HunLeyjW^K.J ^t Relation of tbe Jftsirian to tbe fublit. ?! L« AN ADDRESS: DELIVERED AT THtl r . j SEMI-ANNUAL MEETING I ' or THE »■> ■I' \ .) ■ fet Cemtessee fpical ^0tiei]j, APRIL Gtii, 1*0*. vf BY WILLIAM R. HURLEY, M.D. PUBLISHED BY ORDER OF THE SOCIETY. >r**y &>f KN'OXVILLK, TENN.: PRINTED AT THE SOUTHERN CITIZEN OFFICE. 1858. AN ADDRESS. The science of medicine affords a wide field, and a rich source of gratification, to those who engage in its study. The subjects embrace an extensive and endless variety. No profession or science compre- hends so much of, or has such intimate connections with other scien- ces. In its study almost every branch of human science is made to contribute facts and principles. And when collected, combined and arranged, we have what is denominated the science of medicine. Chem- istry, natural, mental and moral philosophy, botany, natural history, and almost every other branch of science arc taxed to fill the store- house of medical literature. In traversing this ample field of scientific research, we find a rich va- riety to invite and encourage us in our labors. All nature seems spread out before us, and invites us to contemplate its beauty, richness and / nice adaptation of one part to the other. The details of a science which treats of phenomena so interesting in their character, and so wide in their range, cannot fail to enlist the most enthusiastic admiration and most persevering industry of its votaries. But the end and aim of all this elaborate research with the physician, is to comprehend the most mysterious of God's creation—man. It has been well and elo- quently said: The proper study of mankind- Is man. The physician looks upon the human frame, not merely as a ma- chine filled with contrivances so cunning and elaborate, as to render all the mechanism of man rude and bungling, but as a machine full of life—every fibre of which has a nerve attached, giving it power to act; and a machine, teo, having a reasoning soul, the image of the Deity to control its movements, which is destined not to perish—like the body or mind of the brute—but to live through the vast ages of eternity. Of all created existence, "man is the mystery, riddle and wonder 1 of the world." To comprehend man in 1.1- wondrous exi-tcnce, we must study the relation he sustain* to other created thing-, and the law- that operate on hi- physical and moral -vstern. ■ '.V' through this air, this ocean ,in) well the responsibility and importance of it. before he pre-uine- to enter upon its duties. At the very threshhold of the study of medicine, every medical man metis with a serious obstacle to his progress;—in deciding what to receive and what to reject—in deciding between theoru ami The ^tudy of medicine is mainlv the observing, collecting, and com- bining of facts. Facts are learned bv observation. All our know ledge 's based upon observation ; and it is the tacts discovered by observa- tion, which, accumulating from age to age, constitute the -tore of hu- man knowledge. There is a strong tendency in this age to substitute theory for fact in every branch of human science. .Mere theorv never has contributed one grain to the store of knowledge from the earliest dawn of the world to the present. Theory may suggest the existence of facts, and direct the pursuit after them, but observation alone dis- covers them; hence it follows that a man to be successful in attaining mediival knowledge, must be a man of nice discriminating powers, and a keen oli-erver, to enable him to judge correctly between what is fact and what is mere opinion, as well as to improve by what falls un- der his own eye. In the study of fact, he must keep in mind that he must not be satisfied with a knowledge of t/ni.rraf facts, but he must treasure up in metnorv a vast fund of particular facts. The knowl- edge of general facts is dependent upon tnc knowledge of particular facts. The general fact of gravitation was discovered by the observa- tion of many particular facts, but any speculation as to the why, or by what influence one body gravitates, or is attracted to another, i.- mere conjecture or theory. So in medicine the great leading or general facts are established bv numerous individual facts. A theory is a theory till, bv a course of observation of individual facts, it is estab- lished as true, it then lose- it character and is no longer theory, but a fact. The student finds in the history of medicine, that it i- made up mainly of a history of untenable theories. livery period has had its favorite theory. .Men at all times, anil in all countries, have been too [»rone to adopt particular theories. This attachment to theory has done more to hinder the progress of medical knowledge, and to bring the profession into disrepute, than all other causes combined. It is the great stumbling block in the pathway of discovery. .Men attach themselves to some particular theorv, and every fact is viewed with distorted vision in their endeavor to make the fact harmonize with their favorite theory. As intimated, no mere theori/.er ever advance the science of medicine; yet