'J pfuxXt.Cg.S.) y$ A (.JOI^LO^I^V /If THE DUTIES AND ELEMENTS OF A PHYSICIAN. BY THOMAS S. POWELL PROFESSOR OF OBSTETRIC* IN THE ATLANTA MKHICAI. COI.LF.OE. Written at the request of his Cprivate Class. ATLANTA, (;EOR(!IA:\- ^* 1800. °S/i. crri 77& SZuS c 4?. // £ •i >!" .T ,< X'•> 1'V ih;tiViS a M) ■, ril\ >!<■! A N *i >\\ Ift-i -V "V k< ■ i:c:R<;iA ■ i ■ £ »* i X T 1( )JJ\ THE DUTIES AND ELEMENTS OF A PHYSICIAN BY THOMAS S. POWELL, PROFESSOR OF OBSTETRICS IN THE ATLANTA AlEDICAL COLT.FCF. Written at the request of his Private Class, I ATLANTA, GEORGIA: FRtVNKLTN printing house, 1800. T< > THE GRADUATING CLASS ©f the max I860, THIS WORK i- respectfully and affeationately (Dedicated, in the hope that it may prove of service in their professional career, both to themselves and the profes- sion at layers / CORRESPONDENCE. Atlanta, July 12th, 1600. Po Professor T. S. Powell: Dear Sir : At a meeting of the members of your private Class, we, the undersigned, were appointed a Committee to re- quest you to prepare an Essay, or Article, on the duties and elements of the Physician, and read to us at our last meeting, in the present term. Believing that such an article must prove both interesting and instructive to all, in the name of the Class, we anxiously await an answer. Remaining very respectfully, yours, J. W. BAILEY, J. W. COLLIER, T. W. SPRUILL, Committee. Atlanta, July 16th, I860. Gentlemen : I beg to assure you of the deep sense of obli- gation under which I rest, for the compliment you pay me, in requesting from me a lecture upon the duties and elements of the Physician. It is a subject in which I feel profoundly in- terested. It is worthy of your investigation. A correct know- ledge of the duties you will owe to society, to your profession- al brethren, and to yourself, will render your life useful and a blessing to society- As early as time and circumstances will cokuksI'ondknck. permit, it will allbrd me unfeigned satisfaction to comply with your request, and to present (he matter of my lecture in the most serviceable and tangible form. Tender, gentlemen, to my private Class, my warm apprecia- tion of this additional mark of their confidence, and accept for yourselves, personally, my thanks for the courtesy with which you have communicated it. Yours, very respectfully, THOS. S. TOWELL. J. W. Collier, J. \V. Bailey, T. \V. Scuuill, Committee. Atlanta Medical College, I July 2<>th, 1*00. i Professor Powell: Dear Sir: We have received your note in reply to our own, consenting to prepare and read an Article on the "Du- ties and Elements of a Physician." Upon further consultation, we have determined to ask for its publication, in advance of its reading, inasmuch as there will not be time then for it to go through the press, before the close of the present session. Warmly attached to you personally, and cherishing regard for your many acts of kindness, we are induced to solicit, also, your permission to insert in the publication an engraving of yourself. Respectfully, J. W. BAILEY, J. W. COLLIER, T. W. SPRTJILL. Committee. Atlanta, July 30th, I860. Gentlemen: Your note bearing date 26th instant, duly came to hand. After some reflection, I have determined to comply with your request, and furnish the matter in maim- COKKESl'ONDENCE. / script, with permission to publish. In this conclusion, I have been mainly influenced by two considerations, namely: First, a desire on my part to grant you any reasonable request. And, secondly, to impress upon your minds the great importance of a correct appreciation of the Duties of a Physician, and Elements essential to his success. As the best and most concise meth- od of accomplishing my purpose, I adopt the colloquial style. I am conscious the article will go to press with many literary imperfections. It is but just to myself to say, that it will be written in the midst of engagements, which will preclude the possibility of review. Usefulness will be my object. To ac- complish it, it will be no self-denial to me to jeopard mere Lit- erary reputation. Therefore, I shall make no apology to you or the general reader, for its many imperfections. The great object I know will be manifest to the intelligent reader, and I trust appreciated. A part of the manuscript is now ready for the printer, and is at your disposal. I feel, of course, much flattered at your request for " per- mission to insert an engraving of myself in the publication." In this, you pay me a touching compliment; for in it, I see that you value my high regard for you personally, and it is a source of inexpressible pleasure to believe that this attachment is mutual. I could not, therefore, decline a compliment that my heart will ever fondly cherish. With kind regards to you all, I am gentlemen, truly and faithfully, your friend, THOS. S. POWELL. To J. W. Bailey, J. W. Collieu, T. W. Spruill, Committee. / f\, A COLLOQUY. Scene :—Residence of Dr. Morrison, a pleasant country -scat Uncle and Nephew meet in the Drawing Room. Dr. Harry Brightwell is returning to his home in the South from Philadelphia, tohere he has just graduated in the Science of Medicine, and is paying a visit to his Uncle, who lives on his route. ENTER DR. HARRY BRIGHTWELL. Dr. Morrison.—Howd'ye Harry; this visit is real- ly an unexpected pleasure to me, I assure you. I am most happy to see you—how is your health ? Harry.—I thank you, Uncle, for so cordial a re- reception—my health is good : I may safely infer that you are in fine health from your robustness; but how are all the family ? Morrison.—Well enough, so far as I know. Your Aunt and our two youngest children are on a visit to Georgia, to sec my wife's Aunt; Margaret is very much attached to her relations, you know. Harry.—Ah ! yea, I am aware ahc L devoted to UlTlKrS AND KI.KMKNT8 her kin, and, on that account, I feel greatly disap- pointed in learning that she is absent. Morrison.—She would have been delighted to sec you; as it is, we shall have a good time of it to our- selves, especially since I am obliged to keep in-doors because of my Rheumatic affection. Come, my boy, draw near the stove, for I perceive you are shivering with cold. Now, I wish to hear something about your- self—found Philadelphia an agreeable city, I hope, and graduated with honor? Harry.—Philadelphia is a most entertaining city. As to my graduation, I can say but little with modes- ty. To you I may venture to remark, however, with- out laying myself open to the charge of egotism, that I would not be ashamed for any friend of mine to insti- tute an inquiry, of those who are best acquainted with the facts, as to the character of my examination. The associations connected with my Medical pupilage are the most agreeable, when I reflect upon the age and experience, and learning of the Faculty. Several of them are gifted orators, though as practical teach- ers of Medicine, I regard them as inferior to many of our Southern Professors. .Morrison.—Do you think so ? Harry.—I do think so; in truth I know it. I did True eloquence consists in saving alfthat is necess^and nothing but what is necessary.—La Rochefoucauld. OF A PHYSICIAN. 11 not realize the great difference between what the world calls a splendid lecturer and a really practical Medical Instructor, until this winter. It is by no means certain, that oratorical powers are of advantage to the lecturer. Oratory is too exuberant—it cumbers the essential truths in scientific lore, with the non-es- sential speculations of its own gorgeous and brilliant idealism, and leaves the pupil either overwhelmed with a mass of learning, or seduced from the steep and difficult path of knowledge into the dreamy and unreal, though fascinating regions of fancy. The great talent in imparting knowledge consists primari- ly in the ability to teach great lessons in the simplest and most comprehensive manner. To my mind, there is something sublime about the man who can make the wonderful truths of Anatomy and Physiology as familiar to our minds as toys are to children. The practical preceptor, will always strive to make every- thing palpable. The mere speculator, who seeks his own fame, will mystify, and seek to captivate the ear, and intoxicate with pleasure the fancy, which is ever ready to make a bold excursion into the airy realms of beauty and sublimity. Morrison.—You are right. I remember to have heard a very eminent Medical Professor remark that, in thirty years observation, of the many men who have been at different times called to the various I)UTIJ'> AND ELEMENTS chairs of Medical Colleges, he noticed that only those who endeavored to make teaching a practical business retained their post, while those who sought to capti- vate by their oratory, soon retired to the genial shade;, of private life. Yet it occurs to my mind that there arc departments connected with Medical education not subject to this criticism, but which, on the contrary, seem to sanction the boldest flights of eloquence. While the practical branches demand plainness, may not Chemistry intimate that there are no thoughts too grand to be the bearers of her sublime truths ? Harry.—I grant the exception. In this depart- ment, there is the greatest theatre for the display of erudition and eloquence. It would, forsooth, look like a degradation of it, to employ concerning it common place and vulgar ideas. I need scarcely suggest, that the great desideratum in our profession, with both teacher and practitioner, is knowledge. Morrison.—Yes, Harry, you are correct. For in- stance, it has been said "the sparks of all the science in the world lie in the ashes of the law." This is no less true of Medicine. Every theme of value, Me- dical or otherwise, should commend itself to the stu- dent. There are no departments of literature in which Reason wrapped up in few words, is generally of greatest weight. Fundamental truths can never be too familiarly explained. OF A PlIYSICIAls. i>> you may not find profit, not only in a rational sense, but in point of professional usefulness. Harry.—I agree with you, Uncle, and shall endea- vor to carry out your suggestion. It is quite plain that a Physician, above all other men, should endea- vor to store his mind with every kind of useful know- ledge. Without it, I can not comprehend ho\%he can fill his high mission. If the adage be as true as it is trite, that "knowledge is power," it is desirable and has utility in every sphere of life. Knowledge is a giant, and we want its great powers to combat the monster, Disease. Morrison.