AN
INTRODUCTORY   DISCOURSE

                         ON

       MEDICAL   EDUCATION,

           DELIVERED TO THE STUDENTS

                         OF

    (M1ST2WJ1  ffiUMKDiUId  0®IL3LIl®Il3

                  OCTOBER 1,  IS 14.
           By  CHARLES A. LEE, A. M,, M. D,
Professor of General Pathology and Materia Medica in Geneva College.
IIpiv yap Pusdxov enri ^ovi <puX' uvdgwirov
Nog*<piv 'areg ts xaxuv, xa\ a<rs£ ^aXstfoio tfovoio,
Noutfwv t' afyaXswv, 'air' av^atfi y*?£ag* 'sowxav.
                     Hesiod, Opera et Dies, v. 90.
Published by the Medical Class.
                GENEVA:
IRA MERRELL, PRINTER: SENECA-STREET.
                  1844. 
UAL.   £' 
                              Geneva Medical College, Oct. 31, 1844.
Professor LEE:
  Dear Sir—At a meeting of ihe Medical Class of Geneva College, on yesterday,
Cyrus Powers in  the chair, a resolution was unanimously adopted that we request
of you a copy of your Introductory Address for publication.  Allow us to say that
it gives us great pleasure to comply with their request.
                     Yours respectfully,            GEO. C. HAY,
                                                  D.  B. DEVENDORF,
                                                  E.  F. HUTCHINSON,
                                                  11.  B.  SHANK,
                                                  ROBERT HUNTER.
                                Geneva Medical College, Nov. 1, 1844.
  Gkntlemen—It affords me much  pleasure to comply  with  the unanimous
wishes of the Class, as conveyed  through you, in  furnishing a copy of my Intro-
ductory Address for publication.  Please convey to the Class, and accept for your-
selves, gentlemen, the assurance of my high respect and esteem.
                                  Most truly yours,
                                                    CHARLES A. LEE.
To Messrs. Hay,  Devendokf, Hutchinson, Shank and Hunter. 
 
INTRODUCTORY   DISCOURSE.
  Gentlemen: The time has arrived for commencing the tenth annual
course of instruction in Geneva Medical College.  It is an occasion full
of interest to each one of us. Many of us have now, for the first time,
entered these halls; whether for good or for evil, lor honor or dishonor,
remains as yet among  the  secrets of the  future.  We  have come  up
hither from  remote parts of our land: from  the  noisy, bustling city;
from the quiet hamlet; from the pleasant village.   We have left the
peaceful scenes of domestic life; have for a time bidden adieu to our
friends and kindred: and here  we are  assembled, in  furtherance of an
object deeply interwoven with our  own earthly destiny, and with the
well-being of our fellow-men.  It becomes us, gentlemen, to give our
thoughts and reflections such a  turn,  on the present occasion, as may be
productive of profit as  connected with  the duties which lie  before us.
It is no time for rhetorical display,  were  the speaker  capable  of it—
which he is not.  It is no time for the discussion of topics of a general
character, which have no particular bearing  upon the business lhat has
called us together.  But it is a  time to  pause; to collect our  thouo-hts •
to inquire what it is that we are now about to undertake, and how we
may best set ourselves  about it.  It is a great point gained, to find  out
what is to be done, and then how to do it.
  I assume  then that you have assembled  here for the acquisition of
medical knowledge,  to qualify yourselves to practice  successfully the
healing art; an art so ancient in its  origin, so philanthropic in its aims
so beneficial in its results, as to have been universally regarded by the
anei-mts as the gift of the gods to men.  You  come with minds fully
resolved to prosecute your studies with zeal, energy and perseverance
and to ply your utmost faculties in the attainment of medical  science.
Knowing full well that  you  have engaged in one of the noblest as well
as the most difficult of all pursuits, you have determined to consecrate
your lives to a cause which has ever engaged the best faculties of the
human  mind,  and one which  is worthy of its  highest powers.  I  am
persuaded that you feel  the arduousness, the  deep  responsibilities of 
6
your undertaking, and that you need no promptings on my part, to raise
your  minda  to a full conception of its real nature and importance.
With such convictions of duty, gentlemen, resting upon you, and such
motives prompting you to action, allow me  to welcome you to this In-
stitution ;  to extend to you the right hand of  fellowship; and to pledge
you, in behalf of myself and colleagues, our  entire devotion  to your
interests—our unceasing endeavors to promote your  progress.
   On this occasion, I propose to call your attention to some of the mo-
tives  which ought to govern  you in the choice of a  profession;  the
nature of  the preliminary education necessary to its successful prosecu-
tion;  some of the  branches  which the science embraces;  and lastly,
the spirit in which your studies should be conducted.
   Gentlemen: it becomes you  to  scrutinize well your motives in enter-
ing upon  the study of medicine,  and see whether they are such as will
stand the test of  a candid examination.  It will  not do  to  delay this
until you are fairly launched upon professional life; for then it will be
too late.   It must be done now or not at all.  Some young men, it is to
be feared, enter upon ihe study of our profession  with  a very vague
conception of the qualifications  necessary, not only  for success in  life
but for the satisfactory performance of  the duties which it necessarily
involves.  They consequently soon become dissatisfied;  they talk much
of the drudgery, the degrading  nature  of the  offices which they are
called on to discharge; of the  low  estimation in which  their calling ia
held by the  public; of the paltry compensation they receive  for their
services; of  the  great prevalence of quackery; of the  hardships they
are called to  endure: and, if they do not themselves turn  quacks, or
engage in some  other kind of business, they go on grumbling all their
days,  making themselves and all around them unhappy; and all this
happens in consequence of having made a wrong choice of a profession.
   Again: Others commence the  study of medicine,  because, as one of
the learned professions,  it is, in their estimation, more honorable and
dignified than mechanical or agricultural pursuits, and will  give  them
a certain standing in society somewhat  more elevated than attaches to
the latter.  I need  not say, gentlemen, that such views are entirely
erroneous.  The time has been,  and now is in other countries, when
such an opinion prevailed; but it is so no longer.   So wide-spread and
so deeply-rooted, in our  land, is the conviction of the natural equality
of mankind, and of the fundamental  rights which that natural equality
confers upon every human being, that the different  trades and profes-
sions  stand upon the same level; and  no one, in consequence of  the
calling in which he is engaged, can chiim  the  least superiority over
another.   But here, where we have no nobility but that of the mind
no immortality but that  which  .springs from worthy thoughts and noble 
I
deeds, puch a claim can no more be  conceded than that of the divine
right of kings or the  expediency of a hereditary nobility.   If any indi-
vidual should  assume  any superiority in consequence of his calling, it
will  not be long  before he will discover that his position is a very un-
comfortable one; very different from what it would  be  in a  country
where society is made up of well-defined grades and orders, and where
there is a recognized aristocracy.
  Again: There is reason to suppose that some engage in the study of
medicine, because they believe it will afford an easier  mode of support
than agriculture or the mechanic arts.   But those  who have been en-
gaged for any time  in the practice  of our profession, whether in the
city or country, will tell you that this  is altogether a mistake; that there
is no calling in which the body and the mind are so severely tried ;
none in which  more  arduous labor is demanded.   Where is the  trade
or profession that requires  more unremitting toil, in which the  mind is
so often painfully exercised?  in which anxiety and  responsibility are  so
constantly experienced? in which  there is such  frequent deprivation of
rest and sleep? and where the duration of life is so uniformly shortened
in consequence of the hardships,  mental and corporeal, to which we
are exposed, as that of medicine ?  Gentlemen, there is perhaps no pro-
fession with which ours may, in this  respect, with  more justice  be com-
pared, than that of arms.   The trials  and the hardships of both are
very similar.  The soldier and the  physician are equally exposed  to
atmospheric vicissitudes—to all kinds of weather: storm and wind, heat
and cold, sunshine and tempest come  alike to both: marching and coun.
ter-marching, by night and by day;  the former  at the command of his
superior officer—the latter self-moved  at every summons of suffering
humanity: through miry swamp or tangled forest, following an Indian
trail  or on the macadamized road ;  it is all the same to both.  Sleeping
upon their arms, ready at the first alarm to seize their  weapons and en-
counter the enemy, whether at a distance or in  close,  mortal  combat:
promptness, energy,  courage and  decision, alike necessary to both;  to
both a mind fertile in expedients, rich in the treasured resources of re-
corded experience and actuated by the  conviction of right, and the de-
sire to discharge  their whole duty;  there would really seem but little
difference between the two professions, and that so far as  mere worldly
ease and comfort is concerned, a man might as well be enrolled among
the followers of Mars, as the disciples of iEsculapius.  But, gentlemen,
here the similarity ends.  If you follow the soldier into the practical ap-
plication of his art and science;  and the physician in his errands of
mercy, you find them engaged in a very different manner; the one
brings all his resources, his skill, his  courage and his strength to bear
upon the destruction of life;  the other to preserve it:  the one seeks to 
8
mar and destroy God's  image, the other to build up and to save.  The
one racks his invention to contrive weapons of a more destructive kind ;
the other, the true conservative, to find means to prolong human exist-
ence.   They are in short the antipodes of each other in every thing ex-
cept toil and hardship, which are equally the heritage of both.
  Again :  Some turn their attention to the medical  profession because
they are unfitted for everything else: in the open competition of the
bar they could not lor a moment expect to succeed, for here imbecility
and stupidity become as apparent as the  sun at noon-day.  In the pul-
pit concealment would be almost as difficult: they can here hope to pass
for no more  than they are really worth;  counterfeit coin is soon detec-
ted and stamped as base, and so they turn their  attention to medicine,
where deception and  cunning can better  supply the place of talent and
learning.  There is no profession in which ignorance and charlatanism
have such a  boundless field, so wide a theatre on which to operate, as
that of medicine.  But this field  is narrowing every day : in proportion
as a knowledge of the structure and functions of the human body be-
comes  diffused  among the people; which is now  rapidly happening,
through popular works and lectures; in the same proportion will every
species of  quackery be rooted out and  imposture  stand  revealed to the
fight of day.