his conjectures may suggest to the mind a line of observations which may lead to the discovery of a fact. If his hypothesis is correct, then we discover a post tin fact. If found false, then \\\: establish a aeyatirc fact. If all the energy and talent which haw been wasted on theories, had been employed in observation and collection of facts, what a vast amount of pure unadulterated facts would be treasured up, which re- in ain vet unknown : and what a still larger amount of useless rubbish 6 would have remained uncollected. But while the study of facts is our reliance, yet there must be a nice discrimination made between true facts and faise facts in medicine. There is much written and reported as facts in medicine, which is nothing but opinion—these are what I de- nominate false facts. There is no more fruitful source of error, than the disposition to form conclusions from a two limited number of facts. For instance : a physician by some course of reasoning comes to the con- clusion that he will depart from the usual line of practice in a particular case, the patient recovers. He feels encouraged and tries it in a sec- ond case, of similar disease, with like results. Ambitious to take a position as a star of the first magaitude in his profession, he publishes to the world that a certain remedy will cure certain cases; whereas the fact is, the patient may have recovered in spite of the disease and remedy. The science of medicine forbids the conclusion that any particular disease is ever cured by any particular remedy. There are modifying circumstances which makes every case, that has ever occurred in the world, different. But the principles of the science are as firm as the everlasting hills. It is the knowledge of these principles, and their application to particular cases, which makes up the practice of medi- cine. It is essential to the formation of correct conclusion, that all the facts and circumstances in any given case must be observed, combined and arranged in their regular order. Many and grievous errors has arisen from time to time in the history of medicine from inaccurate or partial view of cases. Among the many false theories, we can trace most of them to a partial view of particular cases. Broussais, looking only at one class of symptoms, believed that all fever arose from in- flammation of the stomach and bowels. Boerhave looking to another class of symptoms, believed that fever was caused by a bad state of the blood. Cullen, looking still at another set of symptoms, located the cause of fever in the brain, and Dr. Cook, of our own country, look- ing exclusively to another set of symptoms, taught that fever arose from a congestion of the venous system, caused by a weakened state of the heart. These were great lights in our prosession and had many followers. Their errors in theory often led to error in practice. The celebrated Dr. Hunter in a lecture on dyspepsia, speaking of the various opinions of the stomach formed from the different set of symp- toms, said: " Some physiologists will have it that the stomach is a mill; others that it is a fermenting vat; others, again, that it is a stew- pan, but in my view of the matter, it is neither a mill, a fermenting vat, nor a stew-pan—but a stomach gentlemen—a stomach." Every medical man is bound to avail himself of all opportunities to acquire such a knowledge of the science as will fit him to fill his sta- tion. The community in which he lives has a right to demand it of him. He is not only bound to the community to be qualified to practice his profession, but more. As a member of the general board of health he is bound to warn the people against every dangerous impo- sition upon the public. Warn the people against every new hobby, 7 jsrn, or quack nostrum, which asks for favor and patronage. His warn- ing may be unavailing, still he is bound, as a faithful sentinel, to " cry aloud and spare not." If they refuse to heed his warning, " let their blood be upon their own skirts." Your motives may b,e'impugned, be accused of acting from selfish motives, still it is your duty to the pub-, lie—as well as your profession—to speak out in unequivocal language against all humbugs. If you fail to do so, you are "particeps criminis" as much so as if you were to stand silently by and see the murderer commit his foul deed. You encourage by your silence every form of quackery that you suffer to pass unrebuked. No fear of public cen- sure should deter any medical man from discharging this duty. This fear of the public among our profession, has done more to encourage quackery than almost any other cause. It is the hot-bed which has produced in great luxuriance the vile and foolish isms which has so long cursed this land. There is a deep rooted error in the public mind as to what is the true position or relation of the physician to the public. It is that the physician having to rely in a great measure upon the public for sup- port, that therefore he is not strictly as free as other men. He is re- garded somewhat as a candidate for office, and is expected to demean himself accordingly. The