—The Physician is not justified in hop- ing to discharge his many and varied duties, who neg- lects to apply himself to the accumulation of all the information within his reach. You should bear in mind, at the same time, that however indispensable know- ledge may be to Medical usefulness, it is not all that is necessary to ensure the Physician success and entitle him to the confidence of the community in which he resides, and in which he is expected to be* a guar- dian of public health. Knowledge without Virtue, so far from being a blessing, is a very curse—power for harm. They must go hand in hand, before he can expect and claim the confidence of the moral and upright. I, therefore, beg to warn you against the fatal mistake, into which too many young Doctor.* uu- 14 DUTIES \M> ELEMENTS wittingly fall—namely, that of expecting your diplo- ma to be your passport into a lucrative practice and into the confidence of the world. Do not rely upon it at all, only keep it as a reminder that you have passed mic mile post in your profession—that you have just set out upon a race in which the swift alone can win— therefore, while you seek to accumulate knowledge, strive to adorn and beautify your moral nature; raise for yourself a standard of moral excellence, embodying all that is high and noble in intellect, all that is beautiful and lovely in character, and all that is pleas- ing in manner. Follow it, as your polar star with a fixed purpose to attain the highest moral and intel- lectual excellence. Harry.—I believe, Uncle, as I have already re- marked, that a physician should be a man of learning • but it is astonishing how Quacks, or mere pretenders —men who are ignorant of the very first principles of the science, who have never received the first lesson of instruction, and are indeed incapable of being in- structed—succeed in getting practice. Morrison.—That is all true, but the cause, to my mind, is very plain—you must remember that the people, however well educated they may be under the present system of education, are totally ignorant of their own system—the laws which govern it, and the Scholarship without good breeding is but tiresome pedantry. OF A PHYSICIAN. if) modus operandi of Medicine—Quackery must shelter its ignorance behind mystery, which gives confidence to the afflicted, since ignorace, under the^cloak of mystery, is often received as knowledge. You remem- ber how the double-weaving oracles of Delphi were re- ceived, even by the learned of antiquity, as the un- fathomable speeches of Wisdom herself. Here we have the key to Humbuggery—Mystery is the bulwark of Superstition. The human mind is prone to seek the dark and doubtful. It is your duty, however, to in- struct your patient—to give him the rationale of the treatment upon which you have placed him. 1. It is a duty you owe him. 2. ft is a duty you owe yourself. 3. It is a duty you owe your profession. Thesfe obligations you must redeem, to be true to your noble profession. These are strong words, and are intended to be so; but how few comparatively agree with me ? But, let us reason a little, for these are vital points; and the non-observance of these ob- ligations, upon the part of many of my professional brethren, has been a source of great annoyance to me, ever since I entered the profession. First: You claim to be an intelligent man, familiar with a science by which you constitute yourself, in offering your services, one of the guardians of'the So long as you are ignorant, be not ashamc to learn. Dl/TIEs AND ELEMENT.- public health, and you charge for services rendered, Is it not your duty to look well to everything that af- fects the health of your patrons and the public gem r ally ? It is your duty to instruct in Hygeinc; and, when scut for, to give such information as will satisfy your patient as to the nature of his sickness. The cause, and the reasonableness of the application of your remedial agencies. This course will inspire con- fidence in your patients, from day to day, which will give you time, if your treatment be correct, to cure all the curable maladies. Many that would die, if shifted from doctor to doctor, for the want of confi- Jencc—•which might have been secured by the correct understanding and discharge of your duty in this par- ticular—will be rescued from a premature grave. It is, alone, in this view, that you can realize the fearful re- sponsibility resting upon you. Now, if you grant it to be true, that useful men and women lose their lives by dismissing a sensible and scientific physician, and employing in his stead an ignorant pretender, and that the change occurred because the Physician did not feel that it was his duty to treat the mind as well as the body, you must inevitably grant the imperative obligation under which you rest to prevent such fatal consequences, by a timely discharge of your duty. It is a debt you owe yourself, because it not unfrcqucnt- ly happens that our worst caocs require the least mtu OF A PHYSICIAN. n ical treatment; and, in such a case, if the patient should change to one who believes in roots and teas only, by the wholesale, and should die, you would most assuredly, in the sight of God, to some extent, be held responsible. On the other hand, if your patient should require a heroic treatment, and should, from the neglect of duty on your part, fall into the hands of one who holds to the do-nothing system of practice, and, per consequence, die, you cannot conscientiously, claim to be innocent of his blood. It is a duty you owe your profession, if you believe your system the safe and correct one; because you should do all that in you lies to sustain and firmly cs tablish it. This you should do from higher and no- bler motives than selfishness. It requires courage to take this stand—a sort of heroism, to which few men have ever attained; but self-respect, and the high mis- sion of your profession, demand that you should not falter. It is due your profession, because every case that recovers under a false treatment is an injury to the profession with which you are identified, and which you are bound by every conviction of right and jus- tice, to your own well established sense of truth, to sustain and defend, to say nothing of the tremendous sacrifice of life which this delusion must cost the community. In my professional experience, it has Speak as you mean, do as you profess, and perform what you promis" |S 01 TIES A SI) ELEMENT- often fallen under my observation that scientific phy- sicians have been dismissed, because they did not feel disposed to give their patients satisfactory reasons for not giving medicine in great quantities, and do-noth- ing Doctors have been sent for and patients have re- covered, much to the injury of the regular practition- er, and to the elevation of the pretender. How long the pretender may be encouraged to trifle with hu- man life, from one single apparent success, is impos- sible to tell. How many victims must atone for this neglect of duty, we can never know; sure it is, that the pretender has no cause of complaint at this serious dereliction of duty upon the part of our profession, since the accumulation of money seems to be their primary incentive. • Harry.—I concur with you, Uncle, though I have never thought of it in the light in which you so for- cibly present it. I feel greatly indebted for the val- uable lesson you have taught me; and I shall endeavor to reduce your excellent precepts to practice. I can now comprehend the reason why our profession has not attained that point in the estimation of the peo- ple, to which its great intrinsic merits justly entitle it, and the real cause of the success of empirics. The sin lieth at our own door. We have no cause to complain. The people are ignorant, and, as you have intimated, it has been the policy of nine-tenths of OK A Pit VSR'] AX. IP the profession to keep them so. This is a mistaken policy, and hurtful in principle. I earnestly believe that the profession will be under-rated, and a mere trade, until its members are brought to see, and made to feel this great error; and are taught their moral duty, as well as their professional obligations. Why do not our Professors give more instruction on our moral duties, as guardians of the public health? I am sure that every student, who seeks the profession to fill it in its truest and highest mission, would ap- preciate, and feel deeply grateful for such informa- tion as would serve to make them more successful and useful to their community. A great deal has been said in the last ten years, on the subject of Medical Reform, the standard of Medical Education, et cetera; but nothing has been accomplished for good, and nev- er can be, until the Colleges feel that it is their duty to instruct in morals—to send out their graduates as much enlightened in the duties and objects of their great mission, as they ure in the technicalities and therapeutical effects of Medicine. The people are the judge and jury to charge the law and render the ver- dict, and all the evidence of a narrow and inflated vanity, which refused to give this desirable informa- tion, when the very issues of life and death were in- volved, will be brought to light, and judgment entered He that stays in the valley, will never get over the hill. 20 niTIEH AND EI.EMENT- accordingly. You must convince them that you ale qualified to practice Medicine, and worthy of confi- dence, and this you must do independent of your diploma. Morrison.—I am rejoiced to hear from you such views. They are correct, and if they could be stamped upon every student, Quackery and Empiricism, and every other ism, would soon pass from popular confi- dence, and the members of our profession, being am- ply vindicated, would be regarded by the people—what many vainly attempt to constitute themselves—leaders and benefactors of society. You remarked that you were astonished that Professors did not give more in- struction upon the moral duties of the profession. I suppose, then, you think the duties of the doctor hould be divided into two divisions, viz: moral and professional. Harry.