good,
in the moral  and in the physical  world, is rendered possible only
by the existence of evil.  Let us ever be grateful, in the crisis
of our great national malady, whose diagnosis  and treatment
present difficulties of such  a fearful magnitude, that  our  duties
as physicians lie plainly before us, in  harmony and unbroken
union.
  At the beginning of the war, military surgery was little more
than an exotic in this country.   Its principles were derived from
the views and experience of European states, in which the condi-
tion of climate, food and military organization were very unlike
our own.   For these reasons, methods almost entirely new had
to be  adopted, and  untried means put in practice by our army
surgeons.   It is  perhaps not too much to say that military sur-
gery has been created anew in this  country, with a body of doc-
trines, a fund of resources, and a system of practice  equal to the
demand of so important an art in times of war.  But  it is in the
department of sanitary science,  as  applied to the arrangement
of camps, the construction of hospitals  and in the prevention of
all those diseases incident to army life, that  the most notable
progress has been made.
  It would seem almost providential that  the  claims  of this sci-
ence had attracted the especial attention of the  medical  profes-
sion, and men of kindred  studies, several  years  previous  to the
breaking out of our civil war.   In  1857, an American Congress
for sanitary reform, assembled in Philadelphia and organized  an
association for promoting the cause of public  bygeine.   Annual 
15
conventions of this body, composed of many of the best men in
our country, were held, and a powerful impulse given to sanitary
science, which has been of incalculable aid  in ameliorating the
horrors of war.  The necessity of crowding together large masses
of men, ignorant both of the dangers to which they were exposed
and the means of avoiding them, would often have been fatal to
our army but for the noble organization  which was the fruit of
this movement.
   The Sanitary Commission which has  been established at our
national capital, is an institution of which we may justly boast.
It is  like  our own  time  honored organization, self-created and
self-sustained.   In its noble mission to humanity, its cheering and
beneficial  influence  is  more widely extended,  and  is felt  by a
larger number of sufferers in the hospital, the camp  and  the field
of battle than if it possessed the charter  and power of the  Fede-
ral Government.
   I trust  the society will pardon  me for introducing this topic
into my discourse.   It seems to me that the  members of the Sani-
tary Commission are entitled to the highest  meed of praise which
can be bestowed by us and by all others  whose office it is to pro-
tect human  life and to relieve human suffering.  Let us render
all honor  to whom honor  is justly due; and  the more  because
they are  men ;  0, how rare in these  corrupt and  selfish times!
 who will accept no other reward for their services than the appro-
 bation of conscience, and the gratitude of their fellow men.
   Although  true progress is readily received and even welcomed
 by the medical  profession at large, yet it must be admitted that
 a false, because an unscientific conservatism prevails to a certain,
 and it is to be hoped limited extent among  us,  much to the detri-
 ment  of the public welfare and our own honor and good  name.