  Shall we err in supposing, that some engage in medical study merely
from mercenary motives, with the view solely of acquiring wealth, and
the distinction that wealth confers?  If such individuals do not succeed
in the regular practice of their profession, we often see  them resorting
to dishonest tricks and artifices, or turning off into some of the thousand
by-paths of quackery, reckless alike of their own reputation, and that of
the profession to which they claim to belong. I  know not, gentlemen,
a more humiliating spectacle than to see a physician devoted, soul and
body, to the acquisition of wealth; influenced by no love of science,
prompted  by no generous or  noble impulses  of our higher natures,
indifferent to all improvements and discoveries in  our art, except as they
may be turned to his own individual advantage;  a stranger to the love
of philosophic  truth; with instincts all quickened and awake to the ad-
vancement of his own interests—the increase of his own sordid gains—
but his soul  deadened to all the tender sensibilities.  He heeds not the
complaints of suffering humanity, but pursues his routine path, indiffer-
ent whether  he scatter " firebrands, arrows and death," or is instrumen-
tal in restoring to health and happiness, provided  he is only putting mo-
ney in his own pocket.  It is such  men that bring our profession into
disgrace, and reduce it, in point of respectability, below the humblest
mechanic  arts.  Gentlemen, I trust that you have all engaged in your
present pursuits from a full conviction of the intrinsic importance and uti- 
9
!ity of medical science; with feelings of benevolence and good will to the
universal brotherhood of man; from no  mercenary or selfish  motives,
but with a sincere desire to do all the good you can in the world, know-
ing full well thai there is  no other profession that promises such exten-
sive opportunities of being useful to  your fellow-men, and  that too, in
their hour of greatest need, and intensest suffering. To the benevolent
mind—to the heart  that sympathises with human sorrow,  what employ-
ment can possibly afford  a more sincere delight,  than that of binding
up the broken heart; ministering to  the body and the mind diseased;
watching the returning glqw of health, as it mantles over the lately
pallid and sunken cheek—seeing the smile once more light up the coun-
tenance; strength again invigorating the limbs; hope  reanimating the
breast;  while joy and gratitude warm the heart?  How  paltry and in-
significant do pecuniary considerations appear when viewed in compar-
ison with such rewards as these !  And as we pass along through life,
and feel that the time may be at hand when we  shall need  the same
services and the same attention that we have bestowed upon others, how
cheering the  reflection that, in the hands of  Providence,  we have been
instrumental  in relieving the distresses of our fellow-men—of following,
though at a distance, in the footsteps of our divine Master; whose earthly
mission was devoted to the cure of moral and physical disease.   Gentle-
men, it will be a consolation, at such  an  hour, to know and to feel, that
we have not lived altogether  in vain—that we have been  useful to man-
kind—that the world has been made happier through our humble efforts
—that when we shall have passed away, and bid a last farewell to earth-
ly scenes and earthly sufferings, we shall leave behind  us a name  and
an example, of which our friends need  not be ashamed.  Usefulness,
Gentlemen, you will find to be one of the great means of  human happi-
ness.  The profession of  medicine is one of prominent usefulness, and
there is no greater benefactor of the race than the  devoted, faithful  and
conscientious physician.
   If then your motives have been carefully weighed; if you have count-
ed the cost ere you  began to build; if, after a full  and candid survey of
the whole ground, you have deliberately made up  your minds to perse-
vere, happen what may, in the spirit and integrity of true-hearted men,
bent on doing good, then, Gentlemen, I bid you God speed ; your course
will be like the rising light that shines more and more  unto the perfect
dav.  If your minds are well disciplined  and your  studies well directed,
you are prepared for the certain and successful attainment  of your ob-
jects ; for you have the promise of the " life that now is and of that which
is to come;"  and you will find, that  notwithstanding the drawbacks I
have named,  there is that in  our profession—glorious rewards for duties
faithfully and conscientiously performed—which will amply repay you
                         B 
10
 for all the toil and study, and labor and sacrifices, which it entails upofj
 you.
   There is not one of you, I trust, who does not aspire to the character
 of a well educated  physician ; for such only are needed, such  only can
 be extensively useful, and such the public have a right to expect you to
 be.  But  what are we to  understand  by a good  medical education?
 What kind, and what amount of knowledge will entitle you to such a
 character?   There are different standards of attainment, as there are
 different grades of  intellect;  there are different shades of importance
 attached to different departments of medicine, according to the constitu-
 tion of individual minds.  But all  must agree that  to  form an accom-
 plished physician at the present day,  demands an extent and variety of
 attainment, a union of qualifications of no ordinary kind.  The physician
 of to-day is not the physician of the last century, nor even of fifty years
 ago.  What would then have served to qualify for the practice of the
 healing art, would now scarcely fit one for the  office  of an intelligent
 nurse.  The science of that period bore no more resemblance  to that of
 our day, than that which  was  taught by Galen or Paracelsus.  The
 faithful descriptions of disease, handed  down to us from former genera-
 tions, are all  that is really valuable, which we have inherited  from the
 past.   In this respect, the writings of Hippocrates have never been sur-
 passed, and are as useful guides, to us, as they were to the physicians of
 the age in which  they were written.  I need not stop to point out in
 what respect medical science of our times differs from  that of all prece-
 ding ages; how pathological and general anatomy have been created j
 how our methods of  diagnosis have been improved—legal medicine,
 and  analytic and pathological chemistry sprung into existence J  how
 numerous useful collateral sciences have arisen; and how afl have ad-
 vanced with giant strides, under the guidance of the inductive  philoso-
 phy.  Gentlemen, it needs no great amount of intelligence to perceive
 that the times are changed, and medicine has assumed a  new livery.
 Mankind seem to have arisen from  the torpor of  ages, and taken a  new
 start on the milky way of science.   The starting point of to-day  was the
 goal of our grandfathers.   The constellations of science are revolving
 round the grand centre of truth,  with as great celerity as the planetary
 system revolves around the centre of light and heat.  As members  of a
 learned profession, or as candidates for it, we belong to  this glorious
 galaxy, or should belong to it; let  us  see  that our light is not eclipsed
by the brighter beams of other stars of  greater magnitude ; let us  take
 care, lest, while this constellation  is thus progressing  through the re-
 gions of scientific space, we acquire too great a share of the vis inertia
 and so fly  off into that limbo of fools, beyond its "flaming  bounds," in
 some ci terra  incognita." 
11
    Education, to be worthy of the name, implies the thorough training of
 the whole man—moral, intellectual and physical—no part of our nature
 can be neglected without producing a  distortion—a caricature:  and to
 no class of men is this self-evident truth so important as to members of
 the medical profession.  The reason is obvious.   It is  because the pro-
 per discharge of the duties devolving on us, requires the full possession'
 the constant exercise of all our faculties.  Imagine, if you please, a phy-
 sician of the highest endowments of mind, but destitute of moral virtue,
 of truth, honor,  justice, pity, or benevolence;  or of a sense of  account-
 ability to a higher Power.  Is such a man to be trusted with the lives and
 health of his lellow-men?  Is he a sale depositary of secrets ?  Is there
 any principle  in his nature which entitles him to the  confidence, the re-
 spect, the love of the community ? Will he be satisfied with doing good
 (or its own sake,  with no other reward than the consciousness of hav-
 ing performed a worthy deed?   Or, on the other hand, will the highest
 moral attainments qualify for the successful practice of our art; an  art
 not based upon a barren  collection of practical precepts,  handed down
 from past ages and requiring but a  limited degree of intelligence to put
 into successful operation, but one that reposes on the  established princi-
 ples of science, the result of critical  analysis and rigid logical induction,
 Irom a vast array of facts, developed by long and careful investigation.
 The gift of healing is no longer a miraculous power; it neither resides
 in the seventh son, the royal touch,  nor the prayers of a Hohenloe ; it is
 not a gilt of nature, nor an accidental endowment; but it is the result
 of a cultivated intellect under the guidance of moral principle, acting on
 comprehensive stores of knowledge, the fruit of laborious study and  in-
 cessant application and research.
   But suppose a physician to be endowed with the highest moral and
 intellectual qualifications, but  wanting in physical energy, in bodily
 health, what will all his acquisitions profit him so long as his failing
 strength incapacitates him for their  application?   Extensive usefulness
 in our profession, is incompatible with  feeble  corporeal powers; hence
 the importance of cultivating them in youth and early manhood, to ena-
 ble us to bear up against  the latigues, the privations,  the anxieties inci-
 dent to our calling.
   And now,  need  I point out how our  different faculties  are to be im-
 proved ?  Need I add that it is  only by persevering and constant exer-
 cise ?  The mechanic does not expect to acquire skill from studying the
 theory of his art;  he knows that perfection is only to be acquired by
 years of diligent practice.  This law of  exercise is of universal applica-
 tion, extending not  only to the senses, reason, perception, memory, and
judgment, but also  to the  moral feelings and the physical  powers.  In-
deed, it would even seem to extend throughout nature, embracing inan- 
12
imate bodies; for we find that the power of the magnet is increased by
gradually suspending to it a greater weight; and  musical instruments
improve  in tone and excellence by being played  on by masters in the
art.   You know how the sense of feeling  is improved in the blind by
constant  use ;  how the  arm of the smith,  or  the  stone-cutter, gains a
vast increase of size and strength by the same habit of exercise; and,
in like manner, all the capacities of man are enlarged and strengthened.
Gentlemen, this principle lies at the foundation of  a good  medical edu-
cation, as it does of every other.  It has  long been acted upon with res-
pect to the handicraft arts and trades, all employments in which manual
dexterity is required ; but strange to say, as a necessary preparation for
the practice of the healing art, such an apprenticeship of study and men-
tal discipline, has been deemed a matter of very  little importance.  In
consequence of these mistaken views,  a  suitable preparatory education
appears  to have been lost sight of; young men have  left the plough or
the work-shop,  and plunged at once into the depths of medical philoso-
phy, with no plummit to sound its abyss, no compass to guide them  on
their voyage; no rudder by which to  shape  their course towards their
destined  port.  No wonder  then, that, instead of  a prosperous voyage
to the haven of science by favorable gales, under  a serene sky and smi-
ling heavens, they should have been baffled by head-winds, storms and
tempests; with no sun to shine upon their path, no moon nor stars  by
which to take an observation, till, at last, wearied,  disheartened, discom-
fited, with honor and reputation gone,  the loss of every thing overboard,
they have gladly drifted, at.  the mercy of the elements, upon the bleak
 and inhospitable shores of quackery.
   A successful  prosecution  of medical science, presupposes a certain
amount of preparatory education.  As the moral virtues are to be inculca-
ted by precept, example and exercise; as  the child is to be trained to kind-
ness, benevolence, truth, justice and compassion, by a long course of actu-
al practice ; so is it also with our reasoning and observing faculties.  If you
inquire into the previous habits of those  who have risen to distinction in
the walks of medicine,  you will  generally find that their minds have
 been thoroughly disciplined by previous study; by familiarity with pre"
mises and logical sequence, and by frequent attempts at comparison and
 illustration.  So also the orator  acquires copiousness and fluency of
speech by the habit of clothing his thoughts with words;  and feelings
of veneration towards the great Author of our being, are continually
strengthened by the frequent habit of devotion.  Gentlemen, we  should
never forget  that we are engaged in  prosecuting one of the most diffi-
cult of all the sciences ; one in which  a  cultivated  intellect is  of  para-
 mount importance; a science which reposes for its foundation on well
authenticated facts ; in which causation  is to  be constantly sought out; 
13
for we can not proceed a single step without a knowledge of causes, in
which general principles are to be constantly deduced ; and to do all
this requires the exercise of various mental operations—attention, mem-
ory,  conception  and  abstraction: faculties  which must  be constantly
exercised if we wish  to separate  truth from falsehood, or to have  any
opinions of our own on the  important  subjects that  are to  occupy our
attention.  It is far too common for medical men to allow others  to do
their own thinking ; to follow in the wake of some overshadowing name
—some venerated authority—and thus to have no settled principles, the
result of their own investigation, on  the  great questions  of theoretical
and practical  medicine.  This  deference  to great names, this want of
mental independence, which is the besetting sin of our profession, call-
ing loudly for reform, olten arises from a want of early mental culture,
from a neglect of that salutary mental discipline which gives control over
the intellectual powers; makes reasoning a pastime, and logical think-
ing an unconscious operation of the mind.  Think you, gentlemen, that
the mind, any more than the body, can, without training or preparatory
discipline, put forth all its powers, and bring intu full and successful  exer-
cise, its various faculties?  If you have entertained any such opinion,  I
beseech you  to  dismiss it  from your minds, without delay, for it will
prove a most fatal delusion, when too late, perhaps, for correction.
           "Qui studet optatam  cursu  contingere metam,
           Multa  tulit, fecit que puer,  sudavit et alsit.".—Hor.
