ADDRESS ON THE PROGRESS AND DIGNITY OF THE MEDICAL PROFESSION; DELIVERED BEFORE THE TRUSTEES, FACULTY, STUDENTS and FRIENDS OF THE STABLING MEDICAL COLLE&E, AT ITS ANNUAL COMMENCEMENT, February 17, 1849. By B. T. CUSHING, Esq. PUBLISHED BY REQUEST OF THE TRUSTEES AND FACULTY COLUMBUS, OHIO: PRINTED BY THRALL & REED, JOURNAL OFFICE. 1849. » ADDRESS. Gentlemen : In accepting your invitation on this anniversary occasion, it is my desire to present a subject alike in- teresting to you, as professional men and scholars, and to that community from which you receive this day such cheering testimonials of consideration and respect. Allow me, then, to call your attention to the Dignity and Progress of the Medical Profession. With regard to its dignity, I may remark, that yours is the oldest profession now extant. It had its origin in primary necessities, and needed no artificial systems of society to give it birth. Men had pains physical before statutory laws—they felt diseases of the body before they recognized the depravity of the soul. Thus the Physician must have preceded the Lawyer and Di- vine—npt, indeed, as a member of an elevated and cultivated profession, but as a rude wizard, or Indian "medicine man," seeking among minerals and plants some charm wherewith to allay disease. Soon the em- ployment grew more honorable, and required more skill, and then arose such physicians as Esculapius, and Machaon; of the latter, Homer informs us he was wounded at the siege of Troy, and shows us the ap- preciation in which he was held, by placing in the mouth of Idomeneus the high panegyric— 'ijiTgoc yct^ dvn'g 7ro\\Zv avisos cthKuv. —11. xi. 514. 4 Indeed, Surgery and Medicine were considered of such importance that they were soon ranked with Di- vinity. In Greece was a class of Priests styled vEscle- piades, from whom Hippocrates sprang, and who pro- fessed to trace their line back till it was lost with Esculapius, the reputed son of Apollo, in the twilight of fable. In Egypt, too, the vocation came to be re- garded as sacred, and the Jews themselves associated it with prophecy and miracle. In these more sober days, Medicine has dissolved her union with Theology, and consequently claims nothing from her sacred adjuncts. But her intrinsic dignity and excellence recommend her, as in other ages, to the veneration and esteem of mankind. And this will ap- pear, whether we consider the utility of the end at which she aims, which is nothing less than to heal " all who are diseased," an employment from which our Divine Savior did not shrink whilst on earth—the ex- tent of her acquirements, embracing as she does, a ma- jority of the physical sciences in her range—the emi- nent scholars who have at different periods adorned her annals—the general estimation in which she isiheld by mankind, or the employment she gives, in her pursuit, to all those faculties of contemplation and action which appear most amiable and god-like in man! Bu^ Dignity and Progress reflect light upon each oth- er, and are better observed when they walk in company. Permit me then to call your attention more especially to the Progress of the Medical Science. This is emphatically, an Age of Progress—an Age, eventful in great discoveries and rapid advancement. It is not an age of splendid achievement and remark- 5 able genius. Pericles and Aspasia saw, in Greece, more great spirits than now tread the habitable globe. It is not an Augustan age of literature, nor do the arts find a munificent patron like Lorenzo de Medici. Nor can we recall the age of Elizabeth, with Howard on the sea, Coke upon the bench, Bacon in philosophy, Shakespeare in poetry, Hooker in the church, and " Raleigh every- where !" And yet our age is a remarkable one. It be- yond all others reaches forward and reaps the reward of its own progress. Other eras have been fruitful in abstract speculation, elegant literature and heroic bat- tles. Ours is marked by the rapid spread of thought, and the developement of the individual man. At no period have the masses been so intelligent as now. Old governments and dead ideas are crumbling—the political and social heavens are "rolled together as a scroll," and from them we behold arise "a new heaven and a new earth," whereon is written Liberty. In physical comfort, too, there is a great advance. Per- haps in no century has the world been so well fed, clothed and lodged as in this—in none perhaps have the rewards of labor been more abundant and certain. But whilst we hear self gratulatory peals rising from all Christendom, as each new fact in science or art darts up like a rocket into the blue heaven, and sets men's minds confounded