INTRODUCTORY LECTURE 
OF 
I 868-9, 
AT 
Bellevue Hospital 
MEDICAL COLLEGE, 
BY 
LEWIS A. SAYRE, M. D., 
PROFESSOR OF ORTHOPAEDIC SURGERY. 
JOHN SARELL, PRINTER AND PUBLISHER, 
NEWYORK: 
73 Broadway. (Bellevue Hospital J/ledical College, 
October SSd, 1868. 
Professor Lewis A. Sayre, 
Dear Sir, 
At a meeting of the Class of Bellevue Hospital Medical Collegef 
'held this day, Dr. J. C. Bryant, Chairman, Ceo. if, (Phillips, Secre- 
tary, we were appointed a Committee to solicit a copy of your 
lecture introductory to the course 0f1866-9. Hoping that this request 
will meet with favor, we have the pleasure of remaining. 
Very Respectfully Yours 
J. C. Conover, 
Bobt. Taylor, 
H. R. ’Williams,. 
H. C. Gorham, 
G. W. Dunlap, 
Committee, SB6 Sih Avenue, Oct. SSd, 1838_ 
To Messrs. 
J. O. Conover, 
Robert Taylor, 
H. CR. Williams, 
H, O. Gorham, 
G. W. Dunlap, 
OommiUee. 
Gentlemen, 
Dour note of this day requesting a copy of my introductory 
lecture, to the course of 1868-9, at fßellevue Hospital ■ Medical Col- 
lege, has just been received. 
With pleasure I accede to the wishes of the Class, and if the 
advice given, shall serve to stimulate the Students to constant effort 
in their professional acquirements, I shall he more than gratified. 
With thanks to the Glass for the compliment, and wishing you. 
all success in your professional career. 
I remain, 
Dours very Respectfully.. 
Lewis A. Sayre» LECTURE. 
Ladies and Gentlemen : I am placed in my present unenviable 
position very much against my wishes by the inexorable decree of the 
unanimous vote of the faculty of this institution. To lecture to the 
students either in a didactic course, or more particularly in the clinic 
at the bedside of the patient, is to me the greatest of all my pro- 
fessional delights; but to lecture to a public audience, without a 
selected topic, is not congenial to my taste, and is something for 
which I feel very much disqualified, and would have avoided if 
possible. But the duty has been imposed upon me, by my col- 
leagues, and I thought I could not do better than occupy your time 
for a few moments this evening in considering the relative obliga- 
tions existing between the medical profession and the public, and 
the duties and obligations between the one and the other. It is 
very necessary for the advantage of both, that it should be definitely 
and thoroughly understood, that neither should fail through ignor- 
ance, to discharge its duty toward the other. What then, are the 
duties, the obligations and the responsibilities of the medical man? 
What is his position, toward the public? In my opinion he stands 
above all others. His profession rightly understood and honorably 
practiced, gives to him the greatest responsibility, and a position 
nobler than that held by those engaged in any other pursuit in life. 
He must be a man of the strictest honor and integrity, for to him 
are confided the the secrets of families, the honor of wives and 
daughters ; sacred trusts that are committed to no other. Every 
medical man should feel the responsibility of these trusts, or he is 
unworthy of being a physician. The physician who practices his 
profession merely as a trade, for the amount of money that can be 
made by it, is unworthy of his calling. If he has no nobler and 
higher motive than the mere gain that can be made by it, he is 
unfit to be trusted, with the lives of human beings ; he would be 8 
more interested in keeping his patients sick, than in curing their 
diseases, for more money would be made in that way, than by the 
other. The higher and nobler motive of doing good to others, of 
relieving human suffering, of prolonging human life, is the only 
incentive that ever has or ever will make the great physician. 
In proportion to the weight of his responsibility, should be the 
honor and the Integrity of his character. How easy is it for the 
physician to control the destiny of his patients. On him they rest 
and confide in his knowledge and truth. He decides for them* 
questions of life and death. Happiness or unhappiness it is in his- 
power to give, and why ? Because by devoted study he has learned 
the mysteries and marvels of that wondrous machine, the human 
body. He has studied the laws which govern and control its action,, 
and has become acquainted with the proper mode of assisting nature, 
in carrying out those laws, so that health may be secured and dis- 
ease banished. The greater his knowledge, the greater is his power. 
