r^t: VVIW5T0W f ETve ADDRESSES DELIVERED BY PROFESSORS WINSTON AND EVE, AT THE OPENING OF THE MEDICAL DEPARTMENT UNIVERSITY OF NASHVILLE, OX THE Third day of November^ .1851. •ARV NASHVILLE: EASTMAN, HOVERS & CO., JOB PRINTEKS, AMERICAN OFFICE. 1851. ^tftg^-ertD ojia—eu* i z ADDRESSES DELIVERED BY / PROFESSORS WINSTON AND EVE, AT THE OPENING OF THE MEDICAL DEPARTMENT OF THE UNiyERSITY OF NASHVILLE, 4 ( Third day of November, /l8fcl. NASHVILLE: EASTMAN, BOYERS & CO., JOB PRINTERS, AMERICAN OFFICE, 18 51. OORREBPoNOENOE Prof. C. K. Winston, M. D.: Sir : — At a meeting of the students of the " Medical Department of the University of Nashville," held this day, it was unanimously resolved that a committee of seven be appointed to request a copy, for publication, of your very able, eloquent, and appro- priate address, delivered on yesterday, introductory to the first regular course of Lectures in the medical department, and the committee earnestly hope that you will accede to the unanimous request of the class whom they have the honor to represent. Very respectfully, W. S. POSEY, W. H. PILCHER, JNO. D. WOODS, E. E. SPENCER, J. S. DIXON, S. H. MITCHELL, T. B.TROTMAN, Committee. Nashville, Nov. 4th, 1851. To Messrs. Posey, Pilcher, and others : Gentlemen : — Your note of this day, asking my intro- ductory address for publication, has been received. Permit me to say that it is at your disposal. You will receive for yourselves, as well as for those you represent, my warmest thanks for the complimentary manner in which you are pleased to refer to my effort on that occa- sion. Yours truly, CHA'S K. WINSTON. Nashville, Nov. 4th, 1851. AN ADDRESS DELIVERED BY CHARLES K. WINSTON, M. D., Professor of Materia Medica and Therapeutics. AT THE OPENING OF THE MEDICAL DEPARTMENT OF THE UNIVERSITY OF NASHVILLE, November 3d, 1851« Ladies and Gentlemen: I appear before you, to-day, for the purpose of deliver- ing an address, introductory, to the first course of lectures to be given in the Medical Department of the University of Nashville. I stand, on this occasion, as the represen- tive of my colleagues, who, though proud of the confidence reposed in them, tremble under the obligations which they have assumed. In their behalf, I am permitted to refer to those enlightened and honorable men, on the one hand, whose public spirit and humanity laid the foundations of an institution which I trust will bless other ages; and on the other to those enterprising gentlemen by whose liber- ality we have been enabled to rear these walls, hence- forth dedicated to the cultivation of medical science. I am proud to live at such a time, and and amongst such men : men who believe in the supremacy of science, even medical science; and whose purses cheerfully respond to the calls of its votaries. To the Trustees, then, of the University of Nashville, to the individual benefactors of this institution, I, in behalf of my colleagues, extend my profound acknowledgements. You, in my humble opinion, have done a good work, a work which will stand upon the 0 record to the latent time. You have established a seat of medical learning, and if those to whom you have commit- ted it be men of science, if they be worshippers of the true altar, and have drunk in the spirit of a benign and heav- enly calling, if they make use of the means and appliances so bountifully placed at their disposal, for the establishment of a sound medical philosophy, and a noble professional bearing, then will you receive a full mede for your sacrifi- ces and confidence, whilst other generations will rise up and call you blessed. Medical science is a subject of vast interest to us all. For however much it may be under the ban of derision in the minds of some, however odium like a thick cloud may rest upon it, in the hour of pain and anguish, when " the pestilence walketh in darkness, and destruction wasteth at noonday," it constitutes the palladium of our hopes. Men, in the present state, are compound creatures. They are invested with a spiritual and physical nature, both imperfect, and assailed by a thousand foes. The gospel, on the one hand, with its spiritual provisions, is the all suffi- cient remedy; on the other, medicine with its rich and va- ried stores, is the only hope, the only defence. From the earliest records of our race, the priest and and the physi- cian have been appealed to, to prevent or destroy our com- mon enemies. At first the sufferings and pains of men were assuaged by an appeal to the crude materials prepa- red by the hand of nature. A traditional system of medi- cine was established by experience, without regard to the elementary composition of remedies, their modes of ope- ration, or to special pathology, and handed down from gen- eration to generation. It belongs, however, to modern times to have established medicine more fully as a science, and to have enriched it with those great principles and truths which now command the respect and admiration of mankind. Medicine is specially and rapidly progressive. It knows no stopping point. From its very nature it must go on to perfection. How long haa it been since the cir- 7 culation of the blood was detected ? In our libraries now, there are books which talk of canker, of phlegm, of a thousand ideal, hypothetical diseased conditions. And in our school boy days we used to read of fire, air, earth and water as the four elements of philosophy. Now, minute dissection of the human body is the every day employment of the physician. He talks of bone, tendon, muscle, blood vessel and nerve, with easy familiarity—speaks of irri- tation and inflammation, of secretion and absorption, with flippancy—calls to his aid the microscope, and observes the minute operations of composition and decomposition— enters the laboratory, grapples with essences, and atomi- zes nature from the molusk to man — nor ceases in his progress until all her kingdoms are subsidized to the uses of suffering humanity. Men are born with no innate ideas. All the knowledge they possess is derived. From the smallest spear of grass which grows upon the distant mountain top, from the tini- est flower which unfolds it beauty in the remotest valley, to the most gorgeous productions of the field or the forest; from the minutest insect which creeps upon the earth or swims in the sea, to the huge mastodon, or proud leviathan, all is mystery. Nor is this mystery revealed, except by close investigation, and a careful classification and arrange- ment of facts and phenomena. These constitute the basis of science; they are, indeed, science itself. There are some facts which are self-evident; truths which the mind perceives without an effort, and to which the judgement assents without a struggle ; such, for instance, as that two and two make four, that two parallel lines can never cross each other, that the parts are equal to the whole. By far the larger proportion of facts, however, are intricate, are beyond the reach of ordinary reason. They require the mo^st patient research, they must be ferretted out. In no department of human investigation is this more requi- site than in a physical science like that of medicine. In other departments ignorance may cause loss and inconve- 8 nience, may jeopard our property, or interrupt our ease, but ia this, ignorance overthrows our health, or lays us in the grave. Sooner or later we shall all come under the force of medical agents ; and it is of the highest conse- quence to us, that those who medicate our bodies should understand the laws, so far as they may be known, which govern the organism in health and disease, as well as the modus operandi of the medicines which are adapted to the preservation of the one and the removal of the other.