with wonder, there seems to be a vague complaint among the mass that Medicine has not kept pace with the general progress. We propose to enquire if this charge be just, and know no fairer mode of testing the truth, than by comparing Medicine with other arts and sciences, held in high estimation among us. 6 First, then, it is not true that the age is universally progressive. Besides its lack of brilliant genius, to which we have before adverted, there are very many of the arts and sciences in which it is notorious that no pro gress whatever has been made. In Oratory, who eclipses the vigor of Demosthenes, or the elegance of Cicero'? Who versifies like Homer, or speculates like Plato1? In Literature, the Press teems with new productions for its many readers—but who surpasses the terseness of Tacitus, the richness of Livy, or the manly simplici- ty of Xenophon'? The mighty stream of Bacon's thought still flows as unparallelled as the Amazon. Newton yet waves his sceptre supreme though the vast realm whose laws of motion he decided; and every planet that burns in the midnight firmament, or traces its glittering path across the Zodiac, does homage to the telescope of Gallileo, the laws of Kepler and the theory of Copernicus! Let us turn aside to the arts, and enquire where has been the progress. The finest statuary in the world has been handed down from a remote antiquity. The best paintings are those of the old masters. None can match the softness of Rafaelle—the sublime power of Titian, nor the masterly coloring of Corregio. Even the chisel of Powers cannot equal the Venus de Medicis, nor could Canova charm the beautiful disdain, nor catch the air pf god-like triumph, that lingers and plays about the brow of the Phidian Apollo'? In Architecture, this age, above most others, is deficient in creative skill. It borrows its rules and models en- tirely from those that have gone before. Athenian porticos and gothic towers and windows, lend the rich- 7 est grace that belongs to the designs of our architects. Nor can they, with all these adventitious aids, rival the symmetry of the Grecian temples, nor the vastness of the Egyptian pyramids. We turn now to the professions. In Law, something has been gained; for progress has been made in govern- ment and liberty. But the change is rather in expan- sion and liberalization than nature. The English com- mon law has proven itself like the tent the Fairy Para- banon gave Prince Ahmed, which when folded, could be held in the hand, but which, when spread, sufficed to cover an army. It has, besides, a vigilant array of sons ready to guard with a jealous eye all encroach- ments, and to cry out at every deviation '■'■Stare in an- tiquis viis! Her quaint formula and technical niceties are not yet altogether abolished, and where principles have been modified, their place has been in a great measure supplied from the Institutes of Justinian, and the authority of the Pandects. We have no better ad- vocates than Erskine^no sounder jurists than Black- stone—and if we except the one element of Commer- cial Law, which the genius of Mansfield perfected, no great additions have been made, and no large imperfec- tions pruned. Theology, is not a progressive science. It is said that here a new era has commenced—but when? where"? how1? Such men as Mills, Wetstein and Kennicutt, have collected readings and manuscripts, and the Ger- man scholiasts have heaped up folios, like Pelion on Ossa, to explain the inexplicable. But as far as we can see, no new light has been thrown on a single line of practical duty. Is the Christian of the nineteenth 8 century, with his bible in his hand, one whit superior to the Christian of the first century? Is his duty any plainer? Is his faith aught more certain? Are there preachers more powerful than Paul?—saints with "lips more golden" than Chrysostom?—lives more divine than Ambrose?—or writings more heavenly than Au- gustine? Have we any new weapons against Socinian- ism—any new exposition of the schism of Arian? Can we meet the doctrine of transubstantiation better than we did two hundred years ago? Can we over- come Joe Smith more easily than our fathers did Ma- homet? Still men continue to sin and blaspheme— still they may believe in fortune-tellers and Cock-Lane ghosts; and still a false prophet, in spite of the en- lightened theology of the nineteenth century, can found a sect, write a bible, speak in unknown tongues, feign miracles, and drive men mad with enthusiastic conver- sion. And why not? Theology is no more a demon- strative science than in the first century after Christ; and of the dark world invisible, and the dealings