  I trust that all of you who are engaged in the study of medical sci-
ence, have gone through such a preliminary course  of discipline, as to
thoroughly qualify you  for  the successful prosecution of the objects in
view; and that your minds will prove as  alert, flexible and apt to exer-
tion as your muscles are for bodily exercise.  If you have not, you wilj
labor under many disadvantages; you will probably be bewildered by
the numerous subjects to which your attention will be called ; you will
not, like the fabled Ariadne, find a thread to guide you|>ut of the laby-
rinth  ; you will not be able to bring order out of confusion, light out of
darkness, or beauty out of chaos; you will not, perhaps, succeed in tra-
cing the relations  which exist between the different branches of our sci-
ence, or reduce to proper order the multitude of  facts which go to con-
stitute the foundation of medical theories. But these difficulties are by
no means insuperable.  You are young,  and have time to rectify errors
and supply deficiencies.  Though you know not now the  extent of your
own powers, yet this you know, that  they will all gain strength by exer-
cise;  and that industry is the law of their development.   You may find
it difficult to fix the aitention long upon any one subject;  but steady ap-
plication will soon overcome this ; you may not  be able now, to reason
with facility and correctness, but this  difficulty will also disappear ; and 
14
IT you will only keep before your minds an ideal standard of perfection
at which you constantly aim, you  will not only attain to usefulness  in
life, but acquire a reputation and a name that shall live when your use-
fulness here is at an end.
  Tfiose of you who have not enjoyed the advantages of an academic!
or collegiate course, need not be discouraged.  If you will but make the
most of your time, and be not in too great haste to enter upon the prac-
tical duties of your  profession, you can accomplish much,  and by un-
wearied  diligence  bear away the  palm from  those who, lacking this,
have enjoyed far greater  privileges  than you.  It is astonishing  what
accumulations of knowledge result from the careful improvement of all
our time and opportunities.  One of the most learned and accomplished
physicians of my acquaintance, was  the son of a poor laboring man,
and had  only the advantages of a common district school education for
a few winters.  He studied medicine without^ teacher,  while he was
at the same time supporting himself by teaching school.  He entered
upon practice in a new  and thinly settled part of  the country at the age
of twenty-five ;  and now, at the age of fifty-five, although  he has been
all his life employed in the active duties of his profession,  he has  few, if
any, superiors in it, in the variety and extent of his learning.  He reads
with perfect facility, ten different languages, and has a partial acquaint-
ance with several others: he has carefully studied  the  mathematical
works  of Newton, Euclid,  Playfair,  Lacroix, Hutton, and La  Place,
including his " Mecanique  Celeste ;n  he  has  perused Hippocrates,
Galen,  and  Celsus, with the more important  French  and  German
medical  writers, in their original  tongues; and is now fully up to the
times in every department of medical science and its collateral  bran-
ches ; besides possessing a very accurate  and  extensive acquaintance
with  the best  works on history,  government, law  and religion. He
daily reads the sacred Scriptures, but not in a translation, and finds time
to discharge all the other duties of life, as if there was nothing else  to
occupy his attention.   The secret of all this is, that he wastes no time
in idleness or frivolous amusements; lives a life of temperance; and
turns every moment to some valuable account.   Gentlemen,  you can
all go and do likewise.
   I should but poorly discharge the duty which I have undertaken, did
I not call your attention  to some of the more  important  preliminary
branches of education,  which should be pursued  by every  medical stu-
dent.
   The study of medicine presupposes a good knowledge  of the English
language; an ability to read, write and speak it with grammatical accu-
racy; and no one should think of entering upon professional study, or at
any rate, of graduating in medicine, without a thorough acquaintance 
\o
With  the philosophy of his  own vernacular tongue.  Of so little im-
portance would this seem to be regarded  by the medical institutions
of our  country, that it is not even noticed as a prerequisite of gra-
duation by any of them, except the University of Pennsylvania, which
requires '' good spelling and attention to the  rules of grammar" in tho
thesis submitted by the candidate.   It is much  to be regretted  that our
Medical Colleges do not establish some scale of academic attainments,
as necessary prerequisites for graduation; for nothing would  tend so
directly to enhance the respectability of our  profession, and entitle its
members to the increased  confidence of the public, as the possession of
those literary attainments which go to make up what  is considered an
accomplished education.   It is also highly desirable that the medical
student should become  acquainted with the Latin and Greek languages,
though I am aware that some of the most distinguished names in our
profession have been, to a great extent, or altogether, ignorant of them.
But when we consider  that the technology of our art has been chiefly
derived from the Greek;  that it has served for  the formation of the dif-
ferent compound terms employed in science;  that  the ablest  medical
works of antiquity are locked up in it; that many thousand  words in
English are derived from the Latin through it; that the prescriptions in
our medical works are  generally written in Latin ; that most of our ana-
tomical terms are derived  from this language;  that the diplomas of our
Colleges and Universities, (which those who receive certainly ought to
be able to translate,) are couched in it; that  it is a  universal  language
with the learned, and one  in which has been written a greater  number
of medical works than  perhaps any other, it would certainly seem that
medical men should acquire, if not a critical, yet at least an  adequate
knowledge of these tongues. If it is said that  an acquaintance with them
is not indispensable, it  can not be denied  that it is at least very useful.
The professional phraseology  of medicine as well as law, may indeed
be learned through a lexicon, but this is almost superceded by a know-
ledge of these languages.  Not only from their immediate practical utility
would I recommend to  you the study of the Greek and Latin languages,
but also from their influence in disciplining the faculties to persevering
and patient inquiry, as  a powerful means of mental training.  Those
who would do away with classical study,  as an element of medical edu-
cation, would seem to  have  entirely overlooked its principal object and
design.   They  take it for  granted, that it serves only to store the mind
with ideas;  and that if it can not  be the medium of conveying ideas,
which we could not  derive  through  our own  mother tongue, it
must  be labor  entirely misdirected, and  useless.   Gentlemen, this  is a
very narrow and incorrect view of the subject.  I do not maintain that
there  are any thoughts  locked up in the Latin and Greek, which can not 
16
be distinctly conveyed by means of translations into our own vernacular
longue ;  but what I  do maintain and insist upon, is this, that by  their
study, the mental faculties are so disciplined and brought under control,
that the individual can better apply them to advantage in the investiga-
tion of any other subject that may come before him.   The great end of
medical education, we are truly told,  is to enable a class of men to dis-
criminate and cure disease.  But how is this to be done ?  How are the
discriminating powers to  be trained except by appropriate  exercise?
Were medicine a science of pure  observation, there  would  be some
plausibility in the objection ; but it embraces  principles which are to be
deduced  by a process of reasoning;  doctrines which  depend on  vast
generalizations, requiring the highest powers of intellect to comprehend
and digest into a consistent system of scientific truth.  Can any one be-
lieve that a mind, disciplined by the  study of  the classics—an exercise
which brings all  the intellectual faculties into  active operation—is not
better fitted for the pursuit of medical science, than one which has skim-
med over the surface of the current literature of the  day, scarcely rest-
ing as long on any one subject as the bee rests  upon each individual
flower?  If you doubt the necessity of this intellectual training, take the
uneducated man, and set him to investigate any question in morals, in
medical,  legal, or political science.  He will soon acknowledge that he
lacks the ability to concentrate hi3 thoughts, his attention upon the mat-
ter in hand ; he is a stranger to the powers of  abstraction, of judgment,
of memory, and of logical reasoning,  and he soon abandons his attempt
in despair.
  But it may be said, as it has been,  that there have been great men,
men of eminent usefulness, who knew nothing of Latin and Greek, and
yet who have distinguished themselves not only in the walks of science,
but of polite literature.   Ben Johnson tells us  that Shakspeare  had
"small Latin and less Greek;"  and Franklin, Rittenhouse, Watt, Ark-
wright, Hutton,  Brindley, Leslie, Stevenson, Perkins, Fulton, Buffon,
Davy, Cuvier and Washington, had no knowledge of these languages.
The celebrated  Dr. Armstrong, as you may know, was rejected by the
College of Physicians and Surgeons of London,  for his ignorance of
Latin and Greek:  and yet these are names that will ever shine on the
scroll of  fame, as  brilliant examples of intellectual greatness,  and as
benefactors of their race.  This is true ; but yet who can say that even
these men, eminent as they were, and useful'as iheir lives have  proved
to mankind, might not have  accomplished still more, had they enjoyed
the advantages  of early  mental  discipline through the study  of  the
classics?  Besides, these and  other similar instances  should  be re-
garded rather as exceptions to a general rule.  A comprehensive  sur-
vey of our species shows us that some men are born to greatness : that 
17
is, they have  such an organization impressed on them by nature, as
easily to surmount all difficulties,  and rise, as Saul stood among the
Israelites, head and shoulders above ordinary men.  Such a man, pre-
eminently, was Washington.  He  would have achieved greatness under
almost any circumstances.  His noble intellect would have shone  forth,
even amidst the back woods of Western Virginia, had not the black-
ness of war furnished such a favorable back-ground on which, as on a
canvass, might flash forth  the splendor of his genius.  But few 6uch
minds appear in a century; and it is absurd to reason from these few to
the many.  We  must take men as they are, and form such rules and
principles as will apply to the masses.  Because there are instances of
natural talent so strong as to break through all barriers, and in the face
of every  conceivable disadvantage attain  distinction  in  the  different
branches  of science, or in civil, military or political life, where not only
all facilities of education are  wanting, but  even access  to necessary
books  denied; we  certainly have no right to conclude that therefore
all education is useless, and that time spent in mental  culture and  dis-
cipline is, for all useful purposes, wasted and thrown away. With equal
propriety might we conclude that, because  some men have rendered
their names illustrious in the annals of our race, without a knowledge of
the literature of the ancients or the study of their languages, that there-
fore all such study is unnecessary and destitute of all practical utility.
   Moreover, what a fund of enjoyment, what inestimable resources in
the hours of fatigue, of leisure, or of adversity, has that man  who  can
turn to the pages of classic lore with ever new delight, and feast upon
the mental banquet that ever there  lies  open before  him.   Certainly,
we may apply to them the  language of the Roman orator  on  another
occasion: " These studies are the intellectual nourishment of yoUth and
the cheering recreation of age; they adorn prosperity and  are the
solace and refuge of adversity ; they are pleasant at home and are no
incumbrance abroad; they abide with  us by night, go with us in our
travels,  and  lend  additional  charms  to  the attractions of our rural
 retreats."
   Let me then urge you, as far as your circumstances will permit, to
the ardent and diligent pursuit  of classical learning.  Those  of you
who have neglected it, know  not what treasured riches, what prolific
elements of intellectual power, may be found in the glowing pages  of
Grecian and Roman literature.  In their study, there is scarcely a sin-
gle intellectual faculty but what is brought into vigorous exercise: the
attention must be constantly on the alert; the memory must never flag;
the discriminating power must be in continual requisition; in the appli-
cation of principles and the choice of words, the judgment is constantly
brought to bear; while, at the same time, the taste and the imagination
                        c 
IS
are cultivated, and  the mind acquires  the faculty of combining sirapte
and analyzing complex ideas.  Did time permit, I might also speak of
the influence of classical studies in leading to a clear  and correct un-
derstanding of the force of words, so conducive to the future develop-
ment of the understanding and the acquisition of knowledge ; so vastly
important in communicating knowledge to others or in  acquiring  it for
ourselves.  As many of the disputes in science, especially in medicine,
have arisen from using terms in different senses, it would  seem that this
tendency of the study of languages should commend them to the favor-
able consideration of medical men.