 The  presence here to-day of so large  a representation  of the
 members of our profession, for the express purpose of aiding and
 promoting the advance of medical science,  is proof that the sen-
 timent referred to is far from being general among medical men;
 but its existence cannot be wholly denied.  In nearly every com-
 munity there are medical men, often holding a  highly respectable
 position in  the profession, who  seem to think that in medicine
 "there is nothing new under the sun," or at least nothing new
 that is worth knowing.  If  you  tell  them  of discoveries in phy-
 siology or pathology, which &a»- change their medical  theories, ^^^
 the reply  is  that they are practical men  and do not trouble them------ 
16
selves about new theories.  If you present to them new curative
or preventive measures, and  bring  the  facts to your  support,
they will cite to you the words of Cullen, "that there are more
false facts than  false theories in medicine," and  declare it to be
impossible to get at the true  ones.  But  as  Galileo had only to
appeal to sensible facts in proof that the earth " does move," so
we  have only to refer  these  brethren to the records  of history
for evidence of the reality of medical progress.  The discovery
by Harvey of the circulation of the blood, was scarcely accepted
as a fact during  his lifetime by the conservative members of our
profession.   A dread of change, and the fear of discrediting medi-
cal science  by acknowledging  its  imperfections, was much more
felt at that time than at the present.  Yet who can measure or
comprehend the advance in medical science, rendered not only
possible but practicable by this discovery ?   Modern  astronomy
has not been  more entirely built on the discovery of the earth's
motion around the sun than fcb&. modern medicine on that of tho
true circulation of the vital fluid  in man.  A vague notion that
the blood flowed from one part of the body to another, with a
sort of tidal movement, had been  held by medical men, from the
time of Galen down, for more than  fifteen hundred years, and
had given birth  and  support to those absurd  theories which for
so long a time made medical practice little less than a  scourge to
the world.  If we do not  now use  such unmeaning terms as " cru-
dity," " coction," and " evacuation," to veil our ignorance of mor-
bid action, it is to a progress marked by such discoveries as that
which we are considering, that we owe the change.  Nor should
we be likely to neglect  or denounce all  new  therapeutic  means
if we read aright the history of Dr. Jenner.   He had discovered
that cow pox was a preventive of or substitute for the small pox,
and sought to introduce the practice  of vaccination, and thereby
protect the public against a most fearful scourge.  I should really
be ashamed to repeat here the terms  of distrust and even of cen-
sure with which  this great benefactor of his kind was assailed by
the medical conservatives  of  his day.  But let them and their
vain denunciations all be forgotten, while we honor and  perpetu-
ate  the memory of Jenner in the daily application of the boon
which he has left behind him  for all mankind.   The lesson to us
is, that we are to distrust or reject nothing merely  because it is
new, but patiently to prove all things to whose claims any scien-
tific or practical tests  can be applied.  Although so  few grains 
17
of wheat are left from the clouds of chaff raised up by those who
are ignorant alike  of the history and methods of scientific pro-
gress, we must still toil on.   If we refuse to do this we shall be
left by  tbe  onward tide of knowledge, or perhaps buried in its
flood.
  Admitting that the facts  of medical  science are in the main
well established, but that some of them are probable rather than
positive, and that in certain cases there is room for doubt whether
the result is altogether due to the remedies employed.  Admitting
that in the practice of medicine we have sometimes placed too
much confidence in our treatment, and in nature too little ;  still  -V"X~t_
we maintain the value of, and have confidence in, the practical iAJ^Z1^
ynlna- of medical science, and thoroughly believe in the control-
ing power  of medical art.   It  is not true, as has been asserted,
that " nature alone heals diseases and injuries."   In cases  of Poi-
son  taken into tbe stomach, nature always  does her  best, by
vomiting and by the depurative organs, to remove the noxious
matter.  But unless we come  to  her  aid with our emetics, our
stomacb pump, or our antidotes and neutralizing agents, she will
often fail and tbe patient will die.  So of the more subtle poisons
wbicb enter the system witb tbe air we breathe, or result from
the transformation of tissues.  Nature cannot always throw them
off unaided.   She calls upon us to put such weapons as quinine,
and mercury, and iodine into her bands, or give increased strength
to her arm by our narcotics, and tonics, and stimulants.   In sur-
gical cases the powers of art are manifest beyond the possibility
of a doubt.  Do we not see nature and art working in  harmony
and union together in the cure of every dislocated joint, in the
restoration and healing of every fracture and the closing of every
wound ?   Nature, the vital  .forces  of the  system, and art, the
handmaid of nature, effect  the cure.  Sometimes one takes the
initiative, sometimes the other; but both are necessary in almost
every case.  After  the division  of an  artery, we have all  seen
nature check the flow of blood by inducing  or bringing on syn-
 cope ; yet she must often have failed in saving  life, but for the
 surgeon's ready ligature or other means, applied under tbe guid-
 ance of anatomical and physiological knowledge.
