AN ADDBESS
CLASS OF THE MEDICAL COLLEGE OF GEORGIA,
AT THE OPENING OF THE SESSION OF 1846-7;
CONTAINING
A SKETCH OF THE IMPROVEMENTS IN MEDICINE
DURING THE PRESENT CENTURY.
      By L. A. DUGAS, M. D.,
Professor of Physiology and Pathological Jlnatomy,
(published by the class.)
       AUGUSTA:
/AMES McCAFFERTY, PRINTER.

        1846. 
 
                                     AUGUSTA, Ga., Nov. 12th, 1846.
Prof. Dugas :
  Dear Sir,—At a recent meeting of the  Students of the Medical College of
Georgia, the undersigned were constituted a committee to request a copy of your
very appropriate and excellent Introductory Lecture, delivered on the 9th inst.,
for publication.
  Permit us to hope that the earnest desire which the Class feel, and which they
authorize us  to express—to see your manuscript in a more durable form—will
not allow you to with-hold it.
         We have the honor to be, with great respect, yours, &c.
                                   T. C. DAVIS,        1
                                   J. N. SIMMONS,      } Committee.
                                   ROBT. CAMPBELL.  S
                                         AUGUSTA, 14th Nov., 1846.
  Gentlemen,—Conscious that the Introductory Lecture of which, in behalf of
the Class, you solicit the manuscript for publication, is by no means such as I
would like it to be,  yet desiring to meet the wishes of those for whom it was
specially prepared, I yield to the request you are pleased to urge in such flatter-
ing terms.
  Be pleased to accept and to tender to the Class the expression of my kindest
regard.
                       Very truly, your friend and obed't serv't,
Messrs. T. C. Davis,     1                              L.  A. DUGAS.
        J. N. Simmons,   > Committee.
        Root. Campbell. ) 
 
AUDIDmiSSS,
 Gentlemex of the Class :—
   My colleagues having assigned to me the agreeable office of greeting
 you on the present occasion, I would be doing injustice to the prompt-
 ings of my own heart,  as  well as to the feelings of those I represent,
 were I  not most cordially to welcome you into the halls of this Insti-
 tution ;  not  indeed as strangers, but as  companions of study, as
 co-laborers in  the  great  field of Science,  as brothers in a  common
 cause—a cause replete with interest to  the novice as well  as to the
 teacher—one eminently calculated to endear us to each other, and in
 which  all distinctions disappear, save  those founded on scientific at-
 tainments and  gentlemanly deportment.  Yes,  gentlemen, it is  with
 unfeigned pleasure that we extend to you the right hand of fellowship,
 in token of that harmonious accord we confidently  anticipate from
our future intercourse.
   The  studies  you are about to commence,  although laborious, and
 indeed interminable, present attractions such as are offered by no other
 department of  human knowledge, for they comprehend all that is most
interesting in Nature's works, and relate specially in all their bearings
to the welfare of him who was created in the likeness of his Maker.
The  study of  Medicine, therefore, not only enlarges the mind, but
 also cultivates  those kindly sympathies so well calculated to develop
 benevolence, the most unfailing source of human happiness.   Unlike
those subjects of mental pursuit,  whose end is mere recreation, and
 which  leave no reminiscences on which we may dwell with pleasure,
this is one in whieh the agreeable and the useful are so intimately blend-
 ed, that the farther wc  advance in it, the more fascinating it becomes,
and the greater is the store from which we may draw as utilitarians,
or admire in silent contemplation amidst the turmoils of life.
   The  field is vast indeed; nay, I repeat, it is interminable !   To cul-
tivate it effectually, requires untiring industry.  It has been aptly said
that to make an orator requires action,  action, action! but I tell you,
that to  make a good physician, requires study, study,  study!   The
founder of Medicine begins his immortal  aphorisms with the exclama-
tion that Art is long and life is short!  He  has couched in those few
words an idea that should ever be present to the mind of the student,
to whom so little time is allotted for the  attainment of the great fund of
informatiorAe  will need at the very outset of his professional career.
