lit Ambitions of ijrc (Ionflict. the 
CONDITIONS OF THE CONFLICT. 
O RATIO N 
DELIVERED BEFORE 
|lie jpiical Jiocietj of tie 4omitj of lings, 
BROOKLYN, NEW YORK, 
AT ITS 
FIFTY-SECOND ANNIVERSARY, 
February 24th, 1874, 
{j* 
Alexander Hutchins, M.D. 
PUBLISHED BY SUBSCRIPTION AT THE SOLICITATION OF COUNCIL OF THP 
MEDICAL SOCIETY OF THE COUNTY OF KINGS. 
Nrto Yorfe : 
GEORGE F. NESBITT & CO., PRINTERS, 
Cor. Pearl and Pine Streets, 
1874. “ Apparently our modern science and humanity have done a great deal to 
keep off disease, and bring down the average death-rate in favored communi- 
ties. * * • * In a certain sense all nature is our enemy, and earth, air, 
water, all elements and creatures, are watching to find our vulnerable point. 
Now' all true science is the triumph of the human spirit over the tyranny of 
nature, and all the sciences and arts of health, all safeguards against infection 
by proper management of watercourses and miasmatic grounds, all preventive 
measures against the great contagions that ravage the earth, not only save 
individual lives, but keep evil germs out of the human constitution, and art 
upon the general vitality of the race.” (The Skeleton in Modern Society.— 
Uarper’s Magazine, May, 1874). 
“ Medical studies have now become long and laborious, the physical and 
chemical sciences being now far more than mere auxiliaries, and forming an 
important part in the preparation for examinations ; and the student, after his 
laborious and costly career, finds, on getting into practice, that he has no 
effective protection from the encroachments of charlatans and parasites.” 
(Decline of Medical Study in France.—The Union Medicate of Feltruary \7th, 
quoted by Med. and Surg. Reporter, April 8th, and by Boston Med. and Surg. 
Journal, April 23d, 1874). CSoi\<litioi\$ of tl\e dor\flidt. 
One of the pleasing re-assurances that attach to the ordinal 
experience of a physician comes to the surface when he meets his 
younger brother riding, for the first time, in his new buggy. The 
cheerful sunlight, the fresh verdure, the exhilarating atmosphere 
and clear landscape of a June morning, are Nature’s fitting acces- 
sories to the bright and perfect newness that is dignifiedly moving 
over the patent pavement. Unmarred by scratches, neither mud 
nor dust have dimmed the brilliant lustre of its polish. No stain 
tarnishes the trappings to unbefit them for the adornment and 
control of the well-groomed animal that restlessly confesses to 
his new experience. There is a restrained carelessness in the well- 
cared for boots on the foot-rest, a fidgetty composure with which 
the gloved hands grasp the reins, a warm flushing of the face 
that betokens the timidity with which one ever greets the unac- 
customed and the unfamiliar. As the carriages approach yet 
nearer, there is a nervous quickening of the pace, reasonless, yet 
instinctive; a hastening which a more thorough equipoise would 
have steadily controlled, in deference to a dignity suited to the 
time ; but which self-consciousness, asserting itself by processes 
that outwit the sternest conventionalities of the stanchest pro- 
priety, unluckily inspires and proclaims its owner human. 
But this new buggy is a triumph, and such a triumph as can 
never be achieved again. The self-consciousness that asserted 
itself within it, was honorably justifying the satisfaction over a 
victory achieved against odds, that, could they have been foreseen, 
would most likely never have been met. That new buggy has 
been the fruitage of steady and expectant waiting, that most try- 
ing and exhausting of all labor, obedient to necessity, and yet 
realizing, in the completest sense, the apostolic injunction of 
“ having done all, to stand.” It rests as a terminal of a long line 
of spoken and insinuated taunts at the inexperience of youth, the 
more mortifying from being undeserved and from sheer inability 
to check them, save by endurance. It crowns a contest with the meaner types of selfishness and imposition, against which open 
resistance were failure. It has been wrought out of the mephitic 
poison of crowded tenements, where suffering ignorance and 
treachery, unable to comprehend sacrifice, were serving as a 
power to mould fitness for the events of the future. In it the 
victor summons to himself a reward for discouragements without 
number, cheerily mastered and given to the winds. With it he 
lias achieved a self-possession, a dignity among his inferiors, a per- 
manence among his own, a sense of fitness for occasions that may 
at any moment lift him higher, which, but yesterday, were an in- 
choate, vaporous uncertainty. In the repose of the moment he 
dreams that August suns and December blasts shall never again 
exhaust his tired body, straining to and from his tasks. He 
feels that, from the materials within him, he has worked out the 
problem of success. Henceforth the seeker shall be the sought. 
He has passed the first lustrum of his career. He rides in his 
new buggy! 
But the man that passes him with encouraging recognition is 
not unmindful of the past He may smile at the dreamer’s buoy- 
ancy ; but ridicule has no lodgement in the experience that has 
woven a woof of pathos through his life. Scanning a wider hori- 
zon, his sympathies with the beginnings of a professional life 
have intensified, and not weakened. True, he has not walked for 
many a year; but the restless dissatisfactions of the earlier times 
have had their counterparts in ever-recurring phases, one decade 
after another. The repose that once seemed so sure of attain- 
ment has softened down into contentment with things as they 
are. Mastery over events has glided into meeting emergencies. 
His more thorough knowledge has increased his power; but it 
has taught him humility in the presence of so much that has 
not been revealed. His more polished arts have made easy his 
contact with men ; but they have been equally serviceable in en- 
abling him to w ithdraw comfortably from contact he could not 
escape. Ilis greater familiarity writh his immediate duties has 
promoted ease in their performance; but it has begotten a singu- 
lar monotone in his life. His intimacy with suffering has quick- 
ened his sensibilities; but for his own peace of mind, for the 
greater part, it had better made him marble. The kindlier part of 
him, developed most acutely by the very necessities of his calling, 5 
so little demanded of him, that he carries a useless burden ever. 
The confidant of all, to the relief of all, there is no outlet for 
this accumulating flood. Prospered and independent, yet help- 
less to resist the demand of need or caprice. Skillfully prompt 
in the most exacting emergencies, yet those most benefitted, ut- 
terly and for ever unconscious of the brave deeds done. Self- 
sacrificing so often and so greatly that self is lost in service to 
his kind, with the requital grudged and ill-mannered. Conscious 
of pure motives and wisely-directed action, his motives have been 
maligned by ignorance and unreasoning disappointment has 
discredited his wisdom. Confident in the excellency of his pro- 
fession and its entitlement to respect, his very vantage-ground is 
the arena for the triumphs of pretenders. 
So from the materials of his garnered experience the new buggy 
kindles in him somewhat of rejoicing. The needs of his own 
life may have been too stern for him to have contributed aught 
save a kindly word lowards the result which carries him back to 
his own beginnings; but he recalls the involuntary sigh with 
which he greeted the gilded sign when it first announced the need 
of patronage. He has observed the steady composure with 
which his younger brother has met the years, the discretion in 
deportment, the sobriety of conversation and of habit, the dili- 
gence and accuracy in business, the intelligent and conspicuous 
alliances with schemes of benevolence and good order, and the 
steady growth in public favor and esteem. The new evidence 
that a reward has come to all this he recognizes as an additional 
prop to his own maturity. He knows that no one man can 
absorb all victory, and that each additional warrior, if full pano- 
plied, renders the issue less doubtful. He knows that the hard 
won triumph of the younger man is, by so much, the security of 
his own ; that if others can successfully follow in his track, 
his own life’s labor has not been profitless. The needs that 
are calling for new men are the demonstration to him that he 
has satisfactorily met the duties of his life. His own success has 
smoothed the way for his successors. And so the new buggy 
brings to him the pleasing re-assurance. 