He has knowledge of how to do good, and consequently the power 
to do evil, and hence, the necessity of his being governed by the 
strictest honor and integrity, in order to use that knowledge rightly, 
We naturally love those who confer upon us great and good gifts,, 
and what boon is so great as that of life and perfect heatlh? “ All 
that a man hath, will he give for his life,” it was said of old. Are 
the men of the present day different from those of the past? 
A clergyman without health is unable to perform his duties to- 
ward his fellow man, and is comparatively useless. So the lawyer, 
the man of business, the merchant, and the laborer. All human 
beings regard health as the first and the greatest of gifts, and honor 
and reverence him who is able to protect and preserve it. The- 
physician is entrusted with the protection of health and life—life 
which is the breath of God breathed into us at our birth, and with- 
out which we are but dust and ashes. Should he not feel, therefore >■ 
that to his care has been committed the most sacred of all human 
trusts, and that a fearfnl responsibility rests upon him ; and that to 
him has been allotted the duty not only of preserving life, but keep- 
ing that life in perfect health, which is the normal condition of the 
human body. Shall he fail in that duty? Shall he neglect that 
which he has undertaken to perform? Shall selfish fear, or the 
desire of personal ease, prevent him from undergoing the labor 
necessary to qualify himself to assume this fearful responsibility? 
This is an important question, and upon the answer you give to 9 
■lt, depends the future standing and position of every medical 
student. 
Wait not until you have obtained your degree, before you consider 
this momentous question : whether you will take an elevated rank 
in your profession, or merely follow it as a trade. Determine now, 
at the commencemeat of your student life, that you will take the 
very highest rank as a student. Devote all your energies, all your 
time, by the closest application, to obtain a most perfect and minute 
knowledge of the elementary branches of the science of medicine, 
for upon the accuracy and minuteness of your knowledge of these 
branches, the alphabet of your profession, rests all the superstructure, 
upon which you are to secure the monument of your future fame. 
Have it so broad, so deep and well laid, so strong, that to whatever 
height your fame may reach It can never be shaken from its firm 
foundation. 
If you are deficient in these elementary branches, the only 
enduring basis fora permanent reputation, you will never obtain 
a distinguished position. You, therefore, must see the neces- 
sity for the closest application even at the commencement of 
your career, for it is at this period of the student’s life that these 
elementary branches are taught. No man can become a classical 
scholar, in either the Greek or Hebrew languages, without first 
comprehending and fully understanding both its character and 
alphabet, and having an intimate knowledge of its structure. The 
attempt to gain a knowledge of the beautiful orations and other 
compositions, in these classic tongues, by translations, without a 
knowledge of the rudiments of the language will fail, and you will 
obtain but a faint impression of the ideas intended to be conveyed 
by the author you are reading. So in regard to your profession. 
The alphabet of which is anatomy, physiology, chemistry, path- 
ology, and materia medica. Without understanding these fully and 
minutely, so as first to know exactly, what is the healthy condition 
of man, yon never can comprehend the changes that occur from a 
healthy state, to a diseased one, or know accurately when disease 
exists. The duty of the medical man is not to give physic, but to 
learn %vhen and hozu to give it, and above all, when ?wt to give it. 
Brandreth, Ayers, and all the host of advertising quacks, that sell 
their nostrums by the thousands, can give physic, and so can the so 
called homoeopathic doctors; in fact their principle is to give 
medicine, and a great objection, if not the greatest, to their s}-s- 
--tem, is that they are always giving physic, prescribing for symptoms 
instead of eradicating the causes that have produced those syrup- 10 
toms. The swallowing of drugs which they constantly recommend,, 
by pellets or in potions, is the greatest objection to their practice. 
The object of the medical man should be to instruct his patient how 
to live, so as to prevent disease, or if disease exists, to ascertain its 
causes, and by the removal of those causes, permit nature to restore 
the body, as it almost always will, to perfect health, or to render 
such assistance as may occasionally be necessary. 