   The  profession of Medicine  possesses the  peculiar  advantage  of 
6
being perfectly accessible to all who will unite to natural endowments
a sufficient degree of industry.   In Europe,  where  the Church, the
Bar, the Army and the Navy, are the high-roads to political as well as
to social preferment, we find the members of those professions almost
exclusively derived from the wealthy and aristocratic classes of society.
In our country, those who are ambitious of political station usually select
the  Bar..   The Medical profession  is,  on the contrary, made  up of
those whom neither wealth, nobility, nor political  ambition, prompt to
seek any other than scientific distinction—that which can neither be
bought with gold nor acquired by hereditary transmission, but which
must flow from personal merit alone.  It cannot be concealed that many
enter this profession as a means of earning a livelihood ; but it  is an
innate love of knowledge, a desire to look into the mysteries of Nature,
which prompts them, unconsciously perhaps, to  select this in prefer-
ence to other pursuits in which less scientific research is necessary.
  Inasmuch then as Physicians are not men who have been forced into
the  profession by the accidents of birth or fortune, but who enter into
it voluntarily, as a matter of choice and from the love of science, we
should expect to  find in their ranks most of the eminently scientific
men of all countries.   Indeed, it has been remarked since the estab-
lishment  of scientific conventions in the principal nations  of Europe,
that those bodies are constituted almost entirely of physicians, either
in the active  practice of their profession, or who  have, after acquiring
it, devoted themselves to some special department of natural science.
  The Class in attendance at present, is, doubtless, composed, like all
classes of Medical students in Europe  as well as in this  country, of
the  rich and the  poor, the favored and the less fortunate, the collegiate
graduate and the self-made man, the accomplished scholar and the less
informed.  But, as all  are actuated by the same love of science, these
distinctions will vanish before their professional  progress.   It is true
that those who have received a good education and have acquired the
habit of study, will have fewer obstacles to overcome than those dif-
ferently situated.   It is also true that those who are better endowed by
nature will have the  advantage.   Yet,  it should be borne in mind, that
neither previous  advantages nor superior endowments will  compensate
for  deficient industry—for no  fact is better established than that the
great majority of eminent men have commenced their career with very
slender advantages, and even with natural endowments by no means
in accordance with the position to which they have attained.   Their
advance has  always  been the consequence of that thirst for knowledge,
that intense  application, that unremitting devotion to study,  which
overcome all obstacles.  Let your motto also be  " Labot omnia Vin-
cil," and success must attend you. 
7
   It is proverbial in most communities in which Medical institutions
 are located, that their classes consist of remarkably heterogeneous
 and unpromising materials in comparison with those  attending other
 professional studies.  The reason of this has already been hinted.
 Moreover,  the lover of Truth  and the admirer of Nature, cares but
 little for the vain ornaments of a depraved and fictitious taste, whilst
 the thoughtless, accustomed to judge men by their external appearance
 and attire,  remain unmindful of the important fact that many a gem
 lurks beneath the  crusty envelop which  crude  nature has thrown
 around it, and that it needs but the industry of the lapidary to be ex-
 hibited  in  resplendent beauty!   See the homely  pebble exhumed
 from the mountain-cliff, and thrown aside as valueless by the ignorant
 and unobserving.  It has been rescued by one better acquainted with
 Nature's laws, submitted to cleavage and polish, and lo! it shines
 forth with the brilliancy of a diamond of the first waters !   Behold that
 rude block  of marble,  just drawn from the bowels of the earth, with-
 out form or symetry,  a shapeless mass of inexpressive matter! yet,
 in the hands of a Phidias or Praxiteles, what charms does it not assume
 as the chisel gradually removes the cumbrous covering beneath which
 lies concealed a Laocoon, a Venus or an  Apollo, inanimate, yet full of
 life—cold, yet radiant with feeling—-mute, yet speaking a language  of
 unsurpassed eloquence!
