* fdf)
THE
ANNUAL ADDRESS
DELIVERED BEFOKE THE
Cflitiuttmit  UJebical Stotidg,
AND THE
CITIZENS  OF WATERBURY
WATERBURY, MAY 26th, 1858.
BY BENJAMIN HOPKINS CATLIN^ M. D.,
      PRESIDENT OP THE SOCIETY.
       ---------  ^TbM^
                    $%------


   PUBLISHED BY ORDEU OF THE CONVKXTIO^.
       H A RTFORD:
PRESS OF CASE, LOCKWOOD AND COMPANY.
           18J8. 
<* 
THE
ANNUAL ADDRESS
DELIVERED BEFORE THE
€anutttuut $jje&tcal  Storidg,
CITIZENS OF WATERBURY,
WATERBURY, MAY 361li, 1858,
^;,
BY BENJAMIN HOPKINS CATLIN, M. D.,
       PRESIDENT OF THE SOCIETY.
      ------------------------       <5H 6EflL'^
                           BRA^
PUBLISHED BY ORDER OF THE CONVENTION.
        HARTFORD:
PRESS OF CASE, LOCKWOOD AND COMPANY.
            1858. 
 
ADDRESS.
   Gentlemen :—Assembled in this pleasant  rural city amid  the
greetings of our kind brethren, but more especially under the protection
of the Supreme Being,  we may quietly pursue our deliberations and
endeavor to advance the interests of our profession, though not as on
other occasions of this kind at one of the  capitals of the State, in the
immediate vicinity of the Legislature, from which we have derived
our chartered right.
   As many of us have  recently come from that large convocation of
medical brethren at  the national  capitol,  it is desirable that we
should bring with us some enthusiasm obtained  from that centre of
influence.   Our business this day is to ascertain  what has been done
for the advancement of  medical science, to consider and  recommend
such  other measures as shall seem to us  important for the improve-
ment of our profession.
   Though we shall find little has  been  accomplished in our society,
in comparison with the  great and important improvements which we
trust  are yet to be made, still I am happy  to say the last year has been
one  of progress.  Two  new standing committees, one  upon  regis-
tration, the other upon  publication,  were  appointed at the last Con-
vention, and I am happy to inform you that they have attended to the
duties assigned them.   The  first, by  conferring with the  State
Librarian  and  making  arrangements for the issue of more perfect
blanks for future returns.  The latter have prepared and forwarded to
the clerks  of the county societies  an able and important circular,
requesting them to communicate with those selected as dissertators,
and  press upon them  the importance of prompt  attention to their
appointments.  Important reports, I trust, will be presented by these
committees, which may require farther  action by  the  Convention.
               1 
4
We  hope at least to  receive some valuable  dissertations, reports,
and  biographical notices worthy of  publication with our proceedings,
making a  pamphlet of greater  pretensions than  those heretofore
published.
   In my communication to  the Convention  one year  since, I stated
that  I had  addressed  circulars  to the clerks of the county societies)
requesting  them to present to their county meetings the importance
of having  committees  of inquiry appointed, which, if attended to,
may another year present  facts from  different  parts  of  the  State
eminently useful to the President for the preparation  of his annual
address.  Though I have been informed that  these circulars  were
favorably received, and committees  appointed in most of the counties,
the information desired has not been obtained.
   The chairman of one county  committee sent me a brief note more
than a year since,  but it contained  no facts not already before the
Society.  The clerk of one  county  meeting where no committee had
been appointed, sent me a  few facts showing  the low state of the
society in the county where he resides.   Less than one-half of the
regularly educated physicians of the county are members of the Con-
necticut Medical Society ; no dissertation had been read for several
years.   There was a considerable increase of quackery ; several even
of their members secretly associate and even consult with quacks.
   The failure of these committees shows either that they did not enter
into  my views, consider them  important, or they have manifested
their reluctance to assuming responsibility or engaging in  any labor
necessary for the  improvement of  our  profession, to  which I  have
alluded on another occasion.
   The last Convention passed a resolution approving  and indorsing
the recommendation of the American Medical Association in relation
to the duty of each member to keep  written notes of his practice, and
to report from time to  time  such statements  as  shall seem  important
and interesting, with a view for publication with the annual proceed-
ings  of the  State  Society; and  in furtherance of  this  measure,
recommended the appointment of a  committee by the county  socie-
ties  at their  next annual meetings, to receive  such reports as may
be offered.
   The county of New Haven had previously appointed a  committee
for this purpose, and at the semi-annual meeting they were authorized
to prepare, and issue to each member of the society, a circular setting
forth the  importance   of this  undertaking.   This committee have
attended to the duties pertaining  to their appointment, and  recom- 
5
mended that the  registration of diseases be commenced with the first
of the present year.   Having an earnest desire that this registration
should commence at the same time throughout the  State, and hoping
to aid somewhat in this important enterprise, I issued a short circular
to all the members in the several counties,—except the  county of New
Haven, which was  already supplied,—urging  them to  commence the
record of their cases the first of January.
   As we have so often found that the recommendations of this Conven-
tion to  the  county  societies have been  overlooked, forgotten or neg-
lected,  I have addressed a circular to the county societies,  reminding
the  members of the necessity  of  appointing county  committees in
order to carry out  the plan of  the  State and  National Societies.  If
individual members and county societies  perform  the labor assigned
them, further action  will be required of this Convention.   For the
purpose of insuring uniformity in the returns, blank tables should be
furnished by this Society, so  that  each  member might  every month
copy into them his  notes of diseases and  accidents, made at the time of
their occurrence.   I have procured copies of  the tables  prepared for
the  members of the New York State Medical Society, which will be
useful to a committee which may be appointed to prepare some for the
members of this  society.   A committee  should also be appointed, in
accordance with a resolution passed in Convention last year, to receive,
collate,  classify, and prepare for publication reports received from the
counties or individuals, or they might be referred to the  standing
committee on publication, as you shall deem best.
   I  have before me an address  on the  registration of diseases, read
before the New York State Medical Society in February last, by my
early and distinguished friend, Thomas C. Brinsmade, president of the
society, who has  been justly  styled a pioneer in the  registration of
diseases, having kept a record for near thirty years; and after rejecting
the first few years,  as being too imperfect in  his opinion to be worth
tabulating, he has  prepared,  and  published  in connection  with  his
address, a general  summary of all  diseases occurring in his  practice,
from 1837 to  1858  inclusive.   He  says: " I think  any man  who will
persevere in keeping a record for one year, will afterward reluctantly
relinquish the practice.  The entries  must, however,  be made every
day, or if unavoidable obstacles should prevent,  as  soon  after as
possible, for if delayed even for one week, the time required to write
forty names, with the diseases  and other conditions, will be  more than
most physicians can spare at one time, so frequent  are the interrup-
tions to  which a man in full practice is liable. 
6
   " The daily practice  of registration must  inevitably benefit  every
man who pursues it.   He  can not write even the name of a disease
without  thinking enough about it to decide  its diagnosis, its causes,
and the treatment adopted to remove it.   So  far from occupying time
which might be  devoted to  reading, it  necessarily compels him to
study, and confine his researches more  closely to subjects connected
with his daily pursuits, and he thus becomes more identified with and
attached to his  profession.   The  systematic habits  which it induces,
enable  him  to accomplish more work and in  less time than he  other-
wise would."