young practitioner, when first entering upon the arduous and responsible duties of his profession, looks around to see who is to share with him the field of his labor. He may find among those bearing the title of Doctor (for it is easy to obtain) who uses all sorts of dishonorable means to obtain public favor and patron- age, he is a low down contemptible quack. But on inquiry, he, per- haps, hears with astonishment that this quack is doing a very exten- sive practice and is quite distinguished. He find4 another, and on making his acquaintance, finds him a well educated and skillful physi- cian, who relies on the slow process of people finding out who and what he is. He has stood silently by for several years and seen this quack flourish like a green bay tree, but never uttered a word for fear of being injured in public estimation. He makes the acquaintance of a third, who is well qualified to practice medicine, but seeing that the people wish to be humbugged, and to compete successfully with his quack neighbor, notwithstanding he would like to act the honora- ble part, he has yielded to what he calls stern necessity, and conde- scends to the arts and tricks of the charlatan and thus degardes his high and honorable calling. The young man is astonished at what he sees, and is really disgust- ed with his profession. He would willingly reform public sentiment, but he feels unable to do it. He finds whims and caprices and false ideas among the intelligent as well as the ignorant, which he grieves to see and would be glad to reform, but he dares not the attempt, but takes the public as he finds it and attempts to do the best he can with it. In other words, he succumbs to public opinion and places himself on common ground of the quack. Thus encouraging the popular error in the public mind, instead of trying to correct it. The medical fraternity owe it to themselves, as well as to the public 8 good, to effect a reform and place our profession in its proper position before the world. If we can not and do not do it, we had better all yield the field to quackery and charlatanism and seek more profitable^ and more agreeable employments, and let the public eat the fruits of their own culture. False standards are set up by the public by which the physician is judged and passed upon. A man's qualification i.s often judged by his knowledge of things unimportant in themselves, and which, if acquired at all, must be at the expense of time which should he devoted to his profession. In this age of romance the phy- sician is often judged by his familiarity with works of friction. If he is familiar with all the new and fulsome trash that loads our mail, and which is sent out weekly or monthly to excite the already vitiated taste of the public, he passes as a gentleman, physician and scholar. If he is familiar with all this world of stuff which is thrown out in such profusion from the heated imagination of the novelist, I pro- nounce him a weak disciple of the medical profession. He lias no time for such reading, he cannot be familiar with them unless he utterly neglects the text books of his own profession. Novel reading generates in the mind a morbid appetite for something exciting to the imagination, and creates a distaste for the profound learning of the medical writer. Hut aside from the injury done to the medical man himself, he is encouraging a practice dangerous to the health of the Vonnnunity. As before said, 1 hold that the true medical man should, in all cases, warn the public of any cause likely to produce disease. Will any be started at the declaration that novel leading is a fruitful cause of disease .* The young girl has no sooner attained the age of puberty, than her mind and nervous system are placed upon the rack of novel reading and sentimental love stories. There is just enough of truth in most of these maukish productions to excite the passions and distract the attention of the young girl from the love of nature and her teachings, and all rational ideas of real life, and to cause her to despise the (to her) common-place parents, whose every hour may be occupied with considerations for her welfare. She regards all use- ful employment as low, contemptible and vulgar, and hence will not engage in any business calculated to develope the organs of the body, and the consequence is a feeble, delicate house-plant, is made of what should be an active, ruddy, buoyant and happy creature. For want of exercise the lungs are not developed, and all the vital powers suffer in proportion. She becomes predisposed to consumption, and thou- sands upon thousands of eases are finally developed into confirmed consumption, and fall an early sacrifice to the habit of novel read- ing. The licentious characters presented in all the glowing tints of a de- praved imagination, can not fail injuriously to affect the youthful or- ganism. Nothing can be more certain than the production by these works of a precocious evidence of puberty. The forces of the young heart and vascular system, are thus prematurely goaded into epheme- ral action by the stimulus of