   As nothing can be more unwise than to attempt to determine the
 character of inanimate objects by mere superficial  observation, the
 principle must apply with tenfold force to man, whose noble and im-
 mortal spirit can never be but imperfectly represented by his physical
 appearance.  The genius of Lavater has failed to render physiognomy
 an index of the innef man, and the acumen of Gall to impart any real
 value to the  form of the  cranium; and shall we still found our esti-
 mate of  individual minds on the garments worn by the body ?   I am
 happy to say that such  is not  the  case in our city, whose population,
 being comparatively small, and consequently brought into more imme-
 diate contact with the students, merit is more properly appreciated and
 has uniformly met with the kindest regard and hospitality.
   The course of instruction we have to offer you,  is divided into the
 Elementary and the Practical branches; the former comprehending
 Anatomy, (normal  and pathological,) Physiology,   Chemistry, and
 Materia  Medica; the latter the Practice of Medicine, of Surgery, and
 of Obstetrics.  The Practical branches, being based upon principles
 deduced  from the Elementary,  it  becomes of paramount importance
 that these be thoroughly understood by the Student, before he can ex-
pect to derive much advantage from lessons in the former.  Hence it
should be the business of the less advanced or junior  members of the 
8
class to give especial attention to  the Elementary studies, whilst the"
senior members will naturally look with most interest on those termed
practical.
  One of the most striking features of the human mind is the love of
mysticism, of the marvellous,  the  incomprehensible, the creations of
fancy.   We see this daily and hourly in our intercourse with man-
kind ; we find  it in strong relief in every periodical thrown into our
hands-;  it is the leading attraction of the great mass of publications
even of a more  permanent form.   How immense the number of works
of fiction, when compared with those of observation,  of fact! and  how
few there are who read the latter, whilst the former are sought  with
avidity by  all classes of readers !   The history of Medicine presents
one of the strongest illustrations of this mental peculiarity.  The very
founder of Medicine, although acquiring immortality by his vast collec-
tion of facts, which, as such, must ever remain invaluable,  could not
refrain from mixing them up with the  most extraordinary vagaries
imaginable.  Galen, who advanced our knowledge of the Elementary
branches more than any single individual prior or subsequently to his
time, has so completely wrapped up his discoveries in  numerous and
ponderous volumes of theoretical trash, that it were an Herculean task
to winnow its wheat from the chaff.
  For fourteen centuries after the death of Galen, we find in Medical
literature little  else than commentaries on  the theories of this great
master, or substitutes offered  for them by writers of less genius, the
profession at large still regarding his views as oracular.   Although to
the three centuries preceding the  present Ave are indebted for many
important discoveries,  we find theoretical sectarianism then still in the
ascendant, and whilst the ancients were Dogmatists, Empirics, Method-
ics, &c, more modern  medicine presents us the sects of  Chemists,
Anatomists, Mathematicians, Yitaiisls, Humoralists, Solidists, &c.
  To the nineteenth century emphatically belongs the merit of a sys-
tematic effort on  the part of Physicians to  dethrone Imagination, to
elevate Observation in her stead,  and thus to establish Medicine on
the sure basis of f.icts, and facts  alone.  Let us review some of the
results obtained by this effort in the brief space of fifty years.
  Anatomy had long been in advance of the  other branches of Medi-
cine.  Being  purely demonstrative, its progress was never impeded
by theoretic speculations, and could only be retarded by the supersti-
tious prejudices of former ages.  Anatomists, however, having descri-
bed  with considerable accuracy the various organs of the body, seemed
to have accomplished all in their power, when the genius of Bichat,
penetrating beyond mere external  forms, analyzed the organic structure
itself, and  led to the  establishment of those simple tissues, which in 
9
 their turn yield  to the chemist the elementary  principles  of animal
 matter.  If we add to these improvements the discoveries of Serres,
 and GeofFVoy St. Hilaire, in Transcendental Anatomy; ofEhrenberg,
 Donne, Mandl, and others, in Microscopic Anatomy; of Cruveilhier,
 Andral, Louis and Carswell, in Pathological  Anatomy; of Velpeau
 and Breschet, in Embryology ;  and of Cuvier, Meckel and Carus, in
 Comparative Anatomy, we must acknowledge that in this department
 of our profession, the present  century has far exceeded any other in
 the multiplicity ^ind importance of its results—that it has indeed made
 of Anatomy a new science.