— How fearful is the position of that man who falls into the hands of the quack ! For however much we may doubt the advantage of the educated physician over no physician at all, the difference between a good physician and the ig- norant pretender is immeasurable. Upon this point, the public mind is not informed. And hence the newspapers are filled with the publication of nostrums, endorsed by the certificates of distinguished men, subscribed in their own hands, and the brainless charlatan elevates his serpentine crest at every cross road, There is no mechanism in the Universe so complicate as that of man. After the creative hand had been educated, had tried itself, in the production of grass, and herb, and flower; after the water had been separated from the dry land ; after.the stars had been set in the beautiful concave above, and the sun established in the heavens; after the fowls of the air, the beasts, of the field, and fishes of the sea had been formed, that wonderful structure, the human body, invested with' an immortal spirit, and controlled by a thousand recondite laws, was brought forth. And yet, a foolish, ignorant man, a seventh son, who cannot give one single intelligent idea in regard to the organization of bird or beast, is called upon to set in tune a harp of a thousand strings. Wonderful infatuation! But how shall this evil be overcome ? Perhaps it cannot be entirely. And it cer- tainly cannot be by vilifying quacks and quackery. Not by bulls of excommunication ; not by requiring evidences of qualification; nor yet by statutes flaming with penal 9 sanctions. Ours is a free country, and men have a right to choose the mode of death. Quackery is a sort of necessary evil, it is the legitimate offspring of ignorance, and can only be abridged by eleva- ting the standard of medicine, and disseminating a correct public sentiment. By elevating the standard of medicine, I do not mean, so much, that the elementary requirements should be en- larged, or that the period of pupilage should be lengthened; these, perhaps, are already sufficient. But I do mean, that medicine should be divested of that superstition and myste- ry in which it has been, from time immemorial, enshrouded to the common mind, and which, at the present day, is perpetuated by many qualified doctors. Truth, when dimly seen, may have a spectre form, but when fully dis- covered, when fully observed, is of fair proportion!! and ex- ceedingly simple. As simple in medicine, and as explica- ble, as in mechanics or the arts. And yet, how few physi- cians seek to bring its laws and practical details up to the touchstone of common reason, of common sense. When I go into a sick room, with a knowledge of my own com- parative ignorance, with a knowledge of the vast fields hitherto unsubjected to satisfactory investigation, why should I put on an air of such wonderful sagacity ? When I feel the pulse, when I examine the tongue and interrogate the various symptoms, why should I seek to establish the idea, that I have, with astonishing perception, penetrated the economy and perceived disease as it eits embodied, atomic, in some distant nervous radicle or billious pore ? And why do I say my patient has hydrothorax, when I might say he has a collection of water in the chest; or that he has gastretis instead of inflammation of the stomach? And why do I say give a potion of oleum riceni, instead of a dose of castor oil ? All such procedure but degrades my profession. It drags it down from its lofty position, and paves the way for the quack. Why should I seek to smother a rational science with untimely technicalities, 2 10 and to cover its practice with mystery ? If I would ex- plain to my patient the character of his disease in sim- ple language ; if I would tell him what medicine I pro- posed to give, and what would be its effect, when the curs was effected he would be satisfied that I understood my business ; he would see that the result had been accom- plished by rational means, and his confidence would be rivited. He would regard me as a safe, intelligent practi- tioner. Whereas, if I made no such explanation, he might conclude that the end had been secured by a sort of hocus pocus, and like a worshiper of Delphos, regard me with superstitious awe and reverence. He might attribute to me qualifications and powers to which I had no claim. I should, really, in such a case, stand upon the same plat- form with the quack, because I had given him no means of judging of the difference. There are, then, two methods, and only two, as I have said, by which medicine can be placed upon its true basis, and all others should be discountenanced. The one is the improvement of the intelligence of the people, the other is the proper elevation and enlightenment of the medical mind. The one is accomplished by the general diffusion of learning, the other by the establishment of medical schools, in which shall be taught, thoroughly, the principles of med- ical science, and sound medical ethics. Until those two things are brought about, we shall fret ourselves in vain at the prevalence of quackery. Quackery is deception, fraud, and it cannot flourish in an intelligent community. In large cities there will be found more ignorance than any where else, and hence, cities swarm with quacks. In intelligent country places a quack cannot live by his profession. No intelligent man will employ an ignorant pretender any length of time. In our vicinity, a pretender with a large reputation happened to be called in, to one of our intelligent neighbors, as he was passing along, to see a sick child. The gentleman was out; but the doctor communicated to the mother the alarm- 11 nig condition of the child. He wrote out a prescription for the apothecary. The gentleman upon his arrival heard of the dangerous condition of his child, with alarm ; put the prescription in his pocket, and started to town. When he arrived he thought he would look at the prescription, and read as follows: "mr -----, will git at the potecary three dost calemy and give on evy three hour in serup, Yours as ever. -----M D." He tore up the recipe and invited a physician to see his family. And this would be the case in every instance if individuls had the means of judging, which is alone intelli- gence. There are some intelligent men, it is true, in every community, who, from obstinacy, or to be regarded as singular, seem to delight in the support of quacks. They are exceptions to the rule. But as it is not my intention to discuss this branch of the subject, I shall proceed to the other. The importance of medical schools has the sanction of time and wisdom. Gentlemen who design pursuing the profession, here find means and appliances for the acqui- sition of knowledge, which exist no where else. Whatever may be the information derived in the shops of laborious practioners of medicine, it certainly falls far short of that which is obtained in a thoroughly organized medical school. Upon this point there is no difference of opinion. The true question before us is the propriety of the establishment of a medical school in the