the imagination alternately moved to laughter and tears and sexual passions. A morbid centre is thus ere- 9 atcd in the system, whose pernicious action is manifested in the diver- sified forms of hysteria, and nothing less than the total wreck of the youthful body often follows this infernal hot-bed of the passions—this altar of sacrifice for the young. Could we induce ourselves to believe that the sole mission of the physician to be the administrations of pills and potions, and to yield a servile obedience to the caprices of his employers, (a bondage that dishonors and degrades him,) our remark- would be impertinent. But we believe our profession to be that of a teat her of the laws of our being, and guardian of the public health. " Our college edifice is magnificent; aye, as extensive as the earth ; our labratory and cabi- net, whatever it contains; our p.upils, mankind; our text book, the page of nature." It is true we may meet with many discouragements in the discharge of our duty, but to the best of our perception, we ought always to speak the truth boldly and fearlessly, in the face of all discouragements. Whenever we fail to speak out against any error in the public mind, of which our profession should take cognisance, we encourage the er- ror by our silence, and confirm the public in that error. This idea in the public miud, that our profession is dependent upon it, is ruining the character and usefulness of our high calling. It is high time we should set about a reform. Who is to effect this^re- form ? Why, sirs, the physicians must do it themselves. But the im- portant question now arises—how are we to do it ? I answer, by asserting our rights. By declaring our independence ! 1 Let us declare to the world that we are no more dependent upon the people than they arc upon us. That we can do as well without their patronage, as they can do without our service. On this declaration let us take our stand, and pledge our lives, our fortunes, and our sacred honor to maintain it. Keep this principle steadily before our minds, and act accordingly, and as sure as the sun occupies his place in the centre of the planetary systems, justfto sure, will our profession take its true position before the world. Instead of our being swayed about by public sentiment, we will mould that sentiment to our liking—we will be a power that will force a due appreciation of our legitimate position. The ignorant and eunnino- pretender, in his conscious weakness, will retire before the storm of public scorn and contempt, and the true men of the profes- sion, in proud consciousness of their real strength, will stand forth, free and unshackled, and receive the reward of the true soldier. Let it be our highest ambition to merit public favor and patronage. Let us study, not so much the science of patient-getting, as patient- curing. Let charlatanism and quackery practice its arts around you, let nothing tempt you from your post of honor. Remember you have a high and noble calling to sustain. Put on the whole armour, and you will be able to withstand all the evils of wicked quackery and false notions, from whatsoever quarter you may encounter them. Be thoroughly acquainted with the great principles of your profes- sion, and ready to apply those principles in the divine art of healing 10 and administering to the suffering invalid, but never yield to any temptation, to act the dishonorable part, to compete for public favor. Rebuke false notions and ignorant pretenders, wherever and whenever met—make no compromises. True science makes no compromise with ignorance. If your good deeds are evil spoken of by the ignorant, " forgive them, for they know not what they do." Should you be tempted to adopt some low and contemptible subter- fuge to gain public favor, because some wicked pretender is making inroads in your practice; in sternness and manly firmness say—" get behind me satan." The reward of virtue is not bread. There is an impression abroad, that our's is a lucrative profession. That physi- cians charge high for their services. This is a very great error; while some few in large cities make nloney, a large majority live and die poor, who rely alone on their profession for a living. There is scarcely one well qualified physician in the hundred, who could not make more at some other business with far less labor. There is no business that subjects men to so much mental and physical labor and fatigue, as that of the physician. He has not an hour he can call his own. He is deprived of that regularity of living, so essential to comfort and health. He is liable to be called for at any hour, and night after night for weeks, nay, months, sleep is an entire stranger to his eyes. No kind of weather will excuse him—no matter if rain or snow, the rudest blasts of winter; nor yet, the fervid heat of a summers' sun will excuse him—he must go. He is called from midst his friends in social converse to the bedside of suffering, where all the faces are overspread with gloom. Should pestilence invade the community, and terror seize the pub- lic mind, while many flee for safety