   By preparing and issuing circulars to members  and county societiess
I may have laid myself open to the charge of attempting extra-offi-
cial duties.  If so, I have no excuse to offer,  except that  I was actu-
ated by an earnest desire to do what little I could, while I was  called
to preside over this ancient and honorable Society, to promote its best
interests and prosperity.
   A correct understanding of the appropriate duties of this  Conven-
tion,  the County  Societies,  and individual members, and a wise
distribution  of  the labors  to be performed, between  these several
departments, would conduce greatly to the advancement  of our pro-
fession.   We can not take a step  in advance without the earnest,
efficient action  of individuals.  If every member of this Society had
any  just appreciation  of  the responsibilities  he assumed  when  he
united  with  it, and engaged in  the  practice of medicine,  and was
willing to meet these obligations  according to  his  best abilities, em-
bracing every opportunity to make improvements, carefully observing
everything worthy of observation, recording  and communicating the
results to the County meeting,  soon  a vast number of facts would be
collected, eliciting discussion, and when collected in the State Society
would with others from all parts of the  State, be eminently  useful in
establishing important principles.  Alas ! too many seem to practice
medicine only as a means of living, without any correct idea of their
high calling, or a thought that  they could do  anything to advance and
improve the profession of their choice.   The  efforts  of  those mem-
bers of our Society who are  alive to the importance of improvements
should be especially directed to individuals, arousing and stimulating
them to action.
   Next in importance to individual action are the County  Societies.
They are like democracies and municipalities, where members meet
en masse, affording the most favorable opportunities for the consider-
ation and discussion of subjects brought forward by individuals.   If 
7
all the members in each county would make it a point  to  attend the
county meeting, (two or three being held each year,) and make them
as interesting and useful as possible, we should soon  have an amount
of business sent up to this Convention that would require several days
to dispose of appropriately.
  The state society being representative in character, and limited  in
its powers, is designed more to collect, concentrate and publish the re-
sults of the labors  of individuals  and county  societies.  The  recom-
mendation of subjects for their consideration  and action, according to
our custom in years past, would be wise were they met with that re-
sponse their importance demands ; but too often we have found'them
remain dead letters upon our proceedings.
   Our profession suffers greatly from the  want of well  qualified and
efficient nurses.  It is enough for physicians to bear the responsibili-
ties resting upon them as prescribers, without being held accountable
for failures arising from bad nursing.  It is often  the case that nur-
ses are employed to take  care of our patients who are  opposed to
our system of practice, and cannot be depended upon to carry out
our views.  This difficulty should be remedied by  the proper train-
ing and  education  of nurses.   There  are in all our communities
persons, especially  females,  who  need  employment; and, if proper
facilities were  afforded,  they would  become well  qualified for the
duties of nursing.   Every  physician can  do  something in bringing
out the proper individuals,  and giving them  some instruction, but a
course of  lectures  should be  given once a year to nurses  by the
professors in our Medical Institutions.   That  queen of  nurses, Flor-
ence Nightingale, has set us an example,  by the establishment of an
institution  in  England for the  instruction and training  of  nurses,
which  I  trust  we  shall  not be slow in following in this land of
freedom.
  There is a petition from  this society before  the Legislature  in re-
gard to the establishment of a meteorological observatory, which may
demand your attention at this time.
  I would again recommend to your notice the efforts now being made
for the establishment of an institution  for  the  improvement of the
imbecile and idiotic.
  As my  official connection with  this Convention  and Society will
cease after the delivery of  this address and your  appointment of my
successor, I shall, with the  above brief remarks and suggestions, leave
the dark side of our profession, for you, the members of this Conven-
tion, to adopt the appropriate  treatment, and turn your attention to a 
8
brighter and more hopeful prospect by presenting some of the Claims
of the Regular Medical Profession,* upon the Confidence of the Com-
munity.
   While all forms of quackery, and every false system of practice,
have, by means of the press and free lectures, been urged with great
effort upon the notice of the public, the members of our profession,
being satisfied that their claims to  confidence were good and  valid,
have gone on quietly attending to their ordinary duties,  trusting the
time would come when a discerning public would appreciate a  learn-
ed, scientific profession.  It would be  Avise to continue this course,
were the community disposed to examine this  subject carefully, and
judge  it by  those principles  and  with that  impartiality they de-
cide  other  questions  of  less importance to  themselves and  their
friends.
   There are some difficulties in attaining a  just appreciation of our
claim by the community, even  were they disposed to give the subject
that attention  its importance  demands.  Years  of close  study and
severe labor are  requisite to become acquainted with the science and
practice of medicine.   How then  shall those who scarcely give it a
thought, till the moment they require the service of a  physician, be
expected to judge wisely, and decide correctly! While we are perfectly
satisfied with the confidence and patronage so  generously given us,
and fully appreciate the difficulties in presenting  this  subject  in a
lucid and interesting manner, we hope to be able  to  advance some
principles which, illustrated by experience and observation, may be
 useful in guiding the minds of honest inquirers  after truth, so that
 they may be successful in obtaining the best medical assistance.
   In order to understand the  claims of  any class of persons, or pro-
 fessions as to their ability to perform any specified object, it is necessary
 to understand as precisely as possible the nature of the work to be ac-
 complished,  whether it be simple and definite, easily  comprehended,
 or on the contrary intricate and  uncertain, requiring years of study
 and labor to comprehend it, even in an  imperfect measure.
    If  it were  to dig a ditch  across a meadow of  a  definite  length,
 depth and width, carefully staked off, a man  of very  small  mental
 powers might perform it,  provided he had the requisite  physical  de-
 velopment.   Higher and different powers of mind would be  neces-
 sary to correct the derangements of machinery, even though it were

   * Every profession has a right to choose its own name. We prefer the above, though
 long, to Allopaths, or other names given by our opponents. 
9
simple in its construction.  The management of more intricate  and
complicated machinery would require a still higher order of talents,
a long course of training and education.
  If disease  was  a unit, as some claim, or was all in the blood, ac-
cording to others, or still all in  the stomach ; if cold was disease or
death, and heat life and  health ; if each disease could be  cured by
a medicine which when taken in health produced symptoms  iden-
tical with  those attending  the disease,—then,  indeed, the  cure of
disease would be a very simple matter, and it  would be useless for
me to present the peculiar claim of the regular medical faculty for
your consideration.
  Most happy would it be for the community if the practice of med-
icine were  such a plain, simple  matter that even a child could under-
stand and carry out its  principles.   But  unfortunately  there  is no
truth in these claims to simplicity in the practice of medicine.
   It is not my design at the present time  to combat error or expose
false  systems, but rather  to present the true  and  valid claims of
regular medicine.   Any allusion to other  systems  will be  incidental
or by way of  illustration.
  Enter any of these large, massive  and elegant buildings so common
in this city, designed for manufacturing purposes, and you  will find
a great variety of  curious and complicated machinery, performing its
appropriate work with great regularity and sometimes with seeming
intelligence.   You look  about  for some  motive power, and find a
water-wheel, or a  steam engine, (which of itself would rank with the
seven wonders of the world, were it  not  so common,)  the capacity
of which can be calculated with mathematical exactness.