city of Nashville. To this there are objections, which I shall now briefly notice. The first objection is of a general character, and is the impolicy of the multiplication of medical schools. It is contended that there already exist enough, if not too many medical schools, and that it would be best to elevate, and sustain better those already in existence. In making this objection, individuals forget that we live in a free country, where all men are competitor?, and where the necessity of a thing is regulated by the supply and demand. We may expect to see medical schools arise in every portion of our 12 country, if there be materials for their support. Of the great number, now in existence, by far the larger proportion are sustaining themselves handsomely. It is said, how- ever, that the multiplication of medical schools cheapens the acqusition of medical learning, and stimulates many to embark in the profession, who, otherwise, would direct their attention to other objects. This is, no doubt, true. But is it any objection to medical learning that it is cheap? And may not this additional number, who engage in the profession, but increase the facilities of the people, enlarge the boundaries of usefulness, and add strength to the sci- ence ? Who ever yet objected to the multiplication of acadamies upon this ground? And what if the whole community were instructed in the principles of medicine. I imagine that this objection will be found to be predi- cated either upon a want of reflection, or that an increase of doctors might perhaps interfere with those already enga- ged in the practice. I am almost prepared to say that the objection is founded upon selfishness. Who ever yet ob- jected to an increase of artizans and mechanics, but arti- zans and mechanics themselves? And who objects to a multiplication of medical schools, but medical schools and doctors ? But suppose we had the statutary power to fix the number of medical schools in the United States, does it follow that medical science would be elevated, or that the sum of medical skill and efficiency would be augmented by such policy ? By no means. I am of the opinion that such a course would check the progress of medical science. The teachers would become haughty and dictatorial, and medical men would arrogate to themselves an exclusive- ness altogether opposed to progress. There are, however, particular objections to the estab- lishment of a medical school in Nashville. These may be embraced under the general idea that the science of medi- cine cannot be as thoroughly taught in Nashville as at other points. If this objection be well founded, every friend of humanity should oppose it to the extent of his 13 ability. It certainly would be wrong to hold out a tempt- ation to those who are entering upon an honorable and responsible profession, to avail themselves of defective opportunities and means, when those altogether superior are entirely within their reach. I contend that medicine can be as thoroughly taught, and in some respects and for some purposes, more tho- roughly taught here than in any portion of the United States. This declaration may be startling, I do not say that the professors in the medical school at Nashville can teach medicine as well as others ; that is to be judged of hereafter. But I am prepared to show that with the right men, medicine, in all its various departments, can be as thoroughly taught here as any where else. I know, ladies and gentlemen, that the sun rises in the east, that there he first dispels the gloom and mists of night; but it should always be remembered that he reserves his more gorgeous beams to be poured in a flood upon the west. An elementary fact ascertained, a phenomenon observed, may be as thoroughly taught, as firmly impressed upon the mind of the pupil in Nashville, as in Philadelphia or New York. Medical science is made up, as I have intimated, of facts and phenomena classified and arranged, and these stand in connection with various departments, the great substratum of which is human anatomy, which teaches the minute construction of the human body. Now, I would enquire, whether this department cannot be as thoroughly taught in Nashville as at any other point. The climate is suitable, the material is abundant, and there is no restraint upon investigation. The nerves, blood vessels, lymphates, bones, and muscles may be as minutely observed, and as thoroughly studied. A pupil, in Nashville, will find all the advantages for the study of anatomy which he could desire. It is contended that, however true this may be of anatomy and some other departments, the practical branches, can- not be taught without the intervention of large hospitals. I am ready to admit the value and importance of hospi- 14 tals to human life, as well as to medical science. But their importance to medical students, I contend, is greatly ex- aggerated. All the announcements, issued from the large cities, lay great stress upon their hospital advantages ; and yet, not one half of the students take the hospital ticket, and those who do, frankly acknowledge that they lose more than they gain by the time consumed in this way. The fact is, a medical student who listens to five or six lectures a day, has but little time to devote to hospital lectures.— And if he should, what does he gain by it? He passes along the wards with the preceptor,hears his interrogatories, and observes, as far as he can, the evidences of diseased action, as well as its treatment. But all this is indefinite and unsatisfactory. And then, the character of disease, as well as the mode of treatment, is altogether different from that which he will meet in ordinary practice. The same thing, to a great extent, is true of surgical cliniques established in connection with hospitals. The operations which are there performed, may excite the ad- miration and curiosity of the pupil. They may magnify and extend the celebrity of the operator—they greatly in- crease his skill. But do they really add to the surgical skill of the student? Is not the more substantial knowledge de- rived from actual operations upon the dead subject? Cer- tainly it is, so far as medical teaching in the proper sense is concerned. There is, if I may so speak, academic medi- cine, and practical medicine. The one is taught in the shops and schools, the other is derived from actual observa- tion in regular practice. The mere witnessing of opera- tions can no more teach men surgery than the beholding of a smoothly gliding ship can teach the art of navigation. You may behold a thousand arms amputated, or as many arteries tied; but yet, until you have actully performed those operations, you must be more or less embarrassed. And when you are called upon, years after you have wit- nessed operations, to operate yourself, will you rely upon the knowledege then derived? Will you not on such oc- 15 casions refer to the authorities? Will you not carefully read over all the minutia in connection with such cases. Why, this is true of the most distinguished surgeons. They always refresh their memories by a particular exam- ination of the authorities, upon all important occasions. The basis of surgery is anatomy. When this is thoroughly understood, and the relations of parts are firmly impressed upon the mind ; when you have become expert in the use of the knife, from long experience in dissection ; when you have performed, again and again, all the operations upon the dead subject, you will be very nearly as well qualified to practice surgery as if you had witnessed a thousand oper- ations in the college clinique. The most which is required, after the acquisition of such knowledge, to become safe and expert surgeons, is practice. But of what value then are hospitals ? I answer, much, every way. In the first place, they are hospitable retreats for the wounded and diseased. And in the second place, they afford so much material to the practitioner, as to ren- der him exceedingly skilful. And, in the third place, they are the most prolific source of medical facts. The rapid progress of medicine and surgery, of late years, is to be at- tributed, more to the well appointed hospitals of Europe and the United States than to all other causes combined.