In this profession, as in all others, the stock is ever being re- 
newed. The advent of the new is the perpetual stimulus to the 
elder and, without trespass, is forever pushing it on. The’acces- sion of new force not only enlarges the domain of its operations, 
but increases their power. As the laborers are more numerous, 
the boundary lines of labor become more enlarged, and the indi- 
vidual labor more concentrated. The contributions of each are 
to the common stock and the successes of each strengthen the 
foundation of the common edifice. The accumulated arts of learn- 
ing are the lineal heritage of its votaries. Those who enter into 
the mysteries of the inner temple are dignified and adorned by 
ministering at its shrine. The person may be on the hill-tops 
for a space, but time passes on at a rapid rate and soon the work- 
ers vanish in the work achieved. 
“ Tho individual withers, but the world is more and more.” 
The science, that this Society is constructed to nourish and 
protect, may well stretch out a welcome to all who come within 
its fane with clean hands and who, in the spirit of honorable 
manhood, pledge perpetual adoration at her altar. Her tri- 
umphs, like all others, have been won for her at the cost of many 
things. Her faithful servitors bear one common torch, offer one 
common sacrifice, receive one common unction, and go forth on 
the errands of a common ministry. 
And who is this man that they call “ Doctor ? ” Strange confes- 
sion is it to the unity of his order that his individuality is so 
often merged in his title ! The title that graces the most skillful 
practitioner of medical arts descends through infinite depths 
and clings to the half grown boy that unscrews soda-water and 
deals out doses of salts at the pharmacy. The druggists take to 
the title like ducks to water. The myriad pesthood of patent 
medicine makers flare the title as their claim to the public confi- 
dence. Natural bone-setters and eclectics, cancer-cures and 
homoeopaths, old sands-of-life and indian-herbs, equalizer and 
movement-cure, health-lift, hydropathy, neuropathy, kinesopathy, 
thomsonianism, clairvoyance, mesmerism and second-sight, with 
the more cruel types that wallow in the ooze below, and all the 
leprous and abominable heresies of medicine that prey upon the 
prejudices and fears of men, flaunt “ Doctor” on the red flag of 
their festering commune. 
“ All the grizly legion* that troop 
“ Under the sooty flag of Acheron.” 
“ Perverse, all monstrous, all prodigious things, 7 
“ Abominable, inutterable and worse 
“ Than fables yet have feigned, or fear conceived 
“ Giorgons, and Hydras and chimaeras dire. ” 
Not all are fools or blind. To tlie average man the doctor is 
one who relieves or cures his physical infirmities. He questions 
no further. For him it is sufficient that the ability to do this is 
claimed and that the claim is made good to his satisfaction. lie 
requires certain services and pays for them. This terminates the 
transaction. To his notion the service can be performed in vari- 
ous ways. He chooses the way that suits him best. There are 
some agents that, in his judgment, are unsuited to the animal 
economy ; the man who discards these is his doctor. He is con- 
vinced that Nature has a simple for all our frailties; the pur- 
veyor of herbs is his doctor. And 
“ Some to the fascination of a name 
<! Surrender judgment hoodwinked.” 
But who is this man that is called “Doctor”; this Doctor 
Medicinse; a man learned in medicine? He it is who, by virtue 
of his training in the structure and functions of the human body, 
by his entering into possession of the entire inheritance amassed 
by the learning and industry of his fathers, by his movement 
abreast with the intelligence and discoveries of his kindred work- 
ers, by his broad sympathy with all investigation, by his cath- 
olicity in the acceptance of all that has been proved of value, by 
his liberality towards all unsettled problems, by his alertness in 
application, and by the unstinted devotion of his entire strength, 
in bringing the experience of the past and the wisdom of his 
cotemporaries, through the alembic of his own personal ingenuity, 
to the relief of physical ills, sets forth himself, by right of history, 
by right of lineage, by right of brotherhood, confessedly, the 
Healer. Dealing with vital processes, tenuous, mysterious, and 
eluding all grasp, the unfamiliar is ever at his side. His steadiest 
laws forever rocking in the undercurrents, re adjustment is the 
order of his life. The father-confessor to manifold experiences 
coming up through all grades of distorting media, the quality of 
his mind is exercised less against sincerity, than against misap- 
prehension and misinterpretation of facts; so accustomed, by 
necessity, to weigh doubts and correct error, that partisanship is 
difficult for him, but the scales of justice rest easily on his hand. Ilis self-reliance is sucli as belongs to none other. Alone in 
emergencies that stifle the voice and blanch the cheek of minis- 
tering attendants, his unfaltering promptness brings back promise, 
or ’tis his to forecast and announce the inevitable. A bravery is 
his such as belongs to none other. He does not avoid the assump- 
tion of service, which, as sure as the day comes, will be fraught 
with mortification and suspicion, because it’s his mission and his 
duty. His daily appointed work and obligation are among those 
not of his own seeking, yet so manifold his tact that among all he 
is able to appease the common need. His versatility, trained to 
extremes, is his universal passport. From the solution of psy- 
chological problems which some refined melancholy has thrust 
upon his decision, problems which exhaust and defy the dialectics 
of the schools, but which he must answer ex cathedra, the next 
moment he is ministering to some floundering, unkempt offspring 
of ignorance and crime, whom a kindly word has scared into 
staring silence. His charities are written all over each day of a 
busy life, never to be collated among his memoirs. Called to 
do impossible things, he does them without hesitation. The inti- 
mate familiarity with which he is brought in contact with every 
grade of social position and social degradation, begets for him an 
amount and variety of criticism, in spite of which he lives and 
prospers, and never altogether outlives; and this, taken all in all, 
is the most wonderful and convincing testimony that could possi- 
bly be adduced to the multifarious gifts developed in him by the 
necessities of his calling. 
But is this the man that winds his ceaseless way over mountains 
and through morass to and from the scattered hamlets of the 
poor? Is it the same man that daintily presses the velvety soft- 
ness and breathes the perfumed stillness whence Dives struggles 
into Paradise or Hades? Is the unknown toiler on this highway 
included in the definition of him who stands, unabashed, to be 
acknowledged the Master in the innermost penetralia of regal 
pride and the haughtiness of wealth? Question it, ye who will. 
Not one hair’s breadth can you vary the kind, though there be 
variation in degree. Dissociate the surroundings and change 
their places, and the specific duties would be as well performed 
in the one case as in the other. Deriving their acquisitions 
from one common storehouse, working to the same ends on 9 
similar material, with resources common to all, the equality is 
identical. 
What creates the necessity for this man ? The physical in- 
tegrity of the race is no symbol of the usefulness of the epoch. 
The ruddy enormities that swept through the Middle Ages, with 
their coats of mail, were as distant from the triumphs of this 
sallow-faced civilization as was the Philistine warrior from the 
Heaven-directed shepherd boy who slew him. What abysses 
separate the sinewy savage, with his feathers and the baubles in 
his girdle, from the pale of flaccid delicacy whose fancies rock 
the world into delirium ! 
“ For I count the gray barbarian lower than the Christian child.” 
IIow far removed from the enterprise that has built up com- 
merce is the oily African that burrows in the sand-hills, and for 
colored prints and beads barters the treasures of the jungle ! 
Save under exceptional conditions, the desertion of “ the simple 
tents and Nomad ways” for what we understand by civilization, 
is at the expense of physical force. But there is no room for 
choice. Civilization is a force that attracts. The competition it 
invites is a competition that has no goal, and cannot cease. That 
it can he guided is the salvation of the competitors. 