  Notwithstanding all this apparent perfection, you will readily un-
derstand that this  machinery is liable to  derangement: one part  is
worn by ordinary  use,  another may be  broken by  accident.   You
step up to  one of the gentlemanly owners  or managers of the estab-
lishment, and inquire of him whom he employs to repair damages, or
correct derangements caused by wear and tear, or the carelessness of
unskillful workmen.  Will  he  tell you it is not  important who is
intrusted with this duty ? that a man taken direct from a shoemaker's
bench, or from following the plough, is fully competent for the busi-
ness ?  Not at all. On the contrary  he will inform you that he has in
his establishment one or more  trained and educated machinists, theo-
retically and practically acquainted with the general principles of the
machine, its various parts, and the materials of which it  is composed,
whether they be wood, steel or brass.  He may also be acquainted 
10
with those branches of mathematics applicable to the  mechanic arts.
If he did otherwise, you would pronounce him deficient  in  common
sense.   Suppose this machine, instead of being moved by an external
power, whose capacity could be calculated and determined with great
certainty, had a motive power within itself, the extent and  force  of
which could be  learned only by its  effects, would  not the difficulty
of making repairs greatly increased ?  Suppose farther, this  machine
had the power of self-extension  so as to  be  prepared  for  different
kinds of labor, at different periods of its  existence, and a power more
or less perfect for repairing damages, the machinist being required to
be more or less perfectly acquainted with these powers to enable him
to co-operate with  them, and never to  counteract their  beneficent
action;  would not the difficulty of making repairs necessary to keep
the machine in  working order be greatly increased ?  Would  not a
higher order of talents, and a more  thorough  education, be requisite ?
Most certainly.  If you were to imagine still further,  that these ma-
chines were endowed with an intelligent principle, acting upon every
part, and every part acting upon  that,  would it not be  difficult  to
obtain machinists competent to manage and repair such intricate and
complicated machinery ?
  The suppositions I have made convey a very inadequate  idea of the
difference between a machine made by man, however great his  genius
or exalted his powers,  and the  workmanship  of an Infinite  Creator,
perfect in all its parts  though liable to derangement.  When you look
at man, the workmanship of the  Almighty,  you  see at  once in the
action of the joints, muscles and tendons, an exhibition of mechanical
principles :  but that internal machinery which drives the blood from
the right ventricle  through the arteries into the capillaries, and from
thence returns it through the veins  to the right ventricle ; which again
throws it through the pulmonary artery into the lungs, spreading it
out upon those delicate membranes  which form the air cells, placing it
in a situation favorable for those changes so necessary for its purifica-
tion;  that   machinery and chemical  laboratory which  receives,
masticates, digests and assimilates the food; and those wonder-working
powers  which are so silently and constantly enlarging the body from
infancy to old age, or removing  and remodeling those portions of the
animal structure which by use become unfit for  the  performance of
the functions assigned them,—these are  not evident to  our  senses.
The  general facts in  relation to them are so familiar to medical men
and to many intelligent non-professional  persons, that it is difficult for
us to realize that many years, yea,  centuries of laborious study, dissec- 
11
tion and experiments, upon living and dead bodies, have been neces-
sary to  discover and establish those principles.  When  we leave
inert, unorganized matter, and come to organic, living beings, whether
of vegetable origin, from the lowest order which springs up in a night
and perishes under the  influence of the first rays of the morning sun,
to the stately trees  which live  for centuries, or  all grades  of animal
life, from the smallest insect to  man, the lord of all, we come upon an
entire new field, requiring the knowledge of new laws.
   We pass  over this vast field of organized living matter, vegetable
and animal, which separates the  inorganic substances of which the
most curious and intricate machinery is constructed, from the human
system, the diseases of which  it is our business to treat.   The vast
extent of this intervening field shows the infinite distance  between
them.   That we are " fearfully and wonderfully made," all will admit;
and I think after a little  investigation, every one would be satisfied
that long, deep  study and  extensive  investigation  are  necessary to
prepare one to treat diseases with  success.   It  will of course  be
impossible for the physician  ever to become as  well acquainted  with
the  organization  he  is  required to keep in repair, as the machinist
with his machine.   But there is much that he can and must learn, in
order to qualify himself for the performance  of his duties.  He can
become  thoroughly acquainted with  anatomy, physiology,  materia
medica,  pathology,  and  therapeutics;  with  chemistry,  especially
in regard to those  chemical articles  used  as medicine and animal
chemistry.  The surgeon must understand mechanical  principles in
order to reduce dislocations and  fractures  and retain them  in their
place, to correct and remove deformities.  The  practitioner of medi-
cine should have the requisite knowledge of meteorology to understand
the influence of the weather and climate upon diseases.
   The progress of medicine, of which I shall speak in another place,
is constantly enlarging and extending the range of studies and science
necessary to be understood by the physician.  It is now necessary for
him to  be  acquainted  with acoustics, or the science of sounds,  in
order to ascertain the normal and  diseased state of the heart, lungs,
and other internal organs ; with the science of optics, so as to use with
accuracy the microscope, which  is aiding much in the investigation and
diagnosis of disease.  The  practice of medicine can not be pursued
with eminent success without a minute and extended observation of
facts, a  great  amount  of deep, profound  thinking  and reasoning,
requiring a  thorough knowledge of mental philosophy.  A profession
that requires a thorough knowledge  of these  sciences may well be
                 2 
12
 called a learned profession.   That all  the  members of the regular
 medical faculty are thus learned, is not claimed, but it is our constant
 effort to raise the standard of medical education.   There are  many
 men  in our profession who  though not  very learned  in medicine  or
 the collateral sciences, yet are men of sound judgment and discrimi-
 nation, capable of understanding and applying in practice the princi-
 ples discovered by their more learned brethren.   Few, comparatively,
 can become familiarly acquainted with the microscope, but their skill
 can be employed  for the benefit of others.
   No practitioners outside of our fraternity, with a very few excep-
 tions, make any  claims to scientific  attainments.   They base their
 claims upon  the  simplicity of the practice of medicine, the  one idea
 principle  that disease is a unit.   The advantages of education and
 science  are  nullified when their  possessors embrace  a  false  system,
 unless in some rare instances it enables them to resort to true science
 when they find their false theories failing.  Much may  be learned of
 the claims of any profession by  the character of its  members.   The
 successful practice of medicine requires the faculty  of  careful, close
 observation,  a  retentive memory, great discrimination, and  sound
judgment.   That these  faculties  are possessed by the members  of the
 regular profession, in an eminent  degree, as they are exhibited in their
 character  as men  and citizens in  the  communities  where they reside,
 will,  I  believe, be readily  admitted by every unprejudiced  mind.
 Some, however, do not seem to understand that the man who possesses
 these desirable qualifications of mind and character, will carry them into
the investigation of disease and apply them in his practice.   A gen-
tleman of  good character and intelligent in ordinary matters, but who
had employed various kinds of doctors, from one  extreme of absurdity
to another,  said to a regular and experienced  physician whom  he
chanced once to employ, '' Doctor, I respect you  very much as a man
and a Christian, but I  do not believe in your  system  of practice."
Now,  as a minister said of a certain woman, she was a good Christian
but a  poor cook, so a man may  be a good  Christian, an honorable,
upright citizen, manifest sound common sense in the ordinary transac-
tions of life, and still be a poor physician, but we can  hardly conceive
of such a thing as being possible.  We always admire to  see  the
exhibition of true benevolence in others, however we may fail  in the
exercise of it ourselves.  The  medical  profession fully realize  the
import of  the words of our Saviour, " For ye have  the poor always
with  you."   Every  physician  doing  a large  business, extending
through a period of thirty years,  will find on his book thousands of 
13
 dollars  unpaid.   A larger amount is thus  given by the members of
 our  profession, according to their income,  than  by any other class of
 persons.  But it is often  said this is nothing: physicians  charge  the
 rich enough to make up these losses.  This is not true, for those able
 to pay are not charged more than the services rendered are worth
 The gratuitous  services of our profession to the poor have been con-
 tinued so long that they are  considered  as a matter of  course ; their
 performance calls forth no commendation; the neglect now to con-
 tinue them would rather call forth unqualified condemnation.
