NEW YORK ACADEMY OF MEDICINE. 
1877. 
Anniversary Discourse. 
BY 
DR. T. GAILLARD THOMAS. NEW YORK ACADEMY OP MEDICINE. 
1877. 
Anniversary Discourse 
BY 
DR. T. GAILLARD THOMAS.  yORK yLCADEMY OF yA.EDIClNE, 
12 West Thirty-first'Street. 
Regular Meetings, First and Third Thursday Evenings in the Month. 
OFFICERS FOI\ 187 7. 
President. 
Samuel S. Purple, M.D. 
Vice-Presidents. 
Gouverneur M. Smith, M.D., Fordyce Barker, M.D., 
William T. White, M.D. 
Recording Secretary. 
Horace T. Hanks, M.D. ; 
Corresponding Secretary. 
John G.?Adams, M.D. 
Treasurer. 
Horace P. Farniiam, M.D. 
Trustees. 
Edmund R. Peaslee, M.D., James L. Banks, M.D., 
Austin Flint, M.D., Samuel T. Hubbard, M.D., 
Isaac E. Taylor, M.D. 
Librarian. 
Laurence Johnson, M.D. 
Edwin R. Purple, Assistant. 
Assistant Secretary. 
Edwin F. Ward, M.D. 
Statistical Secretary. 
Allan McL. Hamilton, M.D. COMMITTEES FOR 1877 
T Committee on Admissions 
Ellsworth Eliot, M.D., Chairman, Edward H. Janes, M.D., 
Mark Blumenthal, M.D., T. Matlack Cheesman, M.D., 
Joseph E. Janvrin, M.D. 
Committee on Medical Ethics. 
Oliver White, M.D., Chairman, Thomas C. Finnell, M.D., 
T. Matlack Cheesman, M.D., Moreau Morris, M.D., 
John C. Peters, M.D. 
Committee on Medical Education. 
Alfred C. Post, M.D., Chairman. James R. Beaming, M.D., 
Edmund R. Peaslee, M.D., Charles C. Bee, M.D., 
Frederick A. Burrall, M.D. 
Committee on Library. 
James R. Beaming, M.D., Chairman, John H. Hinton, M.D., 
E. Darwin Hudson, Jr., M.D., George Bayles, M.D., Secretary, 
Laurence Johnson, M.D. 
Committee on Ways and Means. 
James Anderson, M.D., Chairman, Willard Parker, M.D., 
Samuel T. Hubbard, M.D., Jared Linsly, M.D., 
John G. Adams, M.D., Stephen Smith, M.D., 
Samuel S. Purple, M.D., Gouverneur M. Smith, M.D., Sec'y. 
Committee on Building. 
Samuel T. Hubbard, M.D., James L. Banks, M.D. 
SECTIONS. 
Section on Surgery. 
Regular Meeting, Second Tuesday Evening in the Month. 
Stephen Smith, M.D., Chairman, A. B. Judson, M.D., Secretary. 
Section on Theory and Practice of Medicine. 
Regular Meeting, Third Tuesday Evening in the Month. 
Gouverneur M. Smith, M.D., Chairman, A. A. Smith, M.D., Secretary. 
Section on Obstetrics and Diseases of Women and Children. 
Regular Meeting, Third Monday Evening in the Month. 
Isaac E. Taylor, M.D., Chairman, Salvatore Caro, M.D., Secretary. LIST OF PUBLICATIONS 
OF THE 
JlEW y ORK ACADEMY OF EDICINE, 
The following Publications of the Academy can be obtained at the Library, 12 
West 31.si Street, on application to the Librarian ,* at the prices affixed; or the 
same may be had in exchange for medical works, etc., not already in the Library. 
First Series. Vols. 1, pages 461 ; 2, pages 454; and 3, pages 476, each, $2 50 
Second Series. Vols. 1, pages 429 ; and 2, pages 502 ; each 4 00 
TRANSACTIONS. 
Vols. 1, pages 588 ; 2, pages 562; 3, pages 470 ; and 4, pages 264, each, $2 00 
pip* Single Parts of the Transactions and Bulletin will be sold separately 
(when complete sets are not broken by so doing) at the rate of Ten cents for 
every sixteen pages. 
Copies of the Transactions, Vols. 1 and 2, Second Series, in cloth, will be 
exchanged, with Fellows of the Academy, for copies in paper, by the payment 
of fifty cents each volume. 
BULLETIN. 