  But whatever difference of opinion may prevail with respect to ther
advantages derived  from  the study of the Greek and Latin, there is no
dispute in relation to those which flow  from  an acquaintance with the
French and German languages.   No one, desirous of  excelling in the
learning  of his  profession, can willingly remain ignorant of them,  for"
they abound in medical works of the highest interest and value, which1
have not been translated into English,  and  they furnish  the record of
the most important discoveries and improvements in medicine.  Indeed?
no one can keep pace with the progress of our science, unless he is able
to' peruse the works that are  constantly being issued from the press ire
those countries.  Occasionally some  of their best productions are trans-
lated into our tongue, and a brief synopsis  of others  is  now and there
transferred to the pages  of some  of  our medical periodicals; still, the
great mass remains beyond  the  reach of the mere English scholar,
constituting a mine of intellectual wealth which he only can explore
who has a knowledge of  their languages.
  As a  branch  of intellectual culture  and discipline, the study of  the
mathematics has always occupied a  high rank in the estimation of the
learned.  In certainty ; in the precision of its  signs ; in  its completeness
and independence of all other branches, this  science stands alone, and
its study is admirably calculated  to give  precision and exactness of
thought and expression.  When pursued to   a considerable extent, it
has been supposed to give a partial  direction  to the  mind, and unfit it
for pursuits of a different character,  but perhaps there is little danger
in your case, from this source ; and  I may therefore recommend you ta
devote to it as much of  your time  as  you can spare from your other
more urgent avocations.  You will find that  nothing expands and ele-
vates the mind  more than the acquisition of a mathematical truth, the
demonstration of some grand law which is obeyed throughout the uni-
verse.  But though  the  prosecution of mathematical science does not
call into exercise the powers of observation, of discrimination  and of
judgment, it nevertheless teaches us to  conceive with clearness;  to con-
nect our ideas in a  train of dependence; to  reason  with strength and 
19
  demonstration; and to distinguish between truth and falsehood.   " We
  should study the mathematics," says Locke,  " not so much to make us
  mathematicians as to make us reasonable creatures."  And Lord Bacon
  observes, that  " the pure mathematics do remedy and cure many defects
  in the wit, and faculties intellectual.   For if the wit be dull, they sharp-
  en it; if too wandering, they fix it;  if too  inherent in the sense, they
  abstract it." I have thought that mathematical studies exerted a pecu-
  liarly happy influence as preparatory to the pursuit of medical science .
  leading the mind along, as it were, step by step, from the known to the
  unknown; from axiom to demonstration;  from one proposition to ano-
  ther ; forming  a  golden chain, whose value  depends on the soundness
  and entireness  of each individual link.
                  " Whatever link you strike,
           Tenth, or ten-thousandth, breaks the chain alike."
  When we read  in Euclid that " things equal to the same are equal to one
  another,"  and "the whole is greater than its parts," we are perhaps at
  first disposed to smile  at the simplicity of such self-evident propositions;
  but as we proceed, we soon perceive their  use in the demonstration of
  other problems  of a more recondite and abstruse character.  And so in
  the study of medicine.   The mind, trained to mathematical pursuits, first
  inquires what constitutes the axioms,  the basis on which the  science
  rests.  Such a man does not begin to construct his pyramid at the apex,
  but he digs deep and lays the first stone where neither frosts nor rains
  nor any other  disturbing cause can reach.   He  sees that anatomy,
 chemistry and  physiology lie at the  foundation of medicine.   After
 learning the structure, he proceeds to make himself  acquainted with the
 healthy functions; in  other words, the offices and uses of the different
 parts or organs  of the  body in their natural and healthy condition ;  and
 then the phenomena exhibited by them in disease; and so on from  the
 simple to the more complex, exactly as when mastering the propositions
 of Euclid.   Let  such a person plunge at once  into the mysteries of  pa-
 thology, or of therapeutics, and he sees instinctively what is wanting; he
 works his way out of the labyrinth without difficulty, and beginning in
 the right way, goes on successfully, until all difficulties are vanquished
 and overcome.  Reverse the order, and it is  as if  a person  should
 commence the study of mechanics  with the steam  engine; chemistry
 with organic matter; or algebra with Newton's Principia.
  It is presumed no one will deny that a knowledge of Natural History
 ought  to constitute part of a complete medical education; including in
 this, comparative anatomy and physiology, zoology and botany; and
 yet from the apparent  desire of lowering, rather  than of raising,  the
standard of learning in our profession, I should not be  surprised ere long,
 to find  even thi3  dispensed with.   As the competition among our ruedi- 
20
cal schools has increased, and the rage for graduating  large numbers
gone on pari passu with the multiplication of incorporated colleges, the
requirements for the doctorate have been gradually curtailed, so that in
a short time, there is reason to fear, that every thing will be dispensed
with, except a  three years' course of study.  And yet, as  far back as the
year 1767, according  to  the regulations of the Philadelphia school of
medicine, the first medical school established in the United States, a
student was not permitted to take even a bachelor's degree in medicine,
until  ' he satisfied the trustees and professors, of his knowledge in the
Latin language, and such branches of mathematics and natural and ex-
perimental philosophy as shall be judged requisite to a medical education.'
   Of botany and chemistry I shall speak more particularly hereafter; of
general physiology I have only time to offer a few suggestions.
   It is generally admitted that human physiology can only be properly
studied  by a constant reference to the comparative  structure and func-
tions of many different classes of animals; and accordingly we find that
most works on this science are prepared with an outline  of the develop-
ment and actions of each system in the inferior tribes, as well as a similar
view of the comparative structure and functions of vegetables.   Cuvier
has very truly remarked that the different  forms of  animals  may  be
regarded, " as so many kinds of experiments ready prepared by nature,
who adds to or deducts from each of them,  different parts just as we
might wish to  do in our laboratories, showing us herself  at the same
time their various results."  Adopting this  idea, that the laws of life
can only be searched for with a probability of success by investigating
their operations wherever presented to us, and that the study of physi-
ology can only be scientifically prosecuted if the attainment of these
laws be regarded as its ultimate object, by embracing within its range
the examination of the phenomena exhibited by all classes of living
beings,  Dr. Carpenter  has carried out this  plan in his " Principles of
General  and Comparative Physiology," in a most interesting  manner,
presenting such a view of the various gradations among organized be-
ings as to enable  us to appreciate correctly the true nature of the sev-
eral functions that characterize  vitality.  Comparative  physiology has
taught us also this important  fact,  that in proportion as the structure
becomes more complex the functions also become more numerous and
perfect;  it has also elucidated  many phenomena  in the  economy of
man which have hitherto remained wrapped  in doubt and obscurity.
   But we can  neither understand human nor comparative physiology
without some knowledge of other branches of natural philosophy: as the
human body is a machine constructed upon exact mechanical principles,
we must have some acquaintance with the principles of mechanics in or-
der to understand its movements, and Dr. Gregory tells us that a know- 
21
ledge of the principles of hydraulics is necessary  to enable us to under-
stand the laws which regulate the motions of the different fluids, circula-
ting as they do in the system through tubes of different diameters.  No
one, at any rate, can deny that the eye is an admirable optical instrument,
and that the phenomena of vision cannot be well explained without a
knowledge of the principles of optics.  Nor is it less clear that  as the
body is surrounded  by atmospheric air, which is subject to great chan-
ges, both as regards its temperature, moisture, gravity, &c, some  know-
ledge of pneumatics is very desirable to  the medical man.  Other simi-
lar examples might be given, showing  the importance of an  acquain-
tance with the different branches of natural philosophy to those engaged
in prosecuting medical studies, but  as our  time  will not allow further
discussion on this head,  I pass on to other topics.
   Too much importance can scarcely be  attached to the study of anato-
my; a science now universally regarded as constituting the foundation
of medicine ; teaching, as it does, the material structure or organization
of living beings, and involving a knowledge of all the conditions which
combine to complete the structure and conformation of animated bodies.
   I need not say then that too much attention can not be paid to this
demonstrative branch of our science; one which,  apart from its eminent
utility, appeals to your observing  faculties, now the most active of all,
while it pleases that fondness for certainty, which elsewhere sometimes
seeks for gratification in vain.
   Physiology will be taught, as it always  ought to  be,  in connection
with anatomical structure.  How natural,  when  learning the  structure
of an organ, to inquire into its mode of action,  its uses: to separate them
would be like studying the different parts of a watch, or the mechanism
of a steam engine apart from the uses to which the different pieces are
subservient.
   Surgery, like physiology, finds its solid foundation only in anatomy:
and its principles, which are few and simple, and easy to be comprehen-
ded, have a most important and intimate relation with those of medicine.
Your success as  physicians will very much depend upon a full and ac-
curate knowledge of the principles and practice of surgery.   It is fortu-
nate for science and for humanity that surgery and medicine have not,
in our country as in Great Britain, ever been  separated.  It has never
been the fashion with us to divide man,  and assign one half to the ser-
geon and the other to the physician; our schools of medicine have not
been satisfied with  teaching one half of the science, and you must cross
the Atlantic to find the  man  who would rest contented with knowing
half of  his profession.   With us specialities have never been in favor,
for it needs no argument to  prove that the  eye and the ear are
parts of  a man, the lungs  and the heart have something  to do with the 
22
 rest of the body, and the skin and the teeth are not beyond the influence
 of the general laws of  the system.  " If  thej foot shall  say, Because I
 am not the hand, I am not of the body ; is it therefore not of the body?
 And if the ear shall say, Because I am not the eye, lam not of the body;
 is it therefore not of the body?   If thewhole body were an eye, where
 were the hearing ?  If the whole were hearing, where^were the smell-
 ing?"  "Whether one member  suffer, all the members  suffer  with it;
 or one member-be honored, all the members rejoice  with it."  It is evi-
 dent that St, Paul, the  christian philosopher, was no convert to the doc-
 trine of specialities^His reasoning and illustrations, though intended to
 eet forth the unityfof^the church, carry with them an irresistible convic-
 tion of the truth I wish to enforce; and he who  supposes that he can
 prescribe for one organ of the body without an acquaintance with the
 laws that govern, and the sympathies that bind together all parts of the
 organism, may derive  a  useful  lesson from the twelfth^chapter of the
 first Epistle of St. Paul to the.Corinthians.  Surgical diseases are gen-
 erally medical diseases; affections of the eye and the ear are often symp-
 tomatic of constitutional  disease, and', the same is  true of every other
 organ : how then can  you expect to treat their maladies rationally or
 successfully, unless upon those  general principles of pathology which
 are founded on  the fact that every part of  the system goes to constitute
 one symmetrical whole?
  Chemistry  is  another of those  definite and fundamental ^preparatory
 branches, without a knowledge of which your progress will be continu-
 ally impeded and unsatisfactory.  I need  hardly remark that this sci.
 ence, which is  itself but  a  department  of natural philosophy,  with
 which it is indispensable you should make  yourselves Jacquainted, has
 of late assumed a marked and decided influence  over medical theory
 and  practice.   The  progress of Animal  Chemistry, in the hands of
 Prout, Berzelius, Tiedemann and Gmelin, Liebig, Dumas, Thomson and
 others, has laid the foundation  of a solido-humoral pathology, which
 promises to  survive the  wrecks of former partial systems.   It has al-
 ready swept away exclusive  solidism,  and is gradually building up a
 composite structure, combining in itself every element and condition of
 permanence and  durability.   During  the last twenty years, we have
seen this science undergoing  a most rapid  course of development, espe-
cially in its organic department; advancing, step by step, from the sim-
ple facts already ascertained to the investigation of those  more complex
 and intricate phenomena that are still  shrouded in  mystery.  Having
 made us familiar with  the effects of forces upon the most  important
inorganic matters in nature, it has now ventured to endeavor to aster-
 tain and define the exact share which those forces take in the vital pro-
cesses ; the limit of  their sway  in the living  organism; and thus to 
23
to distinguish and  separate the purely chemical actions  from the ope-
rations  of  the ultimate cause of  vital  phenomena:  in other  words^
from the effects of life itself.