The physician’s function is that of the skilled adviser through 
this conflict. He is to so advise as to lessen the friction. He is 
to prolong life so that projected schemes may be furthered. He 
is to avert calamity by regulating opposing forces. He is to re- 
store the fallen by the wayside, that they may pursue their jour- 
ney. He is to repair the consequences of excess. The de- 
mands upon him increase directly with the achievements of the 
material and the polished arts. Civilization, with every stride of 
its own, pushes him on as a make-shift in an emergency, or rather 
she keeps her city of refuge close, and this city must be strength- 
ened as her foes become more powerful. Men cry for the preser- 
vation of the life that has been made useful to them. The mul- 
tiplying causes of disease that prostrate one and another must be 
known ; the pestilence that unnerves the strength of universal 
labor must be resisted and driven back. This rampant civiliza- 
tion that is accomplishing so much, and is attempting so much 
more, has within itself the elements of its own destruction. The 
excess, the crowding and the overstrain would, if unchecked, re- suit in their own paralysis. Men do not see this, and with diffi- 
culty can be made to believe it. Blot out the medical skill that 
each day is unobtrusively doing its legitimate work, and ere long 
the fiery energy which is asserting itself in myriad directions 
would collapse, and Macaulay's New Zealander would gaze from 
London Bridge on the ruins of an earthquake. 
The shifting and multiplying demands developed by the 
unequal play of the forces that make up the current civilization, 
creates in this man an accumulation of resources that shall ade- 
quately meet the demands. He does not anticipate evils so much 
as he originates and adapts means to correct evils. lie is essen- 
tially a reconstructor, and though it is part of his growth to 
improve upon the old methods, yet it is preeminently his function 
to follow up along the line of change, and by new devices to 
meet the new requirements. If it be true that this man owes his 
existence to certain needs that inhere essentially in the common 
nature of the race, needs which are the product of the wasting fric- 
tion which is forever hastening to decay, (it being his special 
function to moderate this friction, and thus prevent this hasten- 
ing,) and if it be true that this development, which we call civili- 
zation, is a two-forced energy, to ripen and destroy, that every 
epoch of this development is an unfolding of new necessities, in 
whose immediate wake this man must ever be found, alive to 
their faintest call, then it follows, beyond peradventure of cavil, 
that the reservoir whence issue his resources, is the storage reser- 
voir of the latest refinements of human culture. To him are all 
the elements of human thought tributary, whether beggared by 
poverty, prolific by affluence, made critical by the law, pene- 
trating by science, broadened by statesmanship, profound by the 
pulpit, whether clothed in purple, in ermine, or in rags. 
It were a calling of no considerable importance if this profes- 
sion of medicine operated by fixed rules on abnormal and diseased 
conditions of the human body in communities where the uniform- 
ity of social condition suffers little change, and where steadiness 
of labor and similarity of taste permit only the most casual 
variations from unruffled calmness as the years pass by. Even 
here the laws of decay, by the economy of things, hold good, and 
human hope and passion, worldly ambition and the chances of 
success are subject to them, so that it is difficult to depreciate or modify the importance of that profession whose business it is to 
hold the subjects of these laws in check, and to save them from 
the consequences of their infraction, even where the field of 
operations is remote from the great energies of life and among 
communities which seem to play so unimportant a part in the 
universal drama. On the contrary, it is impossible to over-esti- 
mate its importance, if one is willing to concede the Universal 
Maker of all men, and the over-ruling Providence that guides 
them by ways of which they are ignorant, and that therefore 
there must be a purpose to their being; for if there be a purpose 
to all being, it should be protected, and not allowed, through 
ignorance of the physical laws which govern it, to violate or cor- 
rupt its integrity. Human life is sacred, and no man shall be 
permitted to say of another that he is useless; and no man shall 
calculate and compare and discriminate when the ship founders 
and the life-boats are launched. 
But we are justified, nay, we are compelled to make different 
estimate of this profession in its enlarged operations on the vary- 
ing planes where the industries and activities of the race are mul- 
tiplying material progress and revolutionizing thought. Concede 
the importance of the results which have been wrought out by 
the wonderful resources of man’s indefatigable energy; which 
invention, discovery, all forms of culture and all efforts of hard- 
handed industry have accomplished ; concede that man’s cravings 
are unappeasable, that the gratification of old desires is the germi- 
nal stem for the outgrowth of new wants more exacting and more 
difficult to satisfy; concede these, and the possessors of the higher 
and later civilization are a different factor, of higher importance 
and more varied needs. So likewise the profession that preserves 
the factors of this civilization is a more exalted body of learning, 
ministering to more important needs, fitting into higher stations, 
with responsibilities increasing in weight and subtlety, pari passu, 
with the ripening age. Caring for the individual, ’tis true, but as 
a body speaking with authority, exercising a protectorate over 
the public weal. Awaiting its decisions are all those problems 
touching the conditions under which the health of large communi- 
ties can be preserved. Its accumulated experience among indi- 
viduals is generalized into instructions concerning the influences 
of industries on the operatives, to prevent the greed of capital from undermining the strength of the employed. It organizes 
and carries on institutions which shall relieve society from its 
useless and demoralizing burdens. Towards these higher ranges 
of thought and effort is the legitimate tendency of the profession, 
both by reason of its being the logical sequence of the needs that 
called it into existence, as well as by its possessing the only 
culture available for this end. 
In this view of the necessary and progressive relations of the 
Doctors of Medicines to society, the body of learning, which is 
their inspiration and source of power, is entitled to the distin- 
guished rank of an applied science. It is heresy among certain 
circles, in these days of original investigation, to urge the pica of 
utility as any criterion of real value in giving rank to a science; 
but these very scientists, while they are laboring in the hope of 
discovering laws which shall reconcile discordant phenomena and 
find themselves happy in the unfolding of new relations, plume 
themselves most triumphantly on results which can be turned to 
account in the useful arts. But, heresy or no, the investigations 
that tend to promote the general welfare, facilitate intercourse, 
and turn labor into more profitable channels, are the investiga- 
tions that command the benediction of the multitude, and the 
arbitrary and dogmatic dictum of ever so sincere a minority to 
the contrary notwithstanding, with very little question, the vox 
populi is the vox Dei Measured by its usefulness, as affecting 
universality of application and efficiency, it holds a precedence 
above all the sciences. Its whole strength is put forth on its 
journey that it may the sooner return laden with brandies for 
the healing of the nations. The very air it breathes is redolent 
with effort for the upbuilding of the people. It estimates its 
success by its increasing power to strengthen infirmities. It 
counts those acquisitions the most valued which enable it most 
speedily to remedy misfortune. Its processes of thought are 
stretched out to ingather all truth that can be made most imme- 
diately available. It lavishes, nay, squanders, its choicest trea- 
sures, in the very ooze of squalor, for the dear sake of pity. It 
knows no marketable value for its most hard-wrung possessions, 
when from any misery comes up the beseeching cry for help. It 
demands from its votaries their all that all things may be in com- 
mon for the truth’s sake. It counts no toil unworthy where sor- 13 
row is to be appeased. It holds naught as sacrifice that shall 
send the poorest back to his labor. It robes alike its acolytes and 
priests that there shall be no withholding of the fullest ministra- 
tions. It criticizes unsparingly the oppressed by avarice and 
greed, that the toilers may take courage by relaxation. It enters 
into the abodes of wretchedness and drives out the poison that 
color may come to the stricken by neglect. Everywhere, among 
all peoples, in all climes, on frontier or in crowded city, in ham- 
let or on prairie, in midnight vigil or the ministering at noon-day, 
in palace or in hovel, amid poverty or affluence, with saint or 
felon, by staring idiocy or the divinity of thought, by the side 
of elegance or the clownishness of boors, by lord or serf, by 
prince or peasant, in desolation or in luxury, in expectation or 
dismay, whether with assurance of reward or the sombre con- 
sciousness of bread upon the waters, with hands that have been 
laid pityingly on the sorrows of the past stretched forth to soothe 
the aching pillows of the future, its genius is the rescue cry. 