Dr. John W. Francis’ Anniversary Discourse 1847. $0 25 
Dr. John W. Francis’ Inaugural Address 1848. 10 
Dr. James R. Manley’s Anniversary Discourse 1848. 25 
Dr. Valentine Mott’s Inaugural Address 1849. 10 
Dr. Alfred C. Post’s Anniversary Oration 1849. 25 
Dr. Isaac Wood’s Inaugural Address 1850. 10 
Dr. Joseph M. Smith’s Anniversary Discourse 1850. 25 
Dr. Thomas Cock’s Inaugural Address 1852. 10 
Dr. F. Campbell Stewart’s Anniversary Discourse 1852. 25 
Dr. E. Delafield’s Biographical Sketch of J. Kearny Rodgers, M.D.1852. 25 
Dr. John H. Griscom’s Anniversary Discourse 1854. 25 
Dr. John Watson’s Anniversary Discourse, “ The Medical Profes- 
sion in Ancient Times ” 1855. 1 00 
Dr. J. M. Sims’ Anniversary Discourse, “Silver Sutures in Surgery” 1857. 50 
Dr. J. P. Batchelder’s Inaugural Address 1858. 10 
Dr. E. R. Peaslee’s Anniversary Discourse, “The Progress and 
the Spirit of Medical Science” 1858. 50 
Dr. Wm. C. Roberts’ Anniversary Discourse, 1859. 25 
Dr. John Watson’s Anniversary Discourse, “ The True Physician’’.I860. 25 
Dr. James Anderson’s Inaugural Address 1861. 10 
Dr. V. Mott’s Eulogy on Dr. J. W. Francis 1861. 25 
Dr. S. Conant Foster’s Anniversary Address 1862. 25 
Dr. John W. Draper’s Anniversary Discourse 1863. 25 
Dr. A. C. Post’s Eulogy on Dr. Valentine Mott. Steel Portrait.. .1865. 50 
Portrait of Dr. V. Mott, on India Paper. Small 4to, 50c.; large 4to. 1 00 
Dr. James Anderson’s Valedictory Address 1867. 20 
Dr. Gouverneur M. Smith’s Anniversary Discourse 1869. 25 
Dr. John C. Dalton’s Anniversary Discourse 1873. 25 
Dr. D. B. St. John Roosa’s Anniversary Discourse 1874. 15 
Dr. Austin Flint’s Valedictory and Dr. Purple's Inaugural 1875. 15 
Dr. E. Darwin Hudson, Jr.’s, Anniversary Discourse 1875. 15 
Dr. Wm. T. White’s Anniversary Discourse 1876. 20 
Dr. S. S. Purple’s Inaugural Address on Medical Libraries 1877. 20 
Dr. T. Gaillard Thomas’ Anniversary Discourse ,1877. 20 
ADDRESSES AND MEMOIRS. 
* dSP* The Library is open daily from 2 to 5 o’clock P.M., Sundays and Holidays excepted. TEE INFLUENCES WELCH ARE ELEVATLNG MEDICINE 
TO THE POSITION OF A SCIENCE. 
AN 
ANNIVERSARY DISCOURSE 
DELIVERED BEFORE THE NEW TORE ACADEMY OF 
MEDICINE; NOVEMBER 15, 1877. 
BY 
T. GAILLARD THOMAS, M.D., 
PROFESSOR OF OBSTETRICS AND OF THE DISEASES OF WOMEN AND CHILDREN IN THE COLLEGE 
OF PHYSICIANS AND SURGEONS, NEW YORK. 
NEW YORK: 
PRINTED FOR THE ACADEMY, 
12 West Thirty-First Street. 
1877. ANNIVERSARY ADDRESS. 
MR. PRESIDENT AND GENTLEMEN, FELLOWS OF TIIE NEW YORK 
ACADEMY OF MEDICINE: 
When your kind request was conveyed to me that I should 
give to-night the address which is customary on each recurring 
anniversary of this Society, I felt that inclination to decline 
which is always the first impulse of a busy man who dreads 
assuming additional labors; but the pleasurable prospect, 
of standing in your midst, in the friendly relations of this 
moment, soon dissipated this feeling, and induced me to accept 
your invitation cheerfully, cordially, and thankfully. As, how- 
ever, a search through your archives to discover, by an exami- 
nation of -similar efforts on the part of my predecessors, what 
was required of me, has brought to my notice the chaste and 
finished addresses of Manley, of Mott, of Stewart, and of 
Smith; the eloquence and humor of the genial Francis; the 
learning and research of Watson, of Post, and of Draper; and 
the able efforts of so many whom I recognize around me now, 
I have shrunk from the task from a different feeling, a fear 
that your selection of an orator for the present might belie your 
sagacity of the past. Unlike those whom I have mentioned, I 
have neither research nor eloquence to bring you, nor can I 
offer you, as some of your members have done, the brilliant 
results of personal investigation and inquiry to be sent forth 
from these halls to other lands, to take their stand among the 
contributions of our country to modern medicine. 
Failing in ability in these two essential respects, I have 
chosen as my theme to-night, 
“The Influences which are elevating Medicine to the 
position of a Science.” 
I trust to your kind indulgence to follow me through a rapid 
review and comparison of ancient and modern medicine, and 8 
dk. Thomas’ addeess. 
an examination of the causes which are so signally changing 
the character of the latter, and advancing it from the level of a 
mere empirical art to the dignity of a science. Should neither 
interest nor profit result from our study, then will the fault be 
entirely yours. You will suffer, and suffer justly, from bad 
judgment in selection of an orator; for surely never yet did 
theme possess in itself more of absolute merit and importance, 
or present a better field for gathering instructive and useful 
lessons. As votaries of the healing art, we “ have but one lamp 
by which our feet are guided, and that is the lamp of expe- 
rience.” What could we more profitably do then than, with 
retrospective glance, to interrogate this experience as to those 
influences which have advanced and those which have retarded 
the most noble of all studies—the science of medicine. 