   Fifty years since, travelers passing through the town of Farming-
 ton on the road to Hartford, would observe a little cage set in a bank
 near the turnpike, occupied by a raving maniac, staring and shouting
 to the  passing travelers ; subsequently  he was removed to a barn
 near by,  where  he sat crouched  on his  limbs till they  inflamed and
 adhered together, so that  he could not be straightened.   Here he sat
 year after year,  covered  over with an old blanket, and had his food
 given him as it  was to the chickens  of  the  barn-yard.  This is  not
 mentioned as a reproach to the good people  of Farmington, there being
 few  towns whose inhabitants  have a more  enviable reputation  for
 morality and true religion.  Other cases  perhaps as revolting existed
 in other towns.   Those who were poor were sold like other paupers to
 the lowest bidder, to be confined in dungeons, cages, strait jackets, or
 chained to  the  floor.   A  few physicians, in connection  with other
 benevolent individuals, made  arrangements for the establishment of
 the  Connecticut  Retreat.  The  Connecticut  Medical  Society gave
 every dollar of its funds.  Private benevolence, with  aid from  the
 State,  has now  made  provision  in  part  for all  these unfortunate
 persons where they can be treated like human beings.
   An eminent physician of Hartford  was so unfortunate as to have a
 daughter  deprived of hearing and speech.  Deep sympathy  on  the
 part of  the father and  his brethren,  led to the  establishment  of  the
 American  Asylum  for the  Deaf and  Dumb,  where, through  the
 munificence of the several States of New England, provision is made
 for the gratuitous education of all their indigent deaf  and  dumb.
   The physicians of New Haven,  seeing the necessity of a hospital in
 that  city, by their hearty efforts  and material  aid,  with assistance
from benevolent individuals and the State,  established the Connecti-
cut State Hospital, where they have ever continued to give the best
medical and surgical attendance without fee or  reward.  The  physi-
cians of Hartford are doing the same for this city.
  The manly exhibition of courage ever calls forth the spontaneous 
                               14

plaudits of an admiring multitude.  Even though we may be men of
peace, we can but commend the soldier as he marches  up  fearlessly
to the cannon's  mouth, and as his comrade is  cut down before him
steps up to fill his place.  Who has ever read the story of the brave
Spartan band, under the immortal Leonidas, at  the straits of Ther-
mopylae, without having his spirit stirred within  him ?  And yet, says
Dr. A. Clark, President of the  New York  State Medical Society,
in his eloquent address,  delivered  at   Albany in 1853, " I  have
known the soldier of twenty battles turn pale and  flee  before  the
least of the physician's perils."
   There is much to strengthen the soldier's courage.  The  spirit-
stirring music,  the  pomp and parade, the marching  and  the  coun-
ter-marching, the noise and confusion.   The  thousands or hundreds
of thousands  around him to encourage or witness  his  cowardice, if
he suffers  it to be manifested.  The physician, on the contrary, goes
quietly and alone into the dark chambers of sickness and death, filled
with all the elements of disease, or down into the filthy  abodes of
the poor, reeking with contagion.   " The pestilence strikes terror to
the hearts of every man : the physician  never turns  away from it.
From the  dreadful days when death grew frantic with its own work
of slaughter,  and Hippocrates stood up to wrestle with  it  night and
day in terror-stricken Athens, to the hour when the affrighted peo-
ple of our time fled before the most dreadful of  all plagues that ever
scourged the  earth, the physician has never turned his  back on dan-
ger."*
  I shall never forget the  fear and alarm  which spread over this
whole nation  " when the first blow of this last and most relentless of
death's agents" * first appeared in our country, more  than a quarter
of a  century since.
  The laws of  this epidemic were not then well  understood.  No one
knew that any part of the country would escape its ravages.   As it
spread from city to city, from town to town, the inhabitants fled before
it in  the wildest confusion.  Physicians alone remained voluntarily at
their posts of danger and death.  Many of those living in places ex-
empt from the disease,  visited  the cities where it was  prevailing;
sent  by the board of health at the public expense, or going at their
own  charges, to study the character of the epidemic ; visiting the pub-
lic hospitals, seeing hundreds of cases of the disease, witnessing many
deaths, and making examination after death  ; and all for what pur-
*Dr. A. Clark's Address.
t Ibid. 
15
pose ?   That they might be better qualified to treat the  disease in
case it appeared in their own field of practice.   " Of thirty assistant
physicians doing duty  at the Bellevue Hospital  in  the  city of New
York,  during the late prevalence of ship fever  in that  city, twenty-
one took the disease, and five died  of it;"  one of them the accom-
plished son of one of our own members; " and even of the nine who
escaped it there, three had already suffered from it  in other medical
charities : yet  their ranks were always  full; and I speak [says Dr.
Clark] from personal knowledge, when I say that I know  not  where
to look for a body of young men whose duty is performed  with  more
conscientiousness and courage and  intelligence."
   All  will recollect a more  recent case; the prevalence  of the yel-
low feveri n Norfolk, three years ago, where forty of our " profession,
being four-fifths of those in that community, swelled too as  their ranks
had been, by volunteers, from  other cities, fell manfully  contending
with disease and death."  " Greater love hath  no man than this, that
he lay down his life for his friends."
   Another claim of regular  medicine to confidence, is its progressive
character.  Many things, excellent and desirable  in themselves, are
insignificant in their commencement, but having vitality in their
nature, progress more or less regularly and rapidly, till they  attain
great  perfection.
   Some efforts were probably made at an early period of  the world's
history, to alleviate the pains and  sufferings of  the failing and dis-
eased  body, but they must have been extremely rude and  unsatisfac-
tory.   The first phase  of medicine, according  to  history,  is the
Magical.   In this form it exists in all savage and barbarous nations.
We hear in our day of the  great  efficacy  of  Indian remedies, and
the skill of Indian doctors, but all  Indians,  before  their  intercourse
with the white man, had medicine men, or conjurers, and depended
on them  for the cure of their diseases.  Next  in  order was the
Empirical.  A certain article relieving a certain symptom, or set  of
symptoms, was recommended in cases of a similar character.   Then
followed the time for theories  and  hypotheses.  Many of these were
elaborated with great shrewdness and skill, and put forth with great
confidence and abundant display.   Others soon followed, which if not
more shrewd and plausible, yet from  their novelty supplanted their
predecessors.
   Efforts to maintain  a theory lead to the perverting  or falsifying
of facts.   Everything that can be pressed into its support  is  sought
with   avidity,  while  whatever is unfavorable, is rejected or per- 
16
verted.  The evil influence of these theoretical  speculations did not
prevent all  valuable  discoveries.   Prominent among these were the
discovery of the circulation of the blood by the immortal Harvey, and
vaccination by Jenner.   Neither did great discoveries at once pre-
vent theoretical speculations, but rather opened new channels for their
development.   While the influence of theories has  been on the whole
evil,  some  have contained, buried up  under  a  great  amount of
rubbish, very important principles.