  You are aware that these attempts have been denounced by some
and ridiculed by  other? ; and the labors of Liebig, Dumas and  Berze-
lius ranked with those of Van Helmont,  Sylvius,  Willis, Booerhaave
and Van Swieten—the iatro-chemical philosophers of  a past age.  But
such a  comparison is evidently unjust.  The iatro-chemists of the six-
teenth century made but few, and no accurate, experiments  for the
purpose of proving their doctrines ; and they believed, without excep-
tion, that what they saw take place in their crucibles  occurred  also in
the living body; that the actions  and reactions of acids and alkalies
and salts went on within the living blood-vessels, just as they saw occur
in their alembics and  test-glasses.  Moreover, they did not even under-
stand the alphabet of organic chemistry, and they used chemical terms
in a loose and metaphorical manner;  so that their language was as in-
definite as the results which  they pretended to arrive at.  For exam-
ple : they made five principles or simple substances; mercury, sulphur*
salt, phlegm and earth.  They gave the  name of mercury to spirit, be-
cause  it is  volatile; as alcohol,  spirit of nitre, ether: in fine, to every
thing which disengages itself from bodies in a state of fermentation.
By sulphur,  they understood whatever was inflammable; by salt,
whatever could be incinerated; by phlegm, any aqueous, insipid  fluid,
that is unsusceptible of volatilization  by a considerable degree of heat;
by  earth,  any  gross substance  that remains unchanged by any test
to which  we may  submit it.  They believed that the movements of
all  natural bodies  depend  on  the  first  three  of these;—namely,
mercury,  sulphur  and  salt;  while the last  two are merely passive.
Now, I think you  will agree with me that there is  very little resem-
blance between the nature, tendency  and results of chemical investiga-
tions and doctrines in the sixteenth century and those of the  present
day; scarcely greater, indeed, than between the astrologers of the dark
ages and the astronomers of the  Newtonian school  of modern times.
If we go back to antiquity, we can  trace even in the dogmas of the Gre-
cian philosophy,  the idea that diseases are produced by some changes in
the elements of which the body is composed ; and we track this idea from
the Jewish legislator to Thales;  from Thales to Galen ; from Galen to
the iatro-chemists of the sixteenth  century; and it still reigns predomi-
nant in the medical philosophy of our own living writers.  But it never,
until recently, assumed "the  form and pressure" of exactitude  and de-
monstration, so that we can no longer resist the conclusion, that changes
in the  nature and chemical composition of the fluids,  whether from
changes in the healthy properties of  the chyle, or the retention in the 
24
blood of matters that ought to be discharged through the usual secreto-
ry and excretory channels, exerts as great  an  influence upon the de-
rangement of the corporeal fabric as the state of the living  solids, as
operated upon by the vital forces.
  Why should physiologists have such a dread of these chemical inves-
tigations ?  Is it that they are afraid that some new truths will be dis-
covered,  which will sweep away some favorite theory or  hypothesis?
Truth is  precious, in whatever direction  it may point; and all truth is
consistent: no one truth ever contradicted another ; and all truth is bene-
ficial to man.  Who does  not desire a clearer insight into the intimate
nature of the vital processes ; a  more accurate  knowledge of the causes
which exert a disturbing influence over them?  It is not true that mod-
ern chemists, like Sylvius and  Paracelsus, refer all physiological and
pathological phenomena to  chemical  principles; they distinctly recog-
nize the  existence of vital forces, distinct from the properties of inorganic
matter;  of organs whose constitution can not be expressed in formula?,
nor their properties accounted for by analysis; but then, they claim that
the vital  processes embrace besides, the  effects of many unascertained
causes, the knowledge of which is essential to a complete understand-
ing of the laws and conditions of the  organism.   After  the  method of
Galileo and Bacon, they endeavor to fix, by numbers, weight and  mea-
sure, the apparently uncertain and ever  variable phenomena of life;  for
though chemists have long attempted to investigate minutely the con-
stituents of animal and vegetable bodies, it is but recently that quantita-
tive, as well as qualitative analysis, have  been successfully applied to
physiology and medicine. In this respect, also, it has no resemblance to
iatro-chemistry. " It is not," says Liebig, in a lecture recently delivered
at Giesen, " it is not the true chemist  who has endeavored to apply to
the animal organism his notions derived  from purely chemical processes;
he has not had the  remotest intention  of undertaking the explanation of
any really vital phenomenon, upon chemical principles.  The only part
 which chemistry now, and for the future, can take in the explanation of
the  vital processes, is limited to a more precise designation of the phe-
nomena, and to the task of controlling the correctness  of inferences, and
insuring the accuracy of all observations by number and  weight.   Al-
though  the chemist is able to  analyze  organic bodies and  tell us their
ultimate elements, he does not  claim the power of synthesis, or of pro-
ducing  them  again by the union of  these elements; if, transgressing
the  bounds  of true  inductive reasoning,  he claims that  their properties
 result from the combination of the elements which  he extracts from
 them ; that it is in  virtue of any chemical properties they possess, that
 the fibrine and albumen of the  blood, the muscular,  cellular and ner-
 vous tissue, or the cerebral matter perform their peculiar functions, and 
25
not by means of  a vital power, far above and beyond our imitation  or
comprehension, he forfeits his title to the character of a philosopher, and
becomes, so far,  a visionary theorist.
  Gentlemen, has the chemist done nothing to entitle him to our thanks;
nothing to aid us in arriving at a knowledge of the causes and treatment
of disease ?  When  he shows us how to destroy noxious effluvia,  by
which the lives and health of families and even whole communities are
often  preserved; when he points out how the mysterious circle of or-
ganic life upon the surface of our globe is completed and maintained;
how vegetables,  seizing upon the carbon, the hydrogen, the ammonia
of the air, fashion with  them all the organized products of the vegetable
kingdom; the caseine, albumen,  gelatine and  fibrine, which  animals
appropriate as nourishment to their own use, and from them reproduce
carbonic acid, water, ammonia, azote, which  return to the air to repro-
duce the same  phenomena  through all time; when he shows us how
solar  light and heat,  bring into play this unparalleled apparatus, caus-
ing carbonic acid to yield up its carbon, water its hydrogen, nitrate of
ammonia its nitrogen, thus clothing the earth with verdure and furnish-
ing food for the  whole  animated creation; when he shows us that ani-
mal as  well as  vegetable  bodies  are chiefly composed of four simple
gaseous elements;   that  the atmosphere is  the  mysterious  medium
which supplies, the mysterious link which connects  them, and the chem-
ical rays of light, the wonderful agent by which all the transformations
are effected ; " how all that the atmosphere yields to plants, plants yield
to animals, animals  restore to the air: eternal round, in which  death is
quickened,  and  life  appears, but in which matter merely changes  its
place and  its form;"*  when he points out to us how the vital fluid is
renovated  by a  chemical change, effected by exposure to the atmos-
pheric  air  in  the pulmonary  apparatus;  how certain secretions are
modified by certain  chemical remedies; how the formation of certain
calculi depends on the chemical properties of the ingesta, and how they
may be prevented by the appropriate  chemical  remedies; how  oxalic
acid is developed under certain conditions of the system; how benzoic
becomes hippuric acid ; how grape  sugar is formed in diabetes; when
he shows us the  composition of the blood, and the changes it undergoes
in disease; how  certain maladies  are produced by the retention of cer-
tain morbid matters in the vital  fluid; when he teaches  us the  proxi-
mate  as well as ultimate elements of animal  bodies,  the  true composi-
tion of milk, pus, mucus, bile, saliva, tubercle, muscle, bone, fat, cerebral
matter,  gelatine, calculi, &c.; when he actually discovers new diseases,
the result of deranged  secretion tending to an excess,  or deficiency, of
some  of those elements, (as albuminaria, or Bright'e disease of the kid-
  * Dumas.
                          D 
26
ney:) when he explains the origin of many maladies and points oat the
most direct mode of preventing  them ; when he teaches us the anti-
dotes to a numerous class of poisons, as albumen for corrosive sublimate
and acetate of copper, the alkaline sulphates for sugar of lead; the alka-
line and earthy chlorides for liver of sulphur ; the hydrated per-oxide of
iron for  arsenic; ammonia  and chlorine  for prussicacid;  when he
teaches us how to detect these same poisons, in medico-legal investiga-
tions;  and how to  separate the active medicinal  principles of plants-
and other vegetables;  when, in short, we are indebted to  him for  our
knowledge of incompatibles ; the adulteration of medicines ; all the pre-
parations of pharmacy ; our quinine, our morphine, our salicine, and alii
our vegetable alkaloids, which  have given us  new power over disease,
to say nothing of galvano-magnetism, which is one of the  noblest gifts-
of chemistry to our art.  I say,  when the chemist has done all this, and
more, shall we turn round and warn him  off from what we assume to
be exclusively our own territory; eject him  from a  claim, which he
would seem already to hold by prescription ?  Shall  we forbid him to
render such further assistance as he may, to physiology, pathology, or
practical medicine;  to multiply his  experiments;  apply his improved
modes of analysis to other objects ; to extend,  and augment, and render
more precise, the signification of terms, and ascertain  more accurately,
the composition of organic substances, with their origin, their properties-
and their relations ?  Gentlemen, we should rather hail the  chemist as a
fellow-laborer, and bid him God-speed in exploring with us the common
field of scientific medicine.  If he commit errors, as he doubtless may
point them out, if you can; but because he is liable, sometimes, to form
erroneous conclusions, do not therefore reject whatever of  truth he may
be able to  discover.
   ft is necessary, doubtless,  to exercise  great  caution  in  admitting
what are claimed as discoveries in chemistry, recommended, as they
often are,  by novelty, simplicity, and high authority.  The chemist,
above  all others, is tempted to  generalize too far;  to  apply principles
more broadly than facts will strictly warrant.  You  see this well illus-
trated  in Leibig's late work on animal chemistry, one of the most splen-
did productions of the age; characterized by  extraordinary grasp of
intellect and power of analysis, and yet deformed by a crude mass of
hypothetical  speculations on physiology.   Think you that the chemist
can satisfactorily explain the  narcotic effects of morphia, or the febri-
fuge action of quinia, from their chemical composition ?  Can he tell
us why oxalate  of potash should prove a most deadly poison, whilst the
bicarbonate,  which  differs from it only in containing one  equivalent
more of oxygen, is perfectly innoxious ?  And yet Liebig has attempted
 to do this!   There is thie excuse, however, that the field is coropara- 
27
 tively new, the subject intensely interesting, and the reward of discov-
 ery great.  Many ardent inquirers have recently entered upon its culti^
 vation;  and there is danger of forgetting that patient labor is indispen-
 sable  to the acquisition  of that which will endure  the  test of time.
 *' Great, even in this early stage," says the British and Foreign Medical
 Review, " and notwithstanding our comparative ignorance, are the ben-
 efits that have accrued to the science of medicine, from the prosecution
 of  pathological chemistry;  and proportionably great, therefore, is the
 encouragement we may derive from its further cultivation; as it is im-
 possible to doubt that increased knowledge will add to the precision and
 fitness of our remedial measures, as well as to the accuracy of that up-
 on which all treatment must be based—our diagnosis of disease."
   I have said nothing of the tendency of chemical  science to exercise
 the intellectual powers , and yet it is peculiarly adapted to this end.  It
 gives  constant and active employment to  the  observing faculties: it
 habituates the mind to the analysis of complex phenomena; to the in-
 vestigation of  causes : it gives constant employment to  the reason, the
 memory, the judgment;  and it commends itself to all  classes,  by its
 obvious  practical utility.   I need not commend to your special attention
 the science of  Chemistry.