— And yet, for the purpose of teaching medicine according to the American system, or as I have described it, they are of comparatively little consequence. In fact, the time spent in them might be almost as profitably employed in method- ical reading, or positive anatomical investigations. To the objection that Lexington had no hospitals, Dr. Caldwell, endorsed by Dr. Yandell, replies: [Med. Jour. Vol. 1, No. 3, pp. 441,] " Medical students have no leisure, during the two courses of lectures usually attended, to profit by hospitals. The diseases of such institutions are mainly of a chronic character, and beyond the reach of medicine. A large class cannot surround the bed of a pa- tient, to make the examinations which are instructive, and 16 the plan of attending to the patients in them, with nurses, etc., is too expensive for- country practice, the only kind that we in the west have much to do with." For these reasons, says Dr. Yandell, and we think with him, he con- siders the advantages of hospitals to medical students at- tending but two courses of lectures, (as is common in this country,) four months each year, nominal merely, and not real. But, after all, if hospitals are thought to be so important, we shall have, in Nashville, as many hospital cases as young men would care to see. We already have a hospi- tal, which we hope to see enlarged this winter. Having, thus, alluded to some of the principal objections to the establishment of a medical school in Nashville, (for I take it for granted that no one will doubt our ability to get here as fine anatomical preparations, drawings, models, apavatus, etc., as can be obtained at any other point what- ever,) I shall proceed to show some reasons for it. In the first place, if the United States were entitled to a definite number of medical schools, Nashville should have one of those. It is the centre of one of the most impor- tant commercial basins in the Union. A railroad to Chattanooga, one to Mobile, another to New Madrid, to Henderson and Louisville, and Nashville will control an area of from two to four hundred miles in diameter. Al- though but small now, with a population of 17,000, the day is not very distant when an hundred spires will kiss the clouds, when the shrill notes of the steam whistle, sustained by the bass of the foundry, when the rattling of drays and the rumbling of carriages, added to the music of spindles, shall greet our ears from " early morn to dewy eve." Here will be congregated the refined and intelligent of our own and other states. Here will be established manufacturing and commercial depots ; courts of judicature will hold their sessions ; legislatures will convene, and all the transactions of a magnanimous people, and a proud commonwealth, calculated to polish, refine and enlighten, will be continu- 17 ally passing in review, before the eyes of those who come here to seek a medical education. The rapid influx of population, together with the casualties ensuing from an increase of machinery, and rapidity of locomotion, will afford ample material for hospitals ; while the urbanity and chivalry of our citizens will suit the tastes, and meet the desires of those who have been reared beneath southern skies. Being easy of access, in every direction, in the midst of one of the most productive, healthful, and beauti- ful regions, it seems especially designated by the hand of nature, as well as of enterprise, as a seat of learning. Besides, there is no other place that can come in compe- tition with Nashville as a place for medical instruction, which is not already in competition with her. There are two schools at Cincinnati, two at Louisville, two at St. Louis, three, (I believe,) at Memphis, one at Augusta, and one at Lexington; and what is a little remarkable, all these schools, which are in full operation, are quite successful. Tennessee itself sends more than two hundred students annually to medical schools, and Nashville is of right en- titled to a large proportion of these. We ought to educate our own children, ought to sustain our own institutions, of whatever kind. We should not be forever tributary to those who eat up our substance and then " turn and rend us."* Who take our money, and then pour contempt upon our institutions, and cover our names with infamy. Again, Nashville is one of the most healthful points in the union. It is almost entirely exempt from serious epidem- ics. Since my residence, a period of ten years, we have rarely been alarmed by any disease, except the cholera, which defies all laws, and evades all investigation. In the winter season, especially, it will be a safe and pleas- ant abode for those raised in the north and west, as well as the south. It is a fact worthy of serious consideration, that many of our brightest and most promising young men fall * Note.__No allusion is here made to the medical faculty, or medi- cal institutions of the north. Far from it. 3 18 victims to pulmonary and other affections, incident upon a residence in cold climates, every winter; in New York and Philadelphia, for instance. I can now call to mind several melancholy instances. Nothing is more hazaradous than for a young man of delicate constitution to brave the snows and ice of a northern region, while he is compelled to adopt the sedentary habits, and undergo the mental fatigue of a medical student. Here, however, there is no danger. He will be fanned by the same balmy air, and warmed by the same genial sun which he left behind. His cheek will be mantled with the flush of health, and in the spring he will return to his home, improved and invigorated by study, to enter upon the joyous pathway of life. Besides, no young man should be placed where he could not have access to refined, intelligent society, especially female society. Nothing is more necessary to give elegance and tone to the manners, to impart self-respect, and to in- flame the soul with a noble ambition. I do not care how studious a man may be, he should never fail, at proper in- tervals, to refresh himself with the society of the intelli- gent and virtuous. I do not say that he should become a gallant, or fall too much in love. But I do say, that he should go in company enough to feel that woman's inspi- ring eye is upon him, if he would win the greenest laurels, or reach the highest goal. Now it is manifest that this sort of intercourse, this kind of society cannot be enjoyed, in New York or Phil- adelphia, by medical students; and even if it could, it would fail to produce the desired effect, because the man- ners and customs of the people must differ essentially from our own. But they cannot have access to society, and hence after a stay of six or twelve months in the north, we are astonished that our friends are not more improved in man- ners, they seem to have gained nothing — in fact they have rather retrograded. And this is the result of legitimate causes. They could not get into society, as I have said, unless their fathers or relations happened to be known there. 