to some healthy retreat out of the range of its influence, he must stand firm while thousands fall around him victims of the pestiferous malaria. The physician must not only remain at his post, butmust expose himself to the pestilen- tial influence under the most powerful predisposing causes of disease —bodily fatigue and mental anxiety. Though he may see some of his brethren falling around him, humanity demands of him that he should go on in his services to the sick. No wonder then, the physi- cian is numbered among the short-lived members of society. During the prevalence of yellow fever in Philadelphia in 1793, of the thirty- five physicians who remained in the city—eight (nearly one-fourth of the whole number) died, and but three escaped an attack of the disease. And for all this toil, anxiety, perplexity, and shortening of life, the physician is but poorly paid—and grudgingly what he does receive. A large portion of those who receive his services are too poor to pay him any thing, and those who are able postpone the payment, much longer than any other debt, and often grumbles even when the bill is paid. The evident tendency of this state of things is to drive men of real ability out of the profession, and keep others out of it. For as before stated, there is no man capable of practicing medicine efficient- 11 ly, but might employ his talent more profitably at some other bus- iness. Whereas, men of small caliber encouraged by the bold- ness of ignorance, will rush in by thousands. Medical schools have lowered their standard of qualification for graduation, to suit the ca- pacity of applicants for the honors of their schools. Time was, when we had but few medioal institutions. Having but little competition, the standard for their honors was set high, and many young men were rejected and sent home for further study. But who ever now hears of even one being rejected !! In the name of common sense, are they all qualified ? What is required now for graduation ? Two courses of lectures, and the fees paid. This rivalship among medi- cal colleges for patronage, instead of elevating our profession, as they should do, and building up a vast and colossal structure of medical learning, are reducing it to a low and contemptible standard, and bringing a reproach upon the name. But while much blame is to be attached to the profession itself, the public is still more to blame for the downward tendency of medical education. The public is driving the very best talents from our pro- fession to other and more remunerative employments, by refusing to sustain the true men of science. Eclecticisms, Homcepathy, Hydro- pathy, Thompsonism and quack nostrums arc liberally patronized, while in the same vicinity the true man of science can scarcely keep soul and body together. In deep mortification and chagrin, he ex- claims, What is the use of my having spent years in close study— what is the use of my having spent so much precious time, and so much money in obtaining a medical education—if a man may, with- out study or preparation, without even a smattering of the rudi- ments of our science, be esteemed by the public as my equal, and in many instances, my superior. He feels a disgust for the practice of medicine, however much he may have delighted in the study of it. He feels like abandoning his profession, and many do so. Ought he not to do so ? But suppose he has been practicing for years in the same place; has established a reputation for skill; is a man of ac- knowledged learning; suppose, for instance, an Homoepathist settles in his town, and by huge pretensions, gets the public enlisted in his favor. The old friends and patrons of our noble fellow dismiss him with as little ceremony as they would dispose of a family horse, or a pet pig, and run wild after this worst of all humbugs. He sees this impostor giving the mere shadow of medicine without regard to any principles whatever. And so any other of the new isms of the day may supplant him, and he is either bound to look out for another home or quit the practice. Shall w'e stand silently by, and see our brethren thus treated ? " Out, you impostors, Quack-solving, cheating mountebanks—your skill Is to make sound men sick, and sick men kill. Void of all honor, avaricious, rash, The daring trihe compound their boasted trash ; Tincture or syrup, lotion, drop or pill, 12 All tempt the sick to trust the lying bill; There are among them thu*e who cannot read, And yet they'll buy a patent and succeed; Will dare to promise dying sufferers aid, Kor who when dead, can threaten or upbraid? With cruel avarice still they recommend More draughts, more syrups to the journey's end ; I fuel it not—"then take it every hour," It makes me worse—"why then it shows its power;" I fear to die;—let not your spirits sink— Your always safe while you believe and drink ! I'1 One, two, or a dozen men, can not correct public abuses of this kind, but if all the true men of our profession will resolve in a body, they can do it. Let them set their faces like steel against every imposition. Speak out, as with one voice—tell the