   It cannot be  necessary  to  enlarge  farther upon this point.
 Apart from all speculative theories and opinions, tbe experience
 of every intelligent practitioner of medicine must tend to estab-
              3 
18
lish this truth—medical art does render positive and efficient aid in
the cure of diseases.
   But skepticism in medicine is by no means the worst enemy to
its progress and usefulness.  To any advance in knowledge, doubt
is even  necessary.  Society in  all its  interests has less  to fear
from unbelief than from superstition  and bigotry.   In  Homoeo-
pathy we have a scheme of imposture which  saps the very foun-
dations  of all positive science.  Treating  as  valueless  all its
discoveries and conquests, refusing to be tested by its rules and
methods, it adopts the language and the spirit, as well as the lowest
motives of quackery.   To give  up modern medicine, or exchange
it for Homoeopathy, would be as great a step backwards  in sci-
ence, as to  give  up astronomy for astrology, or chemistry for
alchemy.  Its law of cure, " similia similibus, curantur," contra-
dicts all the analogies  of nature, by bringing into direct opposi-
tion  the laws of health and those  of  disease.  Now these two
conditions must have laws and processes common to each other,
that is, physiology and  pathology are parts of one great science
of life, or all observation and generalization of natural phenomena     a
have hitherto been idle and in  vain.   Of the means of  cure em-
ployed by Homoeopaths, little  need be said.  No  one who has
once conceived the rules and  limitations of scientific  inquiry,
can believe them to be of any effect.  A double concave  mirror
could not reflect one single ray  of light from the infinite littleness
of this  system of error.  Science has  to do  only with  positive
tangible facts.  It can have no experience of the infinitely great
or the infinitely small.   The  hundred thousandth millionth part
of a grain of charcoal  or of sulphur has no practical or positive
value.   But we will not condescend to fight against shadows.
   Extremes tend to meet; and as medical skepticism, and this
monstrous wonder of credulity and superstition, known as Homoeo-
pathy, reach  the same  end, that is  nihilism in practice; the
former,  though in perfect contrast to the latter in its principles
and real character, has sometimes shown a very large degree of
sympathy for it.  Homoeopathy,  say the do-nothing doctors among
us, "has  taught the  medical  profession what nature  can do
unaided by drugs, for the cure of disease."  Now we claim that
it was not medical men who needed such teaching,  but  the non-
medical public.   The healing power of nature was  as distinctly
recognized by Hippocrates as its  was  by Sydenham in  bis " vis
medicatrix natura," or  as it is now by the whole medical  profes- 
19
sion.  It was the public who needed to have it impressed upon
their minds, that in hygienic and prophylactic measures lay the
chief strength and value of medical science.  And what has been
the effect upon the public of this system from which we are  bid
to take lessons in medical practice ?   It has, so far as its influence
has reached, swept away the very foundations of rational medi-
cine, in the public mind.   Who cares  to know anything  about
the causes of  or changes produced by disease, and how to avoid
them, or how to foster  and aid the healing powers of nature,
when the beginning and end of medicine is that every symptom
has its specific,  " similia similibus,  curanturV  It is with great
pains and risk that heretofore we have taught primary medical
truths to patients, determined to find in drugs the way to escape
the penalty of their own vices and follies.  But here is a sect, in
the light of the nineteenth century, eager to lead the public to
deeper depths of ignorance and superstition than was reached by
the medical priests, centuries before the christian  era, and we
are directed to take lessons of them!  I regret to be compelled
to say that some who are called priests to-day, are steeped in the
same ignorance and folly as those of earlier times.
   The  advertising medical quacks, in making some  appeal to
medical  knowledge and common sense, are much more worthy of
respectful consideration.   They at  least pretend to recognize sci-
entific facts, while the Homoeopaths blindly reject them.  Instead
of looking  upon Homoeopathy as a harmless  folly, or as a useful
satire on medicine, we should endeavor  to awaken in the public
mind a sense  of its debasing and its destructive effects, not alone
on medical science and art, but on  those who need their true and
enlightened application.