   The skill of  the physician lies chiefly in accuracy of diagnosis, and a
 correct  acquaintance  with  the therapeutical  properties  of medicinal
 agents.  Nosological definitions and details will be found of little use  at
 the bed-side; but a knowledge of anatomy, chemistry and physiology
 is indispensable.  If you  make yourselves thoroughly acquainted with
 these,  you proceed to the investigation of disease by a  transition  so
 natural  and  easy,  that you  become initiated  into the  phenomena  of
 morbid  action almost  without effort, and in an imperceptible manner.
 It is therefore better not to enter upon the study of fever, and inflamma.
 tion, and other difficult and complex diseases, until you are thoroughly
 grounded in  these preparatory branches.  A different course will only
 serve  to confuse and bewilder, impede  your progress, lead to discour-
 agement, and eventually to empiricism.  This is essentially a practical
 age, and the student of medicine wishes, above all things, to have every
 thing so  presented as to  be made directly subservient to practical pur-
 poses.   In haste to arrive at a knowledge of the treatment of disease,
 he is in danger of neglecting those preparatory branches  on which all
 rational treatment is founded, and the study of which prepares his mind
 for the successful prosecution of those of  a mere complex and difficult
 nature;  of forgetting that there is a  connecting  link between anatomy
 and physioloffy, and practical  medicine, which, if wanting, renders the
former useless and the latter nothing  better than  blind  empiricism.
This is  General Pathology.  The founders of this  practical school of 
28
 medicine have therefore acted wisely, in making this one of the regular
 branches of instruction; for it is this, and  this only, that  elevates our
 profession from an empirical routine of drug-dosing, to an  art based on
 established principles of science.  It is ignorance of pathology, in other
 words, of  the principles of disease, which makes a man a quack;  and
 it is an acquaintance with them, that makes him a skillful and scientific
 physician.  A want of this knowledge renders  our  art indefinite  and
 uncertain: its  possession  ensures its success  and positive usefulness.
 It is from not understanding the principles of medicine, that the public
 are led so generally to doubt the efficacy of  our art, and  are so ready to
 swallow the most absurd pretensions of the most ignorant charlatans,
 as well as  their medicines.  If you are ignorant of general pathology,
 by which I understand a knowledge of the changes induced in different
 parts of the body by disease ; of the processes or actions  by which these
 changes are wrought; of the causes which originated these processes ;
 and the consequences of the same changes, or  the symptoms they occa-
 sion: I say, if you have not this knowledge, your practice will be no
 better than that of old women and nurses: you will be employed in
 treating symptoms only, without reference to their causes, or, in other
 words, the true nature  and seat of the disease.  Owing to the imperfect
 education of physicians in past years, much of the medical practice in
 our country, it is to be feared, is of this empirical character; but I  am
 rejoiced to know that  it is  gradually  disappearing, and  that  in a  few
 years symptom-doctors will be confined  to  the school of Hahnemann.
 If you examine, you will find that our most judicious  and skillful prac-
 titioners are guided by precise views of diseased function  and structure ;
 that is, by general pathology;  and no practical  man of  sense treats a
 disease according to its name merely.  True pathology  has been well
 defined to  be the  embodiment of the result of experience in disease,
 with a knowledge of structure  and function  in health ; thus constituting
 the only connecting link between the preparatory sciences and  practical
 medicine.
  But having made yourselves acquainted  with  the  causes, symptoms
 and  effects of  diseases, it is very evident that if you stop here you  are
 no better off than if you had learned  nothing.  If you know not how to
 apply this knowledge to the treatment of disease,  you  might as well
 have remained ignorant of all you have acquired.   Here then  comes in,
 to crown the superstructure you have so carefully raised, the science of
 Therapeutics—the application of remedial agents to the removal of  the
 existing malady; that consummation so devoutly to be wished, and to
 accomplish which all other knowledge is to be made subservient.   The'
rapeia, or the science of healing, is  founded in the principles  of physi-
ology and pathology ;  but it implies a knowledge  of every other branch 
29
of medicine; a full acquaintance with the recorded experience of the
past; great powers of discrimination and  actual opportunities for wit-
nessing disease.  She lays under contribution every department of na-
ture—the animal,  vegetable and mineral: she ransacks earth, ocean
and air, and calls  in the other sciences, as hand-maids, to aid in  her
arduous work.   Botany yields up her choicest stores at her command :
mineralogy, from the lowest depths of the earth, gives  up her earths
and ores and metals : animals, from the icy pole or beneath the equato-
rial sun, are obedient to her call: chemistry seizes them, and by refined
and delicate processes of art, extorts from them their hidden virtues;
forces them to confess  their secret source of action; and  then science
steps in and applies them all to the  relief of human maladies and the
cure of disease.  Here, gentlemen, is a noble field for study and inves-
tigation.  Human ambition could scarcely wish a broader theatre for
enterprise and action.   Notwithstanding all that is  known, how  much
yet remains to be discovered !  What trophies are yet to be won, what
victories achieved, in our conflicts with disease!  The vegetable mate-
ria medica of our country remains  as  yet  almost  unexplored : many
valuable remedies are to be ascertained, by those who have time  and
opportunities to engage in  their investigation.  And in connection with
this branch of my subject,  allow me to commend to  your attention the
study of Botany.
   Apart from its obvious practical utility, there  is no science, the study
of which  has a more direct tendency  to  strengthen the intellect; to
quicken our powers of observation, discrimination, judgment and memo-
ry ; to habituate the mind to habits of analysis and profitable reflection,
than  that of Botany.  I do not mean the dry detail of technical terms
and learned names, which  are but the implements, the machinery of the
science ; but in addition to these, which serve only as the means of dis-
tinguishing, arranging and naming the objects which this grand division
of nature presents to our view,  I allude also to a knowledge of the  ele-
mentary structure and internal organization of plants; to their manner
of growth; of appropriating nourishment  from  surrounding media; to
the development of their organs; the laws which regulate their distri-
bution throughout  the earth; the influence which culture,  soil and cli-
mate  exert in modifying the forms and properties of different species,
as well as controlling their  geographical limits.
  I know that botany, pursued  to  this extent, would occupy a conside-
rable  amount  of time;  but it  would be time well employed : for  you
would not be engaged merely in the acquisition of an accomplishment,
bnt of a science replete with practical benefits,  and indispensable not
only to the character of a well-educated physician, but to the duties and
pleasures of a rural life.  Need I  call your attention to  the cases in 
30
 which botany affords important aid to the sister sciences and the useful
 arts ?  Need I show how it is the handmaid of agriculture, and horti-
 culture, and floriculture ? how it enables  us to select appropriate reme-
 dies from the plants which are indigenous to our country or  our neigh-
 borhood ; to indicate what are poisonous and what are inert ?  I trust that
 you have no sympathy with those who believe that we already possess,
 against disease, all the remedies which nature affords ;  nor  with those
 who, carried away by  the  attraction of specious generalities,  believe
 that one tonic is as good  as another tonic, one alterative as another
 alterative, one purgative as another purgative.  There is  great plausi-
 bility in the theory that  every country spontaneously furnishes remedies
 for those maladies to which the people of the soil are naturally subject,
 and that foreign drugs would soon  be superceded, if the properties of
 our own indigenous vegetables were thoroughly understood.   It would
 seem, as Lindley has suggested, that the  peculiar climate of a country,
 the food and habits of the people, together with other circumstances of
 an analogous kind, predispose them to  varieties of disease for which
 foreign drugs furnish no sufficient remedy, and render that which is re-
 lied on in one country unworthy of dependence in another.  Certainly,
 no country on the face of the globe abounds with a  greater  variety of
 medicinal plants than our own.   There is not  an indication  which we
 cannot fulfil with vegetables gathered from our own fields and forests.
 There is not a disease, within the reach of human skill, which may not
 be controlled, with equal success, by the natural remedies  which a  be-
 neficent Providence has spread around us.  Along our water-courses
 and in marshy districts,  where intermittents are liable to  prevail, grows
 the willow, from which salicine (equal in energy, as an antiperiodic, to
 the quinia) is obtained, and which has actually supplanted the latter, in
 many parts of our country.   And so it may eventually be found, that
 the diseases of every particular district may be subdued by  the  vege-
 table remedies natural to that region.  Believe not  those who tell you
 that we already possess the most powerful agents in the vegetable king-
 dom, and that there is therefore no occasion to seek  for others; that all
 we want is a better acquaintance with  the remedies we have, rather
 than the introduction of  others whose virtues are as yet unknown.  Had
this doctrine, now urged  by some writers on this subject, been acted on
for the last half century,  we should lack some of the  most valuable arti-
cles of the materia medica; and if it is to  be acted upon  in future, fare-
 well to all hope of  improvement  and of progress in the science  of
 therapeutics.
  There is scarcely a year goes by, but what witnesses the introduction
of  some new and valuable medicine, and  generally from  the  vegetable
kingdom:  there is scarcely one in which  others are not passed by, or 
31
dropped for their inertness, or because we have discovered more efficient
agents.  You know not where your future destiny may be cast;  wheth-
er in some distant region of the globe, or some newly-settled  part of
our own country, where, cut off from all foreign pharmaceutical supplies,
you may be thrown upon your  own  resources.  You  will  then  find it
very convenient to have such a knowledge of botany as to  be  able to
identify the plants that  may grow in your vicinity.  Indeed, when we
consider the extent to which the adulteration of medicines is now car-
ried, as scammony, jalap, cinchona,  sarsaparilla, senna, rhubarb, and
many other articles in common use, it is hardly too much to expect that
more efficient substitutes  may  be found growing almost  at our own
doors.  As I shall have  much to say on this subject hereafter, I  will on-
ly add, in this place, that our indigenous materia medica invites you to
its exploration, as a field rich in treasures, abundant in promise, and one
that can not fail to reward abundantly those who zealously cultivate it.
   I have said nothing of the favorable influence which this study of
botany exerts upon the bodily health, nor of the intellectual gratification
it so  richly supplies.  Who can  doubt that, had our first parents re-
 mained  in their original state of innocence, their only study would have
been the works of the Creator, as manifested in visible nature 1   Placed
 in a garden, whose beauties, as exhibited  in its vegetable productions,
 the imagination can but poorly shadow forth;  with a specific command
 from the Almighty " to  dress and to keep it;" surrounded by all manner
 of trees " pleasant to the sight and good  for food,''  with  innumerable
 objects attractive by their beauty, wonderful by their construction, or
 interesting by their economy ;  his days would have been passed in sur-
 veying the material world, while his heart would have been enlarged
 and his reason exercised, in meditating on all that he saw.  Each new
 discovery would have but increased his veneration  for the Author of
 such wonders; and his contemplations would have been  those of the
 inhabitants of heaven.  The study of  nature was coeval with the crea-
 tion of man, and was the employment which the Creator himself devi-
 sed  as  the source  of human  happiness.   But although a blight has
 passed  over the spirit of man, his nature is  not altogether changed:
 though care, and trouble, and sickness, and death have fallen to his lot,
 yet this remnant of primeval pleasure still remains;  the volume of na-
 ture still lies open before us, in all its variety and all its beauty; and if
 we cannot escape altogether the consequences of original sin, we can?
 at least, find a solace and enjoyment in the same occupations and pur-
 suits for which man was originally destined.