It may possibly have suggested itself to some of your minds, 
tliat this view of the profession is not that in which it is ordinarily 
seen, and it may likewise have occurred to you that the unbe- 
lievers in this doctrine are not altogether resident outside the 
limits of professional life. A moment’s further reflection may 
suggest that, in the estimation of a very large majority of the 
laity, the profession of medicine has a two-fold relation to them- 
selves, viz. : that there is a routine practice common to medical 
men and the element of personality to which they incline. A 
more intelligent and respectable minority have been educated into 
the belief that this profession of medicine is the possessor of a 
vast variety of disjointed facts relating to the effects of cer- 
tain agents on certain conditions of the human body, and that 
the comparative good or bad in the profession consists in the 
superior of lesser ability, with the wider or more limited ex- 
perience of certain members thereof in making use of these facts. 
In both cases the personnel of the profession stands out in bold 
relief from the profession itself; in both cases the trade of the 
profession comes handsomely to the front. If medical men and 
the laity, whom they serve, are agreed on this platform, it cannot 
well be urged that there is any well-grounded complaint on either 14 
side. The laity get the best there is to be had and, taken all in 
all, the profession is pretty well provided for. The religion of trade 
is to get the best article for the least money and, in this case, there 
is very little haggling about trifles. 
But, on the other hand, the profession of medicine puts a dif- 
ferent estimate on itself; an estimate which, in a most general 
way, I have endeavored to define, and which, if it be accepted, 
presents some startling suggestions why its sources of light have 
been so effectually concealed, and why its seclusion from the public 
gaze has wrought so great a misunderstanding as to its merits. 
It were folly to deny that this misappreciation of the real 
merits of the profession has been, and is, the fruitful source of 
some jealousy and much personal discomfort among medical 
men, and a not inconsiderable sacrifice of their calling on the part 
of many, too sordid to follow truth through good report and evil, 
to the level of a trade. 
The unrest of the profession is no unfamiliar story, and this 
unrest belongs not altogether to the accumulation of a patronage, 
but also to the preservation of that patronage. But this unrest 
must be limited, with great precaution, to what is known as the 
practice of the profession, which is the furnishing certain re- 
sources which the profession possesses to supply a demand, for a 
consideration, the person supplied being at liberty to judge 
whether the demand is met and being, at the same time, not re- 
strained in criticism of any part of the transaction or the skill 
there exercised. 
I suppose it is perfectly safe to assert, without fear of contra- 
diction, that the complaints of the younger members of the pro- 
fession have two general directions, and but two; and these are, 
in the first place, the disgust begotten by familiar contact with 
social relations which are entirely beneath them, and, in the sec- 
ond place, by difficulties that beset the recovery of such comj>en- 
sation as custom has led them to exact for their services. There 
is no especial pleasure in this examination, nor would it be profit- 
able to expend time in rehearsing what is so well known. The 
only points that it is desirable to insist upon are that within these 
limits are included the major part of the unpleasantness that 
attaches to the practice of the profession, and that, under the pre- 
sent condition of things, these results are inevitable. If we understand this, we may be led to something higher, for 
it will be seen at a glance that these are but contingents and are 
no constituent part of the profession. They are one’s personal 
belongings, and they vary with the person, with his idiosyncracy 
of temperament, with his executive ability, with his power of 
expression, with his natural diginity of character and deportment. 
A man of tender sympathies, and consequently of sensitive na- 
ture, if thrown among associations, coarse, ignorant, and unap- 
preciative, will be jarred infinitely more than another man whose 
kindness and good judgment may be equally faithful, but whose 
emotional nature is less easily aroused. But in the ordinary 
practice of the profession no man escapes this contact, because 
necessity or duty, which alone impel any man to put himself 
among uncongenial surroundings, are both driving him thither 
perpetually. Each young man is a candidate for public favor 
and, as a rule, he must commence at the bottom. From the most 
unpleasant, through all grades up to the most satisfactory sur- 
roundings, his duty is in spite of the surroundings and ever the 
same. And, as the tongues of Kumor are as the winds of heaven, 
his faithfulness to duty is his impelling force upward, and the 
grinding fact is that he knows it; he must take what comes. 
So, on the other hand, it is equally apparent how unconducive 
this practice of the profession is to exercise, in its own behalf, 
any self-assertion of its dignity. 
“ On their own merits, modest men are dumb.” 
The taint of personality follows it all through. The strife for 
personal salvation from failure, to say nothing of all the ambition 
for personal aggrandizement and independence, that are the inspi- 
ration of all labor, is the same old battle of life fought here as 
everywhere. And it is a thought that ought not to be repressed, 
but rather should be placed before the sober regard of all who hold 
faith in the uprightness of humanity, that this strife among medical 
men with all their opportunities for covert action, develops so little 
that is mean or sordid. And this self-assertion of dignity is diffi- 
cult, nay impossible, for the inclusive reason that through so 
large an extent the profession is the seeker and not the sought. 
Its ability to perform, it proclaims; its opportunities for per- 
formance are its sources of revenue. It is properly restrained, its very genius limits it, in the search for these opportunities. In 
all the formative stages of what is known as reputation (and let 
it not be lost sight of that the personality is ever prominent) the 
effort to win over by complacency of manner, no less than by 
skill in action, is as recognizable as it is needful. So that any 
self-assertion of the acquisitions, hereditary or original, which 
are the common treasury of the profession, that cannot, at the 
moment, be brought down to the test of desired results, would 
plunge headlong down the abyss between arrogance and absurd- 
ity. In this apology, let it be recollected that temporizing is 
out of the question; action must be prompt, and, leaving out 
of sight the unquestionable fact that inexperience will turn pale 
no matter how polished its weapons and how multitudinous its 
unused resources, the problems that are thrust on the novitiate 
are the same problems that baffle the sage. 
I imagine that we shall have little difficulty now in finding 
some solid basis on which to rest the statement, tliat either the 
profession has an over-weening estimate of its own importance, or 
else, that there is a very inadequate estimate of its excellency on 
the part of those whose interests it subserves. In brief, it arro- 
gates to itself an accurate understanding of the physical struc- 
ture and functions of man, a growing comprehension of the 
causes that tend to undermine his integrity, and with that growth 
an ever increasing ability to check its tendency to decay, and that 
this growth is based on sound knowledge acquired by liberal 
investigation. Opposed to this is a faith which has a very com- 
prehensive constituency, a faith which has been very well sum- 
marized by a modern English medical w’riter, Dr. James Johnson, 
and which I quote for three reasons: because it embodies the 
sneer which is a popular sentiment against legitimate medicine, 
because men seize so eagerly and with so great gusto upon any 
ridicule a man may cast on his own calling, no matter how truth- 
less so long as it is derisive, and because the extract was promi- 
nently placed in the humorous department of the most widely 
circulated popular magazine in the country. He says : 
“I declare my conscientious opinion, founded on long observation and re- 
jection, that if there was not a single physician, surgeon, apothecary, 
“ chemist, druggist or drug on the face of the earth, there would be less sick- 
" ness and less mortality than now obtains. When we reflect that physic is a 
“ *conjectural art,’ that the best physicians make mistakes, that medicine is “administered by liostsof quacks, that it is swallowed by multitudes of people 
“ without any professional advice at all, and that the world would be infinitely 
“more careful of themselves if they were conscious that they had no remedy 
“ from drugs, these and many other facts will show that the proposition I have 
“ made is more startling than untrue. But as it is, drugs will be swallowed 
“ by all classes, rich and poor, with the hope of regaining health and prolong- 
“ ing life, and also with the expectation of being able to counteract the culpa- 
“ ble indulgence of the appetites and passions.” 