   You will excuse me, I trust, that I have deemed it not out of
place here, to devote a few moments to a notice of Homoeopathy.
True it is only a fashion of quackery, which under  the light of
science must  soon pass away, and give place to some other, which
will probably come to vex and confuse the painful  but onward
way of medical  progress.  Yet  duty  demands that we  should
 consider and expose these  changing  errors and impostures as
 they arise, and take care meanwhile that they find no shelter or
 protection under the garments of truth and medical science.
   It has seemed impossible for some to  believe in the reality of
 progress in medicine, while they are forced to admit the impossi-
 bility of bringing it to the degree of scientific exactness.  But we 
20
most  clearly conceive of a  progress  towards perfection, which
yet shall never arrive at that point.  We are also bound, in medi-
cal as well as in  moral science, to accept for the  time, partial
facts  and probable  proof, as  the basis of our practice.   Such
facts, even, as that mercury  neutralizes the syphilitic virus, and
quinine the malarial process of intermittents, are by no means con-
stant, and it is easy to find a logical flaw in the proof that they
exist as facts at all.
   The element of faith in the exhibition of remedies, which is
sneered at by ultra scientific men on  the  one  hand, and wholly
relied on by medical drones and  impostors on the other, has a
real importance in the mind  of the practitioner as well  as in that
of his patient.  It is by the combination of faith and knowledge
that the greater part of nature's gifts  are secured ;  and this must
continue while the world remains, so far as we can  see.  Meteo-
rology and vegetable physiology are  as imperfectly understood
as the phenomena of human  life in health and  disease.  But be-
cause the farmer  cannot regulate the  weather, or comprehend
fully the processes of germination and fructification, he does not       /
therefore refuse to prepare or plant his fields.  He rather  seizes
upon such imperfect knowledge as is accessible to him, and though
it may not satisfy his speculative curiosity, he  accepts  it as a
sufficient guide to his labors, until he  can add to and improve it.
Thus year after year he prepares his ground, sows his seed and
cultivates his crop, in the confident  expectation that he shall
finally reap  the fruit of his  labor.  He has full faith  also that
the harvest which he has gathered is the legitimate result of the
means employed to obtain it;  and though he may always fail to
comprehend the whole philosophy of  production, he will never-
theless continue to plough and plant and reap.  So too with the
practitioner of medicine.  He has given certain medicines when
certain combinations of symptoms were present in his patient,
times without number, and  has witnessed very often  the same
happy result of his treatment.  He cannot always fully under-
stand how his remedies affect the organs and functions of the
body, or how the morbid tendencies and conditions were corrected
and overcome; but he will not for these reasons cease  to admin-
ister them.  He will speak of the cures which he has performed,
as well as the farmer of the  crops he has raised, and with equal
truth and propriety.   If the farmer refuses to learn and apply
what  is known about soils,  and tools, and modes of culture; if 
21
he plants wooden pumpkin seeds in a gravel bed, for instance, in
despair of making an exact science of agriculture, or expecting
that miracles  will  be employed for him, his crop will be a light
one indeed.   So if the medical skeptic confines  himself to the
use of bread pills, or sugar globules, because  his medical philo-
sophy does  not  fully comprehend  the modus operandi of all his
remedies, he will be untrue alike to science and to humanity.
   The modern theory of light, which has been adopted and taught
by nearly all of the wise men  in the whole world, rests rather on
" brilliant conjectures " than  on well established scientific facts;
and yet no one thinks of refusing to use and employ this universal
and all-pervading  agent  or power of nature, simply because all
be in reality knows of it is contained in the brief history of its
advent on  earth.  God  said,  " let there be  light,  and there
was light."