—I do. No man is prepared to assume the heavy responsibility attached to the office of the physician, who is not fully as familiar with his moral accountability to society, and to God, as he is with the theory and practice of Medicine; and the Professor who neglects to impress upon his pupils their moral duties, cannot claim to have discharged his duty upon the specious plea that he is only re- quired to teach his branch of the science of Medicine. A fault is made worse by endeavoring to conceal it. OF A PHYSICIAN. Then the young graduate, in entering upon his hardly acquired profession, would know how to conduct him self so as to reflect honor upon his profession, and secure a practice in a high-toned manner; and in that way discountenance, by his example, the many dis- honorable means which are too frequently adopted to secure patronage, and for the want of which knowl- edge many young physicians, having all the elements of the gentleman, have been found guilty of resorting to undignified, if not unscrupulous means of get- ting practice, to be repented of at leisure, when the true and honorable deportment of our profession is made known to them by years of experience. This would really be a reform. This would be raising the standard of the profession in a way that society would honor and reward. Nor would this unmeaning quar- rel continue about Summer and Winter sessions, inte- rims, localities, &c. Don't you know, Uncle, that the people are capable of exercising their right of judg- ing of the ability of the Doctor to practice, and of his worthiness of their confidence, whether he gradu- ated North or South, Winter or Summer; whether he had read two years or five, (or rather pretended to study,) before his first course, or whether he attended two courses, without six months interim, or two cour- ses with an interim of twelve or twenty months spent in sleep, fishing, hunting, and forgetting what they IHTIES AND ELEMENTS had already learned't Depend upon it, the people aiv not quite so blind as this spirit of censorship would have us believe. This tree of selfishness will in time bear its fruit, bitter as '-worm-wood and gall," to the would-be A polios by whom it is so faithfully and af- fectionately watered; and the day will come when the credit of being a member of the regular profession will be decidedly apocryphal, if this dictatorial and unpardonable selfishness does not cease. If they are honest, and really wish to raise the standard of Medi- cal dignity, to do good to the profession and to the community, let the reformation begin in the College Halls, by sending out graduates in whom the people can readily recognize profound Medical scholarship, and those moral qualifications we have discussed, Then our calling will be the noblest, save one, that ever enlisted the heart and intellect of man. Morrison.—I admit all you say to be true. Dut permit me to interrogate you upon the direct point. You say Professors should teach morals as well as Medicine. Do you mean that every College should have a Chair devoted to morals and ethics? Harry.—Nay, I do not suggest that plan. I mean that every Professor should be a perfect gentleman, and improve every appropriate occasion, in his regu- It is much hotter to reprove openly, than to he in anger secretly. OF A PHYSICIAN. lav lectures, by the introduction of thoughts on morals, duty and politeness. Morrison.—Would not the Professor, who should adopt such a course, subject himself to severe criti- cism? Harry.—Yes; but the man who allows the fear of criticism to deter him rrtjrn the discharge of a known duty, deserves not the [position of a teacher. My principle is, to do my duty regardless of consequences, and trust in the truth of the Bible and God's promi- ses for safety and protection. Morrison.—I congratulate you, Harry, for the oc- cupancy of so strong a position. I am a believer in the Bible myself. There is nothing so well calculated to inspire us with courage and confidence in right ac- tion, as that passage of King Solomon which com- mands us to "Be not afraid of sudden fear; neither of the desolation of the wicked when it cometh, for the Lord shall be thy confidence, and shall keep thy foot from being taken. Withhold not good from them to whom it is due, when|it is in the power of thy hand to do it." But you say, that every Professor^oould be a per- fect gentleman—so do I—and so should every phy- sician. No doubt all are gentlemen, according to their own estimation of the accomplishments and princi- ples which make up the true gentleman. The term 'i-l DVTIES AND ELEMENTS -cntleman, however, has become so general that w» can hardly tell its significance, for all claim the pri vile^e of construing it for themselves. For example, one will think himself a gentleman because he can use blackguardisms, vulgarities, and slang phrases. Ano- ther says the gentleman consists in being present and taking part in all the sprees and fights which disgrace his community. Another thinks it consists in having a little money, and making an ostentatious display of it. Another class, who call themselves gentlemen, arc made up of the "bloods," those who glory in personal difficulties to be settled upon the field of honor. Thus, you perceive, Harry, that gentlemanly conduct, with some men, consists in doing as they do. A distin- guished prelate was once asked the distinction between Orthodox and Heterodox, to which he replied "Or- thodoxy is my doxy, Heterodoxy is your doxy." Most men define a gentleman in the same way. It is gen- tlemanly to do as I do; ungentlemanly to do as you do. Harry.—I am aware of it, Uncle. It is a lament- able fact that some of our Medical men have no high- er standard. "Do as I do" is the edict they utter to all, and, whoever has the manliness to apply to the true criterion, falls inevitably under the fearful ban of their displeasure, and is considered as wanting in the instincts and education of a true gentleman. From Tell me with whom thou goest, and I'll tell thee what thou doest. OF A PHYSICIAN. 2§ such men wo cannot, with self-respect, receive our moral teachings. They are veritable quacks. " They are blind"—stark blind—"leaders of the blind."— Their theory, once granted, would make every vaga- bond a gentleman. Morrison.—Your commentary is severe. I discov- er that you are quite a connotseur. Since you seem to have given the subject some attention, I would gladly have you portray to me the character of a true gen- tleman. What are the essential elements of such a character? Harry.—My dear Uncle, if I did not know you to be the very soul of sincerity, I would accuse you of flattery. I lay no claim to analytical powers; but, as nearly as I can, I will attempt to answer your ques- tion. One of the first elements is good manners— " that rare quality so difficult to define or portray, and much more difficult to impart, but much more valua- ble than affluence or the most commanding personal appearance." It were better to be as poor as Lazarus, craving the crumbs that fall from a banquet table, and have those accomplishments which so adorn and beau- tify manhood, than to be as rich as Croesus and pos- sess disgusting habits; or to be as ugly as Deformity itself, and throw around life the fascinations of ele- gant manners, than to have the splendid personal appearance of a Murat, or an Osceola, and bring a Conciliatory manners command esteem. 3 Dl'TIES AND ELEMENTS blush tn the check of Refinement, .Modesty, and Virtue. Mobrison.—Can you explain in what good man- ners consist ? Harry —Not perfectly. There are many virtues that cannot be defined, as there are many beautiful clouds that no painter can ever represent on canvass. [t consists in part, however, in that mode of behavior which not only gives no offence, but which adorns; social life, and every sphere into which duty invites us. The distinction between good and spurious man- ners is as great as that which exists between a genu- ine diamond, sparkling wherever the light touches it, and a miserable paste representation, which can only deceive the stupid and ignorant. A fragment of glass may deceive a child into the belief that it is valuable; but enlightened manhood can distinguish between this worthless fragment and the precious and brilliant dia- mond and opal. Another element is seen in a disposition to gratify and oblige others, whenever it is reasonable or possi- ble, without a sacrifice of honor, and the duties we owe our families and ourselves. The true gentleman also concedes to all men the right to entertain and express their own opinions, in a kind and respectful manner, on all subjects, leserving to himself the same right. OF A PHYSICIAN. ^7 Morrison.—Would you require a man to sacrifice so much, before he can claim to be a gentleman ? Harry.—Ah, Uncle, I was taught to believe that the true gentleman makes no sacrifices. A great Phi- losopher was compelled to kneel and recant his theory of the diurnal and annular movements of the earth. When he had finished the recantation, which the au- thorities compelled him to make, he arose and said, " Still it moves." There can be no permanent sacri- fice, when we adhere to truth and the right; when our pathway through life is lighted by those benign stars of heaven, Truth and Right, there is no cause to repent, for it is the way of peace and pleasantness, and, so far from being a way of sacrifice, is the way to moral and intellectual wealth. Those who reject this rule, and persist in transgressions, must either humiliate themselves, or be humbled by others. It is gentlemanly, yes, heroic, in a man when he has been misled by sudden passion, or inadvertence, to confess it. It takes a brave man, however, to do it. Your inflated, boastful man, who thinks to acknowledge a fault, a degradation, is minus a brave and generous heart. But more vicious than all, is he who does not meet magnanimity with equal magnanimity and hon- or and forgive that spirit which seeks to repair an in- jury. An important element is politeness; politeness without importunity, gallantry without affectation; •28 DVTIEB AND ELEMENTS that hearty attention to the comforts of those whom business or pleasure brings into our immediate sphere. In it, there is a perfect enchantment. It serves to soften the austere exactness of the business man; as a vine or rose bush relieves the regular angles of a building. It is kind—it is indulgent—it is generous. In the heart it has its origin; it is the development and exercise of outward manifestation; the practical application of the royal law, " whatsoever ye would that men should do to you, do ye even so to them." Truthfulness is another element to portray. It is the keystone in the arch of real worth, without which, the beautiful granite structure falls into a mass of ruin. It is indispensable the—sine qua non in the character of a perfect gentleman. It is the brightest jewel in the diadem of charaoter. To society, it has value beyond comparison. It is a hearing virtue, that has an impersonation in the brightest angels around the "everlasting throne," radiant with the smiles of God, with the love of the Son of Righteous. ness glowing upon its face. There arc many other virtues that I might mention, which blend in the char- acter of the gentleman. Those I have suggested are indispensable. With the qualities to which I have al- luded, a man will be a gentleman in the eyes of the world. Morrison.