If proof is asked for the statement that the public respect for 
legitimate medicine is not that to which, its practitioners claim, 
its dignity is entitled, dismissing all special cases, the one promi- 
nent fact that the public is tolerant of what it styles the different 
schools and practices of medicine, is answer conclusive. 
Thus far, in this discussion, I have steadily avoided any direct 
allusion to the Science and the Art of Medicine; but any proper 
understanding of the difficulty in question, must bring these 
terms prominently to the front, for on these the issue pends. 
Legitimate medicine elaborates the Science and on that bases 
its Art. All the manifold heresies of medicine with unanimous 
accord, confess the Art, but deny the Science. 
That this misconception should be fully grasped is essential 
before it is possible to make good the pretensions of legitimate 
medicine. For a proper understanding of the merits of the case, 
let us accept two definitions, that are of the most general charac- 
ter and which, from their inclusiveness, can be generally accepted, 
viz.: defining Science as a systematic arrangement of general 
principles; and Art as a system of rules designed to facilitate 
the performance of certain actions. 
The history of all medical heresy, no less than the history of the 
popular heresies of to-day, has been unmistakably consistent on 
two points : first, that it has never made any pretence to a Science, 
but has begun and ended in its claim to accomplish certain re- 
sults by certain procedures ; and second, that without exception, 
the end of its existence has been to promote the pecuniary 
emolument of its teachers. The implied claim is, therefore, and 
it is the popular objection, that the body is obnoxious to certain 
infirmities, that there are certain things to be done to relieve 
these infirmities, and that the discovery of the means whereby 
these results are obtained may be, indifferently, accidental or the result of investigation, and that the knowledge of the appro- 
priate use of these means is the doctrine of medicine. The in- 
telligent use of means suited to the relief of disease is, unques- 
tionably, the Art of medicine, and those, who believe that this is 
the end of the story, are thoroughly consistent when they allege 
that there are many ways to one end, and that any body of men 
who claim that they can cure'disease by certain modes and can 
make good their claim, are entitled to the honorable distinction 
of a school of medicine. And it follows, legitimately, that so 
soon as this is admitted, a highway is thrown open for an inter- 
minable procession of schools. 
Conjectural or no, if medical Art is all there is of medicine, or 
to put it again, if medical Art is all that is useful in medicine, 
then the heresies of medicine have the argument by undeniable 
concession, and are heresies no longer. Certain wants are to be 
supplied, the purveyors to these wants are supplying those most 
interested, and are driving a respectable trade. It must be ad- 
mitted that there results considerable friction, as the facts show. 
Individual ingenuity is pitted against collective learning. Ec- 
centricity no matter how erratic, insolent bravado no matter how 
blundering, conceit no matter how stupid, so long as a following 
is obtained, gain the prize of merit in that constituency. Of 
course this constituency is subject to great fluctuations. Repu- 
tations hang on a very brittle thread. The cow doctor was con- 
sulted in a critical case and though, as he said, he didn’t know 
much about humans, he’d give a pound of salts to a cow, and he 
thought a quarter might do for the young woman. It proved a 
bad case of ne sulor ultra crepidam, for in the style of the modern 
paragraphists, the mourners noticed a sweet smile on the face of 
the coqise and the procession did not reach the cemetery till after 
dark. The darkey’s is a case in point. A southern planter was 
taken suddenly ill and, as the nearest doctor was a long way off, 
an old negro, of considerable repute on the plantation, was sum- 
moned to prescribe. The patient not improving, the doctor was 
obtained, who asked the darkey what he'd given. “ Gib massa ai m 
and ros’n.” “ Alum and rosin ! what for? ” “ Why I gibs de al’m 
for to draw the parts togedder, and de ros'n for to make urn stick.” 
These are gross illustrations which set forth the principle that 
underlies all empiricism ; a belief which contends that experience 19 
is the one thing needful in medical art, that is, mere experience, 
without knowledge of principles; an empiricism, older than 
Pliny or Aristotle, who wrote of it; an empiricism which, all 
along the upward track of knowledge, has set itself in antago- 
nism to scientific medicine. 
It is to be asserted, without fear of successful contradiction, 
that there is not a single instance to be brought forward from the 
accumulated archives of the intellectual history of all time, where 
the professional advocates of these pseudo-schools of medicine 
have contributed one iota to the mass of human knowledge out- 
side of the elaboration of their particular pet theory which is 
their stock in trade. Consistently they aver that the successful 
practice of medicine does not require it. If this be true and if 
this be all, the title of a learned profession is a misnomer beyond 
parallel. 
Is it possible, in these days of the diffusion of knowledge that 
one should be driven to argue the inferiority of an Art, whose 
system of rules has been knocked into shape by hap-hazard ex- 
perience, to the dignified composure of an Art which has been 
built up carefully and by slow processes, through successive gen- 
erations of investigation, whose classified knowledge has unfolded 
the processes of Nature and moulded the Art in conformity 
thereto ? Shall the community of intellect confess the conceit a 
novel one, that truth is a unit and cannot be dissociate, that each 
science is an analogue to every other, and that the broader the 
research the safer the guidance ? 
The truth then is before us, that there is need of a Science of 
Medicine on which to found the Art. 
What is the Science on which the Art of Medicine is founded? 
Medical science is classified knowledge of the structure and 
O 
functions of the human body, of its laws of growth and decay, of 
the influences that affect its integrity, and the laws by which they 
operate. 
The element of interference is involved in the etymology of 
the adjective that defines the science. Medical, medicus, the 
healer, from Medeor, to heal, cure, apply remedies, and this from 
the ante-Homeric yedoyai, to provide for, to attend to. Ac- 
tive interference for purposes of repair is the etymological genius of the 20 
Science. The study is inspired by the intent to affect processes 
by medicines, by agents, by any means whatsoever. The intent 
to affect is its distinctive character. 
It is included in that department of Natural History known as 
Zoology, in its investigation of structure, function and habits. 
It assumes a fool hold for itself as an independent Science, when 
that plane of investigation is reached where order is studied for 
purposes of interference and protection. 
In common with all other Sciences, it seeks to establish gen- 
eral principles through the relation of facts. Observation and 
deduction are the conditions of its growth. Alone of the Sci- 
ences it seeks to provide for the restoration of order. 
All other Sciences are tributary to it, not for study of similar- 
ity and correlation of law, but as their results can be turned to 
account in the purposes it proposes. 
Let us state the problem in another form. There is a physical 
structure of the human body, its several components working ac- 
cording to certain laws, the purport of which is called function ; 
that even in the most ideal conception of supply and demand, 
there is a tendency to the exhaustion of these energies, the com- 
bination of which is called life, and, as a practical fact, the con- 
ception of that ideal relation defies statement, for external influ- 
ences, in myriad form, are working to impair the balance of func- 
tion. To preserve or restore this balance is the need. The accu- 
mulated knowledge which is required to satisfy this need, sys- 
tematically arranged, is Medical Science. 
It is contended that there can be no Science when the muta- 
tions are so rapid, and extinction so sure. Of course, this begs 
the whole question, for if general Science has developed any- 
thing, it has authoritatively pronounced the universality of 
change and tendency to extinction of present modes of being. 
The objection is resolved into one of degree. It is complex be- 
cause it draws from so many sources to promote its ends. “ Med- 
icine,” says Whewell, “ in its original and comprehensive sense, 
as one of the great divisions of human culture, must be consid- 
ered as taking in the whole of physical Science.” The complex- 
ity is increased, not because the relations are more occult than in 
other organisms, but because the element of repair enters in. 
The objection fades before the fact that, as a Science, its theories 21 
are put at once to tlie crucial test. The Science and the Art are 
in the same hands, and the Art must be prosecuted to procure 
the means to develop the Science. “ It does not plant itself on 
the dogmas of authority, precedent or tradition. Its doctrines 
are based upon the eternal and immutable laws of Nature, and 
are estimated by high scientific standards. Precedent and au- 
thority carry no weight here, except so far as they accord with 
the principles which science has proven, and has established as 
reliable guides * * * The old is valued only as it squares 
with the new. The past is estimated solely by the standard of 
the present.”—(Dunster.) 