From the earliest periods of civilization medicine has been 
practised as an art, and men have devoted their lives to the 
careful observation of the phenomena of disease, the recogni- 
tion of those developments which would enable them to appre- 
ciate the probable course of different affections, and the means 
of counteracting their baneful influences upon the human sys- 
tem. As centuries rolled on the experience of one generation 
was, by manuscript records, preserved for those which succeeded 
it; the wisdom of one race was handed down, as it passed away, 
to nations which followed it; and each succeeding civilization 
found itself enriched at the very commencement of its career 
with the stores of learning accumulated by communities which 
had gone before. 
Through the writings of Diodorus Siculus, of Herodotus, and 
of Strabo, we obtain a glimpse of the earliest records of medi- 
cine as it existed among the ancient Egyptians; and although 
we glean from them little to admire or to imitate, we learn that 
in this primeval land the art of medicine had its birth. Here, 
on the banks of the Nile, in the far distant days of the Pha- 
raohs, undoubted records tell us of men who strove against dis- 
ease, struggled after progress, and toiled through their genera- 
tions, as we do now, in their ministrations to the sick. Peace to 
their mummied forms, they have long rested from their labors. DE. THOMAS’ ADDEESS. 
9 
For over four hundred years the Jews lived in Egypt in a 
state of bondage. When a leader, who proved equal to the task 
of freeing, leading, and elevating them, appeared, they wTent 
forth as a nation well instructed in all the learning of their 
former masters. The Egyptians were the medical instructors 
of the Jews, as they were likewise of the Greeks. 
The seed of knowledge thus planted produced among the 
first of these nations the sanitary laws which we read and ad- 
mire to-day, and which must, in the early times in which they 
framed, have accomplished a vast deal for the benefit of 
those for whom they were designed. 
To the latter -we owe the birth of that school of medicine, 
which, founded by the illustrious sage of Cos, four centuries 
before the birth of Christ, comes dowrn to us as that to which 
we give our adherence to-day. Then came the Romans, adding 
to wdiat the Greeks had taught them, to be succeeded by the 
Arabs, whose teachings come down to our own time in the writ- 
ings of Rhazes, Avicenna, Haly-abbas, and Albucasis. 
And now the accumulated experience of the ages was appro- 
priated and added to by the developing nations of Europe, 
until those centuries which have received the name of the 
“Dark Ages,” threw their pall of bigotry and retrogression 
over the civilized world, and benumbed the progress, and fet- 
tered the advance of all learning, science, and art. Thanks to 
the religious society of those times—to the old monks who with 
shorn crowns, and garments of serge, hoarded up the manu- 
script contributions of more liberal and learned periods—all 
recorded experience was not swTept away; but safely garnered, 
and jealously watched, it was given forth as a rich boon to 
those who, during the sixteenth and seventeenth centuries, 
were to wdtness the dawrn of a new era—the revival of learning, 
which had so long lain dormant and non-progressive. 
If a dividing line can anywdiere be drawn between ancient 
and modern medicine, between the periods wdiich marked med- 
icine as an art and medicine as a science, it would, with the- 
greatest propriety, be drawTn at about the latter half of the six- 
teenth and the commencement of the seventeenth centuries. 10 
dr. Thomas’ address. 
During this period, three great events occurred, which laid the 
foundation for that scientific research and accurate knowledge 
which were henceforth to place medicine among the sciences. 
These were the establishment of inductive philosophy, the per- 
fection and utilization of the microscope, and the discovery of 
the circulation of the blood. The first of these prepared the 
minds of men for a new, rational, and safe method of study; 
the second afforded a means of studying, by the sense of sight, 
the microcosms concerned in anatomy, pathology, botany, and 
chemistry ; and the third, giving evidence of the wonderful re- 
sults of these methods of inquiry, opened new channels for 
thought, and prompted similar styles of investigation in other 
departments of medicine. This is the tripod upon which in 
the beginning rested the new-born science of medicine ; these 
the three grand events which were to mark a new era in its 
history. 
Then was it that Yesalius, and Pare, and Harvey, and 
Aselli, he to whom has been by some accorded the title of the 
u English Hippocrates,” the illustrious Sydenham, lived and 
labored. And then, as the eighteenth century advanced, ap- 
peared as fruits of the new era in medicine, Boerliaave, Yon 
Haller, Morgagni, Jenner, and the two Hunters. 
It- was in the first quarter of the seventeenth century that the 
important revolution, already referred to, occurred in the then 
existing systems of philosophy. The establishment of induc- 
tive philosophy by Francis Bacon, who has justly been styled 
“ the father of experimental philosophy,” unquestionably ex- 
erted a marked effect upon the methods of thought and investi- 
gation hitherto adopted in medicine. Influenced by the 
Baconian philosophy, from this period the habit of arguing 
from facts which had been carefully observed, and, wherever 
possible, tested by experiment, began to grow with steadiness; 
and it soon became evident that both moral and physical 
sciences were henceforth to combine in elevating our noble 
calling. 
In the seventeenth century, too, a most marked influence was 
exerted upon medicine by the invention of the microscope, which DR. THOMAS5 ADDRESS. 