   Time will not permit us to  dwell on the other branches of science
  embraced  in the curriculum of  instruction pursued in this institution;
 nor indeed is it necessary.  You doubtless justly appreciate the impor- 
32
 tance of them all, and agree with me in the opinion that none of them
 can be neglected without serious  disadvantage, as connected with a
 thorough understanding of your profession.  As I  have called your at-
 tention to some of the sciences which ought to be embraced in a com-
 plete course of medical education,  allow me, in conclusion, to offer a
 few reflections on the spirit and manner in which your studies ought to
 be pursued, if you wish to arrive at any  great degree of honor or of
 usefulness.
   In the first place, I need hardly observe that diligence is necessary to
 the  acquisition of knowledge.  Nothing great, nothing worth  possess-
 ing, can be obtained  without labor:  it is the grand law of our  nature.
 Mental labor is the peculiar distinction  and privilege of man.   We talk
 of self-educated men ; but every man who has an education has educa-
 ted himself.   The office of the teacher is but  to draw forth  the latent
 powers of the mind and set them to work:  all he can do is but  to point
 out the  means of obtaining knowledge; to  rouse and guide the awa-
 kened intellect into the best path for obtaining the end desired ;  and all
 the rest is self-performed.  The mind, no more than the body, can ac-
 quire strength by having every thing done for it.   Each  organ and
 each faculty must work out its  own  vigor and its own range of action ;
 must attain its perfection of strength  by  its own repeated  trials and
 efforts.  " The world of mind, as well as the world of matter, is shape-
 less and void for all the purposes of man, until he lays upon them  the
 hand of labor.  The materials only are given us, to be wrought and
 shaped  by ourselves to our own  individual purposes.  Absolute truth,
 ready-made, no more presents itself to us in one department, than finish-
 ed models of mechanism, ready-made, do in another."*
   Cultivate a spirit of observation, as well as the habit of it; for it will
 go with you  through life, and prove of inestimable value.  There is no-
 thing in which men differ from  each other more than  in the use which
 they make of their eyes.  You see one  man travel leisurely through a
 country, and when he has arrived at  his journey's end he can  tell you
 of nothing, scarcely,  that he has seen: he can give no intelligible  de-
 scription whatever of  the face of  the  country, its natural curiosities or
 artificial structures: nothing remarkable has excited  his attention, and
 his mind remains a blank, like the surface of a mirror from which every
 thing glances and  nothing penetrates.  Another individual goes over
 the  same ground; he  sees the same objects; he scrutinizes every
 thing that comes under his observation:—the  geological structure, the
 nature of  the soil, mode  of  tillage, kind  of productions,  manner  of
 building, of fencing,  of irrigation, of drainage,  ol fertilization: every
thing in nature or  art  is treasured up in his capacious memory, ready
    * Dewey. 
33
for use whenever circumstances call for it.  And so it is in the practice
of our profession.  I have sometimes, when called in consultation, found
physicians who could neither tell me the state of the pulse, of the skin,
of the tongue, or of the secretions :  nothing whatever as to  the precise
condition of the patient could be learned from them ;  a few barren gen-
eralities, of no practical importance, being all  that could be ascertained.
How different from what we often  meet  with  in other practitioners!
With them, a habit of close observation has become, as it were, a second
nature: nothing is too minute or trifling  to escape their notice:  every
thing that can possibly furnish the slightest pathological sign, or throw
the  least  light on the  seat and nature of the disease, is marked, and
weighed and scrutinized; and the mind, habituated  to  such habits of
close analysis and of  rapid induction, seems  to grasp, as  by intuition,
the  entire features and character  of the  disease; and the entangled
web of morbid  action is thus unraveled,  with almost  the  celerity of
thought.   To the practised eye  of scientific observation,  the human
body becomes, as it were, transparent;  every organ  and every function
stands plainly revealed  to the mental sight: while  to the careless and
unobservant physician, nothing  appears; but disease is wrapped in
doubt, and mystery, and darkness palpable.  The latter resembles, in
many respects,  the "mystery man" of  the  western Indians; and his
prescriptions are about as likely to have the desired effect, as the incan-
tations and jugglery of the red " medicine man" of the Rocky Moun-
 tains.  A talent for observation is to be  acquired:  it is  the result of
 training.   The senses all have to  be educated,  like the reasoning and
 moral powers.   The eye,  the ear, the touch, the  taste, the smell, all
 acquire acuteness by frequent exercise ; and that physician or surgeon
 who has  the nicest  perceptions, will,  other things being equal, excel
 most in diagnosis.  Disease, to be studied to the best advantage, must
 be seen and felt;  and you  must endeavor to overcome all  that repug-
nance to witness unpleasant sights  and  painful operations and maladies,
which is so natural to us all.  It was an omen of the future distinction
of the man, when Ambrose Pare, wishing to witness an important sur-
 gical operation at the  Hotel Dieu of Paris, passed a  severe winter's
 night upon the  cold  stone steps of the stair-case of the operating the-
 atre, in order that he might obtain  a good view  of the  operation when
 the doors  should  be  unbarred in the morning.  The most distinguished
 men in our profession have displayed, in early life, the same fondness
 for  observation; and no obstacles have  been sufficient to  debar them
from the  enjoyment of sufficient opportunities.
   The grand object,  in  attending a  systematic  course of medical lec-
tures, is to obtain a  thorough knowledge of  the  principles and facts of
medicine; to make  yourselves acquainted with its  theory, and those
great land-marks which may serve as a guide to practice; and to pre-
                            E 
34
pare you for observing, to the best advantage, the actual phenomena of
disease.  You come here to qualify yourselves to see with intelligence;
to learn how to read, and understand, and  interpret  the great  book of
nature,  when  it shall be  opened before you: in short, to prepare for
clinical study.   Such is the great end to be attained  in attending  medi-
cal lectures; and a person  might as well undertake to read  Hebrew
before he had learned the  alphabet, as to study clinical medicine before
he is well grounded in the important facts, laws and principles of our
art.  I believe it is this haste to visit the sick and see practice before
young men are well grounded  in  the theory of medicine, that leads so
many into the  paths of empiricism ;  that causes them to speak dispara-
gingly of a science whose principles they  never knew, and  dishonor  a
profession for which they were never properly qualified.  I assure you?
gentlemen, I have never known an individual who had been  thoroughly
imbued  with  medical science,  and  fully taught  in  those great truths
which lie at the foundation of the  healing art,  ever speak lightly of his
profession,  or  enrol his  name among the disciples  of system-builders
and reformers.  Such a  man  can clearly perceive  that  no exclusive
system in  medicine can  possibly be true; and he rejects them all aa
alike contrary to sound reason and the ascertained laws of  the organ-
ism.   Banishing all prejudice from his mind, he examines every  thing
cautiously, and submits  every thing to  the test of actual experiment.
Neither captivated by theory nor influenced by hypothetical speculation,
he yields not his mind to authority;  but  gathering facts on every side,
like Rush, he is not ashamed to learn from an Indian, an old woman or
a nurse.  He lays all under contribution, and all  has to pass  through
the alembic of his discriminating understanding;  the ordeal of that
intellectual fire that separates the golden ore of truth from the dross of
false hypothesis and error; and thus he goes on, adding fact to  fact and
store to store, till he is thoroughly furnished for the  observation of dis-
ease at the bed-side.
  Clinical instruction is the connecting link between the knowledge of
the principles  of medicine and  the personal  application of  that know-
ledge in actual practice.  An acquaintance with the different branches
of medical science is of but little  avail, unless we know  how  to  apply
that knowledge to  the treatment of disease.   The  great body of the
medical profession in the United  States  have been regularly trained to
the practice of medicine under the eye of  their respective preceptors j
and during the years of their pupilage, abundant opportunities, not only
of seeing, but  of treating disease, are  thus supplied to thousands of
medical students,  scattered as they are  over the whole extent of our
land; and while they are thus deriving  useful lessons of practical wis-
dom, they relieve their  teachers of a  share of the heavy burden  of
practice, while they render the most important services to ihe suffering 
35
patients.  Accustomed to the frequent performance of all  the  minor
operations of surgery, of weighing, dispensing and administering the
different articles of medicine, as well as watching their effects upon the
sick, they are gradually initiated into all the secrets of the art; so that
when the period of apprenticeship has closed, they are prepared to en-
ter upon practice, to assume  the responsibilities of life and death, with
a  self-relying confidence which nothing but  experience  can  possibly
supply.  It is this personal observation and handling of disease, during
the period of their  apprenticeship, that gives such a practical cast to
the mind of  American physicians, and renders them the most successful
practitioners of the healing art.
   I would caution  you particularly  against  becoming wedded to any
exclusive sect or system in medicine ; for nothing tends more to prevent
all improvement, to contract the mind, and narrow the views,  and ren-
der men illiberal, captious, discourteous  and mean-spirited, than the
adoption of  some  exclusive  theory or  doctrine.   If you desire to look
into the merits of Mesmerism or of Homoeopathy, do so with all candor
and fairness ;  but beware, as you value your usefulness, your reputation,
your self-respect, how you adopt them as the polar stars of  your medical
creed, or view them, as some do, as  special revelations, made,  in these
latter days, for the physical salvation of man.   To young  men in par-
ticular, who can not be supposed to have surveyed the whole  medical
horizon, and whose minds,  therefore, are not prepared to sit  in judg-
ment on different systems of  medical philosophy, modesty  and  humility
are very becoming.  They should neither subject themselves implicitly
to the  verba magistri, nor should they become the partisan supporters
of systems and doctrines in medicine, to the  exclusion  and condemna-
tion of  all others.  Judicious and philosophical eclecticism will be found
most conducive to  your progress, as well as usefulness  in  after life;  as
it is most in accordance with a wide and impartial survey of the pheno-
mena of health  and disease, of the  laws of physiology, and with the
established principles of pathology and therapeutics.
  I have endeavored, in the preceding discourse, to indicate such apian
of education as will qualify you  to observe, think  and reason for your-
selves.   But, if you are  to follow the  example of some, and swear in
the words of  Hahnemann, such a system of mental discipline is entirely
unnecessary.  This celebrated  reformer, indeed, has himself said that
his disciples have no business to  think for themselves; that  all they have
to do is to  believe  what he has written.   Judging from what I have
seen, I conclude that his followers acquiesce in this claim : at any rate,
this I will affirm, that the practice of medicine according to his  system,
is  as much a mechanical art as the cutting of a coat or mending of a
watch ; for while the tailor takes  the measure of the outer man, by tape
and rule the homoeopath does the same as to the inner, according to the 
36
exact rules of Hahnemann's measure ; and then both proceed according
to the established principles made and provided for their respective use.
  I would  urge you  all to  cultivate a spirit of patient investigation.
Without this, you may store your memories with the diversified opin-
ions of others, but you will have none of your own.   It was a frequent
saying of the immortal Newton, that if he possessed any habit or en-
dowment in  which  he excelled the generality of men,  it was  that oi
patience in the examination of the facts and phenomena of his subject;
and such, too, was the humility of this great philosopher, that after  all
his discoveries, he used to speak of himself as having been all  his life
but " a child  gathering pebbles on the sea-shore."
  When we consider  that we  are engaged in investigating a science
which treats of the complex and ever-changeable relations and proper-
ties of matter, embracing an almost infinite variety of objects, in which
there is great difficulty in tracing effects to their true  causes, and causes
to their true effects; in which the phenomena of health and disease are
ever  fluctuating; in  which the controlling element is  an intangible,
mysterious agent, called a vital principle, whose scope, and power, and
influence can neither  be justly estimated nor efficiently controlled ; that
we are unable to estimate the influence of the peculiarities of age, and
sex, and temperament of body and  mind,  which produce  great  uncer.
tainty in our investigations, and qualify, in  an important  manner, the
effects of remedial agents, and thus causing great difficulty in the ap-
plication of acquired  knowledge to new cases; when we consider that
the objects of medical study  are to acquire an extensive  collection of
well-authenticated facts ; to arrange, classify, combine or separate these
facts; to trace among the facts, sequences or relations,  the relation of
cause and effect; and lastly, from an extenaive collection of facts to de-
duce  general principles,* we shall readily perceive that a spirit of pa-
tient, philosophical  investigation,  is  indispensable   to success  in the
study and practice of  the healing art.