of God with man, we have learned and can learn nothing new! All the wisdom of our divines, all the eloquence of our clergy cannot force the human mind to compre- hend the doctrine of predestination and free will. All the speculations of Taylor, and the revelations of Swedenborg cannot satisfy it as to the nature of a fu- ture state! What then constitutes the great progressive feature of the age? I answer, aside from its political changes, and the labors of the press, its greatest improvements are purely mechanical. We understand better than our fathers how to do old things; we contrive easier 9 methods, more effective agents. The most of our dis- coveries are built upon simple facts—some old and some new—which illustrate and adorn old sciences. Mesmerism is not a science, it is only a fact in the great science of physiology. The magnetic telegraph is but the application of a single fact in chemistry; so of steam to move machinery, and light to daguerreotyping faces. In astronomy and philosophy, the map has been filled, but not extended. La Grange and La Place have but given more perfect coloring to the masterly outline of Newton—Hartley and Ried, Brown and Stewart, have only added new lustre to the brilliant theories of the metaphysicians! These things confound the public mind by their con- templation. It does not seem to perceive the difference between discovering a fact, and perfecting a science— inventing upon the basis of a single fact, the magnetic telegraph, and providing an infallible remedy for each and every disease. The property of electric fluid to communicate along a galvanic wire is one thing—the properties of every vegetable and mineral in nature, and the laws of each, when brought in contact with man's organization, are quite other in variety and dif- ficulty. It requires numberless facts to build up such a science as Medicine; and besides, when we reflect that the industry of man has already been operating upon it for ages, we should not expect new facts here to spring daily into life, like those in Geology and Chemistry, which are sciences but of yesterday. And yet it is even so. Of all the professions, of all the arts and sciences, none have made, during the last two hundred years, more rapid and substantial progress. 2 10 There is no science to which so many new facts have been added, none in which a more practical application has been made of the teachings of nature. Chemistry and botany are her handmaids in the great work. In Anatomy, Physiology, Pharmacy and Therapeutics, rigid analysis and sound deduction have taken the place of vague conjecture and bold pretension; and loose theo- ries and superstitious nostrums have given way to pow- erful simples, and a scientific adjustment of means to ends. A moment's glance at the learning of the ancients, as contrasted with our own, will prove the correctness of this position. Their Materia Medica was vague, cumbrous and unsifted. Of Pathology, they knew comparatively nothing; of Anatomy, little beyond the superficies of the body, in which their beautiful statues show them to have been close observers. But it was not until 1619 that Harvey discovered the circulation of the blood, and without that knowledge, judge how im- perfectly the other organs could be comprehended. What could be known of the heart that forces its cur- rent—of the lungs that purify it—of the stomach and chyle ducts which prepare its material? Surgery was confined principally to the curing of wounds gained in battle, and the cruelty and unskilfulness of its opera- tions may be illustrated by the fact that the Arabians plunged the stumps of amputated limbs in boiling pitch to stop the flow of blood; and in Europe, until within the last two hundred years, the same object was attain- ed by searing the vessels with red hot iron. But how different is the picture now presented! There is not a nerve or tissue, vein or artery, organ or 11 muscle of the human body which anatomy has not ex- plored. She has laid bare the secrets of nature's most wonderful mechanism—taken the manikin apart as a skillful silversmith would a chronometer, looked at the handiwork of the Almighty as at a watch or a cot- ton gin! She has studied the healthy uses of each organ, and its states of disorder and weakness. She beholds in the heart a forcing pump—in the lungs an instrument of chemical purification for the blood—in the brain a source of nervous activity and thought. Nor do her triumphs pause here. The discoveries of Ambrose Pare have driven the boiling pitch, red hot searing irons, and caustic vitriol, which rendered ampu- tation as terrible as death, from our hospitals and