   The theory of Brown,  known  as the Brownonian system or the-
ory, from its great simplicity was for a time very popular.  Dividing
all disease into two classes, Sthenic,—or diseases of increased action,
Asthenic, or diseases arising from debility or deficient action,—it claim-
ed to  make the  treatment of disease extremely simple ;  like Sir
Robert Peel's sliding scale as applied to  the  corn  laws of  England.
But it was soon found that something  more  was necessary to cure
disease, than barely to reduce action by evacuants, and other  antiphlo-
gistic means, to the healthy standard, or by the use of stimulants to
raise it to that point.    Blood-letting would not cure all inflammation,
or stimulants remove every form of debility.
   While the theory, like all its predecessors, was soon  exploded, the
idea of division of diseases into  those  of increased or diminished
action, was found to be a great principle, ever true and all important.
I shall have more to say respecting this theory when I come to treat
of the principles of medicine.
   For many centuries there was  such  a superstitious  reverence for
the dead body, that no dissections of it were allowed, whereby  physi-
cians  could  obtain a knowledge  of anatomy,  the  science of healthy
organization.   This being removed, all intelligent persons are  aware
that it has long been studied and taught as  a science,  and brought
well nigh to perfection.   Morbid or pathological anatomy, which treats
of  diseased structure,  has been  more  recently  improved.  It has
taught us the existence of  diseases not before suspected,—instructed
us how to cure diseases once incurable.
   Physiology, the  science  of life, which  treats  of  man as a  living,
acting being, has long been pursued as a science, but greatly improved
within the last half-century.  The use of the microscope has aided in
the advancement  of this as well as pathological  anatomy.  Materia
medica has  been  recently greatly extended and advanced by the aid
of chemistry and botany, adding new articles, and developing or sepa-
rating  new  principles  from those already  in  use.  Therapeutics,
which treats of the operation of the different means for curing diseases 
17
 and  their application in practice, has been equally advanced during
 the last few years.
    During the last  half-century great advances have been made in
 ascertaining the causes of disease, but more particularly in determin-
 ing  their distinction or diagnosis.   The  knowledge  of  physical
 signs  has  been  greatly advanced,  so  that we  now  readily  and
 accurately  detect and distinguish  diseases of the heart and lungs
 and  other  internal  organs,  in  some instances  so early as  to  find
 them  in a  curable state ;  and we  are  to  anticipate  greater  im-
 provements  in this  department,  so as to arrest and cure many cases
 now incurable.   By the  aid of chemistry and the microscope, we are
 able to examine the secretions  and the excretions, ascertaining the
 exact seat of the disease and its nature, and thus be able to apply
 the appropriate remedies.
    Had Bacon  lived at  an earlier period, his philosophy would not
 have aided  medicine, for the facts were too few and observation too
 limited, to have established any  important principle.  But in his time
 these were collected in sufficient numbers to commence the  establish-
 ment of medicine upon a  philosophic and rational basis ; and from that
 period to the present, an  immense number of facts have been carefully
 observed and recorded, relating  to the causes, nature and constitution
 of diseases,—their symptoms, diversities, distinctions, results and pre-
 vention,—the effect of remedies under the various circumstances of
 disease and condition of  the  patient:  all these enable us to establish
 general principles founded upon  truth.
   "The  principles,  elements, or institutes  of medicine,"  says  Dr.
 Williams of London, " comprise those leading and general  facts and
 doctrines regarding disease  and its treatment, which are applicable,
 not to individual cases only, but to groups or classes of diseases.  This
 branch of medical  knowledge is also  designated by the term general
 pathology and therapeutics,  to distinguish it  from special  pathology
 and therapeutics, or the  theory and practice of medicine in relation
 to individual diseases."
   " The principles of medicine may be deduced in part from a knowl-
 edge  of animal structure  and function, anatomy and physiology, con-
joined with an acquaintance with the agents which cause and remove
 diseases; but chiefly they are derived from a generalization of facts
observed in  an extensive study of disease itself, and its effects in the
living and in the dead body." *
  "The leading rules" or principles "of practice,  those which  guide

  * Principles of Medicine, by Charles  J. B. Williams, M. D., F. E. S., page 29. 
                                18

the most experienced men, are founded on general views of diseased
function and structure—that is, general pathology.   The condition of
the system—that is, the function, is to be taken into account; and the
variations of this condition, the states of sthenia and asthenia, tone
and debility, excitement and depression, plethora and anaemia, are the
very subjects which general pathology explains and  shows how to
treat." *
   These general principles constitute an important branch of medical
knowledge, as yet imperfect,—-can hardly be called a science, yet so
far advanced as to  be eminently useful  to  the  practitioner.  They
relate to the causes of disease, pathology proper or disease itself,  the
division  and  classification of disease, their  distinctions, results and
prevention.   Under the  head of causes they  treat not only of  the
local, definite cause  of each disease, but  of the general laws of con-
tagion, epidemic influence, epidemic constitution, or periods, all which
have an  important influence in modifying the appearance and nature
of  diseases, and their proper treatment.
   While speaking of the Brownonian system, I stated that it contained
the idea of a great principle.  It was the idea, and the term used to
describe it, rather than the principle itself, that we  have adopted.
Brown treats of the sthenic and asthenic diathesis, or the different
state or condition of the body under disease ; but when he comes to
treat of particular  diseases, he  places them  on his  scale  by name,
either above  or  below the state of health.  This is theory, not  truth.
The principle applies these terms to the condition of the system when
laboring under  disease, without any reference to the  name.  In  this
way we find that scarlet fever, puerperal fever,  rheumatism, or small
pox may at one time be attended with inflammation or increased action,
at other times   with  deficient action  or debility.  It  is under the
guidance of this great principle that the  scientific physician learns to
treat with success diseases of the  same name at  different times, under
the varying circumstances of climate, season, constitution or idiosyn-
crasies  of his  patients,  with  directly opposite  treatment.  In  the
application of this  principle to cases as they occur  in practice, the
truly wise and  judicious physician has an ample field for the display
of great discernment and eminent skill.   Nothing can be more erro-
neous than  the prescribing for the names of a disease,  though  it is
common among many classes  of doctors  and  in all  communities.
 Families having their globules, or other domestic remedies, often feel
competent to prescribe if they can  get a physician to name the dis-
* Principles of Medicine, page 20. 
19
 ease.  The regularly educated physician feels the pulse, examines the
 tongue, the skin, the complexion, the  bodily  strength or debility, to
 ascertain not only the name and seat of the disease, but the particular
 state or  condition of the system.  Take for instance a complaint as
 simple and common as pain in the back.  The empiric or mere routine
 practitioner can  remember something that has cured such pains ;  he
 prescribes, and perhaps in one case out of ten he may chance to hit
 right; if he fails, he tries  another, and so on.  The educated phy-
 sician examines the case, inquires in his own mind whether the seat of
 the disease is in the muscles, the bones which form the spinal column,
 the spinal cord which passes through the bones, or in the kidneys, or
 in some  other  internal organ.  If the case is  an intricate one, he
 examines the  secretions  and  the excretions, by chemical test  or the
 microscope.  Having ascertained the  seat of  the  disease and  the
 pathological state of the diseased organ, and general condition  of the
 system, he  can  judge with great certainty whether  it is curable  or
 incurable.  If the former,  he knows the remedies that are appropri-
 ate ; if the latter, he knows what is best calculated to palliate suffer-
 ing and make life more endurable.