   Physiology, the offspring of Anatomy, has advanced with it under
 the fostering care of Magendie, Bell, Burdach, Muller, and Carpen-
 ter, who, by direct experiments and vivisections, have elevated it to a
 degree of importance equal at least to that of any other of our profes-
 sional acquirements.
   Most of our principles of diagnosis, and consequently, of the treat-
 ment of diseases, are founded on the knowledge of the normal functions
 of the organs; hence, every step made by Physiology must be hailed
 as a victory.  But,  however  much  we  may perfect our means of
 scrutiny, there is a limit beyond which we can never hope to penetrate.
 Of efficient causes, of the manner in which results are produced, we
 must ever remain ignorant.  We know, for example, that there issue
 from the  spinal cord numerous  nervous filaments, certain of which
 convey to the parts to which they are distributed the faculty of motion,
 Whereas the others  preside over sensibility; but  it were difficult
 indeed to  assign the cause of this difference  of function, and much
 more so that of the production  of either.  These limits to the human
 understanding are not peculiar to the study of animal functions; they
 are felt in all sciences.   The natural philosopher is taught the lesson
 of humility by the very first laws of physicks.   " The communication
 of motion from one body to another by impulse, appears a very simple
 phenomenon, but how  little idea have we of the cause of it!  we say
 the bodies touch each other, and so the motion is communicated.   But
 in the  first place, we cannot say why a  body in motion,  coming in
 contact with one at rest, should put the  latter in motion ;  and farther,
 we know that they do not come in contact.   We may consider it indeed
 as ascertained, that there is no such thing as the actual contact of bo-
 dies under these circumstances; and therefore, the fact which appears
 so simple, comes to be as unaccountable as any phenomenon in nature.
 What again, appears more intelligible than an unsupported body falling
to the ground ?   Yet,  what is more inexplicable  than that one mass
of matter should thus act upon another,  at any distance, and even
though a vacuum be interposed between them ?"  We know that food
                                B 
10
placed into the stomach is changed into chyme, that the liver secrete*
bile, that saliva flows from its appropriate glands, and that the braira
is the organ of perception ; but the cause of cither of these results-, or
even of this diversity of action, is yet, and must ever remain shrouded
in impenetrable obscurity.'
   The study of remedial  agents,  and of their action on the system,
engrossed  much  of the labours of the ancients, and constituted, in
many instances, the  principal source of their celebrity.  Under the
conviction  that  each disease had its antidote in  Nature, the Materia
Medica could not long  retain its  original simplicity,  but became
crowded with every variety of natural productions, and almost every
form of composition  in the power of man to invent.  Simples were
indiscriminately thrown  together without regard  to discordancy of
action, and the efficacy of the prescription was deemed proportionate
to the number and diversity of its ingredients.   At present, the Ma-
teria Medica  of  the  scientific Physician is limited, with  but  few
exceptions, to those agents which have  been demonstrated to act on
determinate parts of the system, and  in a fixed, invariable manner ;
thus enabling him to know with much precision  the result of most of
his prescriptions.   These usually  increase, diminish, or otherwise
modify the functions of certain organs.  The peculiar action of each
being established, we may, at will, occasion emesis, catharsis, diuresis,
narcosis, &c, with a degree of invariableness  amounting almost to
positive certainty.
   The strides of Chemistry during the  present century,  are so well
known to every one, that it is barely necessary to refer to them in this
place.  It has not only furnished us with a large number of our most
valuable remedies, but opened to us an entirely new field of observa-
tion in relation to the acts of the animal economy.   Animal Chemistry
may now  be regarded as constituting a new science, the beneficial
effects of which are  as yet incalculable.   With  such men at its head
as Berzelius, Thompson,  Prout, Guy-Lussac, Thenard, Liebig, and
Simon, Chemistry may at present boast as bright a galaxy of intellect
as any department of human knowledge.