ope- rating rooms; and the improvement of Hunter, by which a ligature may be drawn around the artery above the place of incision, has rendered operations, formerly regarded most dangerous, comparatively easy. Limbs are now removed, new features constructed, tumors, through which the carotid and femoral arteries pass, can be cut away—the internal organism of the body is entered, and the House of Life invaded with fearful temerity. Tumors have been cut from the breast, when the liga- tures restraining the blood had to be passed, almost around the heart itself. When operations so grand and terrific are on record, why need I allude to the more delicate and beautiful? To those upon the eye for cataract ? To the creation of a new pupil, when the old one has been obscured by disease, by the passage of an instrument through the ball of the eye, opening a new window for light ? To the entering of the larynx by a probang, with a solution of nitrate of silver, in 12 cases of chronic laryngitis, which was regarded a few years since as anatomically impossible, but which has been successfully demonstrated to the profession by a fellow-countryman* The modes of healing are also vastly superior to those formerly in use, and wounds are now closed in three weeks which it once required many months to cure. Whichever way we turn, Improvements in Surgery present themselves. Indeed, gentlemen, to trace its progress, you have but to go into the street and look at a barber's pole. There it stands, silently speaking of that age when the Romish priesthood, which had suc- ceeded the priests of Isis and Apollo in the practice of the healing art, were forbidden to draw blood, and Surgery descended to the barbers. Then were those poles erected as signs of their vocation; some tell us, representing the wand of Esculapius, with the serpent, emblematic of wisdom twisted about it—others say, of the bleeding arm, with its bandages. Be that as it may, we have before us a visible evidence that Surgery, now one of the most dignified of the professions, was once connected with the lowest of all mechanical trades! The province of Materia Medica displays a like progress. I pass over the numerous improvements, fa- miliar only to the practitioner, and refer for example, to such discoveries as Iodine, Quinine and Chloroform, which are of popular notoriety. Scarcely a medical journal can be opened which does not reveal some new remedy, or the chemical purification of an old one. But this subject demands a detail too minute and ex- tended for this occasion. I trust you will permit me * Dr. Green, of JN«*r York — Tide " Green on Broncbitig." 13 merely to refer to it in general terms. But one feature of progress in this respect, ought not to pass by unno- ticed. I refer to the drug bill recently introduced in Congress by Dr. T. O. Edwards of this State. For years our country has been flooded, and the skill of our physicians rendered nugatory, by the immense quantities of adulterated medicines shipped to the United States. This bill forbids these medicines to pass the custom-house without the application of severe chemical tests, and the examination of experienced and able men. The result is already highly gratifying. During the six months intervening between July and January last, more than fifty thousand pounds of spu- rious and adulterated drugs were rejected at the single port of New York * In lieu of such trash, a large amount of pure drugs are now being received, which the competition of these worthless articles had before excluded from the market; and our physicians may soon hope for a Materia Medica whose operation will do justice to their science and skill. Nor has that portion of the Medical Science where it connects itself with Law, remained stationary. In- deed, no where is it more easy to trace progress than in what is technically called "Medical Jurisprudence." The ignorance of medical men, two hundred years ago, upon those topics on which their opinion is of weight in courts of justice, and where it often decides questions of liberty, property and life, was truly deplorable. In a case tried at an early day in England, and reported, where Spencer Cowper, Esq., was accused of the mur- der of Mrs. Sarah Stout and acquitted, it was a matter * See " Report of Dr. Edwards, on the practical operation of the drug bill—1849.'' 14 of dispute whether the body of a person committing suicide would not sink in the water, whilst a body thrown in, after death by violence, would float!