   It is given  to man, by patient and intelligent effort and labor,
to direct and change the processes  of nature in  the organic as
well as in the inorganic world, and he will be held to a severe?
and fearful accountability ifor neglects this high privilege, /fit
   There remains  another kind of medical  progress, personal to
every member  of our  profession, and  worthy of a high place in
the estimation of us all.  In no science worthy  of the name does
all its dignity and value consist in merely practical utility.   The
pursuit alone of medical  knowledge, leading, as it does,  into the
most delightful walks of nature  and of duty, is a source of the
highest and  most elevating  enjoyment, and  is, indeed, its  own
best reward.  As it has been said, that to philosophize is better
than philosophy itself, so the study of medicine is infinitely bet-
ter  than dull repinings  after some complete system which shall
ignore all necessity of medical research.
   I need only remind you of  the moral elevation which the pur-
suit  of such  lofty  studies, and the practice of our humane art
should produce.  Let  me quote  here the words  of Dr. Watson,
one of the most learned and honorable medical  writers of this or
any age : " Amid  all its  responsibilities, the profession of medi-
cine  is a noble profession, and worthy of the  devotion of a life
time.   If we fit ourselves for its high functions, and pursue it in
earnestness and in truth, it  will conduct us to usefulness and
honor,  and  it will prove a salutary school of  mental and moral
discipline.  Toils and doubts belong to it and disappointments,
but it has also privileges and  immunities  peculiar  to itself. 
22
Affording ample scope and exercise for the intellect, it is conver-
sant with objects that tend to elevate the thoughts,  to chastise
the feelings, and to  teach the heart.  It  brings  beneath our
minute and daily notice that most remarkable portion of matter
which is destined for a season  to be the tabernacle of the human
spirit, and which, apart from that singularly interesting thought,
excites  increasing wonder  and admiration the more closely we
investigate its  marvelous construction.  The sad  varieties  of
human pain and wretchedness  with which our daily avocation is
familiar, should rebuke our pride while they quicken our charity.
To us are intrusted, in more than ordinary measure, opportuni-
ties of  doing good  to our afflicted fellow creatures, of showing
love towards our neighbor.   Let us beware how we idly neglect
or selfishly abuse a stewardship so precious, yet so weighty.  The
profession of medicine, having for its end  the common good of
mankind, knows nothing of national enmities, of  political strife,
of sectarian dissensions.  Disease and pain, the sole condition of
its ministry,  it  is disquieted by no misgivings concerning the jus-
tice of its client's case, but dispenses its peculiar benefits, with-
out stint or scruple, to  men  of every country,  and  party, and
rank, and religion;  and like the quality of  mercy, of  which it is
the favorite  handmaid, it blesses  him that gives and him that
takes—recalling continually to our hearts and understanding the
most impressive lessons, the  most  solemn  warnings.  Familiar
with death  in  its manifold shapes, witnessing from  day to day
its sudden strokes, its slow but open  seige, its secret  and insidi-
ous approaches, we are  not permitted to be unmindful  that our
own stay is  brief and  uncertain,  our time, even when longest,
very short if measured by  our own moral wants and intellectual
cravings."
   This  brief and yet comprehensive sketch, by a master hand, of
the duties,  responsibilities and character of the true physician,
must command the approval of all who worthily bear the burdens
and enjoy the privileges of our profession.   No one can fail to
perceive the justice and accuracy of such words when the life of
him who uttered them is  their full  and  perfect  embodiment.
And can we not, gentlemen of the society, as this occasion brings
back the memory of those who were once gathered with us here,
but who are now in the presence of  Him whose healing we  all
need :   Can  we not, I say, recall the names of many  whose lives
were made up of deeds of  devotion, of charity and self-denial ? 
23
Let us all emulate their brigbt examples, and render ourselves
worthy of their glorious reward.  So shall we best commend the
present claims of medical  science, and by thus strengthening its
foundations in tbe esteem  and confidence of the  public, we may
all contribute something to its advancement in the future. 
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