   Surgery, until a  comparatively recent date,  abandoned to barbers
and itinerant quacks, was rather a dexterous art than a  cultivated
science.   As its practitioners possessed  no knowledge of physiology,
and very little of anatomy, they were indebted for their success solely
to their boldness and adroitness.   Not unlike the jugglers of the pre-
sent day, many of them roamed from  land to land, practicing with the
most mysterious injunction of secrecy, operations for the performance
of which they had acquired more or  less celebrity.  In the hands  of
such individuals,  destitute of  principle as well as of education, this 
11
 important branch  of the healing art made but little progress.   Its
 connection with the study of medicine however, impressed upon it a
 new character, and upon surgeons a degree  of respectability such as
 to secure amongst  them talents of the first order.
   For the last thirty or forty years the improvements of Surgery have
 been such, that were it possible  to resuscitate the  ablest Surgeon of
 the  last century, he would with  difficulty  recognize the fraternity to
 which he had belonged.   What, indeed,  would be his surprise on
 seeing Lues considered by many as a local  disease, and treated suc-
 cessfully by antiphlogisties alone ?   Strabismus, Club-foot, and even
 Curvatures of the Spine, which had baffled his best efforts, now effec-
 tually cured !  Hydrocele, ranked amongst the most manageable  af-
 fections ; irreducible strangulated Hernia no longer necessarily fatal;
 the amputated limb dressed with mere adhesive strips, instead of cum-
 brous  loads  of unguents, lint,  compresses, huge  bandages, &c.; a
 simple seton ossifying ununited  fractures;  the delicate silk ligature
 substituted for the  clumsy cord, and fearlessly carried around the ca-
 rotid,  the iliacs,  the subclavian,  and  even the inominata; the ampu-
 tating knife  and saw penetrating  the hip-joint,  removing the lower
 jaw, the clavicle, the elbow and knee joints; and the calculus removed
 from its repository without bloodshed and without pain!  And yet,
 after witnessing  all this, he would have  seen but a small portion of
 what the cause of  humanity had gained during his short absence.
   Striving, with the assistance of enlightened principles, to obviate as
 much  as possible all resort to the knife, modern surgery has gloriously
 succeeded in establishing the maxim that the palm should be awarded,
 not to  the adroit  performer of a  mere  manual operation, but to him
 who renders it unnecessary.  Dexterity is confessedly  advantageous
 to the  surgeon, yet  being possessed by few practitioners, it  has been
 the especial care of the present age to reduce operations to such fixed
 rules  as to materially compensate for the deficiency of that natural
 gift;  so  that operations, hitherto practiced almost exclusively by a
 few  famed residents of large cities,  now systematized  and fixed  in
 their various stages,  are within the  performance of every  country
 practitioner who has devoted any time to the study of Anatomy.
   We find the science of Obstetrics also keeping pace with the other
 branches of our profession, and  in many  respects approximating to
 positive precision.  Most of the  principles which guide  the practi-
tioner  are purely  mechanical,  and  consequently  invariable.   The
addition  of the rich store of facts and observations collected by Mad.
Lachapelle, Mad. Boivin, Denman, and Dewees, to those already re-
corded by the distinguished Baudelocque, has placed obstetrics  in a
state of  perfection almost a3 great as it can be expected to attain. 