—True, Harry. A man who possesses OF A PHYSICIAN. 20 good manners, who can bow with grace and smile with a show of pleasantry, who can assume a manner and suaviter in mode, though no special virtue distinguish- es him from the mixed multitude, may be pronounced, by the beau monde, a paragon of gentlemanly perfec- tion. Reputation exists mostly in the opinions of others; and, hence it is transitory, like a bubble. You remem- ber that Colton observes; "Honor is unstable and sel- dom the same, for she feeds upon opinion, and is as fickle as her food; she builds a lofty structure upon the sandy foundations of the esteem of those who are of all beings the most subject to change." This author, tart as the words indicate him to be, is not so severe as the unrivaled bard of Avon, who calls honor "a word—air—a trim reckoning," and possessed by him "who died a' Wednesday." Character is, however, a thing of palpable substance. It lies deep in the individual; and is not a thing of extraneous birth. Therefore, I think, integrity is an important element. Indeed I hold it to be an indispensible requisite. Honesty of thought and conduct; an inflexible hon- esty in all things, decision and firmness, should be ad- hered to by every man who calls himself a gentleman. Shaftsbury says, in speaking of honesty: "A right mind and generous affection hath more beauty and charms than all other symmetrian in the world be* :>o DUTIES AND ELEMENTS sides; and a grain of honesty and native worth is of more value than all the adventitious ornaments, estates or preferments; for the sake of which, some of the bet- ter sort, so apt turn knaves." Of Honesty, Montague says : "All other knowledge is hurtful to him who has not honesty and good nature." To this conclusion, we are brought by this train of argument, namely, to be a gentleman, one must have integrity and honesty, and must have them from principle. These virtues, will centre in him the confidence of men; they will give him resolution in every worthy enterprise; they will make him brave in the cause of right; for he knows that they will vindicate him with heaven-born eloquence, when devilish detraction would enlist the masses of society against him. A beautiful quality, that every gentleman should possess, is reverence for all religious institutions, be- cause they are devoted to our highest and best inter- ests—interests that not only affect our happiness in these earthly tabernacles, but extend into the cycles of an eternity of heavenly bliss. It adorns and beau- tifies manhood in every walk of social life; it engages the love of beautiful childhood—commands the re- spect of sterner years—makes bright our life-pilgrim- age, and gives a peaceful pillow when the small, still voices of night are whispering, as happy, approving A man's own manners, commonly frame his fortune. UE A PHYSICIAN 31 angels, or fierce accusing spirits, and finally, when the dark night of Death falls upon us, we shall hear that voice which greets the Christian ear: "Whosoever trusteth in me shall not die, but have eternal life." It is the duty of every one, and more especially the Doctor, to do all that is in his power to build up, en- courage and foster all religious institutions. For this, God, according to His certain promises, will reward you. He will do it upon this earth, and in Heaven, for HE has so declared. The history of eminent Physicians from early ages, exhibits the fact that, in their noble mission of the healing art, they were not unmindful of the impor- tance of these great and good influences. Hypocrates did homage to the gods of Greece. Galen vanquished Atheism for awhile in Rome; Botallus, the illustrious father of blood-letting, in some of his writings, advises a Physician, when called to visit a patient, never to leave his house without offer- ing up a prayer to God for the success of his prescrip- tion. What an example is here furnished from the records of antiquity for modern practice ! Prayer to God! to Him who effects and permits the success of remedies, and without whose countenance, no invalid is raised to health. Cheselden, the famous English Anatomist, always implored, in the presence of his pu- Liberality makes friends of enemies; pride makes enemies 0f friends. 32 DUTIES AND ELEMENTS pils, the aid and blessing of Heaven upon his hand, whenever he laid hold of an instrument to perform a surgical operation. This was a confession of the weakness of man, even when supported by the best learning; and it was a recognition of that higher power, without which man's efforts will never avail. Every man should realize the truth, that Christianity is the source from which we derive all that we are, and have, as a free, enlightened and happy people; and that without its pure and elevating influence, there can be no great achievements. Without it, we would have been involved in the darkness of ignorance, su- perstition and vice. Realize, fully, these great truths, and you cannot fail to be impressed with the imperi* ous corresponding obligation, under which every gen- tleman rests, to love and honor God, and to exert every means in sustaining and diffusing the Gospel. Harry.—I suppose then, Uncle, you think that be- fore one can be a perfect gentleman, he must be an earnest believer in religion, besides possessing the qualifications of which wg have been speaking. Morrison.—Unequivocally, I say yes. There ate very many men, it is true, who are entitled to my con- fidence and your own, who live a courteous, upright, dignified life, who are filled with all sorts of generous emotions and practices; but, it is only religion that can center in a man all the graces, and finish him for OF A PHYSICIAN*. 33 the walks of life. In thus remarking, I do no injus. tice to those admirable men who do so much for soci- ety, without the restraining influence of the religion of Christ Jesus. Harry.—Upon that point we shall not disagree. Indeed, I think your views worthy and just. May my course through life vindicate their truthfulness. I will endeavor to be all, in these respects, that you could desire. These are interesting topics. From their dis- cussion I feel myself vastly benefitted; and would that time and circumstances allowed their fullest elucida- tion. But I am, like all men, possessed of selfishness, and wish to avail myself of your counsel. I expect very soon to locate at Louisville. I know but one family in the place. Col. Butts and family, to whom I refer, are friends of our family. He is a very spe- cial friend to my father, and writes to him that he wishes me to locate in Louisville; speaks encourag- ingly of the place, and insures to me a good practice. Col. Butts is a man of extensive influence, and my father did not hesitate to make arrangements for me to be there within one month. Now, Uncle, I shall go, I trust, feeling my responsibility, as a physician, but believing the trite adage to be true, that " the first impressions are the most lasting." I desire to know how to make, upon my introduction to that corn- He who oppresses honesty never had any. 34 DUTIES AND ELEMENTS munity, the most favorable impression, that I may bring to bear the many good influences which a true man may wield, and at the same time secure practice. Please give me a few hints. Morrison.—Certainly, Harry. Earnestly, the sa- cred writer observes, "the conclusion of the whole matter is, fear God and keep his commandments." I say to you, do right, and practice the precepts we have been discussing. Harry.—Thank you, Uncle. Do right is, and ever shall be, my motto. But what line of policy shall I pursue to insure confidence, before I have time to es- tablish a character for uprightness ? Morrison.—First, call on your friend Col. Butts, and make yourself agreeable as possible, without fawn- ing to him and his family. Let them see that you are a man; that your object is to work from principle, in obedience to the law of God; that with you, doing good is a primary object. Do not appear " stilted," for that is contemptible. No great man was ever pos- sessed of a foolish vanity, which seeks to proclaim its own merits. Worth is like Charity, so beautifully de- scribed by Saint Paul. I would refer to it, if you please, and when the word Charity occurs, substitute the words true merit: " Charity sufiereth long, and is kind. Charity envieth not. Charity vaunteth not it- Greatness, supported by Goodness, is hard to be overthrown. OF A PHYSICIAN. 35 self; is not puffed up; doth not behave itself unseem- ly ; seeketh not her own; is not easily provoked; thinketh no evil; rejoiceth not in iniquity, but re- joiceth in the truth." After you have done all the good that it is possible for man to accomplish—when you have relieved dis- tress, comforted the widow and orphan, honored geni- us, and brought your best gifts to the altar of Christ, do not be puffed up with pride, like the Pharisee; do not declare that " I have my diploma; I have been successful in the practice of Medicine; I have given to the Church and to the poor, and I have helped the community;" but rather imitate the example of New- ton, when congratulated for his wonderful and sublime discourses in Science, who said: "I have only stood upon the shore and cast pebbles into that vast ocean which is yet to be explored." But, as important as these cursory views are, and as deeply as I would have them impressed upon your mind, I must recur to those instructions which you have kindly asked me to give. Secondly, with the conference and advice of your friend, Col. Butts, procure an office in an eligible part of town; make it known for its respectability and neatness; arrange your books and medicines in good taste, with due regard for economy. Your profes- sional brethren will soon, as it will be their duty, call 36 DUTIES AND ELEMENTS to see you. Receive them politely and cordially.