19 And then, if they could, the society did not improve them, because totally different to that which they had left be- hind.* Now it will be altogether different in Nashville, with all high minded, honorable students of medicine. Here they will rind fathers, mothers, sisters and friends, kind, warm-hearted and generous, like those whose smiles cheered them at home. In Nashville they will feel their identity will not be lost in the multitude, but will realise that they are observed, judged and appreciated, accord- ing to their merits. Nothing is better calculated to engen- der idleness, and induce dissoluteness of character, in a young man, than to know that he is beyond the scrutiny of those who will mark his habits. There is implanted in the breast of every man, a moral sense, which teaches him to respect the opinion of the good and the virtuous ; but in large cities we feel that our individuality is so com- pletely lost, that the conviction is forced upon us, no one sees, no one cares. Hence, a course of conduct is often a- dopted, totally at variance with moral or scientific progress. In Nashville, however, every young man will be seen, and known ; his pride will be excited, his ambition stimulated, and wholesome checks placed upon his tendency to idle- ness and vicious engagements. But the chief argument in favor of the establishment of a medical school in Nashville is, that medicine should be taught upon the same theatre where it is to be practised. Natural philosophers have shown a great variety in the constituent parts of the earth, as well as of vegetable pro- ductions, in the different portions of the world; and this variety is equally well marked in the animal kingdom, not excepting man. In fact, variety is a universal law of na- ture. So true is this, that it is said there are no two things exactly alike. Infinite wisdom, pointing to an intelligent first cause, is, perhaps, as indelibly impressed upon the works of nature, by this endless variety, as in any other *It is not meant that the society of the south is better than that of the north; but simply that it is different. 20 way. When we compare the cedar of Lebanon, which lifts its ambrosial branches to heaven, to the dwarfish specimen which grows upon our own barren rocks ; or the mountain oak, which for centuries has struggled with the storm winds, to the black-jack of the prairies ; or the ea- gle, as he looks forth from his craggy home, or in majes- ty soars amid clouds and storms, to the sparrow-hawk, we are forcibly struck with this variety. The Esquimaux, the Hottentot, and Hindoo, are men ; but when compared to the European, we are disposed to reject the relation- ship, so marked is the difference. And shall this palpable variety exist in all the visible works of creation, while uniformity is expected in the mysterious realms of disease? Would you expect to find the same forms of fever in the hills of Scotland, or the snows of Russia, as among the sunderbunds and jungles of Burmah ? Or would you ex- pect to find the same modifications of disease in the large hospitals and densely crowded cities of the north and east, as in the small towns and among the rude population of the south and west ? Every well informed physician knows that climate and occupation, as well as the social, religious and political institutions of a people, not only de- velope special forms of disease, but modify, to a great ex- tent, those which are common. This position is not con- troverted. But it is contended that though this be true, yet that as these varieties and modifications are succinctly and graphically described in the books, the facts may be as well taught in one place as another. This argument is specious, but it is sophistical. Other things being equal, I know, the same causes always produce like results. Berze- lius in his cabinet in Sweden, and professor Lindsley in his labratory in Nashville, would arrive at the same con- clusion in analyzing a volume of atmospheric air, or drop of water. But in calculating the vital forces, or in ac- counting for the phenomena in connection with organized matter, a thousand influences might intervene to vary the result. Disease, like all other earthly things, is undergo- 21 ing perpetual change. Every fresh epidemic is but anoth- er problem to be solved by rules hitherto.untried. Hence, books written a few years ago, containing minute de- scriptions of disease, as well as the modes of treatment, are now laid aside as comparatively useless. And if this were not so, who can as thoroughly describe, or as indeli- bly impress upon the mind that which he has read, as that which he has observed, experienced. Take the best educated physician of the north, set him down in a ma- larious region of the west, in the midst of billious fever — congestive fever with its characteristic insiduousness, if you please — and what do you suppose would be his success ?— Why, whilst he would be preparing the system for quinine, or calculating the relative advantage of a half, or one grain of calomel, the patient would be hurried to the tomb. Or let the north wind blow, and in its train bring pneumonia, or pleurisy — whilst he would be administering ptisans, or applying leeches, or cut cups, inflamation would consume the lungs. No, sir, western and southern diseases must be treated, must be elucidated, taught, by southern and western doctors. Men who have grappled with the foe in his gruffest moods and borne off his prey triumphantly, who understand his wiles and the violence of his onsets, and who can explain, illustrate, and impress these upon the youthful mind. Besides, we have in our midst a class of population unknown to any other portion of the union. Our negroes are unique, suigeneris. In temperament, hab- its, employment and mode of living, they differ materially from every other class. It would follow, therefore, that disease, as well as its treatment, would be peculiar, in con- nection with such a people. And so it is. It either comes with the stealthy tread of the midnight assassin, or else pre- cipitates itself upon the victim with the violence of an avalanche. And then, the remedies employed are altogether different from those which are used in refined society. You can obtain but little information by interrogating the intel- lect, and all the remedies must be addressed, mainly, to the animal. There is no room for the cheering influences of hope, 22 or sustaining-powers of faith. Now a large proportion of southern practice is in connection with this sort of popu- lation. It would be irrational to suppose that northern tea- chers could give correct instruction as to the most effective modes of treatment in such cases. And this is another strong argument in favor of teaching southern students of medicine upon southern soil. This ground is ably sustained by Dr. Caldwell. He says : "It is well known that the ablest physicians of Europe are igno- rant of the treatment of American diseases. The most skilful