11 
for a long time before this period had been known as a com- 
paratively useless magnifying glass. Once rendered a practi- 
cal device, it gave a wonderful stimulus to investigation and 
inquiry, lent precision to facts loosely fixed before ; and to the 
vision of the histologist, the physiologist, the chemist, the 
botanist, and the pathologist, opened worlds whose very exist- 
ence was not hitherto imagined. More plainly than by 
words it told them that there were things in heaven and earth 
not dreamed of in their philosophy. As the telescope taught 
the astrologer of old to see in place of a few shining stars, 
world beyond world, system beyond system, in distances too 
great even for human conception; so did the microscope open, 
to the enraptured vision of those who had hitherto groped in 
darkness, a microcosmic universe before unknown. Henceforth 
the old things of medicine were to pass away and all things to 
become new. The eyes of the brave Vesalius were as keen as 
ours, his intellect as bright, his devotion as great, but by the 
aid of this wonderful invention our eyes suddenly became a 
thousand times more penetrating than his, our limit of observa- 
tion a thousand times more extended. The minute anatomy, 
the real seat of disease in each organ, became as clear to us as 
the gross anatomy was to him. What was for him a dark red 
mass penetrated by blood-vessels and nerves, became for us a 
collection of acini, surrounded by connective tissue and filled 
with cells. Then the diseased conditions of each of these ele- 
mentary parts became, in a similar manner, comprehensible, and 
the road to still greater advances, from deeper study, could be 
seen opening up to the future. 
There are thoughtful men who declare that so great has been 
the influence of the discovery of iron upon the development of 
civilization, that if it were even in our present advanced state 
taken away from us, we would not only cease to progress, but 
would absolutely retrograde into barbarism. In the same way 
it may be said that if we were to-day to lose the influence of 
the microscope, all progress in medicine would cease, and we 
should gradually lapse into the sloughs of uncertainty and 
speculation from which it has done so much to elevate us. 12 
dr. thomas’ address. 
And now occurred a remarkable event for medicine which 
demonstrated the grand results of the combined application to 
its study of the moral and physical sciences : of inductive phi- 
losophy and anatomical research and experiment. In the first 
half of the seventeenth century William Harvey demonstrated 
to the world the circulation of the blood, and opened the flood- 
gates which were in future to pour a copious stream of knowl- 
edge upon physiology, and to enrich the science of medicine. 
Henceforth no foothold was to exist for the wild chimeras 
hitherto sustained in reference to the blood, its functions, and 
its course through the body. Harvey’s opponents and detrac- 
tors, whose name was “ Legion,” supported their views by argu- 
ment; the great innovator enforced his by demonstration as 
clear, as convincing, and as unanswerable as the most certain 
deduction in mathematics. This grand discovery Bacon, a con- 
temporary of Harvey, lived to see, but Vesalius, who opened 
the way for it had died sixty years before this glorious fruition 
of the seed which he had sown. 
Who can tell how long, without Harvey’s great work, impene- 
trable darkness would have continued, as of old, to encompass 
physiology, and the pathology and treatment of cardiac disor- 
ders ? Who for a moment can suppose that without it medicine 
could ever have been, with reference to these affections, anything 
else than an empirical art ? The possibility of drawing exact 
deductions from certainly-ascertained premises was attainable 
only by absolute physical demonstration. This was henceforth 
and forever entirely at our disposal. 
At this late date it may be imagined that when, as in this 
ease, science and empiricism grappled in conflict, the victory 
gained by the former was immediate, decisive, and unquestion- 
able. Far from it! Harvey contended for a lifetime against 
bitter opposition and vindictive detraction. “Truth crushed 
to earth” does “ rise again,” but often it rises like an exhausted 
athlete, slowly, unsteadily, and feebly, till time has been given 
it in which to grow firm in the upright position. With Har- 
vey’s discovery it was but a question of time; ere long it had 
swept aside all opposition, vanquished all scepticism, and vindi- dr. thomas’ address. 
13 
cated its right to being considered a discovery equal in impor- 
tance, as far as the benefit and happiness of mankind are con- 
cerned, to that of Columbus. 
Up to this time medicine not only existed, but flourished, as 
an art; a noble, God-given art, which scattered its benefits 
lavishly. But at no period could the term science have ever 
been appropriatel}7 applied to it. It was pursued by wise, and 
good, and devoted men, but pursued as an empirical art, and as 
such was it handed from one civilization to another, as we have 
watched it passing onwards in its advance to the more modern 
times. But now, not by any sudden impulse or unexpected 
development, but by slow, laborious degrees, one man advanc- 
ing here, another there, with many years intervening between 
them; each working some isolated strand into the forming 
structure—as it were line upon line, and precept upon precept; 
here a little and there a little, very gradually the science of 
medicine began to take form and to grow. Once securely 
established it has, during the last half century, made advances 
which have far surpassed those of any other period, and to-day 
we look upon it with satisfaction and pride, as bearing the 
relation to medicine as an art which the brain does to the 
members which it controls and directs. 
None but an enthusiast can believe that medicine will ever 
become a pure and exact science. It must ever exist as a com- 
bination of science with art. Without the science to guide 
and instruct it, the art must remain pretty much what it was 
in the ages that have passed. Without the art, the science 
would stand a useless, profitless tissue of speculation. But the 
more completely the art becomes the handmaid of the science, 
the more certain will be its advancement, the more perfect its 
utility. Before we proceed let us pause here and inquire as to 
the true definitions of, and real distinctions which exist between, 
a science and an art. 