To obtain this intimate knowledge of the structure of the human- 
frame and the laws that govern it, how little do the public know of 
the sacrifices the student is compelled to undergo. 
Follow with me in imagination a student’s life, during the three 
years of his devoted study to acquire a knowledge of his profession 
requisite to enable him to assume and discharge the duties and the 
responsibilities I have before described. 
Coming it may be from some quiet country home, where he has 
been surrounded by all the pleasures of social life ; fond parents, 
loving brothers and sisters, dear friends with whom he has had 
many a happy hour, all these are to be sacrificed. He comes to 
the great city, it may be for the first time, sunmunded with all its 
allurements and enticements for pleasure and enjoyment, which he 
must forego, and the first introduction he has, is into the dissecting 
room. Those of you who have never been placed in this position 
can scarcely realize the effect that is often produced by this first 
exhibition even upon the strongest and most stoical mind. Yet 
here, in this charnel house, in close communion with the dead, must 
he spend his hours for three long years, in the minutest dissection of 
the human body in order to obtain an accurate knowledge of its 
structure. “We must dissect the dead or we must mangle the 
living,” was said by one of former days. The saying is as true to 
day, as at the time of its utterance, as it is only by the minutest 
investigation that we can possess ourselves of the intimate know- 
ledge of its structure. Not only must this knowledge be possessed, 
but so also a knowledge of physiology, a knowledge of the func- 
tions of all the various organs, which are thus revealed to us ; ot 
the various complicated actions of secretion, absorption, nutrition, 
growth and decay, and all the mysterious changes that occur in the 
life of a human being. This knowledge can only be obtained by a 
constant and close observation of the functions of the different 
organs, as displayed by the physiologist, in his observations and 
experiments upon the lower order of animals. 11 
The dangers of the dissecting room are not a few, yet they must 
be faced, as it is only by the minutest knowledge of anatomy that 
the student can be properly qualified to diagnosticate diseases. The 
battle with death, which every student meets when in the dissecting 
room, is a risk of life which the public little comprehend. The 
slightest scratch upon his finger, (as has been instanced in numerous 
cases) may terminate his life. These are the constant risks he runs, 
in order to obtain the knowledge which is necessary to do good in 
the future, and yet this knowledge can only be obtained by devoted 
labor in the dissecting room. The superficial knowledge of the 
organic structure of the human frame, which may be obtained from 
books and drawings, and from the lecture-room, is not sufficient to 
enable the student or the physician to diagnosticate with accuracy 
the various diseases and accidents to which we are liable. The 
minutest relative anatomy of the parts is often called into play, as to 
the exact location of disease, whether it be within a joint or exterior 
to it—whether it in reality involves a blood vessel or an organ, oris 
simply in contact with one or the other. Scarcely a month passes 
that cases are not brought to me, frequently by men of eminence in 
our profession, where just these errors have been made from the 
want of that very accuracy of anatomical knowledge, but which 
they are excusable for not possessing, in as much as anatomy was 
not permitted to be taught when they where students, with the 
freedom of the present time. AH honor to the law-givers of our 
noble State, who have legalized this necessary means of instruction. 
New York was the first State to legalize anatomy, and by conferring 
upon the medical student the privilege of an examination of the dead, 
they have granted him the power of obtaining a knowledge which 
will enable him to preserve the living. 
This minuteness of knowledge and accuracy of observation is not 
only necessary to enable you to do justice to your patient, but it is also 
absolutely requisite to enable you to protect yourself. For you 
may find persons, even in our own profession, who from ignorance, 
envy, or malice, will combine with some pettifogging lawyer of no 
repute, to trump up a suit for mal-practice against you, in order to 
injure your professional standing and reputation. 