   I have alluded  more particularly to this important principle, because
 of its extensive application, and for the reason that it can be readily
 understood  and appreciated by every intelligent person.  While the
 regular, scientific  physician rejects all false theories and hypotheses,
 and follows only the philosophical and rational science of medicine,—
 "true, simply, because it obeys the laws of induction,"—the empiric,
 or supporters of partial  systems lay their foundations upon some old
 theory long since  exploded.   For instance, the  humoral pathology,
 "all diseases arise from  bad  matter in the  blood;  they only differ in
 the mode of expelling it from the system;  one  purges out the peccant
 humor, the other washes and sweats it forth."*
   It has often been said as a reproach to medical men that "doctors
 disagree."  Formerly this was  too often true ; even thirty or forty
 years ago there  were great divisions of parties in the profession, one
 party advocating a depleting or antiphlogistic course, and the other a
 high stimulating course.   Happily these divisions have passed away ;
 now there is great harmony in the profession;  all are united in their
 efforts to establish  a rational system of practice,  depending  more
 upon  the  recuperative efforts of nature.  The saying that "the doc-
tors  make worse before they make better," is  with exceptional cases
3
* Principles of Medicine. 
20
no  longer  true  of the wisest and best classes of physicians.  Their
practice is  more of a soothing, quieting character, often making their
patient more comfortable from the first visit.*  If this  improvement
in practice shall remove that feeling which many families have  long
indulged, fear of sending early in the disease for medical assistance,
lest " they  should certainly be sick if they had a doctor," it will do as
much good indirectly as directly, giving an opportunity for the use of
appropriate means in the forming states  of the disease.
   The American Medical Association, composed as it is of delegates
from all parts of the United States, has an important influence upon
those members of the profession who have identified themselves with
it, so as to derive those benefits from  it which it is  designed to  im-
 part.  This association,  in connection  with the state and  county
 societies,  is making great efforts to induce  medical men to make
 more careful observations in relation to the history, symptoms, treat-
 ment and results of  disease,  the  nature and action of remedies.
 This plan, if carried out faithfully, will have  an important influence
 in correcting present principles, and establishing new  ones.
   I have given a rapid and very imperfect sketch of the science of med-
 cine, but sufficient to show that it is progressive, not regularly and uni-
 formly, but as we witness the growth cf a human being,from infancy
 to adult age; we see not  a regular uniform advance  from year to
 year ; rather some years stationary, or making  hardly a perceptible
 advance,  then  as it approaches manhood,  making  rapid  strides to
 maturity; or rather like the intellectual  faculty, manifesting itself in
 the infant as a feeble, flickering, variable principle, progressing through
 childhood, youth, mature age ; clouded for a  time by the infirmity and
 decay of animal life, but destined (if sanctified) after it has escaped
 from its prison house to make more  rapid advances,  shining brighter
 and brighter throughout eternity.   So  with  medical science: having
 passed through infancy,  childhood  and youth,  it has during the past
 years of the nineteenth century, been making rapid  advance toward
 perfect manhood, and is destined  hereafter to attain to  great per-
 fection.
    It is characteristic of all mere theories and false systems of practice
 that they are not capable of embracing the truths already established.
 In order to maintain them with any plausibility, facts must be sup-
 pressed, or perverted ; but there  is  not a  truth in Thomsonianism,
 Chronothermalism, Hydropathy, or Homeopathy, that our system can
* See Prize Essay by Prof. Worthington Hooker, Rational Therapeutics. 
21
  not appropriate and apply, in building up a perfect structure. Unfor-
  tunately, the truths, compared with the errors and false principles in
  these systems, are infinitesimals.   We are prepared to receive truth
  from every department of nature, from any source, however humble.
  Some of our important remedies have been brought  into notice  by
  humble individuals in domestic practice.
    Regular medicine may be compared to a great edifice with exten-
  sive wings.  It is founded upon a rock.  The basement and  the first
  stories are built of solid and permanent  materials.  The  superstruc-
  ture and the wings are  yet imperfect; some of the materials used are
  faulty; some of the wings are not in proper  proportion ; but such is
  the construction of the building, that the failure of a  stone  here  or
  there does not endanger the building.  The defective materials may
  be removed, and perfect ones  substituted.  Some  of the wings may
  be removed or remodeled.  There is  an appropriate place in this
  extensive edifice,  for every  perfect  building material,  and every
  tasteful ornament.
   So medical science is of a compound character, or rather including
  a number of sciences.  It is  founded  upon the  rock  of truth; then
  come those sciences that are nearly  perfected, and demonstrated,
  anatomy  and  physiology, the  collateral sciences, which may be com-
 pared to wings; the superstructure to  practical  medicine, yet in a
 forming, improving state, but destined to be more and more  rapidly
 improved and perfected.
   Another evidence of the truth and vitality  of our  system, is the
 fact that it is the only one that has maintained its hold upon the
 confidence, upon the most intelligent portions of the communities, for
 any long period.
   Others have for a short time blazed up with some  brilliancy, but
 like the ignis fatuus,* flitting  from bog to bog, over the meadows,
 now shining, then dark, then faintly flickering, till the sun arises, and
 it is gone.
  I have  only very imperfectly presented the claims of our profession,
 but I have no time to pursue the subject further.  I will briefly allude
 to the mutual responsibilities of physicians  and  their patients or the
community.
  One great fact should be impressed upon the mind of every physi-
cian and his patients, that they  have not only mutual responsibilities,
but their interests are  in  a great  measure identical.  Whatever the
*Jack o'Lantern. 
22
physician does to qualify himself for the  practice of his profession,
whatever skill he may acquire and exercise in the  rapid and perfect
cure of his patients, will also promote his own interests, extending his
reputation, enlarging his business, and adding to  his  resources, but
above all, giving him that peace of mind which arises from  the per-
formance of good deeds.  On the  other  hand, whatever  patients do
for the benefit of their physicians, in ways that I shall point  out, will
tend to make them better practitioners, so that in  subsequent atten-
dance, they may be able to afford more efficient aid.
  If the difficulties and uncertainties attending the practice of med-
icine, the amount of learning requisite to  prepare one to engage in it,
are in any measure what I have represented them to be, the  respon-
sibilities resting  upon  the  physician  are  enough  for men of the
greatest minds, of the most untiring industry.
  Every one about to enter upon  the practice  is under imperative
obligations to obtain a  thorough education.   His mind should be well
disciplined  by a thorough course, adapted for that  purpose; then a
thorough study of the  elementary and collateral sciences, attendance
upon the best medical  schools of the country ;  after this he should
learn  clinical  medicine under the instruction of  wise teachers, in
hospitals and private practice.   No conscientious man, if he under-
stood the subject, would do  less.  The physician  should know that
his  professional business  is  of sufficient  importance  to  occupy the
best energies  of his mind and body.   He cannot be a successful
practitioner if he gives any considerable portion of  his time to poli-
tics, farming, or manufacturing.  The study and practice of medicine
are such as to demand the undivided attention of the greatest minds,
much more those of moderate capacity.
  He is to continue a  student  as  long as  he continues  in  practice;
there is to be no relaxation on account of age or experience.  There
are yearly, monthly, and daily improvements in medicine, which he
can not know and take advantage of, unless  he attains  and keeps up
the habit  of study and investigation.   If he gives  up study,  let
him leave his patients  : he has no right to  approach the sick, unless
with the best preparation in his power.