world in plain and unequivocal language that it is imposition ; resolve in medical societies to stand right before the public. (!ome up as as a band of brothers, and we can, and will, destroy this hvdra-head- ((1 monster with his hundred, thousand, or ten thousand heads. We must set public opinion right with regard to our profession, or it will become a hissing, and a bye-word among the multitude. The title of Hoetor once conferred honor on those who bore it. It was synony- mous with being learned. But, my medical friend, do you feel that any honor is now attached to it. Why, sir, it is about as easy for a man to get the title nowa-davs, as it is'to put on his hat. And what- ever your learning may be, and however proud you may feel, from the consciousness of that learning; why sir, after "all, you are only a Doctor, and so is Mr. Squire Bolus, a Doctor, tpo, and' his neighbors say, is n wry good Doctor. Do your neighbors sav as much for you '{ Reform is demanded ; the public'mind must be set right. But to do it effectually, we must set ourselves right. Some of our own medical brethren ingood standing among their compeers, must be rebuked a little, and if possible, brought back, for in truth thev have gone a little out of the way. We can look upon the low tricks of quackerv, among quacks, with much more composure than upon the same things practiced by men whom we recognize as of us. But, the facts are so, and let the truth be told if the heavens fall. Some of our profession' are hi the habit of stooping to the lowest arts of the charlatan to gain patronage, and done, too, so cunningly, and with so much inge- nuity a- not to lose caste with his medical brethren. Such men, while we receive, them as our equals, do our profession much harm. But how are we to bring sue], men back from the error of their wavs? Why, sirs, when a medical man, no matter what his attainments are, condescends to the contemptible tricks of the charlatan, treat him as you would the quack. He is in bad company, and let him sutler like "poor fray." Kvery medical man, who ha-spent ten or fifteen years in the prac- tice ot Ins profession, has observed a general disposition against our profession When we look candidly upon the public benefits our profession has conferred upon society, such as instituting and maintain- 1 ^ lo ing hospitals, insane asvlums, institutions for the deaf and dumb, and blind, besides the various associations for the advancement of the scien- ces, it is a fact deeply to be deplored, that there is so little interest felt by the public for the profession, or so little consideration taken of its merits. Many intelligent persons encourage every innovation upon the regular practice—though none but the best attorneys would be employed by them—and none but educated ministers could preach for them. The very best men of the land seem to be influenced by novelty, and are influenced by it in the choice of a physician, as in other things. They often show their want of consideration for our profes- sion by employing some mere pretender, of whom they know little else, than that he calls himself a French or German Doctor, and has an abundance of hair about his visage. Whether their chosen man has any knowledge of medicine or any thing else, they can not tell, for his ignorance of our language will hide as much ignorance of this and other subjects, as he may choose to conceal. What evidence has any person that he has any qualification whatever to practice medicine '. But these men will say that in Europe they have better facilities for medical education than in the 1'uited States, and frequently the only recommendation they have to public favor, is that our schools do not afford facilities for a medical education at all. They are .encouraged in such foul assertions, by being patronized, aud that too, at the sacri- fice of an old family physician. Is it for want of confidence in the family phv-ician? Not at all. lie has been tot) long and well tried to doubt his skill; he has served to the sixth trouble, and did not for- sake in the seventh. It is this lore of novelty, and this indifference to the feelings of his physician. Let a European come to this coun- try and claim to be learned, it is taken for granted that he i- so. I do uot wish to be misunderstood at this point. Many who come to this countrv deserve patronage, and no man would more readily ac- cord it to them than I would. But while worthy men, and men of true science come, this raging thirst for novelty in the public mind renders imposition easy. Men of no medical attainments whatever, under the guise of some foreign name can, and often do, get such a reputation that patients will be carried hundreds of miles to them, aud they are consulted like oracles. I hit if a truly worthy brother from any country, or clime, chooses to make his home among us, I give him the right hand of fellowship. But should he claim any superior ad- vantages afforded by the institutions of any country over my own, and get some willing dupes to trumpet the same as ,-onie do, I would treat him as I would the most arrant quack in the land. In the name of common sense, and the spirits of the fathers of our iroble countrv, when will we cease to hear this everlasting cant about foreign superiority. When will we cease to have the word German, English, French and Spanish prefixed to the name of article- we wish to go for more than their real value. \«» matter what is offered in market to insure large sale and good profit, the name of some foreign countrv must be attached. Every man who loves hi.