If you are not certain of the accuracy of your diagnosis and the 
correctness of your treatment, you will, through fear, yield to their 
demands, and pay the hush money desired to prevent a public expo- 
sition, and thus benefit the “ black-mailers” and ruin yourself. But 
if you are conscious of the accuracy of your diagnosis and correct- 12 
ness of your treatment, you will not only court, but demand, the 
strictest investigation, perfectly conscious that when facts are 
brought to the observation of intelligent, competent, medical judges ; 
the infamy of your traducers will be fully exposed, and the justice 
of your course sustained. 
As with a knowledge of anatomy, so too, with a knowledge of 
chemistry and materia medica ; they must be equally minute. The 
effects of poisons upon the system, the influence of various reme- 
dies upon the different secretions, must -be minutely investigated, 
to be thoroughly understood. To obtain this knowledge reauires 
the most careful and devoted study, and constant labor in the 
chemical laboratory. So too, in regard to the actions and effects 
of the various drugs' and medicines upon the human frame. 
Your knowledge of them all must be equally minute, and can only 
be obtained by a careful study of the materia medica, and to com- 
prehend it, a knowledge of Botany is also necessary. As an instance 
of the necessity of this knowledge and its importance, allow me to 
refer to a case which recently occurred. Summoned in haste to a 
fashionable hotel, to see two gentlemen who were supposed to be 
dangerously intoxticated, I found them with feeble pulse, and the 
greatest muscular prostration, with dilated pupils, and partial loss 
of vision. In a recumbent posture, apparently perfectly well, with 
the exception of the feeble circulation and want of muscular power 
before mentioned ; with the intellect unclouded and exhibiting no 
signs of intoxication. In an erect posture the heart almost ceased 
to beat, and they fell almost lifeless to the ground, exhibiting in fact 
all the symptoms of poisoning with prussic acid. Both were affected 
in a similar manner, but the one more seriously than the other, the 
symptoms being of the same character, only differing in degree. 
The question now was, how had the prussic acid been adminis- 
tered—whether by accident or design? A friend present, who was 
perfectly sober, stated that he had dined with them, and that pre- 
vious to the dinner they were in perfect health ; that they had all 
drank of the same wine, in apparently nearly equal proportion ; 
and as he was entirely unaffected—that what they had drank could 
not have been the cause of their present condition. He stated that 
these two gentlemen who were sick had dined upon partridge, 
whilst he had partaken of a different dish, and that the one whose 
symptoms were the worst had eaten more of the partridge than the 
other; and the symptoms began to develope themselves in both 
gentlemen very nearly at the same time, about forty minutes after 
the commencement of their dinner. 13 
Finding no source of poison in any thing else that had been par- 
taken of by them, I naturally inferred that it was obtained from the 
partridge. How did it get there? Happening to be a long win- 
ter, when there had been seven weeks of continuous snow, and the 
ground constantly covered, these birds had been prevented from 
obtaining their ordinary food, and had been compelled to feed upon 
the berries of the laurel; therefore their flesh had become charged 
with the potent poison of prussic acid, which in a minute quantity 
is found in the berry of the laurel. Then looking at the charac- 
teristic symptoms presented, paralysis of the heart, dilated pupil, 
peculiar weak faintness, and the clear intellect, indicative of prussic 
acid, cause and effect were rightly understood ; and by adminis- 
tering the antidote of prussic acid both gentlemen were speedily 
restored to perfect health. 
Take another case, as an example of the necessity of an accurate 
knowledge of chemistry, as well as anatomy and physiology, and 
the influence of poisonous drugs upon the general system. A person 
affected with paralysis of the exterior muscles of both lor ear ms, 
supposed to have been dependent upon a disease of the spine, and 
for which she had been treated with a spinal brace, which she had 
worn for two years, and described by a recent author as a case of 
“ carnomania,” * or insanity of the flesh (if any one knows what 
that means), came to me a short time since. 
She had been treated for disease of the spine, a brace had been 
applied, and she had been assured that the paralysis of the arms, 
would be removed in two or three months, or at all events in a 
very short time, so soon as the disease in the spinal column had 
been cured. She was sent to her distant home, and for two long 
years has worn the spinal brace, with still increasing deficiency o 
the power of the fore-arms, until within the last few months ; she 
had become perfectly paralyzed, and was helpless, unable to pin her 
clothes, comb her hair, or feed herself, or indeed, do anything more 
than simply close her fingers. Upon making a most careful in- 
vestigation of the case, I could find no disease of the spinal column, 
or in any part of the body that would justify this peculiar condition 
of the fore-arms, and there was nothing that could produce it, ex- 
cept the potent influence of the poisonous power of lead. 