12
  Nor has  the Practice of Medicine, properly so called, been behind
the other branches of our studies, in the march of improvement.  In-
deed, we hesitate not to say, that more has been accomplished in this
department during this, than had been done for many centuries previ-
ous—I might perhaps, without  exaggeration, say since the days of
Galen.   The dawn of this most brilliant epoch of positive medicine is
marked by  observations tending to facilitate the Diagnosis of Diseases,
without a correct  knowledge of which, practice can never be but the
most fatal empiricism.  The origin of correct diagnosis is to  be found
in the valuable work of Pinel, who first attempted a classification of dis-
eases according to the peculiar  structure or tissue affected.   Bichat
seized the idea thus advanced, and emblazoned it with the researches of
his active and philosophic mind.  Broussais, with his characteristic en-
thusiasm and energy, advocated the localization of diseases, and eagerly
invoked the aid of post-mortem examinations as alone capable of indi-
cating their true seat and nature.   The impulse of localization  was
given, and  Pathological Anatomy, hitherto but little known,  was re-
cognized as its most powerful and legitimate auxilliary.  Diseases, so
long regarded as incomprehensible entities,  as subtle agencies spread-
ing their noxious influence throughout the system, and attacking with
equal virulence all its parts, were now to be divested of their  mysteri-
ous character, reduced to known laws of organized matter, and cir-
cumscribed in their existence to fixed organs.   The French  metropo-
lis, in which the  principles of reform  Avere diffused, combined all the
advantages requisite  to the performance of the task.  Its numerous
hospitals, with appended and well regulated amphitheatres, thrown
open to the lovers of science  by an enlightened and liberal govern-
ment, became so  many head-quarters, thronged with men of genius
and untiring industry, from all nations.  The symptoms and treatment
of every case, as well as the post-mortem appearances of all who died,
were carefully recorded for the purpose of furnishing the most valua-
ble deductions.   Diagnosis enlightened, special  modes of treatment
extensively and  systematically tested, medical  statistics  carefully
kept, and  facts substituted for theories, have yielded results  that are
now being applied in every land. The labours of Broussais, Cruveil-
hier, Andral, Rostan, and Louis, in France; of Graves, Stokes, Hall,
Elliotson, and others, in  Great Britain, would furnish us with ample
matter  for  expatiation ; our limits,  however, will  permit us only  to
dwell a few moments, to pay our tribute to the memory of the immortal
Laennec, unquestionably the individual who has done most  for Medi-
cine since  the early ages of the profession ; for if, as we have already
repeatedly asserted, facts constitute  the only true elements of Science,
he who has accumulated tho  greatest mass  should  stand foremost 
13
amongst its benefactors.   And who since Hippocrates has contributed
such a body of them as Laennec ?
   Endowed  with a mind of the  first order, and with industry that
knew no bounds, a liberal education had prepared him for the laurels
he was to  reap in the prosecution of a profession,  to which he was
enthusiastically devoted.  He early saw the invaluable advantages of
the system of study then prosecuted by his compeers, and devoted
himself most zealously to the investigations of Pathological Anatomy,
which he enriched with many striking observations.   He had already
won for himself considerable distinction, when, on visiting a lady who
had an affection of the heart, it occurred to him that perhaps the sounds
usually heard by applying the ear over the region of this organ, might
be modified by  disease, and  if so, it would be interesting to note such
modifications.   Delicacy, however, forbade the immediate application
of the ear in this case, and his fertile imagination supplied the means
by which the exploration might be effected without the least improprie-
ty.  Knowing how readily solid media transmit sound, yet  having no-
thing better at  hand, he rolled up firmly a few sheets of letter paper,
and, placing one end of the scroll against the patient's chest, applied
his ear to the other.  His countenance brightened as every beat of the
heart revealed the importance of his discovery.   He carried his rude
instrument over the chest, and, to his delight, found that even the gen-
tle murmur of the air penetrating the intricacies of the lungs was per-
fectly audible.  Elated with these results—for he immediately perceived
their importance—he sought the best material for the  conduction of
sound, and invented the instrument to which he applied the  name of
Stethoscope,  from the Greek, stethos, the chest, and  scopeo, I explore.
He then, at the Neckar Hospital, devoted himself  assiduously to the
study  of the peculiarities produced  in  the pulmonary and cardiac
sounds by disease, determined their relation to particular symptoms
and conditions, by daily post-mortem examinations,  and finally pub-
lished to the world that imperishable monument of  genius, industry,
and sagacious induction, the Treatise on Auscultation.