There can be but one science of one subject. What facts are 
known relating to one subject must be related to each other. 
These accumulated facts, with their relations, are the materials 
for the Science of that subject. If the conception of the unity 
of Medical Science has been adequately indicated, it must be 
conceded that Medical Science is something wider and more com- 
prehensive than has heretofore been confessed, and the imperfect 
comprehension that has obtained has been an injustice to its dig- 
nity. Almost its entire literature has been in antagonism to this 
conception. Not only has the irrational severance of medical 
and surgical learning endowed each with the appellation of a dis- 
tinct Science, but the parceling out is the genius of the day, and 
the Sciences of Medicine have become more and more numerous 
as industry has been applied to the development of more and more 
restricted departments. The unity is lost in the prominence of de- 
tails. As truth has been wrought out, the tendency has been to 
divide and subdivide, instead of to generalize and unify. 
The history of histological, anatomical, physiological and 
pathological studies is unique in the fact that they have been 
elaborated by medical men, not as side-issues and for intel- 
lectual gratification, but as directly essential to their need. Dis- 
sociation of them from the body of Medical Science is a denial 
of their history in the very face of fact. But it is a violation of 
intellectual honor to apply this fundamental knowledge to certain 
departments, and on the basis of operative procedure, to elevate 
these departments into distinctive Sciences. 
So far as I am aware, there are but three instances in the entire 
array of Medical journalism, where this unity is acknowledged by the titles of these journals: one in Europe, one in Asia, and one 
in America. “The Dublin Journal of Medical Science,” “The 
Indian Annals of Medical Science,” and “The Half-Yearly Com- 
pendium of Medical Science.” Outside of these the changes arc 
rung in every conceivable form on “ Medical Sciences,” “ Medi- 
cal," “Surgical,” “Medico-Chirurgical,” and the like. 
But if there be this unity in the Science of Medicine, the moss- 
grown, ivy-covered wall between Medicine and Surgery, that has 
defied the ages, must crumble; and with its destruction there shall 
ensue a breaking down of all barriers, and over the ruins the 
stately Science of Medicine shall collect itself into the majesty of 
single-handed strength. If there be this unity, objection can be 
unqualifiedly made to the abuse of terms in ranking the depart- 
ments of Medicine as separate Sciences. As sub-divisions of the 
great Science of Medicine, they are but Arts of Medicine, fulfill- 
ing certain functions in the application of that Science. The 
disposition of thought engendered by otherwise regarding them, 
is inimical to a clear comprehension of the unity of Medical 
Science. The sweeping away of these barriers will obliterate 
their fragmentary character and compress them into a body of 
learning. If further argument were needed, it would seem 
that the question could be put beyond cavil by taking into 
account the purpose for which Medical learning exists. The 
singleness of that purpose must unify the power that would 
effect it. 
Except by exhaustive statement, it would be presumptuous to 
rehearse, before this learned body, the history, progress, resources 
and acquisitions of Medical Science. In truth, this rehearsal 
would have but an incidental connection with my purpose. My 
aim has been solely to point out the fallacy and misconception 
through which the various forms of medical heresy have warped 
public sentiment away from a proper understanding of the exact 
grounds on which legitimate medicine is based, and to furnish 
the radical argument which shall lead up to the education of the 
people in a comprehension of the well-grounded claims of Scien- 
tific Medicine. 
It ought not, indeed it cannot, admit of question that where 
there is misconception in a matter of so great importance as the 
relation of the medical profession to the public whom it serves, 23 
that an attempt should be made by those most competent to 
clear up misunderstanding, and that this attempt should be 
adhered to until a satisfactory result is arrived at. Error is 
destructive always, and sows dragon-teeth broadcast to spring up 
armed men who shall assail truth with the sword. But on this 
issue the interests of civilization are intense and should be 
rightly informed, for after all it is the truth that men are seeking 
for; the professed skeptics are but few. So, on the part of the 
profession, the duty is not less important. It cannot destroy 
error by ridicule, and, if it stand still, without raising a hand in 
its own defense, it must suffer. “ When bad men combine,” says 
Burke, “the good must associate, else they will fall, one by one, 
an unpitied sacrifice, in a contemptible struggle.” 
It is easy to see how the unrest of the profession should 
increase in the face of the triumph of medical heresy, and it is 
not difficult to forecast how probably, in view of the dependence 
of the Arts of Medicine on popular favor, disaffection might grow 
and the legitimate Arts of Medicine be sacrificed to the emergen- 
cies of life. It is, then, of the utmost importance, for the preserva- 
tion of its own integrity, that the profession should be alive to 
the demands of the age, and secure itself beyond peradventure of 
inroad by bringing the public mind, face to face, with the cath- 
olicity, the stupendous progress, the multiform investigation and 
acknowledged achievements of Medical Science 
Do not misunderstand me for an instant. I make no convplaint 
touching the position of medical men as individuals in their 
greater or less success. As things run, men get their deserts in 
this world. There is nothing so successful as success, in which 
is involved the truth that opportunities must not only be im- 
proved, they must be created. The unsuccessful man, conscious 
of some power that ought to lead to results, must reckon himself 
deficient in some qualities whereby that power can be utilized. 
Men are ordinarily ambitious of their own fortune, and if there be 
one who feels that there is an inadequate recognition of his merits, 
he must call himself to account for his failure. It is discreditable 
to depreciate any success honorably achieved, and while every- 
thing is fair in love and war, the savoir faire, no matter where 
applied, conditions the royal road. lie who sits down to await 
the advent of fame, will be found sitting when his last trump 24 
summons him into obscurity. All the latent energies in the uni- 
verse are worthless till called into action. And the application 
is pertinent. We are conscious of so much power which is our com- 
mon acquisition, that jealousy will crop out at times, and the airy 
forms of slander will, to our honor, be it said, rarely, attack fair 
fame. Medical men must meet the world as men meet it every- 
where. Each can, by the force of his own character, gain for 
himself a respect independent of his calling. But the Science 
which the profession has elaborated, and from which it draws its 
resources, it must maintain. The very structure of our Science 
defies its prostration before mere purposes of gain; but it has 
rights which truth gives it, and which, for truth’s sake, must be 
maintained. It must be set on the hill-top that all may see it, 
before its power can be recognized. 
It will certainly hold good in the opinion of medical men, that 
the statement of Johnson, above quoted, is not temperate; and it 
is difficult to understand how the statement could have been de- 
liberately made. Such wholesale assertions arc pretty generally 
ill-judged, and this is no exception to the rule. The statement 
is smart and specious, but incorrect. It does not aver that drugs 
are altogether worthless for good and invariably do harm, but it 
asserts that if they could be banished, inen would l>e better off. 
But the fact is that they are here, and the fact is they are useful. 
It avers also that as they are abused, they ought not to lx; used 
at all. It is difficult to seriously discuss a reform that would 
abolish things because things can be abused. Then should Mr. 
Bergh say that, as cruelty to horses not only damages the horse, 
but degrades the moral sense of the driver, therefore horses 
should be abolished. Now horses are a definite quantity, and 
could be swept from existence, if men should so agree ; but 
nothing short of a general annihilation of things could abolish 
drugs. Now some men know, and most everybody believes, 
that drugs are useful, and it is highly probable that the prema- 
ture pippin has driven the objector himself, at some time, to his 
paregoric. Of course he should have ascertained the maturity 
of his pippin, but then accidents will hapj>en, and drugs will re- 
pair damages Excess is a contingent of all growth : no vice, 
no virtue; no right, no wrong. Wisdom shows itself in the 
proper use of things ; unwisdom, which is either recklessness or ignorance, declares itself in their abuse. There is no moral char- 
acter in things, and the moral character of the individual is not 
affected, one way or another, by things which are at rest. So as 
long as drugs are in the world, and a proper education can turn 
them to useful account, it is a trifle foolhardy to assert that that 
education were better stifled, because those who do not and can- 
not possess it, damage themselves by drugs. 