* This case is reported by Dr. C. F. Taylor, in the Quarterly Journal of Psychological 
Medic ne, April No., 1868, pp. 282—283, as a case of “ Carnoirania.” 14 
The peculiar characteristic of lead poison is, that the hands drop, 
and are incapable of being extended, although the power of Jlexion 
exists. We have other varieties of paralysis, attacking different 
limbs; but there is no other characteristic paralysis of the hand 
that simulates the action of lead. I gave it as my diagnosis, there- 
fore, that this was a case of lead palsy. The next question was to 
ascertain how the lead got there. It is a common thing in New 
York, where we drink water through leaden pipes, to see these 
■cases. Others are poisoned by drinking champagne from bottles 
that have been washed with leaden shot, and the lead left in the 
bottle. 
In this instance no lead had been obtained in that way; the 
mother stated that the water was brought from a spring, kept in a 
bucket, and drank from a gourd. I wanted to know if the house 
bad been painted recently. No, “ she had not been exposed to lead 
in any way.” So, I was unable to ascertain any source from which 
lead could have been obtained. I found the lady had ridden a horse 
which had run off with her, for some distance, one or two miles, 
and she was disposed to attribute the loss of power to excessive 
muscular action. Still the peculiar characteristics of lead being so 
marked, I could not give up my hunt for the poison, which had 
been, in some way, so insidiously introduced. After two or three 
days of close questioning, the lady very innocently asked me “ if 
whiting would do it.” When I asked her what it was, she handed 
me a beautiful little bottle, and said, it was “ this,” and on looking 
at the label I found it was “ Laird’s Bloom of Youth,” a cosmetic 
which you will see advertized on all the curb-stones, which had 
been used upon the face, and here was the practical result. “ The 
Bloom of Youth,” producing the palsy of age. Taking the bottle 
to Prof. Doremus, I received an analysis the following day, stating 
that it was highly charged with lead. I immediately administered 
to her the proper antidote for lead. And collecting some of the 
secretions for a number of days, gave them also to Prof. Doremus 
for analysis, and I am happy to state that that distinguished chemist 
has presented to me a specimen of the lead in its metallic form, ob- 
tained from these secretions—thereby fully corroborating the ac- 
curacy of my diagnosis, and the correctness of the treatment. As 
the lead is being eliminated from the body—I am happy to state 
that muscular contractions are returning to the paralyzed limbs, 
and thus ends our case of “ carnomania.” 
These cases show you the necessity of an intimate knowledge of 15 
and the superior advantage of its application, in the re- 
moval of disease, as compared to the plan of mechanical support. 
It might, in fact, be called a case of lead versus steel. The lead 
to paralyze, the steel to brace, and as soon as the lead is removed, 
the steel is not required. 
We have thus proved that the minutest knowledge of anatomy 
and physiology, is absolutely essential in order to recognize when 
the body is in its healthy condition. Without this knowledge, no 
one can tell when disease exists, or when it may be feigned. 
We have also proved that an intimate knowledge of chemistry and 
the materia medica, are equally essential for the proper discharge 
of your professional duties. 
After three years of laborious study, the student finally receives 
his diploma, and then commences his struggle in the actual practice 
of life. 
In the hovels of the poor, in the garrets and back alleys, amidst 
suffering and sorrow, most of his days and nights are spent, witness- 
ing disease in all its forms, complicated with wretchedness, misery 
and poverty. His first few mouths, or even years of practice are 
among the poor, who can give him no compensation, or else cases 
that have been abandoned by others as incurable, and which come 
to him as a dernier resort; his only reward being in the constant 
discharge of duty, the relief of suffering and the doing of good to 
others ; his own personal comfort or even personal interests, sacrificed 
upon the altar of professional duty. The ordinary pleasures and 
enjoyments even of social life which the merchant, the lawyer and 
■ other professions enjoy are not allotted to him. He has no hour 
that he can call his own, not even in the night, nor on- the sabbath. 