   Some are led  into error from mistaking  the true  objects of medical
science, which are, as I have observed, to ascertain facts  and trace their
relations to each other.  If we go beyond this, and seek for the powers
which regulate these relations, we involve ourselves  in error and per-
plexity; for  we are  aiming  at the attainment of what is beyond the
sphere of our limited capacities.
   Be on your  guard against becoming sceptical as to the resources of
our art.  As you mingle with the world, you will hear much  said re-
specting the uncertainty of medicine ; great praise awarded to  certain
systems of quackery ; and very illiberal remarks as to the  usefulness of
our profession.   Sorry I am to say, that these opinions often come from
men of reputed  intelligence,  from whom  we  have   a right to  expect
      Abercrombia. 
37
better treatment:  but as they generally originate in ignorance, and its
sister prejudice, we should pass them by unheeded.  There is really no
more uncertainly in the result of medical practice than there is in that
of the law :  there is no greater variety of opinion on subjects pertaining
to our science, among educated medical men, than there is among di-
vines respecting the doctrines taught in holy writ.  There is no subject,
except perhaps a mathematical demonstration, on which human opinion
perfectly coincides.  What are called  the  exact sciences, have much
unexactness in them.   Great discrepancy of judgment  exists even in
relation to the ordinary affairs of life;  as, the best modes of communi-
cating instruction to the young; the different modes of cultivating and
fertilizing the soil, of sailing  a ship, of building houses, railroads and
steam engines.  And as we  cast  our eyes over the length and breadth
of our land, why is it that we see  such immense masses of human be-
ings congregated together; such  passions agitating  them and moving
them to and fro, as the waves of the sea when agitated  by a tempest?
Why those  fierce discussions ; the loud and animated debate; the heat
of enthusiasm ;  the eye of  fire; the  contributions of money?   Ah i
gentlemen,  there are subjects besides those of medicine,  on which men
differ in opinion.  Because mankind can not agree as to what form of
political government is best fitted  to promote the happiness of  a people,
or as to  the great  measures of public policy which that government
ought  to  adopt and carry out into  practice, they do  not therefore infer
that they would be better off without any form of government at all, or
any decided measures of national policy.  So it is in medicine  : if we
 learn  all that our finite capacities will allow us to do, respecting  that
 marvelous mechanism, the human body, and the mysterious laws which
control  its peculiar  functions; the  phenomena of health and disease;
and then  apply  this knowledge,  according to our  most enlightened
judgment, to the removal of human maladies—we have  a right to ex-
pect, from our fellow-citizens, that they will  be satisfied ; that they will
cheer us on, in our arduous labors, with their smiles  and  approbation.
 And this I confidently  believe they will do.  By our fruits do we ask
 and expect to be judged : if these are like the apples of Sodom, we
 deserve  no  better  than a Sodom's fate.   I trust that we have no pride
 of opinion to bind us to the maintenance of any one particular sect or
 hypothetical system more than another, except as it  seems to us more
 r.onsonant with facts, and reason, nnd  experience ; and  while we draw
from all systems, all theories, all doctrines, whatever  of truth  they may
contain, we may hope to be excused from  enrolling ourselves as disci-
ples of any particular school  which is  founded on views narrower and
more illiberal than those we have adopted, and those  which we  believe
 to be established by nature herself.
   As you become engaged in the active duties of your  profession, you 
38
  will be surprised to find the many tricks, and artifices, and manoeuvres
  of the ignorant pretender, to  gain  the confidence of the public and win
  them over to his own views  and interests.  The pill-vender, for exam-
  ple,  takes advantage of  the popular belief in the humoral  pathology, to
  sell his nostrums; the botanic doctor and the Thomsonian excite  the
  fears of the public by denouncing all  mineral substances as poisons,
  while he is himself employing those from the vegetable kingdom, which
  possess ten times the power of the articles  he condemns; the home-
  opath cries out against allopathy, as if this term embodied any particu-
  lar system or doctrines in medicine: and, lastly, comes in the hydropath,
  or the water-doctor, who goes for doing away with all medicines: and
  then  they all  appeal to experience, as  the grand test of the truth  of
  iheir respective systems, and of the efficacy of their different  modes of
  practice.  It is indeed  remarkable that the public should so generally
 recognize the validity of their claims, when they really have no founda-
 tion  whatever to rest upon, except the assertions of those who make
 them;  that they should  first  swallow the reports  of wonderful cures
 with which our newspapers are fiiled, and then swallow the drugs which
 are said to have effected  the cures.  It would  really seem, when we
 consider the extent  to which  these pretenders impose upon the public,
 that human credulity had no bounds;  and that the  more presumptuous
 and absurd any system or mode of practice is, the more likely it  is to
 gain  the confidence and support of the public.
   It is a pitiful trick of  ignorance and cunning,  to  exclaim against
 learning and  thorough  scholarship in  our  profession ; against book-
 knowledge, as if books were not the only authentic records of the expe-
 rience of all time.  I have always observed  that the man who prides
 himself in his experience, and  denounces books, is generally far inferior
 in knowledge to the diligent student, and far  less successful as a prac-
 titioner.  Medical  opinions  must  have  their original foundation in au-
 thority ; and if we are to have no information but that derived from our
 own innate thoughts, reflections and observations, how are we ever  to
 be qualified to begin  the practice of medicine?  No man has  ever de-
 nounced all hook-learning more than  the inventor of the Thomsonian
 system of medicine;  and  yet he has written a very large book, in which
 he has embodied his  whole  system, and which, with a patent  from the
 United States  patent office, entitling its possessor  to practice in  any
part of the United States, is sold for twenty dollars.
  Individual experience is but  as a drop compared  with the ocean ; a
 grain of sand to the earth of which it forms an infinitesimal part.   Un-
less enlarged, improved and corrected by that of others, it will prove of
very little value indeed.   An aged nurse, who has all her life-time min-
istered to the sick, has had ample experience; but who would trust her
in the sole mangement of  a case of serious disease?  The well-read phy- 
39
cician can draw upon the vast stores of the recorded  experience of all
ages; while he who trusts to his own resources, has no better, or safer
guide, than his own imperfect, varying and uncertain experience.  It was
a  true remark of the celebrated D'Alambert, that "he is  not the  best
physician, (as people generally suppose.) who blindly  and hastily accu-
mulates a vast store of personal experience;  but he who makes the most
careful observations, and who joins to those observations a much larger
number, made in every age, by men  animated with the same spirit as
himself.  These observations are the true experience of the physician."*
   Guard, therefore, against this vulgar prejudice that  thorough scholar-
ship in the literature of your profession will disqualify you for its prac-
tical duties.  Show to the world that there is no incompatibility between
science and learning and practical skill;  between knowledge, however
obtained, and the practical application of that  knowledge.  I regret to
know that this monstrous opinion, which originates in  a desire to shield
ignorance, and indolence,  and imbecility, is countenanced by any regu-
lar practitioners of our art.   I trust it. will receive no support  at your
hands.   It is  too late in the day for voluntary ignorance ol what others
have done or are doing in medicine, to pass for wisdom; and the opin-
ion is gaining ground, (thanks to the increasing intelligence of the age,)
that he who reads most, and who reflects most, other things being equal,
is the best qualified for the successful management of disease.
   But while you guard against scepticism in our art,  do not run to the
opposite extreme of credulity, and expect more from medicine than it
actually promises, and thus be equally disappointed.   You will  not for-
get, that it is an abstract,  rather than a perfect science ; that its princi-
ples do not, from the very nature of things, admit of actual demonstra-
tion ; that  the machinery by which,  and the materials upon which, it
works, are of such a character as to preclude the very possibility of un-
erring,  uniform and strictly mathematical results.  Cabanis has truly
observed, that "absolute  certainty, in the  full  acceptation of the term,
appertains  exclusively to objects of pure speculation,  as the mathemat-
ics ; in practice we must content ourselves with approximations more or
less exact,  and which, on this account, might be called practical certain-
ties. With these we must rest satisfied, for they are the only ones which
nature permits us to attain, and are sufficient to mankind in order to se-
cure its preservation."  Hippocrates had a just appreciation of the  diffi-
culties of our science, for, he remarks, "you can discover no measure,
no weight, no form of calculation, to which you  can  refer your judg-
ments in order to give  them absolute certainty. In our art there exists
no certainty except in our sensations."
   Let me also urge upon you to cultivate a love for the profession of
your choice;  a profession in which you  purpose to  employ your  time
   * Ecclaircissemens sur les  Elemens de Philosophic VI. 
40
and  talents  during the period  of your earthly existence.   You will
doubtless, many of you, have difficulties to encounter, but resolution,
energy and perseverance, will overcome them all.   You will meet with
many trials and disappointments, but a confident reliance on  the wisdom
and benevolence of a higher Power, will enable you to bear up against
them all.  You can not all expect to att.iin to distinguished  eminence ;
nor is it necessary for usefulness or happiness that you should :
          " He is the happy man, whose life even now,
     Shows somewhat of  that happier life to come;
     Who, doom'd to an  obscure, but tranquil state,
     Is pleased with it, and were he free to choose,
      Would make his fate his choice."*
   Ours is a privileged  profession.  When  pursued with proper motives
and  a proper spirit, it improves the heart as well as the  intellect; and
the duties to which it calls us awaken the  best emotions of  our  nature,
foster the benevolent affections, and promote all the charities of social
life.  As there is no profession that holds  out greater inducements for
 industry and honorable exertion than ours; none, the conscientious
pursuit of which carries along  with it so  full  and abundant rewards;
so, also, as I have already remarked, there  is none  which  offers 6uch
frequent opportunities  of doing good; of manifesting that kindness and
disinterested benevolence that blesses the  giver more than the  recipi-
ent.  When prosecuted, I say, with correct feelings and  motives, the
study as well as practice of medicine is pre-eminently calculated to ad-
vance our moral as well as mental improvement.   Who that has wit-
 nessed the remorse of the dying penitent, looking  back on days mis-
 spent, time misimproved and privileges abused and perverted, but will
 be prompted to faithfulness  in  the discharge of his  own personal and
 relative duties?   It would seem that he whose heart is not made better
 by  scenes like those which we are constantly witnessing, would not be
 moved though one should rise from the dead.  Every day, the practising
 physician sees how vice carries along with it its own punishment; how
 the  iniquities of the father are visited  upon  the children to  the third and
 fourth generation  ; how unbridled passions  deform and break down the
 bodily tenement, which temporarily shelters the immortal  principle, 60
 defaced and polluted ;  how, even in this world, virtue meets its just re-
 ward.   Who, so often as the physician, is prompted to reflect upon the
 uncertainty of human health and human life? who so olten reminded of
 its  extreme brevity—"so scantily proportioned to our moral wants and
 our intellectual aspirations?"  Who so often beholds " the silver cord
 loosed, the golden bowl broken, the pitcher broken at  the  fountain,
 the wheel  broken at  the cistern?"   And  who, therefore, has greater
 reason to abide in the  conclusion of the preacher: " Fear God and keep
 his commandments ; for this is the whole  duty of man ?"
     * Cowper.