But the statement avers that Physicians sometimes make mis- 
takes. I do not pretend to deny it Fatalities not unfrequently 
occur from ignorance or carelessness, which bring reproach on 
the profession. But, in a majority of instances, it may safely be 
asserted that such errors will be found to have their source in the 
inadequacy of preparation, which may be objected against most 
all professions, or in other causes inseparable from human im- 
perfection. 
Certainly if medical men and Medical Science are to be thus 
adjudged to indiscriminate slaughter, it is time some one should 
arouse out of slumber. For the more general a belief in the cor- 
rectness of such statements, the greater the indignities that would 
be heaped on the mass of men whose lives are pledged to its sup- 
port, and the more widespread the disaffection from their ranks. 
On the other hand, if Medical Science was held in adequate 
esteem, confessedly, it would be authority in its own department, 
and its votaries would be inspired to greater effort to elevate its 
rank, and though subject ever to criticism in the exercise of their 
calling, that criticism would be on a higher plane, and would not 
trench, in any degree equal to the present, on the dignity and 
self-respect of the individual. The Science itself would protect 
the scientific body. 
With this confession of the authority of Medical Science, 
would slink into oblivion the pestilential host of nostrums, not 
sooner than the distortions, untruthful ness, ignorance and dis- 
honesty of the pseudo-schools of medicine which prey on the 
prejudices and fears of men ; or if ignorance and credulity must 
exist, so long as the world stands, these corruptions of the truth 
would be driven to their boon companionship, excluded from 
corrupting intelligence. 
And, still further, the dignity of Medical Science, once recog- 
nized, would give authority to its mission as guardian of the public safety, and individual intelligence would be better placed 
in the following of advice as to its own interests. 
How is this estimate to be enforced ? Granting that there 
should be a unanimous concession as to the necessity of bringing 
Medical Science prominently to the front, so that its to be 
ranked among the Sciences could be made good in the popular 
estimation, and so that it should receive the homage of respect 
to which, as a Science of the first rank, it is entitled, difficulties 
without number marshal themselves forward to contest the wis- 
dom of the several modes by which this scheme could be carried 
into effect. It is impossible to reject or gloss over these difficul- 
ties. In the first place, the scheme itself is revolutionary. 
From remoter periods than when the Priests of Isis held the pre- 
rogative of medical mysteries, and dealt them out for oboloi and 
drachmae, up through the Dark Ages of Rosicrucian Arts, Necro- 
mancy and the Witches’ Caldron, even to these better days, the 
serenity of medical learning has held itself aloof, in self-con- 
templating and dictatorial dignity, from the vain and babbling 
world. And this self-imposed dignity, if it has provoked the 
sneer of heresy, was well-grounded in one fact at least, that 
there were mysteries, and that these mysteries could not be trifled 
with with impunity, and on them impious and unhallowed hands 
should not be laid. Rut I protest now, as the argument I have 
thus far endeavored to make good is naught if not a protest, 
against this confusion of Medical Arts with Medical Science. 
The Arts require tools, and demand a special education for their 
use ; but the principles on which these Arts are based, are eternal 
truths, and are, therefore, the property of mankind, as they are 
its heritage. 
But again, another class of difficulties, swarming up from the 
first named, cluster around the general objection that the profes- 
sion would be destroyed by the general diffusion of the knowl- 
edge which is its capital in business. There is the aroma of 
antiquity exhaling from this likewise. One of our own craft has 
told the story of how, many a century since, one Demetrius cried 
out to his fellow-workman, and set the City of Ephesus in an 
uproar against the overthrow of the worship of Diana, as that 
“thereby their craft vras in danger of being set at naught.'’ 
There is a general demerit in the objection. For the respect 27 
which is inspired in the unlearned for intellectual power, enhances 
the authority with which that power enforces itself, even though 
there be utter inability to grasp the sources of that power; and 
though the cultivated may investigate the general principles of 
all Science, yet the special education required for the practical 
application of these principles, forbid any general participation 
therein. Faith in the efficiency of the “Jack at all trades,” 
decreases with the diffusion of intelligence. And, on the other 
hand, no decent political economy would stand in the way of any 
progress, that would do away with any need, for the purpose of 
sustaining the labor that supplied that need. When Medical 
Science has risen to her completeness, and public sentiment is 
obedient to her authority, old age will have asserted his legitimacy, 
the nosology will have dwindled, and the medical profession, as 
it now is, will be an institution of the past. If the special duties 
of the profession be, by this means, diverted into other channels, 
what boots it? Civilization, which is progress, will crush the 
imbecile that flings himself afront her chariot wheels. 
But how is this estimate to be enforced ? By three modes, 
which, held as supplements one to the other, are to be combined 
as one force. By the profession bringing Medical Science out 
from its seclusion into the conditions created by the demand for 
Popular Science: by the profession forcing on the public consid- 
eration the lessons it alone is competent to teach ; and by the pro- 
fession throwing about itself such safe-guards as shall secure its 
ranks against occupation save by those who, by the gifts of char- 
acter, industry, intelligence, and culture, are fitted for the high 
places of this calling. 
From metropolitan centres to the outskirts of civilization, there 
is this demand for Popular Science. Great audiences throng the 
lecture-halls to listen in wonder to its startling revelations; jour- 
nals are devoted to its exposition; it has its columns in the 
papers that penetrate to the remotest wilds. The best ascertained 
facts and the very idealities of speculation alike prostrate the 
knowledge-hungry listeners spell-bound in reverence at the 
investigations that have dared and conquered. But what of all 
that has been thus far ventured, even with the glamour of Tyn- 
dall’s fame and the enterprise of Proctor, can compare in exact- 
ness of investigation, thoroughness of research, completeness of results, and the startling character of the processes evolved, with 
many and many a score of the achievements of Medical Science, 
which are the every-day, familiar facts of the profession ? Con- 
ceive the Doctrine of the Circulation put before the Academy 
foot-lights, with all the appliances of demonstration, with dia- 
grams and models and manikins, microscopic and chemical analy- 
sis, vivisection and the calcium light Display from the canvass, 
in the weird darkness of the room, the torrent of the blood rush- 
ing in impetuous force down through gradually diminishing and 
ramifying canals; follow it through the dim mysteries of its 
wonderful mutations, till it re-collects its turbid and more sluggish 
stream on the upward and widening grade: resurrect it by con- 
tact with the all-pervading energizer of being, till, flushed and 
instinct with life, it plunges again into the maelstrom that shall 
hurl it on its ceaseless round! Where, in comparison with the 
disjointed and fragmentary phenomena of light and heat; where 
the dreamy visions that fill up the infinite abysses that separate 
the frigid isolation of astronomical facts, is this one, wonderful, 
exact, complete, conclusive, incarnate demonstration of infinite 
wisdom and power! Penetrate, again, down to the very genesis 
of being, and build up, by lbstological synthesis, from protoplasm, 
through cell and fibre and organ and including frame, till the warm 
flush suffuses the Apollo. Convert the gross elements of material 
substance into chords that quicken into the most subtle sensa- 
tions, whose central source trespasses on the Infinite. Follow 
out the display of the myriad results of Medical Science, by im- 
pressing the truth that they are not the accidents of pleasurable 
investigation, but have been wrought out through long generations 
of laborious endeavor, forever inspired by the hope to make more 
successful the applications of that Science; that hosts of men 
stand ready, at any moment, tp be eloquent expositors of its 
latest refinements, and the demands for Popular Science are met. 