of them, therefore, that have ever migrated to the United States have proved, on their first arrival, very inefficient practitioners—novices, comparatively, in the management of our complaints." He says further: "The general principles of medicine may be taught and learnt in any situation. But suitable adaptations of practice to peculiar modi- fications of disease can be learnt only by experience in the treatment of such modifications, and effectually taught by none but those who have thus acquired experience. To pretend to the acquisition of this knowledge in any other way, is no better than imposture. No physician then, whose sphere of observation has been confined ex- clusively to the large cities of the Atlantic states, more especially, to those that lie northward from the Potomac, has a competent knowl- edge of the peculiarities and treatment of the prevailing diseases of the west and south." Having made these imperfect remarks in favor of a med- ical school in Nashville, I appeal for its support, especially, first to the profession of Nashville and Tennessee. When the medical department was organized, I trembled for the result. I had read the history of other institutions, I knew the obstacles to be overcome, the responsibilities to be as- sumed, I was satisfied that no respectable school could be established without the concurrence and support of the profession; and hence I dreaded the response. I feared that the notes of opposition would come to us upon every breeze — that we should have to meet and refute the petty slanders — to endure the sneers and taunts of at least some of our medical brethren. All these anticipations and fore- bodings have been scattered to the winds ; and I feel to-day proud, doubly proud, of the profession of Tennessee. Our 23 efforts have been sanctioned and sustained, not only by the physicians of Nashville, but the members of the state medical society, as well as the profession generally j have given us unmistakable signs of their hearty co-operation. This support, this co-operation, we would still invoke; and we pledge ourselves, before this people, before the altar .which hears our vows, to maintain untarnished the medi- cal ensign. Because we happen to hold positions in this institution, we would not become arrogant, or exclusive, or dictatorial. We are proud to know that there are many physicians in our midst who are equally well qualified to teach medicine, and perhaps much better. We would not establish an inferior school; we desire that it shall be an honor to the profession — to our city, and to this great commonwealth. I hope that here may repair, every winter, scores of young men thirsting for knowledge, and eager to be conducted along the rugged pathway of medi- cine. Should it fail in this, should it suffer its robes to be soiled in the dust, I pray that it may be demolished, I trust you will tear down its walls, and raze its very foundation. And I appeal for support to this whole community. You are deeply interested in our success. If we seek an eleva- ted position, if we strive to qualify ourselves in our several departments, it is obvious that we must attain to a profi- ciency which cannot be secured by those whose minds are directed to all the branches. Thus the sum of medical skill in your city will be increased. The establishment of this school will give afresh impulse to medical investigation.— It will stimulate the ambition, excite the industry, and de- velope the talent of the profession. And when you are stricken down by disease, when the pale messenger is dis- patched for you, you will have the satisfaction of knowing that you will receive all the advantages of the art. You will be defended from the inroads and pernicious practices of the quack — you will have in your midst an institution to which, I trust, you can point with pride, and to which you can invite your friends, who desire to embark in the profes- 24 sion, with confidence. And more, it will put money into vour pockets. But we should fail of the highest support, did we not ask the co-operation of our female friends. You are the most exquisite portion of the creation. Your nervous construc- tion, delicate and peculiar, will not bear the rude touches of disease. It is your province to tend the sick, to smoothe the pillow. Your pathway leads inevitably through pain and sorrow, and you will sustain this institution. You know the value of medical science. You will repel with indignation all imputations against its truth or efficiency. Its truth, you will remember, on 'the one hand, is demon- strated by well established and long tried facts and prin- ciples ; and on the other, stands vindicated by living mon- uments in your families. You will not permit the criticism too severe, but will maintain for us the maxim, " nihil simul inventum est, et perfectum."—nothing which is new is perfect. And, in return, if we cannot revoke the fiat, "dust thou art and unto dust shalt thou return," or restore the bloom of youth, or abrogate the wrinkles of age, we shall at least hope to assuage your sorrows, and, sometimes, snatch you from the jaws of the devourer. And to you, young gentlemen, who have honored us with your confidence, when it is most needed, I, in behalf of my colleagues, extend a hearty welcome. I welcome you not only to these halls, but also to the hospitality of the "city of rocks." You have left the endearments of home, and have sought an institution of learning hitherto unknown on the records of fame; one which has sprung up amidst rivals firm, strong, in the vigor of manhood, and enwreathed with honors won by years of patient endurance and honest toil; rivals whose long lines of alumni sparkle along the waters of the Mississippi, and in the savannahs of the sunny south; whose renown has filled the page of history, and lingers upon the tongue of a thousand living, moving, illustrious monuments. Amid this array, to find you within these walls is peculiarly gratifying. Your position is singularlyjnter- esting. You constitute a kind of first frnits, an earnest of 25 success almost unprecedented, a distinction unanticipated, Having seduced you from the glittering pathways which lead up to the established fountains of knowledge, we should prove false to you, false to a distinguished profession, and false to helpless, suffering men, did we fail to conduct you safely, certainly up the hill of medical science. We should prove unworthy, eminently unworthy, of the honor and confidence reposed in us, if it should turn out that we had made representations, and held out inducements which have decoyed you from the true sources of knowledge. These thoughts excite the most painful convictions, not only of the responsibilities which we have assumed, but of the high obligations which we are under to you, and especially the cause of humanity. I trust that, without arrogance, with- out egotism, or presumption, or large professions, we shall strive with zeal and industry to impress sound medical Iruth upon your minds. We shall not expect to bewilder you with flights of fancy, or intoxicate you with bursts of eloquence, or bedazzle you with gems of rhetoric, but in a plain, unpretending style to teach you what we know ourselves. We shall do more; we shall watch over your health, and your morals, with the most constant assiduity, knowing that a loss of either must prove destructive to your future glory. You, young