-— Frankly tell them that you desire to get practice—all that you can honorably procure. Nothing could be more disgusting than to hear a Physician boasting of an independence as to procuring practice, especially when he is at the same time using all kind of cajole* ry and stratagems to secure publio favor. Be manly and independent enough to say you desire it. You will only then be asserting what they know to be true j for it would be strange that a man should devote pa- tience, industry and laborious study, to say nothing of the heavy expense consequent upon the course of lectures which he must attend, and yet care nothing for practice. It is that for which you have studied, and all will know it. Be punctual to every call pro- cured upon high professional grounds. But to reduce the rules which should govern you, and present the honorable and dishonorable means of getting business, I cannot do better than to read those presented by the great Dr. Rush. The Honorable Methods of Acquiring Business* 1st. Great application to study. Morrison.—If you have by the dint of study ac- quired what you have, it is clear that it is only with its continuance that you can hope to grow in knowl- edge and make achievements in the science of Medi* Pure religion is the foundation of peace. Of A PHYSICIAN. 37 cine. Investigation alone can explore the mysterious arcana of those wonderful truths of learning. It has made all the discoveries in Arts and Science which have enlightened and blessed the world. There can be no stand still j you must either go forward, or retro- grade. 2d. Punctuality in visiting patients, and fidelity in complying with engagements. Morrison.—In making all your engagements con» sistent, you will find great convenience. You will find in this a very pleasing and time-saving system, and it will make a very heavy practice comparatively easy. See your patient at the precise time you have told him to expect you. He will then recognize in you an honesty and a fidelity which will inspire in him a confidence in you. It will give him assurance that you will be attentive to his case. If some un* forseen circumstance, however, should intervene and cause you to fail on this point, it is your duty to apolo- gize to him—acquaint him with all the facts, and if you really have a legitimate excuse, (and if he be a desirable and worthy patient,) he will readily forgive in you what he before thought an unpardonable neg- lect. One other point; your engagements should not be made with reference to your own convenience, but with regard to the wants of your patient. It is a Fear of God is the beginning of wisdom. 38 DUTIES ANE ELEMENTS habit into which Physicians usually fall, of calling upon patients at times that suit their own convenience, and thereby go at improper times. The mere sug- gestion alone will present to your mind the importance of avoiding this error. 3. Inoffensive and acceptable manners, consisting in the habitual exercise of self-denial as far as relates to the temper, and in universal civility or politeness. Morrison.—This rule we have already sufficiently discussed. But I will add, for your benefit, that the " amenities and elegancies of good breeding and po- lite society, and all the gentle and generous qualities of a refined humanity. The day of Abernethy and his miserable imitators is past; the rough and gruff, surly and dictatorial school must now give way to bet- ter natured and better mannered men. The Physi- cian may no longer sternly arraign or sharply interro- gate his patient, as though disease were a crime, and he the judge, or inquisitor; no longer go through with his professional examination with needless harsh- ness, and brutal indifference, as though the suffering frame before him were already a subject, and the bed on which it writhed, a dissecting table." 4. Sympathy with the sick. Morrison.—In sickness, most persons require sym- pathy and have a right to demand and receive it at Do what you ought, come what may. OE A PHYSICIAN. 39 the hands of their Medical attendant. A want of feeling will not long be endured, and should not be tolerated. " A sympathising look, a kind expression, a mere touch of the hand, may give comfort, and sup- port to the sufferer. Such consolation as kindness can bestow, should always be given; and when it is be- stowed, in return, you get the greatest amount of gra- titude, and insure the lasting affections of your pa- tient. It consoles him; inspires hope, and he will readily obey you, and follow your prescription. It is in affliction that we realize our weakness, the frailty of human life. It is then we typify childhood. It is then we want to hear consoling words. And, lastly, it is then, melancholy, fear and distrust cast their gloomy shadows around our couch. Sympathy, then, is gladdening sunlight. Hence, Harry, remember that sympathy with the sick and the troubled, is not only an honorable way of getting practice, but that it is your professional religious duty. It is sometimes said, that doctors become hard hearted. I think it is seldom true; I am sure it never ought to be. A doc- tor should never outlive his humanity. If that pas- ses away, he should speedily follow it. 5th. Attention upon the poor. Morrison.—Remember this rule throughout life. God knows the poor are sufficiently neglected in the walks of social life, without being uncared for when 40 DUTIES AND ELEMENTS the heavy hand of affliction lays hold upon them. Sickness is deplorable everywhere, in the costliest palace, but in the hovel of poverty it presents a scene over which " the angels might look down and weep.,, Esteem it fortunate that it has fallen in your power to do the noblest act of charity on earth—attending to the poor in sickness. Harry.—You are right, Uncle. But will not this policy make me obnoxious to the wealthy part of the community to whom I must look for support? Morrison. — To some silly, purse-proud people, whose hearts have been sadly corrupted by fortune, (left to them by an old father whose name they never deign to call,) you may make yourself inimical.— These people, however, have neither heart nor brains enough to do you justice under any circumstances— they will expect you to perform a fawning servility to them which would be a disgrace to you, were you to do it, and so there is a very doubtful compliment in the patronage of such people. Be just and kind to all; neither court the rich nor poor. Leave those Physicians to God and their own consciences, who have not courage to go into the most abject circles of poverty on an errand of mercy, for fear they will be laughed at by the rich. For yourself, consider that humanity, mercy, God, demand you should an- Have a place for everything, and have everything in its place. Of A PHYSICIAN. 41 swer their summons. Be not ashamed. The great- est part of the business of the great Drs. Sydenham and Boerheave was confined to poor people. Indeed, it is said that Dr. Boerheave was much more atten- tive and punctual to the call of the poor, than the rich, and being asked on one occasion his reason for so doing, he answered: "I esteem the poor my best patients, for God is their paymaster." Dr. Cullen spent years in doing business for which he was never paid; and the noblest trait of his character was that when he rose to the first rank in his profession, he did not forget the humble class of people from whom he derived his knowledge and reputation. We are also informed that Dr. Fothergill devoted an hour ev- ry morning before he left his house, to prescribing for the poor. Dr. Heberdess not only practiced for the poor, but his " liberality to that -class was so great that he was once told by a friend that he would ex- haust his fortune." "No," said he, "after all my charities, I am afraid I shall die shamefully rich." Take these men, Harry, for your guide, though it may compel you to encounter bitter and ceaseless op- position from the members of your own profession, and though it may often come under the unmanly form of envious insinuations, low sarcasms, and senseless ridicule. Follow them, and your life will bless the 42 111 11ES AND ELEMENTS world, and your name, like theirs, will live long in its grateful remembrance. Harry.—But, Uncle, are not your remarks too gen- eral? Many persons owe their poverty to their own wickedness. Am I to go at the beck and call of the abandoned and degraded? There are many who de- serve to be neglected. There are many who impose upon the Doctor, sending for him without just cause, and even insulting him when attending upon them in charity. Morrison.—Very true. Many are so unprincipled as not to deserve charity; and I would not have you lose your independence or self-respect. You have a right to expect and require gratitude and courtesy from those upon whom you attend for nothing, but many are so degraded and ignorant as to have no idea of the respect due. But we are to see none die with- out an effort to save. They may deserve nothing, but remember we deserve nothing from our Creator, but in His kind beneficence He gives us every good thing. We should follow His example in dispensing our charities, remembering the words of the Lord Jesus how he said, " it is more blessed to give than receive." Every Physician, at heart, should be a Samaratin, and until he is, the profession can never be what God in- tended it to be, or even what some of its would-be Superior abilities are acquired by long application. OE A PHYSICIAN. 43 Priests and Levites claim for it. The millenium will never come as long as malice, jealously and selfish- ness control the hearts of the human family. Nor will the Medical profession ever reach that high point in character, dignity and usefulness, until we go to God and the Bible to learn what constitutes true, gen- uine character, and not to the diction of frothy brains, moved by hearts petrified, indurated and encased by selfishness. A Physician should not only act the Sa- maritan to the poor and afflicted in his vicinity, but should take the broad Bible view, as taught in the tenth chapter of St. Luke, and, when in convention, act for the good of the profession, consistent with the law laid down by Christ in the 27th verse of the same chapter. 6. A regard to decency and dress. 7. A respect for religion. Morrison.