  The gratuitous services of the physician, to which I have alluded
in another place, may  be performed in such a way and with such a
spirit, as to be a task and a burden to  the  one  who performs  them,
and be little calculated to elicit the  gratitude of the recipient.  But
when  they are the result  of a truly benevolent,  cheerful, willing
spirit, they carry their own  reward to  the giver, and often  call forth 
23
the spontaneous thanks of the receiver.  The physician has only to
imitate, as far  as possible, the only perfect being that  has  appeared
on earth, who, while he preached the gospel to the  poor, healed the
sick, in order to obtain the approval of a good conscience, and receive
the blessing of those ready to perish.
   The true physician  will be not only a messenger  of  love, but one
of hope   and  good cheer. Instead of  ministering to the fears and
gloomy anticipations of his patients, in order to get the credit of per-
forming  wonderful cures,  he will give  them the full  benefit of all
the hope there is in their case, allaying all unnecessary alarm, quiet-
ing their fears, and often, by his cheerful looks and benevolent  coun-
tenance, contribute as  much to their recovery, as by the medicine he
administers.
   Much  talking with the sick or their friends is profitable to neither
party, but often leads  to serious  difficulties.   When anything is said,
let it be  the frank, open-hearted, out-spoken truth.  Misunderstand-
ing  and jealousies  are often prevented by  a little  plain talk.   The
whole truth is not to be spoken at all times and under all circumstan-
ces, but whatever is said, let it be the truth, and nothing but the truth.
We  may have the most serious apprehension concerning our patient.-.
and  still there may be so much uncertainty about the result that it
may be wise to communicate our fears to the friends  of the patient
rather than by any direct communication to give unnecessary alarm.
The mutual confidence that exists between  an honest, upright, prudent
physician  and  his confiding,  trustful  patient,  is  of a peculiar and
interesting character and should never be  betrayed.   The physician
who is guilty  of a breach  of confidence, does it at  his peril.   If he
persists in it he is sure to lose his business as well as his reputation.
This confiding spirit, if rightly improved, may eventuate in great good
to the patient.   Sickness and suffering often lead the sufferer to more
just  views of the comparative value of this world and  the one  to
come,  a  more  correct understanding  of  their own character, and
result many  times  in the  formation  of good  resolutions for the
guidance of their future conduct.   It  is within the province of the
physician  to  strengthen  these good intentions, and encourage his
patients, during their convalescence, to higher and higher attainments in
sound morality and pure religion.   Consultations in difficult and pro-
tracted cases,  if rightly conducted, confer those mutual benefits to both
physician and patient, to which I have alluded.  If there is harmony
between  the  parties in the  selection of a counselor, and he has the 
24
 confidence of  both parties, the influence will be favorable, whatever
 may be the result of the ease.
   Patients and their friends should exhibit the same frankness toward
 their medical  attendant, that I have enjoined upon the physician.  If
 his visits are not as frequent as you desire, tell him so plainly, rather
 than complain of neglect.  If they are too frequent, inform him ; but
 then, if he is an honest, conscientious man, leave the decision with him.
 If you wish for a counselor, fear not giving offense by frankly stating
 your wishes.  But in stating the obligation of patients or the commu-
 nity to their physician, I prefer to do it mostly by extracts,  and in the
 first place from the code of medical ethics.
   " Sec. 1.   The members of the medical profession, upon whom are
 enjoined the performance of so many and arduous duties toward the
 community, and who are required  to make so many sacrifices of com-
 fort, ease and  health, for the welfare of those who avail  themselves
 of their services, certainly have a right to expect and  require that
 their patients  should  entertain a just sense of the duties which they
 owe to their medical attendants.
  " Sec. 2.  The first duty of a patient is to select  as his  medical
 adviser one who has received a regular pi-ofessional  education.   In
 no trade or  occupation do mankind rely on the  skill  of an untaught
 artist; and in  medicine, confessedly the most difficult  and intricate of
 the sciences, the world ought not to suppose that knowledge is intui-
 tive.
  " Sec. 3.   Patients should prefer a physician whose habits of life
 are  regular, and  who is not devoted to company, pleasure, or to any
 pursuit incompatible  with his professional  obligations.   A  patient
 should, also, confide the care of himself and  family, as much as pos-
 sible, to one physician, for a medical  man who  has been acquainted
 with the peculiarities of constitution, habits and predisposition of those
 he attends, is  more likely to be successful  in his treatment, than one
 who does not possess that knowledge."
  " Now," says the Rev. Dr. Tappan, Chancellor of the University of
 Michigan, in an eloquent address  entitled " Mutual Responsibility of
 Physicians and the Community,—" Now to whom shall we look for
a reliable medical science ? shall we look to him who  deals in charms
 and spells ?  shall we look to the rude empiricism of  the  unlearned?
 shall we look to the Indian root doctor ?  shall we look to  those who
 without any claim to be scientific,  compound elixirs,  pills  and pana-
 ceas,—men  unacquainted with anatomy, physiology,  chemistry and
 botany,—ignorant alike of nature  and man,—mix drugs at random, 
25
and have no merit but that of exciting the imagination of the unthink-
ing by the mystery under  which they conceal their shallowness or
their atrocity ?   Shall we look  to subtle theorists,  who, although not
without learning, have forsaken the only safe methods of investigation,
and are  led  astray by imaginary facts, and dream of potencies  yet
undiscovered, and voiceless, intangible, aerial agencies ?  Or, shall we
look to those old established schools where  learned men and  true
philosophers  have  ever been  found ?  At these  schools  there  is
neither sciolism nor mysticism.  Here, scholarship is thorough, and
fact is not outrun by speculation.  Here, medical science has advanced
in company  with the other sciences,  and  by the same method, and
often by  the  same men.
   " If genius, learning, philosophical  conception, legitimate investiga-
tion, and the utmost diligence, with all the aids that have hitherto been
collected in our world,  can meet with any success in any region of
inquiry, then we must go to these schools to find the result.    *    *
   " If their  discipline  can not make reliable physicians, then  our
world is  destitute of them.        *       *        *       *
   " Do any find fault with our schools ?   Then  let them aid us to
perfect them.  Try not to pull them down.  There is nothing to put
in their place.   Improve them  as  much as you  please ;  lend every
effort to  bring  them up to  the ripest development.  You can  not
change the  science, the method, the aim,  without annihilating them,
and with them annihilating all medical education.
   " Do any find fault with the doctors of medicine we send  forth ?
Let them create a public opinion that shall stimulate, aid and foster us,
by demanding of our candidates the amplest preparation.  But let
them not abet the magician, the spirit-rappers, the ignorant or unprin-
cipled  empiric,  the wild and  loose theorists  of all  kinds.  We  at
least are on the right  track.  We are trying to do some good  in.a
legitimate way.   If our eagles do not fly near enough to  the sun, do
you find anything more  like  the birds of Jove among the quacking
brood in the marshes below.        *       *       *      *
   " Be at least as prudent in buying medicine as you are in  buying
flour and meat, where you  first assure yourselves  of the quality.