* The professional opinions given on both sides were enough to puzzle alike the attorney for the crown, the judge and the jury. Other cases are on record where the ablest physicians in England were called upon to give opinions as to the signs of drowning, and differed on questions which any county practitioner in our State ought to be ashamed not now to understand. Yet these were the men whose opinions bore the fiat of life and death! But the progress of Medical Jurisprudence can be more fully illustrated from the calendar of in- sanity. Here indeed, the student of legal lore grows sick with horror, as he reads case after case where men have been hung, for no earthly reason, save because God had afflicted them with madness! Lord Coke's definition of the four grades of non compotes mentis, shows the low ebb of knowledge in his day upon this important subject. He describes them as—"1st, An idiot who from his nativity by a perpetual infirmity is non compos. 2d, He that by sickness, grief or other accident, wholly loseth his memory and understanding. 3d, A lunatic that hath sometimes his understanding and sometimes not: aliquando gaudet lucid is interval! is; and therefore he is called non compos mentis, so long as he hath not understanding. 4th, He that by his own vicious act, for a time depriveth himself of his memo- ry and understanding, as he that is drunken." f An idiot was defined to be "a person who cannot count twenty pence, or tell who was his father and mother, * See Hargraye'g St. Trials and Life of Lord Cowper. f Co. Litt., 247 (a.) 15 or how old he is, or what is for his profit or loss. But if he can learn his letters or how to read, by teaching or information, he is not an idiot."* Now, a large number of unquestioned idiots far exceed this knowl- edge, and at Bicetre, in France, and at other schools, by a peculiar system, they are at this day even inducted in the mechanical arts. As regards Lord Coke's second class, few men wholly lose their memory or understand- ing, except as a sequel to madness, disease or some powerful moral cause. Almost all lunatics are sane on some topics. Thus Lord Coke's definitions would ex- clude from the protection of the law, where insanity or idiocy might be pleaded, a large majority of men really non compotes mentis. Lords Hardwickef and Eldon,J both erred after the great master; and Lord Hale was so strongly impressed with the idea that only strength and capacity of mind are affected by insanity, that he made that a test of criminal responsibility, de- claring " though a man were affected with melancholy distempers," yet if he had " ordinarily, the usual under- standing of a child of fourteen years, he might be guilty of treason or felony." || So hi 1723, on the trial of Arnold for shooting Lord Onslow, Mr. Justice Tracy observed, that to be exempted from punishment, " a man must be totally deprived of his understanding and memo- ry, and not know what he is doing more than an infant, a brute or wild beast"§ In the case before him, the culprit was proven to have been of weak understand- ing, disorderly, idle, and sometimes unequivocally mad— a sullen strange boy—a moody man, living by himself * Fitzherbert's Natura Brevium. t Ex parte Barnsley, 3 Atk. 168. JHaslam'sMed.Jur. of Ins., 336. || Pleas of the Crown, 30. § 8 Harg. St. Tr., 332. 16 in a house destitute of ordinary corrveniences—lying about barns and under hay ricks, and sometimes curs- ing at himself for hours together—laughing, crying and rending things without reason, and disturbed in his sleep by fancied noises. He believed Lord Onslow to be the cause of all disorders—that by night he sent devils and imps into his room to disturb his rest; that he plagued and bewitched him, getting into his stomach and bosom so that he could neither eat, drink, nor sleep for him—and under these delusions wounded his fan- cied persecutor. The insanity, at this day, seems mani- fest—the proofs irresistible—but the jury convicted, and the judge sentenced him, and he would have been hung, but for the intercession of Lord Onslow, who procured a change of his sentence to imprisonment for life! Shall I proceed with this horrid detail? Shall I call up from their unconsecrated graves the sheeted corpses in ghastly array? Shall I show you the chains and gibbet with which a technical jurisprudence, founded on an ignorant hypothesis, visited, through successive decisions, the most overwhelming misfortune ever in- flicted by Deity on suffering man? No! No! Shud- dering humanity revolts at the recital, and the enlight- ened spirit of the age raises its hands in horror, and exclaims as did Macbeth to the ghost of the murdered Banquo: " Thou canst not say I did it! never shake Thy gory locks at me ! " Thank God, the proud advance of science spares our generation