   The application of auscultation and percussion by Laennec,  com-
pletely unmasked one of the most extensive and hitherto obscure classes
of diseases to which mankind is  subject,  and one  in which may be
found perhaps the cause of  more mortality  than exists in any other.
The  diagnosis of Pulmonary affections was so little  understood prior
to the researches of this acute and indefatigable physician, that it was
almost impossible to distinguish their various forms from each other.
Pleurisy and Pneumonia, Tubercular Ulceration and Catarrh, were
continually confounded.  Empyema, Emphysema, Chronic Pleurisy,
Chronic Pneumonia, &c, were mere subjects of conjecture.   At pre- 
14
sent, all  obstacles are  removed,  every variety  readily detected,  its
locality determined, and its extent marked with  mathematical precis-
ion.   On approaching  the bed-side of a Pulmonic sufferer, the physi-
cian has at once the satisfaction of being as fully acquainted with the
affection he has to treat, as though it were exposed to cccular observa-
tion;  and although this satisfaction may be occasionally marred by
the discovery of the insignia of his patient's irrevocable doom, his con-
science,  at rest, will not torture him with the horrid suggestion, that an
error of diagnosis was  perhaps the cause of the fatal issue !
   But the advantages  of these physical signs are not limited to the
class of diseases we have just been considering.   They have been
applied with much success to Cardiac and Yascular affections.  Peri-
carditis, Endocarditis, Hypertrophy, Dilatation, and the various abnor-
mal modifications of the  valvular structure  of the  heart, aneurismal
enlargements, &c, formerly so difficult to detect, are now recognized
with the  utmost facility.
   The extension of auscultation and percussion to the study of obscure
fractures, and to the detection with  great certainty of the condition of
the abdominal and pelvic contents, the volume, position and density of
every organ, however deeply seated, as well as the  slightest dropsical
effusion, tympanitis, and morbid tumors, should also be added as legiti-
mate results of Laennec's great discovery.
   At the same time that Diagnosis was advancing so rapidly with re-
gard to diseases of the lungs, heart and other viscera, the phvsiolosrv
and pathology of the brain were also submitted to the strictest scrutiny
by Gall, Rostan,  Esquirol,  and others.   Their success, though  not
equal to that of those who studied organs susceptible of yielding physi-
cal signs, was sufficient to throw much light on the subject, and in many
instances, to  render the diagnosis comparatively ea^y and certain.
   Modern medicine has  been peculiarly successful in facilitating the
treatment of Infantile diseases.  At a time when the patient's testimo-
ny was the  only source of information, a correct knowledge of the
diseases of those deprived of language or of intelligence, as children
and idiots, was unattainable ;  whereas with the  aid of physical sions
and the method of exclusion, by which all organs ascertained to be in
a healthy state are excluded from farther consideration, there are few,
very few cases in which any difficulty will be experienced in  the  for-
mation of a correct diagnosis.
   The improvement in the treatment of Insanity constitutes one of the
most brilliant achievements of our age.  Formerly the unhappy victim
of dementia, cast oftTrom society, secluded in a  loathsome cell, loaded
with chains,  fed with  offals like the lowest of the brute  creation,  and
treated with fiendish cruelty by a mercenary hireling, was left to lin- 
15
 ger out  his  miserable existence  in his own  filth and  degradation,
 friendless, comfortless, and an object of horror even to. his dearest
 relatives, who, entertaining no hope of las recovery, hailed the intelli-
 gence of his  death as a providential and  merciful release!   How dif-
 ferent now!   Provided with  every comfort that benevolence  can
 devise, subjected to the kindest treatment,  without painful restraint,
 the continued  object of affection  and sympathy,  his disease is often
 easily removed, and, in a comparatively short time, he is restored to the
 bosom of his family and to the enjoyment of the inestimable blessings
 of rationality !   We may safely allege that  whilst  this fearful disease
 was once almost uniformly incurable,  it is now  under the complete
 control of our  remedial means, in  at least three-fourths of the cases
 subjected to proper management.