—You should always respect religion, whether you believe its truths or not, because, true or false, it hopeth for your salvation and happiness in heaven; and because it is calculated to improve and ennoble society. These are rules universally acknowledged as honor- able professional methods for procuring practice; and if by these rules, practice is taken from you by a rival Physician, you have no cause to complain; and should you be betrayed on this account into a passion, you 44 DUTIES AND ELEMENTS will forfeit your claims to an observance of profession. al and gentlemanly propriety. If by these rules you succeed, and obtain the business of your competitors, you arc secure from all harm of opposition, The Dishonorable Methods of Acquiring Business. 1. Opposing the principles and traducing the Prac ticc and character of brother Physicians. 2. Producing new popular remedies. Morrison.—It is a suspicious circumstance to hear any sort of a business man traducing his rival. The conclusion is inevitable, that selfishness and jealousy are the sources from whence these disparagements and slanders come. It is indescribably mean to tamper with personal character, to further one's own private interest. You cannot safely censure a brother physi- cian, even when you have just cause, without your motives being questioned by some j and if you have no good reason, it will be impossible for you to escape great injury to yourself. The unprejudiced public will, in spite of your ingenuity, learn the true cause of your efforts to injure your Brother, and will visit their indignation upon you. Truth needs nothing but an investigation to prevail, and it is the duty of the friends of every Physician to investigate every slan- derous charge made against him; and faithful friends will do it. Therefore, Harry, seek no practice by slandering your brethren in the profession, but depend OF A PHYSICIAN. 45 on merit alone. You should not set by and hear a brother Physician's character traduced, and offer no defence for him, if you know him to be a deserving gentleman. In such a case, if you say nothing for him, you will be considered as approving what is said. The proper course to pursue, is to avail yourself ot every opportunity of speaking well of them. Every one will see a nobleness and generosity in you, that will be praised and honored. When you hear a broth- er Physician complimented, it will cost you nothing to listen to it pleasantly, and thus show his friends that you are unselfish, and feel proud of the honor done a member of your profession. It is also wrong to pander to popular prejudice against a remedy. If you find prejudice against Mercury in the community in which you reside, it may increase your practice temporarily to concur in this opposition, but, besides the dishon- esty of this course, your prosperity will be transient, for those popular prejudices, which have no founda- tion in learning or reason, must be short-lived. The people can hardly forgive you for changing your opin- ions every time they do. 3. Taking undue advantage of brother Physicians in consultation. This is pernicious in the extreme. It is evinced Good words cost nothing, but are worth much. -Hi DUTIES AND ELEMENTS more by actions than by words. Such as unnecessary examinations of a patient; questioning the patient closely about the treatment, and implying doubt as to its correctness by strange looks and knowing nods. It is an insidious attack upon him which he cannot repel. It is like a stab in the dark, and, therefore, unmanly and unprofessional. In time, for this course, you must suffer pecuniarily and in reputation; but should you be accused of such highly unprofessional conduct when you know and feel yourself above it, when you know that your patrons know and will tes- tify that you have never attempted to lower the Med- ical character of a brother Physician in their estima- tion, be not discouraged; persevere, continue to walk ': worthy of your vocation," and sooner or later your accusers will admit your honesty. "Ask no favor;" "demand nothing but a " fair field and open sky," and victory will be yours. And, as we are on the subject of consultation, I will call your attention to another very important thought, namely: If a Physician should be oalled in consultation with you, or be invited to see one of your cases by the family, and should you be there, or even get in after his arrival, you should meet him and treat him as you would a good friend at your own house. Indeed, you are, for the time being, his host; therefore, you should treat him Despise not the poor, for you may want their virtue. OF A IMIYRTCIAN. 47 kindly, politely—make him feel easy. Give him the history of the case. Invite him to examine it. Draw his attention to obscure symptoms. Let him see you have been raised a gentleman, and know how to treat one. This is not only due to yourself and your bro- ther Physician, but to those who invited him to call. If you act otherwise, you place the family of the pa- tient and the consulting Physician in an awkward and unpleasant position. If the latter understands his position properly, and fails on that account to exam- ine the case, the design for which he was called is frustrated, and his course perhaps misunderstood and his reputation injured. If the family understand the delicate position of the consulting Physician, and properly appreciate your want of courtesy, self-respect will impel them to cease to patronize you. If such a course were pursued oftener, the great Medical Re- form, that is so much talked of, and by some so much desired, would soon be consummated. Society is held t)gether by certain laws or conventional rules, and the one that I have alluded to is vital to good society, namely : That it is your duty, when in the house of a friend, to treat his invited guest with the utmost po- liteness, however differently circumstances may jus- tify or even require you to act in the street. Your own self-respect says it is right; society demands it; respect for the family in whose house you are, requires 48 DUTIES AMD ELEMENT3 it; and if you do not observe it, good society, refined educated society, want no higher evidence to prove you an impostor and interloper. Another thought, Harry, before we leave this sub joct: your patrons will often request a consultation, and desire, indeed, require you to solect the Physician. Now, Harry, allow me to beseech you, never be guilty of doing as some of our brethren are accused in some communities, namely: of always selecting those whom they know to be inferior to themselves in every re- spect, fearing that an equal might legitimately, pro- fessionally, make a good impression on the minds of some of his friends. There is still another thing, Harry, which I wish to guard you against; not that I believe you will ever knowingly act dishonorably, but you may be unwit- tingly used by designing men. I mean the joining together of several Physicians for the purpose of in- juring a successful and honorable rival. This is the very quintessence of meanness, whether done for the injury of a rival practitioner, or, on a larger scale, for the injury of a rival Institution. Harry, my boy, never be guilty of the like. Be honest be brave—"do unto orthers as you would they should do unto you." Have no policy but truth, honesty and principle, and you need fear nothing; Jealousy is of all things the most contemptible and detestable. OK A PHYSSIBIAN. 4H men may deceive you; false friends will betray you; enemies will assail you; temptations, disappointments, poverty, afflictions, may surround you like the death- dealing armies of Solferino, but only keep your eyes fixed on the God of the Bible, and your heart fully im- bued with these principles, and all the trials, enemies and storms of life, all the powers of darkness and the armies of wickedness will shiver their flaming lances against that great and almighty Arm, which surrounds you, to shield you in your onward course to true great- ness and everlasting felicity. Harry.—I see, Uncle, the great importance, (both for the elevation of the Medical profession and safety of the patient, and I may say the maintenance of friendly intercourse between families,) of observing many polite rules in consultation. I can readily see where the non-observance of some, might cost the life of the patient, and much injury to society, and therefore, before you proceed, I would be glad, to have your views upon this question : If, I am called to a case on account of its urgency, or in the absence of the Family Physician, and he should arrive while I am there, should I continue my attention ? Morrison.—You ought, by all means, to turn the case over to him, on his arrival. Indeed, it is his When men speak ill of you, live so that nobody will believe them. .') ed her that he had, some years before, received thirty guineas for as many visits he had paid her husband, in the days of his prosperity. " I have since heard," said the Doctor, " of his reverse fortune. Take this purse; it contains all that I received from him. It will do your family more good than it will do mo." Similar anecdotes of his liberality, says Dr. (lush, might be multiplied without end. It is said, lie gave away one-half of the income of his extensive und lu- crative business, amounting, in the course of his life, to one hundred thousand pounds. AVhat an immense interest in honor and happiness must this sum pro- duce to him at the general judgment! With what unspeakable gratitude and delight, may we not sup- pose the many hundred, and perhaps thousand persons, whom ho had fed, clothed, and rescued from prison and death by his charities, will gaze upon their benefactor in that solemn day, while the Supreme Judge credits them all, as done to Himself, in the presence of an as- sembled world ! But, in every instance where there are no demands of charity upon you, it is your duty to adhere unfalteringly to this rulo. In this connection, indulge me in a partial digres- sion. You will frequently bo approached by men who have fallen out with their regular Physician, because of the amount of their bill, and for that reason have dismissed him, and wish to employ you. In such a 0E A PHYSICIAN. :>3 case, when informed why the Physician has been dis- missed, you should inquire : " What did he charge you?" You will be told, say one dollar and a half a visit, which is in accordance with the customary charges. It is then your duty to tell the applicant, that his Physician did him no wrong; that you will be compelled to charge him at the very same rates. Honesty requires this of you. It is your duty to your professional Brother—to yourself—because the pat- ron will have a right to complain; for saying nothing and accepting his practice, you tacitly admit that your bill will not be so large; and to your brother, because his conduct has been only what you require that it should be No friend of yours will expect you to charge him less than the standard rates; less than they will be compelled to pay any one else for the same amount of services. If your patient is really your friend, he will patronize you from principle, and even desire to pay you as much as you charge other people, or as others would oblige him to pay. My rule is, to trade with my friends, because they are my friends, and pay them as much as they charge other persons, because I am their friend. Next I will read— The Artificial and Accidental wean* of avonirhv) Hnsmtss. ;>i DL'TIES AND ELEMENTS 1. The patronage of a great or rich man, or of a fashionable lady, or of several powerful families. 