this withering disgrace. The signs and de- grees of insanity are now so well understood that the 17 technical rules of* ancient common law crumble before them. In the case of Theodore Wilson, tried for the mur- der of his wife, in York county, Me., in 1836, the court charged, that if the jury were satisfied that the prison- er was "not of sound memory and discretion, they were bound to render a verdict of acquittal." On Abbot's trial, in Connecticut, in 1841, the jury were instructed to acquit the prisoner "if he was insane at the time of committing the act." Similar language was used by the court on the trial of Mercer for the murder of Heber- ton, in New Jersey, in 1843;* and our courts generally seem inclined to recognize these rules as rational, be- neficent and correct. Thus, as the Sun of Science pro- gresses, are the mists of barbarism rolled away, and even the brow of Justice beams with new light! In Therapeutics, or the Science of the Cure of Dis- eases, a like advance may be traced. Distressing fevers and inflammations are treated with much greater ease and success than formerly—consumption is aided, and chronic laryngitis, once so obstinate, is in most cases em- inently curable.•(* The throat disease which destroyed the venerable Washington, has been treated in cases more threatening than his, with entire success. Scrofula and the terrible goitre have been subjected to iodine, and insanity itself yields to the influence of a congenial regimen. It can no longer be asked of the physician sneeringly— "Canst thou not minister to a mind diseased; Pluck from the memory a rooted sorrow; Raze out the written troubles of the brain, And with some sweet oblivious antidote Cleanse the stuffed bosom of that perilous stuff That weighs upon the heart!" — Sbaespxark. * Ray's Med. Jar. of Insanity. t Green on Bronchitis. 3 18 The bolts, bars and chains which formerly rendered this malady incurable, have given place to well consider- ed mental and physical agents; and a very large propor- tion of patients are restored to reason, as the statistics of our asylums abundantly prove. The average duration of human life has also been much increased during the last hundred years, as ap- pears by the statistical tables of Paris, Geneva and London; and we cannot fail to ascribe this in some de- gree to the advancement of professional knowledge and its application to diet, exercise and remedies. But the Medical Science is sometimes accused of im- becility because there are common diseases which defy her utmost power. Would you make her a god, and place in her hands the Amreta cup of immortality ? In her most perfect state she cannot present an invulnerable shield before the destroying angel—for " there is a time appointed unto all men to die." Nor do we believe the theory of some, which makes old age the only natu- ral outlet of life. That would soon fill the world with helplessness and decrepitude. I honor the silvered head! I have loved the aged father whose steps lingered on the precincts of the grave to bless his children! I have stood by the couch of the good man ere his spirit de- parted, " like the setting of the great sun, when the last song of the bird fades into the lap of silence, and the islands of the clouds are bathed in light," and his memory lives in my soul " like the first star that springs up over the grave of day!" But I felt it a merciful Providence that took him away before he ceased to make happy himself or others—before the "grasshop- per became a burden," and "desire failed," and "all the 19 daughters of music were laid low!" Heaven has, we believe, fixed bounds to the saving efficacy of medicine. The great laws of the physical and spiritual economy have spun the thread of existence for mortals, and no human science, however elevated, can save them from "th' inevitable hour." Among other proofs of weakness brought against the Medical Science, is also her inability to cope with those dire diseases which sometimes ravage kingdoms and threaten to depopulate the earth. This argument is unfair, because Deity here moves by a mysterious and terrible machinery, which human comprehension cannot fathom, and if it did, would be powerless to resist. " Ipse pater, media nimborum in nocte corusca Fulmina molitur dextra ! " — Virg. The great powers and agencies of Nature, are in awful commotion, and from all the sources of life, steals in the insidious poison of death. Whilst the lungs, stomach, and every avenue to existence is thus besieged by a malaria generated in the earth and atmosphere, it must surely be a wonderful alchemy which arrays itself against all nature acting together for