- country must feel mortified to see this -tate of thing-. Why not giw article- char- 14 acter by calling them American, Genuine American, or True Ameri- can, just as well. It matters not for the name it bears; every thing should be judged by its own merit. And so of physicians, they should not be lauded because they are natives of this country or that, but for merit alone. The public mind must be disabused on this point. Some of the medical colleges of this country afford facilities for medical education equal to that of any schools on the globe, and every assumption of superiority to the contrary, is the worst kind of hum- buggery. While on the subject of medical schools, I wish to say a word in favor of Southern medical colleges. We have in the South some good schools well endowed, and professors equal to any, which merit and should receive our encouragement. As a general proposi- tion, physicians educated in the South are more capable of treating diseases of the South, than men educated in a higher latitude. An- other consideration in favor of Southern colleges, is the amount of money taken from our midst and spent in northern cities, which should be spent at the South. We have paid tribute to these north- ern institutions long enough. I am in favor of showing them in every possible manner our independence of them. We have indulged them long enough in their vain boasting. I do not say that physicians should be ultraists on any subject, but I do think that physicians, like other men, ought to speak out boldly, openly and independently. Be decided in our condemnation of this vile abuse heaped upon us by northern fanatics. We are regarded by some of these vile fanatics as but little better than- heathen, because we have slaves among us, and that they should furnish us with missionaries from their institutions to bring us to the light. They claim a very decided superiority over us in morals as well as in intelligence. Their missionaries are among us. The Southern people are brave, generous and unsuspecting. They re- ceive thousands of these fanatics kindly—we welcome them among us. They receive our hospitalities, we encourage them in any and every way. But how are we requited ? In many instances those whom we have warmed and nurtured into life, strike with the venom of the vi- per, and would destroy us. Many impressed with their former error on the subject of slavery, readily acknowledge it and become good southern citizens. But a vast number regard us still as heathen with heathenish customs, and while they will not openly denounce us as such, use many cunning devices to corrupt our people and weaken their attachment to the institution of slavery. Not only so, but sow the seeds of discord among the otherwise contented and happy slaves. The people are, perhaps, not fully aware of it, but the fact is so that we are feeding, nursing and caressing a dangerous enemy in our midst, who is sapping the very foundations of our institutions. Let us teach those of the north, who would assume to condemn as evil, what we regard as right, that we want none of their missionaries among us. We would be glad to receive any good citizens they have to spare, especially if they will bring capital along with them. But such as come here on a kind of abolition adventure, whether under the patron- age of an emigration society, or on their own account, we do not want 15 them. Then as Southern men, with Southern principles, our voice should be for Southern colleges, and to whatever extent we may be able, exert our influence for the domestic institutions with which we arc identified. Let our profession stand right before the public! The physician must be not only qualified, but willing to attend cheerfully and faith- fully to all who call on him. But the question will arise here, Must we attend the poor without compensation ? On this point I wish to be fully understood. There are, says an old writer, three kinds of poor: "The Lord's poor, the Devil's poor, and the poor devils." In other words, the virtuous poor, the vicious poor, and the poor from mere shiftlessness. The first class, or the virtuous poor, should (and generally do) receive the cheerful attention of the true physician. And my friends, you who attend the poor faithfully, receive your pay at every visit in the proud consciousness of having discharged your duty. The public may not appreciate your works of benevolence, no chaplets may adorn your brow in this world, but look in faith to " a crown incorruptible and that fadeth not away, eternal in the heavens." The poor are our especial care, it is a high privilege to minister