gentlemen, have turned your attention to the most wonderful subjects which can possibly employ a finite mind. You have come here to contemplate health and disease, life and death; to penetrate the laws by which these relations are sustained, and to interpose the knowl- edge here derived, for the preservation of the one and the destruction of the other. To attain this position is the highest achievement of our art. It not only includes a full undersanding of structure and function, but like- wise an intimate acquaintance with the metkodus curandi. I need not tell you that to gain this distinction, to ascend this height, you must be laborious and studious, self-sacri- ficing. The mind must be fixed, concentrated upon the theme; the thought must be wrought up to the utmost 26 tension, or you will never stand above the routinist or the hobbyist. It would be a painful thing to us, if any of you should go away from these walls to disgrace your profession. Far better would it be for you, now, to return to your fields and to your merchandize. But we not only desire that you should make high pro- fessional attainments, but we urge you to preserve your reputations and morals untarnished. You are now, most of you, far away from those whose duty it has been to guide you along the slippery paths of youth. You are here in the midst of a gay city, with all its seductive charms and temptations, at a time of life of all others the most susceptible, and unless you set your faces as brass against its allurements, you will find yourselves over- whelmed in vice, if not disgraced by crime. Those of you who are religious should not fail to discharge your duties, because you are away from home ; and those of you who are not, should remember that a physician is bound to be a moral man and a gentleman, and that therefore you should restrain any propensity to walk in the ways of folly. Your punctual attendance in the lecture room, and your dili- gence in study, will soon give evidence of your character, and establish the estimation in which you are to be held by your teacher?, as well as by this community. I hope that nothing shall transpire during your temporary resi- dence here, which shall disturb the agreeable relation which to-day has been formed, or which shall blight your antici- pations of future usefulness and renown. And now, ladies and gentlemen, having said what I de- sired to say, on this occasion, and asking a favorable re- cognition on the part of our cotemporaries, we launch our boat upon the dark waters, and invoke the favoring winds. We throw our banner to the breeze and inscribe on its ample folds, excelsior, excelsior—higher, still higher. Like the eagle Proudly careering his course of joy, Firm on liis own mountain vigor relying, Brensting the dark storm, the red bolt defying, VVitn his wing on the wind and his eye on the sun. He swerves not u hair, but bears onward, right-on. CORRESPONDENCE Prof. Paul F. Eve, M. D.: Sir : — At a meeting of the students of the " Medical Department of the University of Nashville," held this day, the un- dersigned were appointed a committee to request, for publication, a; copy of your very able and eloquent explanatory address, delivered' on yesterday, defining your connection with the Medical School of Nashville. And in behalf of the entire class, we earnestly request your compliance. Very respectfully, f W. S. POSEY, W. H. PILCHER, JNO. D. WOODS, E. E. SPENCER, J. S. DIXON, S. H. MITCHELL, T. B. TROTMAN, Committee.. Nashville, Nov. 4th, 1851. To Messrs. Posey, Pilcher, and others : Gentlemen : — In reply to your complimentary com- munication of yesterday, I place at your disposition, the few remarks I made by request of the Dean, respecting my connection with the Medical Department of the Nashville University. In doing this, I yield my opinion and judgment, to gratify the class; for surely they have but a local bearing, if even worthy of publication. I am, gentlemen, Your sincere friend, PAUL F. EVE. Nashville, Nov. 5th, 1851. ADDRESS OP PAUL F. EVE, M. D„ PROFESSOR OF SURGERY, IN THE MEDICAL DEPARTMENT OP THE UNIVERSTCT OF NA.SHVILLK, November 3d, 1851. Gentlemen of the Class : We inhabit a great country; are members of a powerful confederacy; citizens of a mighty republic. The prophetic vision of our forefathers has been fully realized— a nation has here been born in a day. Wonderful as have been the developements throughout this favored land, in no other portion have they been greater, more rapid or more gigantic than in the valley of the Mississippi. West- ward is now the march of empire. The mountains have already been crossed, and forever is the destiny of this union with these western states. In the vastness of the resources so bountifully bestowed here; in climate and native productions; in forest, moun- tain, lake and river, mineral wealth and adaptation of soil to agriculture; in the genius of the people, harmonizing as it does with the magnificent display of nature surround- ing them, and manifested in the speedy creation of cities and towns ; in the improvements in steamboat navigation, constructing canals and railways, building factories, open- ing mines and furnaces, endowing colleges and dissemina- ting intelligence by the press and telegraph; but above all, in the exhibition of 15,000,000 of happy people, where, fifty 30 years ago, scarce 1000 could be counted; or, in fact, in every thing western, we behold the same legible characters, the same expressive language, marked by the finger of the Almighty, and best represented by the comprehensive, energetic, emphatic word, greatness. Great indeed is the American continent; greater than all others this valley of the Mississippi; GREATEST the world has ever wit- nessed, the enterprising spirit of these western states. We are here to-day in the beautiful capital of Tennes- see, engaged in an undertaking, whose object is the ame- lioration of man. It is a subject worthy the age and coun- try in which we live. Ours is the cause of humanity. In organizing a medical school in this commonwealth of a million of people, we are promoting their true and best interests, their greatest and highest happiness. The edu- cation of those to whom hereafter is to be entrusted the well-being of our friends, and the public health, must be of vital importance to all classes of society. No man, even if he would, can be indifferent to the sanitary condi- tion of our cities, or of the community in which he lives. All are here alike interested, for all are made at times to dread the fearful, wide-spread and devastating epidemic; and sooner or later, disease, accident or death comes alike to every one. And if it be a self-evident proposition, as it undoubtedly is, that no where else can diseases be studied to the same advantage as in the localities of their occurrence, we can and do appeal not only to one of the most active, but to the very first and strongest principle of human action, self-preservation; and for this, our enterprise, we claim the co-operation of the legislator, patriot, and philanthropist, and expect the aid and en- couragement of the good and wise of this city and state. A medical department in connection with the University of Nashville is required both by the law of necessity and expediency. Tennessee should have her own colleges.