2. Great taciturnity with grave and knowing looks. Morrison.—It is an old adage that many a fool passes for a smart man by keeping his mouth shut, and many a wise man has been set down as a fool by keeping his mouth eternally open. You should avoid everything that will subject you to the suspicion that you are adopting stratagem to make the masses think you arc wise. " Get wisdom," says Solomon, "and with all thy gettings get understanding; exalt her and she ^hall promote thee; she shall bring thee to honor when thou dost embrace her; she shall give to thine head an ornament of grace; a crown of glory shall she deliver to thee." Affectation is an artificial means of acquiring business, and cannot be perfect. Ignorance may hide itself for a while behind knowing looks, but its nakedness will be seen at last. 8. Eccentricity of manners and conduct. Morrison.—This is obnoxious, and subject to the condemnation wc have attached to affectation. Many Physicians introduce themselves by adopting eccen- tric manners and unusual styles of dress. With all such persons it is usually a dernier resort in the ab- sence of genuine merit. J-. Great minuteness in inquiring into the symp- hisis "f diseases, (such as examining lips and teeth b> OP A PHYSICIAN. .")5 means of magnifying glasses,) affectation of an un- derstanding of a patient's case by feeling but a few strokes of his pulse, or by barely looking at his coun- tenance. Morrison.—-The people should know that such Physicians pretend to have an ability in Medicine that has never been attained by the most eminent Medical men of this or any other age. Yet, as silly and arro- gant as this pretension is, it is not without effect upon credulous people, who have no just conception of the true science of Medicine. You will doubtless see men indebted to this humbuggery for their practice, and you can scarcely help wishing that the people could see its shameful dishonesty as you do. Finally, under the head of artificial methods, I will r ead this one : 5. Speaking in all companies, of the number and rank of patients, and frequently of their diseases. Morrison.—This, I fear, hits a large class of Phy- sicians. It is a system of puffing one's self into no- tice, but it will prove a Sisyphus at last; for, however much vanity we may suppose men to have, these very persons of rank will conclude, very naturally, if the Physician has no higher qualification than their pat* ronagc of which to boast, they arc unworthy of their patronage. Next, the Oil DUTIES AND ELKMKNTS Just Causes of a Loss of Business, arc : 1. Ignorance in Medicine. 'I. A fondness for pleasure more than the Profes* sion, discovered by constantly frequenting saloons, theatres, cock-pits, horse races, and other places of public amusement. 3. Delay in complying with calls to sick people; a want of punctuality in subsequent visits to them. Of cleanliness and neatness in the preparation of their Medicines, and of correctness in the directions which accompany them. 4. Inattention to the history of tedious cases. 5. A careless, or superficial examination of a dis- ease. 0. A harsh and indelicate mode of behavior, con- sisting of short answers to questions, and of improper rebukes for not complying with prescriptions. 7. Drunkenness, profanity,impiety, and brutal man- ners. 8. A want of firmness and decision of character. Morrison.—If you lose business from these causes, you are not justified in complaining, either of the causes of your patron or of the Physician who gets your business. It is human nature to feel resentment under circumstances of this kind, but you must tri- umph over it. The responsibilities resting upon the Physician are great, and when he betrays a light esti bj' A PHYSICIAN. mate of them, he does not deserve patronage or con- fidence. The remedy is, remove the "just causes," and you will regain your place and cease to feel the humility of unworthiness. In conclusion are presented the Unjust Causes for loss of Business. 1. The discovery and propagation of new principles, or of new modes of practice in Medicine. 2. The early declaration of the existence of pesti* lential diseases in a city or country, and of their origi- nating in domestic causes. 3. The neglecting to name a disease, or calling it by an improper name at the outset. 4. Making light of a disease. Dr. Rush relates a case where a Physician was called to see a child a lit- tle indisposed from teething. He told the parents that its disease was of a trifling nature, and that it would cure itself. The next day, the Physician called again to visit the child. Upon asking how it was, the mother told him he had mistaken its disease; that her neighbors had told her it was a very dangerous one, and that she had sent for another Physician who was of their opinion, and that he had sent the child a Medicine which had in a few hours perfectly cured it. 5. Medicines prescribed unsuccessfully, especially if they give pain. DUTIES AND ELEMENT; (>. Sickness in a Physician, and necessary excur- sions from home. 7. Unpopular opinions in politics and religion. 8. Writing poetry, and upon subjects unconnected with Medicine. 9. By sending in their accounts when due. Morrison.—The above are some of the unjust causes for the loss of business. The people should know them—call their attention to them. Fail not to discourage them everywhere, even though they should give you business, for sooner or later they will operate against you. There is yet another unjust cause which is unmentioned by Dr. Rush. It is the death of a patient. No human skill can intervene at all times. People will die. The power of Medicine is frequent- ly as nothing. Let the people be warned that you wish not to get practice, because your competitor loses cases. Say to them frankly, that under your treat- ment many must die. As I remarked to you before, be dignified in the loss of business; show yourself a man; be just and generous; preserve uniform urban- ity ; for sooner or later the right will be amply vindi- cated. The people will enjoy their pleasure in rela- tion to their Physician. Be as friendly to the man after he has ceased to be your patron, as you were be- fore. Let no business consideration affect your social rclatious. OE A PHYSICIAN. 59 Harrv.—I am glad that we have had this conver- sation. I see that my views of our Profession were not sufficiently enlarged. I see now the high duties which rest upon us. It is exalting to think of making a Profession the medium of so many good influences. I esteem it fortunate that I have heard this discussion just as I am entering upon my profession. Morrison.—I trust you will derive benefit from all these precepts. They are true; full of principle, and I think perfectly destitute of selfishness. I do not think I have uttered a word to which any honorable Professional opponent could object. Why? Because truth and principle harms no one who de- sires, and intends to take it for his guide. There- fore, Harry, let me say to you, in your very com- mencement of life, never be afraid to vindicate the truth and correct principle anywhere, and under all circumstances. Remember: " Truth crushed to earth will rise again; The eternal years of God are hers; But error wounded writhes in pain, And dies amid her worshippers." Gentlemen : The article I have just read, was, (a3 will be seen by the title page,) written at your re- quest, and, readily perceived by the the general rea- der, for your special benefit. I did not know, until it was too late to alter its plan, that its publication would be desired; or, I might, perhaps, have adopted one Fear not while acting justly. uo DUTIES And ELEMENTS altogether different, in order to have made it less lia- ble to criticisms. But knowing that I labor for your practical good, you will, I know, pardon the absence of ornament as well as other imperfections incident to hurried composition. Although I have already taxed your patience in thus reviewing the Duties and Elements of the Phys- ician, yet, my beloved Class, indulge me a few mo ments longer. The painful thought arises, that my instructions and counsels to you, are this night to close; that many of us have met for the last time, until we stand together before the throne of God, to hear the last vindication or condemnation of our motives. Oh, , then! let us keep that meeting ever in view. Let us seek genuine piety. It will guide our feet into paths of peace, and that calm reliance in the atonement. It will teach us to derive all the importance of time from eternity; to estimate that all the results of our actions are not confined to the theatre of life. It will send its effulgence beyond the gloomy vale of Death, and display to our astonished view the celestial paradise, blooming and brightening eternally under the smile of Infinite Love. You will find Religion no less essential to your happiness than your usefulness. However for- tunate your lot in life may be; however your path be strewn with flowers, you will find it to be the only true foundation of Professional usefulness; the only 0i' A I'HYSIClAN. 