I shall use the word “ science ” throughout this address in 
the broadest sense accorded to it by modern lexicographers, 
that which most perfectly distinguishes it from “ art ” and that 
which gives to it its most important and characteristic feature, 14 
dk. tiiomas’ address. 
the acquirement through its instrumentality of knowledge 
which is absolutely certain. Science, derived from “ scio, I 
know,” may be said to consist in absolute, accurate knowledge 
which rests for its certainty upon immutable laws; art consists 
in the application of the precepts of science to a practical end 
or purpose. The end and aim of science is accurate knowledge; 
the function of art is the application of knowledge to the ac- 
complishment of a given end. “A science,” says Whewell, 
“ is a body of principles and deductions to explain the nature of 
some matter. An art is a body of precepts with practical skill 
for the completion of some work. A science teaches us to 
know ; an art, to do. In art, truth is a means to an end; in 
science, it is the only end.” 
As an art then, medicine is so old that it may truly be said 
to be coeval with civilization. As a science it is young, but its 
youth is vigorous, its growth rapid and healthy, and its prospects 
for the future most encouraging. The influences which have 
developed it in this respect in the past are those which are 
likely to do so in the future, and it behooves its well-wishers to 
carefully ascertain and industriously foster them. 
I presume that it will to-day he generally accepted as truth, 
that the most marked feature of modern medicine, and that upon 
which, more than upon any other, has depended its gradual 
elevation from the field of speculation, uncertainty, and hypoth- 
esis, to that of certainty and exactitude, is the tendency to sub- 
ordinate theory to experiment, to require for every dogma a 
demonstration, to push investigation by physical means to the 
utmost degree, and to accept nothing as fact which cannot give 
evidence of truth to the senses of the investigator. To this 
method of investigation, this mode of inquiry, are due these two 
important results: first, the shedding of floods of light upon 
places hitherto dark, obscure, and unfathomable, by subjecting 
them to means of physical exploration which have brought 
them under the influence of sight, hearing, and touch ; second, 
the trampling down of formulas, the defiance of scholasticism, 
the explosion of arbitrary theories, the annihilation of seduc- 
tive dogmas. dr. Thomas’ address. 
15 
Before its adoption the organs of the body were to physi- 
cians like dark caverns with impracticable entrances, and the 
diseases which affected them were subjects for speculations and 
theories, such as only a century ago divided the profession into 
sects under the leadership of Stahl, Haller, Boerhaave, Brown, 
and Cullen. Once established, the day of the medical dreamer, 
who, like the cloistered monk, evolved seductive theories from 
the quietude of his study, passed away immediately and forever. 
The enuneiator of high-sounding dogmas might still flourish 
among the people, for, 
“ Faith, fanatic faith, once wedded fast 
To some dear falsehood, hugs it to the last.” 
But he could no longer take root in medical soil, for exposed 
to the rigid investigation of physical science, brayed in the 
mortar of accurate analysis, his theories were dissolved like the 
baseless fabric of a vision, leaving not a rack behind. 
And more and more as each revolving year adds to our expe- 
rience are the means of physical exploration and inquiry being 
pushed into new and hitherto almost unexplored fields. His 
pathway illuminated by these, the modern investigator, no 
longer groping in the dark like his forefathers, sees clearly into 
the recesses in which lurk disease, and draws his deductions 
from certain premises. 
To physical science medicine is more especially indebted for 
the rapid advances which have marked its career in the century 
in which we live. 
And here let us ask, what is physical science ? To borrow the 
definition given by the most recent writer upon the subject, it is 
that science which “ relies exclusively upon, and is advanced sole- 
ly by means of observation through the senses and experiments 
addressed only to the senses. Here, in its own domain, sense 
reigns paramount and holds undivided sway. Physical science 
recognizes no facts which cannot, directly or indirectly, be made 
evident to sense. All its modes of verifying facts, i. e., of dis- 
cerning the false from the true, are founded, in the last resort, 16 
dk. thomas’ addkess. 
solely upon the testimony of the senses.” * This is the science 
which is forming to-day the corner-stone of medicine, a science 
which often depends so essentially, for the performance of its 
great functions, upon some simple mechanical contrivance, that 
we are in danger of confounding it with an art, and of losing 
sight of its own vast proportions. 
It is wonderful to observe how much has been, in many 
instances, effected for the advance of a science by the invention 
of .some instrument, mechanical contrivance, or plan for phy- 
sical exploration and demonstration. Two of the most striking 
of these are to be found in the mariner’s compass and the tele- 
scope, but there are many others scarcely less remarkable. 
Without the former, navigation, conducted by observation of 
the stars, must forever have remained an insignificant art, and 
worlds would have existed unknown and unsought for. Be- 
fore the discovery of the latter, the astrologers, who pondered 
through the nights in vain contemplation and fruitless study of 
the celestial orbs, drawing horoscopes and predicting destinies, 
dominated science with their senseless babblings. But the far- 
discerning and exact instrument soon scattered them to the 
four winds of Heaven, and obliterated their influence and 
teachings, as the sun clears up the mists from the earth’s surface. 