Be at least as prudent  in choosing a physician as you are in choos-
ing a tailor and a shoemaker, where you first  satisfy yourselves  that
he  is  a proper workman  and no  bungler.   What is  the madness
which impels us to  run  such fearful risks of health and life ? "
   "And  when you have chosen a physician, thoughtfully, judiciously,
and know that he  has  talent, tact, education, experience, kindness, 
20
 truth, honor and morality, treat him accordingly.  Repose confidence
 in him.  Submit to his  skill and discretion in your sickness.   Do not
 call him in merely to hear your own views of your case, and  to share
 the responsibility of your own empiricism.  Let him be fully, truly,
 and wholly your physician.   If results do not come as rapidly as you
 desire, do not dismiss  him to try new  experiments.   His judgment
 must be better than your own.  You may die  in his  hands, it is true.
 But what grounds have you for believing that you will better your case
 by calling in another man, or by resorting to an empirical practice.  We
 must all die at last; and the very change you make to elude your fate,
 may be an act of imprudence, which seals and hastens it."
   " It is your right to ask for consultation ; but respect the judgment
 and wishes of your physician in  the  selection.   Treat  honorably
 your good and tried physician.   Recollect his interests are  your
 interests."  "And when health returns be grateful to him.  Grudge
 him not his equitable fees,  and delay not their payment.   The  man
 who has been instrumental in saving your life, in restoring to you the
 blessed sensation of health,  has  done more for you than if he had
 given you an estate."   " What will  not a man give in exchange for
 his life."
   I have quoted thus largely from the reverend doctor because it is
 eloquently expressed,  and  coming  from  such a  source it  has the
 further  merit of disinterestedness.  For the  same  reason  I  quote
 farther from an unknown authoress.*  " Like  other  men, the physi-
 cian has his susceptibilities to sympathy, and needs encouragement and
 appreciation.   He needs co-operation with his services,  forbearance
 with his mistakes, and the same charity for his foibles and faults that
 we feel  that we have a right  to  expect from him toward our  own.
 Sometimes a physician  is  dismissed for some slight mistake, some
 oversight or omission, which, from the very painfulness of his experi-
 ence in consequence, he would be on double guard  against ever after,
 and his place is supplied by one  who perhaps falls  into the same or
 more  serious  misjudgment, and  in his turn  is likewise  dismissed.
None are infallible; therefore should the ill-timed and unnecessary
criticism be suppressed with the  same  consideration we look for him
 toward the weaknesses and faults his position  enables him to discern
in our domestic circles.   Nor  should we expect in  him creative or
* Melva, Family Guardian. 
27
 omnipotent power ; for when the fated arrow is sped from the quiver
 of the Almighty, no human hand may stay it.
   "Like that of other mortals,  the physician's ear must sometimes
 weary of querulous tones, impatient complaint, and the continued minor
 key of the invalid's moan.  The inmates of that home who during a
 morning call from their family physician impart to him of those precious
 but  intangible social influences which  elevate, strengthen and cheer,
 may unwittingly transmit rays of sunshine and hopefulness through the
 whole round of his  day's  ministrations.   Animal spirits  will flag
 sometimes under constant drafts upon sympathy and patience and the
 pressure of anxiety and responsibility.  Then do such influences  do
 him good like a medicine.
   " Irregular meals, loss of sleep, the driving blast or cheerless rain,
 and the chilly night  air, are  as repulsive to him as  to other  men.
 The mental  quiet that takes possession  of the  business  man's mind
 when  he feels that his  day's work is done, the  physician can also
 appreciate, and it would be equally agreeable to him to feel that there
 was no  liability to an interruption  of the social  chat;  no  call  from
 the  warm, attractive  fireside; no necessity for  relinquishing  slipper
 and easy chair, and the enjoyment of  a new publication, or converse
 with family or friends."   "But if suffering humanity calls, the call is
 imperative.  Personal comfort or social courtesy must  be foregone at
 a moment's notice, and domestic attractions exchanged for the anxious
 and often repulsive service  of the sick room.   Let the family,  then,
 who enjoy the friendship and services of a physician whose  qualifica-
 tions meet their moral and physical needs, who is to them  an acqui-
 sition, a household blessing,  duly appreciate,  love,  honor and  sustain
 him.  Let them remember him at the domestic altar,  and in many a
 token and attention of social life, as they do their pastor, and so regu-
 late  the  intercourse of the relationship that there may be  mutual
 advantages,—reciprocal  aids in learning  how to live and in prepara-
 tion for death."
   I  will add only one or two  ideas to  those  so  eloquently and
 forcibly expressed  above, and  those such as can only be fully appre-
 ciated by the medical  man.  The studies to be prosecuted  after one
 has entered upon  practice, though  all-important,  can  be pursued  at
best only under great difficulties.  The whole  day, including many
times the twenty-four hours, will be wholly occupied  in attendance
upon the sick, and this often in consequence of irregular and untimely
calls unnecessarily made.   This is  especially the case  when the
                  4 
28
 physician's practice extends over a large region of country.  If the
 patients or their friends were only to inform their medical attendant
 of their wants early in the day, stating as near as possible the urgency
 or the opposite of the case requiring attention, he might so arrange his
 business as to leave a valuable  portion  of his time nearly every day
 for reading and investigation, which otherwise may be entirely lost in
 "•oing over and over the same roads and  streets.  This  is another
 instance of the mutual interest of physician and patient.   By giving
 the former time for improvement, he acquires  knowledge and skill
 which is applied for the benefit of the sick.  I have always had some
 families who  were careful to send in the morning, and if the case was
 not urgent to request attendance in the course of the day.  Such
 families have always had  my best attentions, while those who were
 always  crying wolf! wolf!  may  occasionally  have suffered  when
 actually in his clutches.
   In conclusion,  let us for a moment look forward to that medical
 millennium which  we*  shall never  behold, but may be allowed to
 anticipate, when  the science of medicine shall  be perfected; those
 principles now uncertain be fully  elucidated and  established; when
 every practitioner shall be thoroughly and perfectly educated for his
 profession, and withal be a benevolent, upright,  conscientious  man,
having such  full  confidence  in those to whose  wants  he ministers
 that  he  will have no anxiety for his own temporal wants, but be able
 to give the whole energies of mind and body to  the investigation and
 removal of disease and suffering;  when the most delicate and refined
 female shall  be able to find a physician in whom she  can place such
 implicit confidence as to impart to him the first  indication  of disease,
 and  thus  avoid years of suffering;  when  every woman who now
 wisely selects a machinist to regulate her sewing machine, or a prac-
 tical musician to tune her piano, shall act as  discreetly in the selection
 of one to regulate that delicate mechanism  which sends a glow of
 health and  beauty  through her  frame, or those  ten  thousand ner-
 vous filaments, which, when in tune, send thrills of joy  and pleas-
 ure  through  her system;  when every manufacturer shall select his
 physician as  wisely as he does his machinist; every lawyer, who in his
 profession examines evidence so closely and  estimates it so exactly,
 shall examine science  before  he  rejects it; every minister of the
 gospel  shall  hate  nostrums as he  does  Pantheism,—avoid  infini-
 tesimals as  he would transcendentalism,—believing there is science
 in medicine as well as theology; when all persons,  in  every depart- 
29
ment of life, shall fully  and  perfectly understand  the  laws of
hygiene, and be willing to follow them, thus preventing a vast amount
of unnecessary disease,  so that  what is suffered may be justly and
truly termed  a dispensation  of  Providence; when the  whole com-
munity  shall unite  with  the wisest and best physicians in arresting
disease  in its incipient state, curing what in this approaching, enlight-
ened age,  shall be curable, greatly  alleviating  and palliating what
is incurable.   " Blessed  are  they who see the day  of glory, but
more blessed are they who contribute to its approach." *
Seeker.*