— She is free, sovereign and independent in every other ca- pacity ; it is high time she should begin to make herself so 31 in the useful arts and learned sciences. And thank God, she has, this day, taken the first step in the right path towards this desirable end. Every man in this community should take pride in the flattering prospects of this infant institution, and do all m his power to enhance its useful- ness. The true policy of each state is to educate her sons at home, and not force them to go abroad. We should do every thing to develope all our resources, especially those of the mind; ever remembering that knowledge is power. Much, it is admitted, has been done to diffuse gen- eral intelligence throughout our country, and no people, as a mass, are more enlightened than ours; but still igno- rance, the greatest of all evils, prevails — and on no subject so grossly, or so destructive to health, happi1 ness and life, as in medicine. It has been my good for- tune to do something to establish one medical school in this country; a greater honor, I am persuaded, awaits him, however humble he may be, or however small the contri- bution, who aids in organizing this institution. In every well appointed medical college of our land, there are seven professorships. Six were early filled in this one, by gentlemen of decided ability; and at a subse- quent period, the seventh chair was offered me; in accept- ing it the number is complete. We read in the evening rainbow, as it gorgeously spans the heavens, that light itself is but the harmonious blending and concentration of seven colors; and as we look out at midnight upon the millions of brilliant constellations that deck the firmament, we are taught that one star differs from another in glory ; what then must be the glory of the seven ? Here are seven of us happily united to illustrate one department of hu- man knowledge, and, though we boast not to be stars of the first magnitude, propose to illuminate your pathway up / the hill of medical science, and trust that the professional Ho-ht here to be emitted will be so harmoniously blended and concentrated, as to shine more and more unto the perfect day. 32 In defining my connection with this institution, you will permit me to observe that I am here with no divided affec- tions. I have resigned, and forever, in all human proba- bilities, the chairs I held in other colleges. The professor- ship of surgery in the medical college of Georgia, which I occupied from its foundation to a period of eighteen years, I was compelled to resign, that I might try the effects of a western climate upon the health of my family, in accepting for a session only, a similar chair in the Louisville Univer- sity of Kentucky. At the close of the last course of lec- tures there, the professorship of surgery was unanimously and permanently offered me by the trustees, at the earnest and very flattering request of the faculty and students. I have also declined a similar offer made by the Philadelphia, and subsequently by the Memphis Medical College. At the time I was solicited to accept office here, the profes- sorship of surgery was already filled by a gentleman, then in Europe, engaged in procuring museum, apparatus and outfit, for this university. I was to have lectured this winter on surgical anatomy and clinical surgery ; since, however, the return home of Prof. Buchanan, he has most generously relinquished his chair to me, and has volun- tarily taken upon himself the preparation for the post I was to have occupied. Such disinterestedness and magnanimity ought not to be passed unnoticed, and I hope will not go unrewarded. I am here, then, gentlemen, in my old pro- fessorship, and am about to enter upon my twentieth course of instruction on the principles and practice of surgery.— Through the kindness of professional friends, I have been induced to enter this college, and whatever of zeal, indus- try or acquirement I may possess, are all now to be exclu- sively devoted to the interests of the Nashville University. By accepting office in this institution, I renounce all others, and stand pledged to bestow all my energy, labor and time, in its behalf. I have come hither with a single object, to contribute my best efforts to build up this insti- tution. Having cast in my lot with this faculty, come pros- 33 perity or adversity, success or the want of it, I am to rise or fall with them. I am now in Tennessee, and by the help of God, Tennessee shall be in me. In this connection, it is proper to remark, that when I accepted an appointment here, other engagements were in contemplation which might make it necessary for me to terminata my course of lectures this winter, before the end of the session. When elected last year in Louisville, it was for a course of only two months. But however anxious I may be on this subject, to remove any impression that my connection here is but a temporary one, I publicly pledge this class, as I have already the faculty, to waive every other consideration until I shall have delivered as full a course of lectures, on the principles and practice of surgery, as I have ever done, even should it require of me the last day of the present session to do it. My first duty is emphatically to you, and every one of you shall be satisfied that I have faithfully discharged it, to the utmost of my abilities. I hold no office but at the disposal of those who gave it. I desire nothing but what I may deserve by my own individual efforts; my highest reward ever will be the approbation of those for whom I labor; and you may be assured no temporary occupation nor trifling business has induced me to come hither. Intending to act honestly to all, I shall expect to merit the continued confidence of those who have invited me to this city, and if I secure your ap- proval of my work during the present course of lectures, then I shall seek no change. This, I hope, will settle th% question respecting the mode and period of my connection with the medical department of the Nashville University. Few, it is believed, belonging to the medical profession, have passed through so manyand trying scenes, in the same space of time, as he who now addresses you. Within i. the past five years, it has been my lot to have associated with many of the most distinguished members of the heal- ing art. By reason of a most distressing affliction in a long cherished companion, the profession in both Europe 34 and this country was extensively consulted; but notwith- standing the kindest sympathy every where expressed, and the best and wisest measures adopted for relief, it came not; she drooped and died. It is due to my feelings that the first public occasion after this sad evjent, should bear testimony to my gratitude for the many obligations I am under to my professional brethren. And from this excellent opportunity, and observations thus made, be assured, young gentlemen, you have selected a liberal and hoiiprable call- ing, and are soon to become the co-laborers of high minded, generous and noble men. I can but thank God, that so much of my life has been so pleasantly, and I trust profit- ably spent amidst such associates and companions, and I feel certain that in coming to this city, that though a stran- ger in entering it, I am not thus to remain; for already have I received a brother's welcome, and the professional bond will ever unite us; believe me, this is a brother's voice speaking warmly from a brother's heart. ^^7 I v.. ) >r^ / f V- \l I I ^ \