And liow multiform and various are the collateral advan- 
tages which flow from a discovery or invention which would at 
first sight seem to have no influence upon an improvement 
which follows it! It is certain that no sanitary laws, no 
hygienic enactment, no individual or national efforts could ever 
have done so much for the extinction of those desolating epi- 
demics which formerly spread over Europe, as the invention of 
gunpowder has accomplished. While cities were defended and 
taken by hand to hand fighting, streets were made narrow and 
tortuous, the houses which bordered them were constructed 
high and overhanging, each one being a vantage ground for 
attack and defence, and from the dark and dismal and reeking 
byways the sun, with its vivifying and antiseptic rays, was ban- 
ished almost completely. Here the germs of pestilence met 
* Bowen’s “ Modern Philosophy.” DR. THOMAS’ ADDRESS. 
17 
with congenial soil, and grew with vigor. But the “ vile salt- 
petre” compound which cast pellets of iron over wall and 
moat, over bastion and drawbridge, sending destruction from 
afar, rendered all this worse than useless, and induced the con- 
structors of cities to admit the light and air to every by-way 
and alley. 
The three great events, which have just been referred to, did 
more than aught besides to establish medicine as a science; but 
they did even more than this, they prepared the way for great 
results by opening new channels and indoctrinating new meth- 
ods of thought and inquiry in the medical mind. 
How often do we lose sight of the educational influences 
exerted by great discoveries; of the moulding of minds and 
generation of ideas which they accomplish! IIow different the 
standard by which we should judge those who lived after the 
events which we have just noted from that which applies with 
justice to those who existed before them ! Among the ancient 
Egyptians it was firmly believed that the heart yearly increased 
in weight at the rate of two drachms until the age of fifty, 
when it steadily decreased in the same proportion. Every day 
thousands of dead bodies were opened and embalmed by men 
who could not but have had skill, intelligence, and curiosity; 
yet no one seems to have thought of applying to this arbitrary 
theory the test of examination by weight, sight, and touch! 
We can look with leniency upon such unquestioning credulity 
in minds undeveloped by the great discoveries of modern times; 
but it became impossible after the new methods of thought to 
which they gave rise. 
During the seventeenth and eighteenth centuries these influ- 
ences were felt, but it was not until the nineteenth that rapid 
and certain advances were made in the same direction. One 
of the most important of these was the discovery of ausculta- 
tion and percussion for the elucidation of diseases of the lungs 
and heart. Before the discovery of these means, hap-hazard 
reasoning and conjecture marked the diagnosis of the diseases 
of those organs; after it, all became certain and precise. No 
longer did the physician judge of their condition by the pulse, 18 
dr. tiiomas’ address. 
tongue, and rational signs which were well calculated to mis- 
lead. His sense of hearing came to his aid with all its dis- 
criminating powers. 
And now with great rapidity we passed out of darkness into 
the light with reference to other organs. The ophthalmoscope, 
like the electric light illuminating buried hulks far down in the 
depths of the sea, made clear the deep tissues of the eye, showed 
the oculist the little blood-clots upon the retina, and the broken 
vessels from which they had escaped. The laryngoscope threw 
bright rays into the dark nooks within the larynx and enabled 
the operator by.its light to see and remove little polypi, the 
very existence of which could not have been suspected other- 
wise. The speculum uteri opened the way to a proper study 
of the diseases of the womb and to a new field of pathology 
and treatment; and more recently still the sphygmograph 
offers itself as an exact method of recording the regularity and 
force of the pulse; and the spectroscope as a means of testing, 
by a most delicate process, the fluids of the body. 
All these I have mentioned as examples of exact methods of 
investigation which have been stimulated and greatly fostered 
by the invention of some instrument. Two instances of exact 
methods not having this source are those which in our day are 
accomplishing so much good, and which are themselves making 
such rapid advances—medical chemistry and experimental phy- 
siology. The first, by examinations of the blood, the solid tissues 
and the excreta, is lending great aid to the physician. The 
second, in spite of that maudlin pseudo-philanthropy which 
decries it, in defiance of the sickly sentimentality which would 
hamper it, is doing more for the advancement of physiology, 
and therefore of medicine at large, than centuries of reasoning 
and speculation have accomplished. 
Upon no department of medicine have exact methods of 
study excited a more beneficial influence than upon obstetrics. 
A hundred years ago obstetrics was an art alone. It could lay 
no claim to the name of science. Practised ever since the times 
of the Egyptian and Jewish midwives, entrusted to the hands of 
those who should have advanced it during the Greek, the Ro- dr. Thomas’ address. 
19 
man, and the Arabian civilizations, taken from their hands with 
what of the added precepts of ages had been preserved in the 
meagre literature of those times, it went onward to the middle 
of the eighteenth century, almost a mechanic art, unilluminated 
by the light of science, uncertain in all that related to scientific 
deduction. In the last quarter of the eighteenth century there 
arose a man, who simply availing himself of the means which 
had for thousands of years been at the disposal of all who had 
preceded him, means which, it is extraordinary to think, did 
not enlighten the Egyptian embalmers, opened the way to 
scientific investigation for those who should succeed him. Be- 
fore his time men had speculated as to the gravid uterus and its 
contents. After it speculation was replaced by certainty de- 
pending upon ocular demonstration. The work of William 
Hunter upon the gravid uterus is the corner-stone of obstetrics. 