to their sufferings. If we have not money to give them, we can give them what is worth more to them—health. Go, then, quietly as a re- ligious duty, relieve their sufferings, receive their grateful smiles, and their blessings and prayers. Many times have I been made to thank God for the privilege of administering to this class. Their hearts are warmed with gratitude; tell me they have no money,but theybM me a hearty god-speed, and assuring me that I shall have their prayers for long life and continued usefulness and for a final reward in heaven. But I am at a loss how to speak of the other two classes. .They seem to claim the services of the physician as a kind of natural right—as a common blessing like air and water. You may spend time and money —you may toil from day to day, and from week to week- to restore them to health—may be instrumental in saving their life, but when health begins to course through their veins, will refuse you the small pittance of an half days labor; and if you urge your claims they will speak ill of you, and attempt to injure you in public estimation. It requires something more than the mere selfishness of this world to attend on such with cheerful faithfulness—nothing but the untiring, self-sacrificing benevolence of the christian can prompt men to do it. We bestow much time and energy upon such persons, many of whom think that we ought to be satisfied with the empty compliment they pay us, by employing us. It is sometimes asked of me: Do you at- tend on the wicked and vicious poor ? I answer, yes, of course, for if I were to refuse to attend on any but the good, I fear I would not have much to do, and besides, who is to decide how good or how bad a person must be to merit my attention or neglect. But it docs seem to inc that too much gratuitous work is expected of us. What other profession or business is there in all this broad land that does one hundredth part as much of gratuitous service as the physician. We labor day and night for nought—who else does it? The merchant 16 who -ells goo<1> to the poor demands the ready cash and will not sell them without. The lawyer has his fee secured before lie attends tc a case in court. The mechanic is protected by a law called the * > ehanic's lien. But the physician is expected to give his service and medicine to all who call, at any and all hours, no matter what the stress of weather. I think it would be safe to say that we spend one third of our time in the service of the poor. And in some portions of East Tennessee I have no idea that more than half the bills are collected, and much that is collected is deferred so long, and paid at last so reluctantly, that it yields but little profit or pleasure. After we have given away from one third to one half of our time in deeds of charity, we are expected to divide the little we do get, and give as much for every benevolent enterprise as any other class of the com- munity. According to my observation, there is no class that responds more readily, or gives more for benevolent purposes according to their income than the medical. I do not say this in any boasting spirit, nor to claim any particular merit for it; but simply to show our true po- sition, and to show, further, that too much is expected of us. We simply discharge our duty, and console ourselves with the reflection that the reward of virtue is .iot bread. " The generous pride of virtue, Disdains to weigh too nicely the returns Her bounty meets with—like the liqeral good*, * Prom her own gracious nature she bestows, Nor stops to ask reward." Ill conclusion, let us, as a band of brothers, engaged in the great cause of humanity and public good, speak and act in concert in all things calculated'to reform abu-es which are so rife in the land. Let us make such an effort as will convince all men that we are in earnest— and that we feel the importance of our mission. And while we are s nig- gling together, to elevate the standard of medical education, and to rid our"noble profession of the many abuses which tarnish its once bright eseutchean and impair its honor and usefulness. We have a right to demand of the community, which is to be especially benefitted by our efforts, a cheerful and active support. Let us call upon the stable and well-informed citizens to give us their countenance and co- operation in sustaining a high standard of medical education. Let us enforce it upon the public "that they are personally interested in up- holding a well educated medical profession. If they hear us, and will act in concert with us. our profession will ere long stand out before the world redeemed from its thraldom, and be praised of all men. Like pure gold, the dross all consumed by the refining fires of truth aud justice, and the true men of the profession accounted in deed and in truth benefactors to their race. But whether successful or not, let us be bold and fearless in our efforts— " The bra re man ittlv> not popular applause, Nor overpowered with arms deserts his cause ; fn-hamed, though foiled, lie does the best he can, l>\.vc- is of br i- m, but honor Is of man."