61 security against the temptations that beset you; the only help in time of need; the only hope in the day of adversity; the only refuge in time of distress; the only ultimate consolation. Suffer me, then, gentle- men, to entreat you, in these my parting words, to consider the importance of Religion to yourselves, your country and the world. Realize not only the great truth that, without the Bible and the Religion it teaches, you can have no solid happiness on earth, or hope of felicity hereafter; but accept the conviction that Christianity is the vital spirit of the Republic; the light of the world; the dazzling light which St. Paul saw; and the lever of nations. There can be no danger in trusting a Religion which has triumphed, as Christianity has, over its most violent and powerful enemies. Then, above all things, determine to be Christians, always remembering that he only is a real perfect man, who discharges his duty in the fear of God; that he only is truly rich, who enjoys the friend- ship of his Saviour; and that all earthly honors are worse than nothing when compared with the honor that cometh from on High, through crowns and bril- liant conquests. Gentlemen, it is painful at all times, and under all circumstances, to part with those whom a pleasant and tender association has bound together in the bonds of mutual friendship and esteem, but especially is it sad Cr2 DUTIES AND ELEMENTS and affecting to say farewell to you, who have been so long and so intimately associated with me, as my pri- vate pupils and particular friends, during your Cob legiate Course. If you fail in becoming useful, great, or renowned in the Medical world; if, from any cause, you turn aside from the path of duty; spend your life as a "tale told," and make no impress for good on the mind and hearts of men; then, so long as you remain obscure or worthless in the great field of duty, just so long will malice and jealousy slumber, and withhold her forked tongue—Slander; but when you pursue that course which, as I trust you have determined to take in life; whenever you set forward with a brave heart and manly energy to overcome and conquer every ob- stacle to your success; and, whenever the result of your action and your energies are seen in your grow- ing prosperity, and in your upward course, then the demon Jealousy, in many a dark deceptive bosom, will hurl her darts—point them with destruction—and with the force of Slander's tongue, aim them at your fair name. But this jealousy, to which I allude, will not be found so much in the various professions and common walks of life. It will be found, I regret to say, mainly, if not wholly, in the ranks of the Medi The sting of a reproach is the truth of it. OE A PHYSICIAN. 03 Cal Profession itself. It will exist in relation to you, as it now does everywhere, not in the higher and no. bier class of Physicians, but in that lower circle, for whom nature and education have done but very little in fitting them for their high pretensions. Such men have neither the natural capacity, nor the learning and accomplishments which you and others will have. They seek to run with you in the great race of life, but clouds of ignorance darken their path, and with j ealous rage they fall into the rear, and drag their slow length along. They see you soar on the wings of Fame and Fortune, and they, too, invoke the wings of Genius and the power of talents to bear them up in a little loftier flight. But lo ! they have neither the bright pinions of Genius, nor the mighty power of In- tellect, to lift them above the clouds of Ignorance; and they grope and frail on, with no higher aim than that of despoiling you of the fame and fortune which they can never achieve. Let me invoke you to pity such men, and never condescend to occupy their degraded position by openly contending and discussing with them the issues which they will raise. The mousing bat or hooting owl, never attract the notice of the proud eagle, who, heedless of all below him, moves still swiftly on, cleaving the skies in the grandeur of his flight. It is seldom that a falcon, towering in her Though a good life may not silence calumny, it will disarm it. 04 in xii-,h And elements pride of* flight, is, by a mousing owl, hawked at and killed. Let your course be like that of the eagle, all heedless of those below and beneath you; press on to the achievement of a great name and glorious des- tiny. Do this, and you will place yourselves so high in the scale of usefulness and virtue, that the fiery shafts of enemies will never reach your high position. In this connection, I would not be understood as captious or fault-finding toward the brethren of my noble Profession. Far be it from me to undervalue or depreciate any man, or class of men whom wc recognize as our confreres in Medical science. I can appeal to you, gentlemen, to bear me testimony, that, so far from this, 1 have always, and uniformly pressed before you in my public lectures, the vast importance, propriety and necessity, as well as the pleasure and in- tegrity of that mutual courtesy, love and forbearance, which should exist throughout the ranks of the whole Profession, and it is for the maintainance of this sa- cred principle of Professional love, " esprit dit corps," which calls forth this brief admonition; that is, that you forbear and forgive those who, from jealousy chief* ly, may seek your injury. In conclusion, young gentlemen, let me exhort you to resolve this night to live worthy of your noble profession—ever cherish and cultivate that senti- Nolhing is so secret, but time and truth will reveal it, Of A 1'llYSlCTAN, rCi ment of fraternal love which regards the rights and interest of one, as the rights and interest of all. Resolve never to recline upon the bed of indolence and ease. Remember that it will be expected of each one of you to bear aloft the proud flag of your profession, to advance, as far as you can, the cause of humanity. Every other Science and Art is progress* ing; the age is advancing ; time is sweeping on, and ere we are aware of it, we shall find ourselves out- stripped in the march of progress, and left stranded on the barren shores of Indolence and Ruin. The Science of inanimate nature in every depart- ment is going, probably, ahead of us in her wonder- ful inventions, and in her noble achievements. Look over the world at her rise and progress. Mountains bow their rugged brow before her march ; the waste, desert places of earth are blooming and blossoming as the rose; out of desolated ruins are rising towns and great cities, all over the civilized globe ; the blue Ocean, once a waste of silent waters, is glad with the voice of human life, and white with the sails of commerce. The steam, which but recent- ly slumbered in the water or floated in the clouds, now drives our thousand engines along through hill and valley, and propels great ships through the briny deep. The Lightning, which once, in untamed splen- Tnprincipled men live knaves and die beKsr.ir*. ("Hi DUTIES AND ELEMENTS dor, played wildly in the lieavens, has been caught and harnessed to bear the thoughts of man from city to city, and from world to world. But the science of man is, we fear, comparatively sleeping. This is the greatest of them all; it is the science of the body—the home and tenement of his immortal soul. It is the science of that body which will survive all things else. The heavens may be rolled together like a scroll, and pass away. This great ball on which we live, with its towns, cit- ies, mountains, lakes oceans and wonders, must be wrapt in the destroying elements of the last day. We know of no material thing which will live beyond these awful scenes of dying nature, but this human body which is so fearfully and wonderfully made. This body shall come forth again from its mother earth, refined, glorified and beautiful; and if it fulfill its true destiny, it will rise, fitted to shine and corrus- cate in that bright and glorious world of eternal glory and everlasting felicity. Hence, gentlemen, such is the science of this won- derful body—a body, which, in one sense, is immortal —which will at last defy the tooth of Time or the wreck of matter and crush of worlds. Now let me entreat you to fully appreciate and truly estimate the grandeur of your profession ; let in work, toil and struggle, to place it before the world OF A PHYSICIAN. 07 in its true, commanding and heavenly light. If we will, as one man, this day begin that great struggle, it may end in results which will tell on generations to come, and live for time and eternity. Do this, and you may yet live to see the noble Science of Medicine leading every other Science of Nature in the great and onward march of human progress ; you may yet see its race the swiftest, its character the brightest, and its achievments the proudest of all. God grant that you may; and then, gentlemen, you shall have the proud satisfaction of seeing the name, fame and glory of your profession towering before the gaze of an as- tonished and admiring world—the purest and bright- est of all save one—the crowning glories of the Re- deemer of man. And now let me say, that in telling you farewell, I am cheered in the performance of this sad duty, in the hope that my labors, as well as my hopes and wishes for each of you, may not prove vain, in the fu- ture of your life; and when all the seeds which other Teachers and Instructors have sown in the soil of your hearts shall have sprung forth, and are maturing for harvest, may I not hope that the precious seed which I have sown here from week to week may likewise be found there, budding beautifully in time, and at last, blooming with immortal freshness in thr- Klysian fields of eternal glory? rts DUTIES AND ELEMENTS Go, then, gentlemen, and carry with you the prin- ciples I have endeavored to inculcate. Determine to excel in all that is good and noble, and I promise you the highest honors and emoluments of the Medi- cal Profession ; I promise you a taste of its unpolluted pleasures ; I promise you usefulness, reputation, fame, solid glory, and immortal renown. Finally, gentle- men, you know your duties to yourself—to your pro- fession—to your patients—to your Alma Mater—to each other. Go, then, and be eyes to the blind, feet to the lame; and let the blessing of him that is ready to perish come upon you. Pursue the course I have suggested. Resolve to be independent; consecrate your life to honor and usefulness, and as well might your enemies attempt to pluck the stars from the blue concave of heaven, or destroy the fiat of the Almighty who spoke the world into existence, and bade earth, moon and planets perform their perpetual evolutions, as to attempt to destroy your good name. Success shall be yours, and whether your life be "robed in sunlight or darkened by trouble and tempest/' pos- terity will embalm your memory, and a grateful world proclaim you a shining light in your own gene- ration—a benefactor to successive generations of man- kind. And now, my dear young gentlemen, I bid you an affectionate Farewell. Snuly to he worthy of your parents.