So simple the method, so grand the result, that there may be 
many here to-night w’ho wonder that it was left for Hunter to 
develop. But have not you and I, almost within the last decade, 
been as much at fault as were his predecessors and contem- 
poraries? Have wTe not sat hour after hour, day after day by 
the bedsides of patients, theorizing and guessing like empirics 
at the degree of fever from which our patient suffered, while 
in the same room hung a thermometer which would not only 
have made speculation certainty, but would have told us with 
almost equal certainty that the life over which we watched 
would pretty surely be soon extinct ? Had we but thought of 
this, how much of science would have been]developed to guide 
us as to prognosis and general management! But the sugges- 
tive thought did not arise, and hence we did not make one of 
the most important discoveries which has enriched modern 
medicine and done a vast deal towards making it a science. 
Much lias already been done, but much more remains to be 
accomplished. How broad are the fields which are open to 
investigation ; how numerous the instances in which profit, and 
honor, and renown await the successful inquirer. We have no 
reason to doubt that the children of the Pharaohs staggered and 
gasped under the spasms of whooping-cough long before the 20 
dr. Thomas’ address. 
pyramids were erected. This singular affection has been a 
household pest ever since, and many a little grave has been 
tenanted by its influence. Yet what do you or I know more 
than the old Egyptian magi did of its etiology, pathology, or 
even its specific treatment ? I see a score of practitioners eager 
to rise and contest the last assertion. But alas, they would rise to 
defend the claims not of one but of twenty specifics—of prussic 
acid, of quinine, of belladonna, of chloral, of chestnut leaves, 
and of a host of others whose very number proves our poverty 
of resources. And is it otherwise with Asiatic cholera, with 
yellow fever, and a long list of other diseases ? 
I think that I almost hear a whisper to the effect that the 
therapeutical department of medicine, owing to the different 
results produced by the same drug upon different constitutions, 
must ever remain, to a great extent, empirical. Granted : but 
is it not equally true that the surest method by which an ex- 
act and scientific therapeusis will be reached is through the 
scientific study of the disease to be treated ? A few years ago, 
all with reference to the treatment of epilepsy was surrounded 
with doubt and empiricism. To-day, thanks to the careful 
study and research of Brown-Sequard, we are able to check the 
violence of the disorder, to keep it within limits in most 
cases, even to cure it in some. It is most true that this result 
might have been arrived at empirically, as mercury was 
adopted in the treatment of syphilis, and quinine in that of ma- 
larial fever. But the truth that empiricism and not science has 
so long guided us in therapeutics, probably accounts for the un- 
deniable fact that so few specifics exist in medicine to-day. 
Having mentioned mercury and the iodides in syphilis, cin- 
chona and its principles in malarial fevers, the bromides in 
epilepsy, and the chlorate of potash in stomatitis, our enumera- 
tion is completed. Two thousand years and more have elapsed 
since the days of Hippocrates ; two thousand years should have 
given us a longer list than this. But during two thousand 
years medicine was an empirical art; as a science, who can 
doubt that its results, even in the next half-century, will be far 
more prolific than they have been in the whole long past ? dr. Thomas’ address. 
21 
It is not, however, in the discovery of specifics for different 
maladies that we must chiefly hope for great results from sci- 
entific medicine. It is in the prevention, the intimate knowl- 
edge, and the general management of disease. Let me illus- 
trate this remark by a reference to one disorder—phlegmasia 
alba dolens. When, as in the olden time, this affection was re- 
garded as a metastasis of milk, and at a later period as an acute 
post-partum inflammation, we can, from our present standpoint, 
readily perceive how a variety of erroneous, empirical, and even 
absolutely injurious treatment was adopted for it. But, in time, 
science intervened and illuminated the pathology of the subject 
with her pure and certain rays. It was discovered that those 
events of inflammation, the “ tumor, calor, dolor,1’ of the old 
writers, all existed as consequences of a coagulation of blood 
in the large veins of the leg, where they enter the pelvis and 
inosculate with veins connected with the uterus. Here then 
was a condition due in part to an inflammation occurring in the 
inner coats of the veins, and in part to the condition of hyperi- 
nosis, which characterizes the blood state of pregnancy. Even 
to the most brilliant intellect this knowledge would offer no 
suggestion of specific treatment, but even to the dullest it 
would say, in terms too plain to be misunderstood: leeching, 
and blistering, and rubbing cannot remove a hard and obstruct- 
ing blood-clot from the vein which it closes; they cannot estab- 
lish circulation in the limb which is swollen by dammed up 
fluids. Perfect rest, relief of pain by opiates and fomentations, 
sustaining the system by careful feeding, and the use of tonics, 
like quinine and its salts, restoring the depraved blood to its 
normal state by iron, lime, etc., and standing the siege of dis- 
ease till time shall raise it, is the only method of meeting and 
counteracting the difficulty which common sense points out. 
The intervention of science here accomplishes two important 
ends : First, it stops the abstraction of blood from a system al- 
ready suffering from hyperinosis, which blood-letting increases, 
and prevents the teasing of an already exhausted nervous 
system by friction, blistering, and other similar disturbing agen- 
cies ; second, it prevents sensible men from tampering with 22 
dr. thomas’ address. 
their patients by trying those specifics which the shallow enthu- 
siasts of our body are eternally shouting that they have dis- 
covered. 