destruction, and achieves a victory. That modern science has labored with some effect in this palpable obscure, is a matter deserving high praise. The ancients looked upon pestilence as the direct act of God, and knew of no remedy but prayer. David, standing by the threshing floor of Araunah, saw the destroying Angel with a sword drawn above Jerusalem, by which seventy thousand of his people had perished in less than three days, and cried unto God—"Lo I 20 have sinned, and I have done wickedly, but these sheep, what have they done!" and the Lord said to the Angel, " It is enough—hold now thy hand!" * So in the siege of Troy, when afflicted by pestilence, the Greeks saw the avenging shafts of Apollo, and Auv» h KMtyyii yein ctfyugow fitclo. — II. B. 1. And the Thebans, in the Edipus Tyrannus of Sopho- cles, cry out under similar misfortune, 2J»4*{ Ww, &c. — Ed. Tyr 1. 30. And in both cases, all human aid was looked upon as unavailing, and the gods were besought with tears and supplications. As we descend the Stream of Time, to periods regard- ing which we have more authentic history, we find the causes and cure of such disorders veiled in the same impenetrable mystery. Of all scourges of this charac- ter, the Black Death, or Great Mortality, as it was called, of the fourteenth century, was probably the most horrible. It was preceded by earthquakes, floods, unusual heats and famines, which had probably some influence in its production. Its general symptoms were the appearance upon the patient of inflammatory boils, and putrid spots—soon the fauces and tongue grew black, and were suffused with blood—the eyes became distorted and lustrous; the lungs were attacked, violent pains followed, and blood was expectorated; the breath and boils now diffused a pestiferous odor; a burning thirst came on, which no beverage could quench; and * 2 Samuel, ch. 24. 21 the victims died in awful agony, which many shortened with their own hands. This dreadful scourge broke out in the East in the\ year 1333, and with various symptoms traversed, during \ twenty-six years, the whole of the Old World, from Chi- ] na to England. Wherever it came, people were oppress- ed with dumb fear, or grew mad with terror. The church- es were closed—family ties were dissolved—mothers deserted their children, and children their parents. The miser forgot his gold, and the lady her lover. Ev- j erything the sick had touched, their breath and clothes, \ spread the contagion. Merchants of immense wealth '■, brought their goods to the church, but money had be- I come poison, and the monks only received it to die. The church-yards could no longer contain the corpses, and they were left unburied, or arranged by thousands in pits, or thrown into the rivers. China lost thirteen millions of inhabitants. India was depopulated. Tar- i tary, Mesopotamia and Syria were covered with dead ', bodies. The Kurds "fled in vain to the mountains." \ In Caramania and Cesarea, none were left alive. Only a i few cities of Asia escaped, and her loss, aside from that of China, was nearly 24,000,000. From the Orient, f preceded by an offensive mist, the plague settled down i upon Italy and Europe. Here ensued the same scenes J —the closing of churches, the division of families—the I destruction of business, and the devastation of cities. J More than 200,000 towns and villages were depopulated. \ Italy lost half of her inhabitants. Germany 1,200,000. In many places in France, not more than two in twenty were left alive. In England, it is said nearly nine- > tenths of the inhabitants perished. This last is evi- 22 dently too large an estimate, but without exaggeration, Europe was despoiled of 25,000,000, or one-fourth of its entire population! In Florence, it was forbidden to toll the bells, lest the survivors should surrender to despair; and the historian records, that when the plague had ceased, "Men thought they were still wandering among the dead, so livid had terror and anxiety left the countenances of the survivors." Amid this terrible havoc, when Death appeared, seat- ed upon his pale steed, waging a war of extermination against mankind, where were the Medical Profession of that age? With a laudable desire for self-preserva- tion, the most of them declared that medical aid was unavailing, and sought, in contagion, to justify flight. Guy de Chauliac alone remained at Avignon. And now we behold one of the most curious documents recorded in history. The College of Physicians of Paris, being the most celebrated of the fourteenth century, were called upon to give their opinion regarding the Great Mortality. They published a bulletin, which is still