There is no day of rest for the physician, he receives no advantage 
from the eight hour system. The amount of professional service 
rendered at the hospitals, dispensaries, infirmaries, and other chari- 
table institutions; the number of operations performed, and the 
amount of advice given, and the number of hours consumed, cannot 
be measured by money. 
An estimate was made some twenty years ago, taking into con- 
sideration the number of visits made at the dispensaries, and at the 
hospitals, and the advice given at fifty per cent less than the ordi- 
nary charge, even at that time it amounted to $600,000 per year, 
;and with the increasing growth of the city these labors have mul- 16 
tiplied tenfold. What other class of men make this donation to 
the poor? 
The hospitals exist upon the capacity and the knowledge of the 
medical man, who gives his time and his labor without compensa- 
tion. The door-keeper is paid; the butcher is paid, the house- 
keeper is paid, all services are paid, the whole establishment is an 
expense except the doctor, and if it were not for him, the hospital 
would not exist, for it is for his advice the patients come. If a new 
hospital is to be built, the lawyer who examines the title to the 
ground receives a fee for his services, the artist who makes the 
drawings receives a fee for his services, the contractors who consruct 
the building receive a bonus for their labor from the day of its com- 
mencement to the day of its completest organization, and during 
its continuance every person receives compensation for his services, 
except the physician. 
These sacrifices by our profession should be known and recog- 
nized by the community. 
These hurried glances which I have taken, will give you a faint 
idea and outline of the laborious duty which the student is com- 
pelled to undergo, in order to obtain the ground-work upon which 
to commence his practical professional duties; and the sacrifices 
the medical man makes for the public good in the discharge of his. 
professional obligations. 
The pecuniary reward he obtains from his labor is a secondary- 
consideration ; this will always be sufficient to maintain him in 
comfort, at least, if not in affluence. This reward is one of the 
results of his labor ; it is not the object of his pursuit or the ambition 
of his life. If his whole object is to make money, he will pursue 
that object and become dangerous to the community. 
We have described the student’s life as being one of constant ap- 
plication and study. So must the physician’s life be a continuance 
of this same duty, until he gives up the practice of his profession. 
The improvements in our art, the daily advance in medical science 
is now so rapid, that whenever any medical man ceases to be a stu- 
dent, he falls behind, and is not capable of doing that full justice 
towards his patients which they have a right to demand— no matter 
what the disease or deformity he is called upon to treat, if he cannot: 17 
give it the best and most proper treatment known at the time, he 
has failed in his duty. It is the right every patient has to claim 
from his attending physician, that his disease, whatever it may be, 
shall be treated according to the best and most recent information 
to be obtained upon that particular disease. There is no excuse 
which can justify him in being ignorant of any new or improved 
method of treatment, after it has been made public through the 
medical journals. Ido not mean that all vaunted novelties are im- 
provements, that the pretended originators of improvements have 
a right to any recognition, until they have proved them to be facts; 
but what I refer to, is absolute, positive, new truths that are devel- 
oped, truths that are immutable and that can stand the test of all 
coming time. These are the improvements the medical man should 
bring into his practice, and which, for the failure to employ, he has 
not only no excuse, but is culpably ignorant, if he neglect. The 
doctor is a perpetual student. It is the obligation resting upon him, 
in order to do justice to his patient, that he constantly keep him- 
self familiar with the improvements and discoveries that may be 
made in the science of medicine. Time will not permit me to refer 
to many of the great discoveries and improvements of the profession 
within the last few years, but I will merely mention a few of the new 
instruments now employed in physical diagnosis, to illustrate the 
constant study necessary for the physician who desires to keep 
up with the advance of science. The Ophthalmoscope, with 
which we are able to examine with the greatest accuracy the 
minutest structure of the human eye. The Laryngoscope, with 
which we can see a large portion of the internal organs of respira- 
tion, and witness, with perfect certainty, the delicate movements 
of the vocal chords, and ascertain the exact locality of disease, and 
make our applications with mathematical certainty. The Sphyg- 
neograph, with which we trace with perfect accuracy every pulse 
wave from the human heart. The LEsthesiometer, with which we 
register with perfect certainty the changes of sensibility in every 
portion of the delicate and sensitive nervous system. These, and a 
thousand other improvements, I might adduce as an evidence of the 
onward march of our profession, and a proof of the necessity of 
constant study. 