See, too, how much modern pathology, under the guidance 
of the microscope and of medical chemistry, has accomplished 
in the disease now known as septicaemia. A collection of 
symptoms not long ago grouped together under one head, and 
attributed vaguely and arbitrarily to a condition styled inflam- 
mation, are now thoroughly analyzed and fully appreciated. 
Pathology has annihilated the phrase inflammation in such cases 
as completely as did the perfected balance in chemistry destroy 
the old and apparently impregnable “ phlogistic ” theory. 
Are there any lessons which this examination of the forces, 
which have in the past been instrumental in advancing medi- 
cine, may teach us ? Is there any moral to the tale which has 
been told ? It is to be found in this formula: In the past 
medicine has gradually advanced from an art to a science 
through the adoption of means which render all theory subor- 
dinate to physical demonstration, which “ recognize no facts 
which cannot, directly or indirectly, be made evident to sense;” 
and as it was in the past so will it certainly be in the future. 
Exact methods of study, physical exploration, physical demon- 
stration, are the only sources from which reliable deductions 
can be drawn. 
These are the influences which have thus far given to medi- 
cine its character as a science; these the processes of thought 
and inquiry which will perfect that character in the future; 
these the methods which we should ourselves pursue and instil 
into the minds of those who go forth from our schools to take 
their places in the ranks of our profession. At this moment 
thousands of able and devoted men are in various parts of the 
world striving, by an earnest application of physical science, to 
elevate medicine to a higher scientific standard, and wherever 
you see this endeavor most determinedly followed, there you 
see the nearest approximation to success. The thoughtful, 
honest, painstaking, and persevering students of Germany have 
in our day placed that country in advance of all others in scien- DR. THOMAS’ ADDRESS. 
23 
tific medicine. And why ? Because these are their methods of 
study, these their means of inquiry in laboratory and at the 
bedside. In purely scientific medicine, though in naught be- 
sides, America stands far behind her European sisters. And 
again let me ask why? Because Americans work too exclu- 
sively for the attainment of the practical and utilitarian in 
medicine ; too much for medicine as an art, too little for medi- 
cine as a science. Far be it from any American to ignore or 
undervalue the scientific contributions of his country. They 
need not be enumerated here, for they are duly recorded in the 
annals of a profession which never forgets honest and deserving 
labor. In comparison, however, with her contributions to the 
art, those which she has made to the science are disproportion- 
ately small. America boasts with pardonable pride to-day of 
McDowell, of Mott, of Wells, and of Sims, who have given the 
most original and important discoveries to medicine as an art; 
but her Harvey, her Lavoisier, her Yirchow, and her Graefe, 
remain yet hidden in the womb of time. 
The day has surely come when a country which has done so 
much for the art of medicine should do proportionately more 
for the science ; when men should arise who are willing to de- 
vote their lives to the search after truth; not as a means by 
which to coin gold and achieve position, but after truth for its 
own sake. That many such men will live amongst us in the 
future we all hope and believe. That many have lived in the 
past who has the hardihood to maintain ? 
If the premises which I offer you, and the deductions which 
I draw from them be correct, it becomes evident that the road 
to improvement and to national progress lies clearly open 
before us. Let us strive to place upon it the young men who 
are just devoting themselves to medicine by giving a proper 
direction to their labors and energies, and let this Academy 
recognize as one of its highest functions the duty of being 
prominent in this good work. Train the young practitioner in 
the very commencement of his career, not how to gain and 
hold a large practice; but how to study the diseased condi- 
tions with which he will meet; instil into his mind the habit 24 
dr. Thomas’ address. 
of so doing, and the surest blow will be struck at the root of 
our weakness. We may calculate with entire confidence upon 
the intelligence and devotion of the young physicians of 
America. The duty of the hour is to encourage, incite, and 
direct their willing hands to the most effectual method of ac- 
complishing the desired end. 
Of late we hear a great deal said about the advisability of 
increasing the length of college terms, of requiring fuller pre- 
paratory study, and of establishing more rigid examination in 
our schools. That these reforms would prove of value no one 
can doubt, but there are others which are equally needed. 
No more industrious, active, and ambitious class exists amongst 
us to-day than the medical students of the United States. 
If the curriculum of medical studies sends them forth super- 
ficial and unscientific practitioners, the fault is not theirs. It 
is we, their teachers, we who are wanting in our duties, we 
who fail in making them what they should be, through the 
inefficiency of our methods of training and instruction. Let 
the axe of reform be laid at the root, and not used upon the 
branches of the tree, if any great results are aimed at. Let us 
teach our students more in the laboratory and at the bedside, 
and less in the didactics of the lecture room. Let us teach 
them rather how to study disease by the aid of all the exact 
methods at our disposal, than fill their minds with the teach- 
ings of books. Lotus make them work and observe; let us 
inspire them with a spirit of personal inquiry, and incite them 
to personal investigations rather than send them forth, their 
brains teeming with multiform theories, their memories over- 
loaded with a mass of crude material poured into them from 
the rostrum of the lecture room. 
America lias learned many a lesson from Europe, and often 
lias she returned it with interest to those who gave. Let her 
but learn this one, and, in the words of Shylock, she will surely 
ere long be able to say, 
‘1 It shall go hard, 
But I will better the instruction. ”