    The discovery of the  spinal origin  of most nervous affections is
 likewise of  modern date, and has furnished us with the  key to the
 treatment of an extensive and harassing class of diseases.   To it we
 are indebted also for the only  rational  pathology of Rheumatism and
 Gout, and of those widely prevalent Intermittent and Remittent fevers
 which, although described with great perspicuity,  so early as Hippo-
 crates, had  never  been  before well understood,  nor, consequently,
 treated with much success.
   There is  no disease in  which  the usefulness of our profession is
 more signally illustrated than that commonly  called bilious fever, for
 whilst if left to the unaided efforts of nature it will almost invariably
 terminate fatally, it now rarely if  ever does so under early and skilful
 medication.  If to  Laennec should be awarded '.he praise of having
 done most to improve our means of diagnosis, to Pelletier and Caven-
 tou should be equally  conceded that of furnishing us with one  of the
 most valuable remedial agents we possess, for with quinine at com-
 mand, we have the antidote to the most prolific scourge of the temperate
 and torrid zones.  Their discovery was truly opportune,  as without it,
 it would have  been difficult to demonstrate  the  correctness  of the
 pathology of paroxysmal fevers at present advocated by  the most en-
 lightened Southern physicians.  With the possession of this powerful
 and controlling agent, our various forms of autumnal fevers must cease
 to give us any  alarm, if timely aid be invoked.  Intermittents, remit-
 tents,  malignant and congestive fevers, which have  heretofore slain
 thousands and millions of  our fellow beings, must now be regarded as
 comparatively harmless !   These  diseases being heretofore regarded
 as affections more or less inflammatory  and dependent on biliary de-
 rangements, he who was so unfortunate as to be attacked with remit-
 tent fever was subjected to the lancet ad deliquium, to emetics and ca-
thartics without stint, then to mercurials until his  mouth was on the 
16
Verge of dissolution, and his very breath became putrefaction !   If he
still survived, he was now flayed with enormous and multiplied blisters,
and  finally,  perhaps,  resuscitated with Bark and Wine, to  linger
through  a protracted  convalescence of weeks, and  even months!
Contrast this  picture with the practice of the present day,  when,
however violent the attack, it is for  the most part subdued in a few
days, without  depletion,  with but  little loss of stamina, and conse-
quently with scarcely any period  of convalescence!   Is not this  a
triumph  worthy of  the nineteenth  century 1  However exaggerated
this statement may  appear to you,  who have not  yet, perhaps,  learnt
to forget the evils of fever, I trust that before you leave this Institution,
its truth will be established to your entire satisfaction.   The Medical
College of Georgia  may justly claim the merit of having been the first
to promulgate this great reformation in the treatment  of paroxysmal
fevers; yet new views, however manifest their correctness and value
may be, are always slowly and reluctantly adopted by mankind at
large.  The ashes of the great Laennec have now slumbered almost
a quarter of a century, yet how small  the number of practitioners
who  avail themselves of his lessons!   Quinine was  discovered in
1820, and it is but  a  few years that its great value has  been fully
recognized!  How  long will it  not  still be before this recognition
becomes general with the profession!
  Such, gentlemen, are  the principal improvements  in  Medicine
effected in the nineteenth century.  They amply  testify to the pro-
gressive state of knowledge, and show that whilst the spinning-jenny
has been  dispensing comfortable raiment  to the poor of every land,
and the steam engine  civilization to  the most benighted, the Art of
Healing has not remained stationary, but has also contributed largely
to the well-being of society and aided considerably in lengthening the
period of man's existence.   To impart to you the knowledge of these
improvements, untrammeled by  sectarian  prejudices, yet venerating
the  valuable acquirements of past  ages,  is the duty  assigned us.
Lend us your patient  attention, second us in our efforts, and should
we be so successful  as to render our labors useful to you, and to earn
your approbation, we shall have accomplished that which is our high-
est ambition.  Permit us to carry with us the consciousness of having
been, through you,  the instruments  of relief to suffering  humanity,
and it will be to us  the happiest solace of subsequent life. 
 
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