Let us now for one moment pause, and, resting from the consid- 
eration of the duties and responsibilities of the medical man, ask 
what are the duties of the public towards him. 
If the true physician, as I have described him, is one who has 18 
devoted his whole life to the study of disease, its causes and its best 
method of treatment, he is certainly entitled to public confidence,, 
and his opinions and views on all matters of disease and its treat- 
ment should be relied on, and his decision, as to the value of any 
new plan of treatment, or remedy, proposed for the cure of disease, 
should be taken in preference to that of the ignorant pretenders who 
vaunt their nostrums and novelties for the purpose of personal gain 
without any reference to the public good. 
If you wish to have a magnificent building erected, you would' 
not consult your tailor, or if you wish to have a garment fitted, you 
would not consult your blacksmith. If you wish to examine the 
title of a piece of property, upon which you are about to invest a 
large amount of money, you would not employ your coachman to' 
perform this duty, but would seek the advice of some lawyer com- 
petent to protect your pecuniary interests—and yet how often do we 
see men of high standing in the community, of respectable intelli- 
gence upon almost all other subjects, trusting their lives and health 
to the merest pretenders, who are without the slightest knowledge 
of the structure of the human frame, the functions performed by any 
of its organs, or the effects or influences of remedies upon them. 
Even the clergy, and sometimes members of the bar, have been 
found who have dared to take the responsibility of advising the 
people to trust their lives in the hands of persons such as I have just 
described ; thus lending the influence of their professional position, 
to the injury of legitimate medicine and the detriment of the public 
health. 
In all the other transactions of life, people are in the habit of con- 
sulting those who are, or who are supposed to be, the most conver- 
sant with the subject upon which they need information, and yet, 
in a matter of life and health, they trust themselves to persons with- 
out the slightest pretension to any knowledge of the organic struc- 
ture of the human frame, or the laws that govern it—and the medi- 
cal man is severely censured because he refuses to meet in consulta- 
tion with such pretenders. 
This is one ground of complaint the profession has to make 
against the public, which certainly should be corrected. 
The public owe also to the medical man protection against un- 
just persecution and malicious annoyance, and the laws which are 
now inefficient should be so modified as to give him that protection. 19 
At the present time, a pauper can apply to a medical man for 
advice, and receive the best attendance that science and professional 
skill can afford, without fee or reward, and afterward, when actuated 
either by malice or ignorance in himself, or incited thereto by the 
envy, jealousy, or ill-will of other persons, he is at liberty to bring 
a suit in the law courts against the physician for malpractice. 
This the physician is obliged to submit to, and have the case tried 
before a jury of men perfectly ignorant of medical and surgical 
subjects ; his time occupied by the law suit, and he, himself, pre- 
vented from attending to his professional engagements, thereby 
being forced by law to violate his duty toward his patients and his 
own oath. This should not be. Such charges on the part of 
patients should be heard before a commission of medical experts,, 
capable of pronouncing whether such a charge, is tenable, and in 
accordance with their decision, the trial should be held or not. 
At the same time, the patient should be obliged to give bonds, with 
ample security, that, in case the verdict should sustain the physician* 
he should be paid for the loss of time and annoyance to which he 
has been subjected, and the defamation of character from which he 
had suffered. 
These suggestions are thrown out for the benefit of our Legisla- 
tors, upon whom I would urge the necessity of the enactment of a 
law, which would give the protection required, and in the passage 
of which the public should be deeply interested, for in protecting 
the physician they protect themselves. 
“ The wise physician, skilled our wounds to heal 
Is more than armies to the public weal.”