Whatever there is of regard and reverence for scientific truth any- 
where, must be given to Medical Science, as in the first rank for 
elaborateness and utility. 
Coupled with this, let the profession, through its organizations, 
general or local, oppose itself to the recklessness and ignorance 
that unsteady and shorten life, and in its own department preach 
to the people the sermons of right living, of which self-denial is the unvarying theme. There is a recklessness that baffles all in- 
struction ; but, in the main, men are only too willing to abide by 
competent teaching, and the competency of the profession to un- 
fold the problems affecting the general or the individual weal, 
ought not to be a matter in dispute. The demand for knowledge 
assumes the best it can get as the best of all. On the other 
hand, if the profession possess this knowledge, it ought to be 
made manifest. The test of duty is the only test that can stand. 
If it possess facilities that can stay disorder, it is criminal to all 
humanity if it does not use them. The late meeting of the State 
Society proved that the profession is alive to the issue In a dis- 
cussion on drainage, men from all parts of the State urged, with 
intense earnestness, that preventible causes of disease should be 
studied for purposes of removal ; that legislation could effect 
nothing, unless the instruction of the people preceded the legis- 
lation. General Yiele said it was his experience that a medical 
practitioner, wherever found, was a missionary domestic, civil 
and religious, and as such it was his duty to initiate reform.” 
Dr. Agnew urged medical men, on their daily rounds, to force 
this knowledge on the consideration of men. Dr. Moore insisted 
that “ as a body we must seek to enlighten the community, so as 
to secure general laws,” and again, “ we must inaugurate schemes 
that shall command general professional assent and press and 
press them on the attention of the people.” 
Not separated from these two, but upholding both in the pub- 
lic regard, stands foremost the unquestionable duty the profession 
owes to its own dignity in guarding well the entrance to its treas- 
ures. If the personnel be staunch and true, if it be well in- 
structed and intelligent, if it be studious and liberal, if it be 
high-minded and loyal, it shall win its way. There need be, 
then, no fear that the estimate the profession puts upon itself, 
and that in which it is held in the public regard, shall be widely 
separate. An honorable profession, upholding a Science distin- 
guished for its devotion to the public welfare, must be impregna- 
bly fortified in the esteem of men_ 
I have no word of plea for the men among us who have de- 
voted their lives to the cultivation of the special departments of 
our Science, who are shielded thereby from the complications 
that beset the profession at large ; no plea have I for the mag- nates of our profession who, by their excellent gifts and wisely- 
applied industry, are exalted to be our teachers, and are reposing 
with the laurels of well-earned victory. They are our pride, and 
for them I have but congratulation and rejoicing. But I plead 
for the general practitioner, that he shall be such a well-instructed 
and honorable member of a learned and cultured profession, 
that the honor and respect which it has acquired may belong to 
him, as an integral part thereof. And I plead, from the very 
depths of earnestness, for the younger brother, that he may be 
protected from the annoyances that baffle enterprise and stifle 
enthusiasm ; that the profession which has given him rank at the 
outset may be daily bettered by his judicious conduct ; that he 
may be so protected by the organizations that promote unity of 
purpose, diffusion of knowledge and combination of effort, and that 
are our common safeguard against the assaults of misrepresenta- 
tion and calumny, that the temptations to defection cannot suc- 
cessfully assail him, and that his life’s purpose, in whatever emer- 
gencies of trial, may never swerve. 
When these results shall have been achieved, when Medical 
Science shall have asserted itself among the elaborated systems 
of contemporaneous investigation, when its exponents shall have 
the regard due to their ministry, there shall have preceded de- 
cades of labor among the votaries of that Science informed with 
the sentiment which belongs to the genius of all the higher forms 
of labor, viz. : faithfulness to one's calling, that the calling may he 
dignified, so that those who pursue it thereafter may labor on a higher 
plane. 
Shall I enforce this by authority ? From Jurisprudence. Says 
Bacon : 
“ I hold every man a debtor to his profession, from the 
'which, as men of course do seek to receive countenance and 
profit, so ought they, of duty to endeavor themselves, by way of 
amends, to be or help and ornament thereunto. This is per- 
formed, in some degree, by the honest and liberal practice of a 
profession: when men shall carry a respect, not to descend into 
any course that is corrupt and unworthy thereof, and preserve 
themselves free from the abuse wherewith the same profession is 
noted to be infected. But much more is this performed if a man 
be able to visit and strengthen the roots and foundations of the Science itself, thereby not only growing it in reputation and dig- 
nity, but also amplifying it in perfection and sustenance.” 
From Philosophy. Says Fichte: 
“Genius is nothing more than the effort of the idea to assume 
a definite form. The idea has in itself neither body nor sub- 
stance, but only shapes itself an embodiment out of the scientific 
materials which environ it in time, of which Industry is the sole 
purveyor.” 
From Statesmanship. Says Burke: 
“ The road to eminence and power from obscure condition is 
not to be made too easy, nor a thing too much of course. If rare 
merit be the rarest of all things, it ought to pass through proba- 
tion. The temple of honor ought to be seated on an eminence. 
If it be open through virtue, let it be remembered that virtue is 
never tried but by some difficulty and much struggle.” 
From Art. Says Sir Joshua Reynolds : 
“ Excellence is never granted to man save as a reward of labor. 
It argues no small strength of mind to persevere in habits of 
industry without the pleasure of perceiving those advances, 
which, like the hands of a clock, whilst they make hourly 
approaches to their point, yet proceed so slowly as to escape 
observation.” 
From Ethics. Says Edwards: 
“If we are but fixed and devoted to our business, bent on high 
and holy ends, we shall find means to them on every side and at 
every moment, and even obstacles and opposition will but make 
us like the fabled spectre ships, which sail the fastest in the very 
teeth of the wind.” 
From Song. Says Grimwald : 
“ In working well, if travail you sustain, 
Into the mind shall light pass the pain, 
But of the deed the glory shall remain.” 
Says the Marquis of Montrose : 
“ He either fears his fate too much, 
Or his deserts too small; 
Who dares not put it to the touch, 
To gain or lose it all.” 32 
Says Longfellow: 
** Lives of great men all remind us, 
We can make our lives sublime, 
And, departing, leave behind us, 
Footprints on the sands of time.” 
Says Macaulay: 
“ When the goodman mends his armour ; 
And trims his helmet’s plume, 
When the goodwife’s shuttle merrily, 
Goes flashing through the loom ; 
With weeping and with laughter, 
Still is the story told, 
Ilow well Horatiua kept the bridge, 
In the brave days of old.” 
“ And how can man die better, 
Than facing fearful odds, 
For the ashes of his fathers 
And the temples of his Gods." 
Let us stand by our profession, uphold, defend and make good 
its claims among ourselves and among all peoples. Let us, 
whose thought and sustenance issue from and abound in the sup- 
port of man's physical power and integrity, first believe ourselves 
that the full evolvement of the principles to which we have given 
our lives, is to result in the finer and more fruitful development 
of the race, and then teach it on every hand that the physiologi- 
cal purity of the people is the working basis for the highest ma- 
terial and moral standards. Let us teach it to the younger 
brethren, that it may be handed down a heritage from one gen- 
eration to another till the victory is won ; and though we are in 
the struggle, and see but glimmerings of the light, the sure 
things of this Science will prevail, and her votaries shall yet en- 
joy the radiancy of her millenial noon. 
" Blest, and thrice blest, the Roman, 
Who sees Rome’s brightest day, 
And views that grand, victorious pomp 
Wind down the Sacred Way, 
And through the bellowing Forum, 
And ’round the Suppliant’s Grove, 
Up to the everlasting gates 
Of Capitolian Jove.”