preserved, and which, as a professional exposition, is certainly without an equal in this or any other age. They gave, as the occasion of the plague, that the "Con- stellations which combatted the rays of the Sun, had struggled with the waters of the Great Sea, and origi- nated vapors"—that "the Sun and Fire had attracted a great portion of the Sea to themselves, that the waters were corrupted, and the fish died, and the vapor over- spread the earth like a fog," and the like would con- tinue " so long as the Sun remained in the sign Leo!" Thus much for the opinion of the very learned Faculty regarding its cause. The means of prevention pomted I 23 out were equally singular. The Medical College stated that they relied on " Constellations striving with the aid of Nature, by virtue of their divine might to protect and heal the human race," and followed this by recom- mending some simple rules for diet and exercise, for the burning of vine wood and green laurel, and by the sage advice that "fat men should not sit in the sun," nor "rain water be used in cooking." Of the astral influence in producing the Great Mortality all the physicians of that day were fully convinced. A grand conjunction of Saturn, Jupiter and Mars, in the sign of Acquarius, was considered the primary cause of the Black Plague.* Thus in the fourteenth century did Medicine pros- trate herself at the altar of Superstition, and suffer the world to be almost depopulated, with scarcely a visi- ble struggle to resist it. Let us turn away from this disgraceful page, and contemplate her victories at the present day—the day of acute analysis and searching inquiry, of rigid investigation and daring experiment. The fatal Small Pox, which ravaged Europe for twelve centuries, and which is supposed to have nearly de- stroyed the Aborigines of America, has met a noble check in the vaccine virus of Jenner. The Yellow Fever yields now in a majority, of cases to well select- ed arms from the arsenal of physic—and the Cholera —that direst scourge of modern times, has been close- ly and vigilantly approached. To say the least, our physicians have not been guilty of building up fanciful theories and leaving their patients to die unaided; but with scrutinizing eye and ready hand have sought the * Heckei'i Epidemics of the Middle Ages. 24 infected districts, stood by the bed-side of disease, and dared the tainted atmosphere of the dissecting room. Every avenue to knowledge which human ingenuity could devise has been explored, and the ravages of the pestilence have thus 'been materially abated. It is true j no means are yet discovered to reach its advanced stages, j nor is it probable that there will be. Its poison seems too rapid and subtle for any mechanical agent to meet, when it has once pervaded the entire system. Nor can all be guarded from its approach. It must have its j appropriate victims;—the intemperate, the uncleanly, j the careless and debilitated—and,—we know not for what wise purposes,—some noble and worthy among us will be drawn into its dreadful whirlpool. But we cannot fail to give the Medical Profession high praise for their labors in this respect, accompanied with the hope that they may yet have more abundant success. This brings me to the most important portion of my subject—one, in which, more than all others, physicians have progressed during the last fifty years. I mean the branches of Pathology, or The Science of What constitutes a Disease—and Nosology, which treats of the various Sorts of Diseases, their Origin and Symp- toms, and strives to classify them as a Whole. Here shines resplendent the "dry light," of the genius of Bacon, and it is here that modern practitioners partic- ularly excel those of any former age. The great error of the ancients was to establish ab- stract speculation for experience, theory for fact. They framed hypotheses instead of questioning Nature, and loved rather to form sects and captivate public opinion with subtle doctrines than apply themselves to the se- 25 vere study of truth. The brilliant and captivating speculations which grew out of these efforts of the imagination have been the wonder and admiration of successive ages. The Galenic theory—those of Bo- relli, Van Helmont, Paracelsus, and Silvius have suc- cessively filled the world with their praise. But beau- ful as they were, experience proved them barren and unproductive. Well did they deserve the sarcasm of the author of the Novum Organum who declared it "no wonder that the Egyptians (who bestowed divinity on the authors of new inventions) should have consecrated more images of brutes than men; for the brutes by their natural instinct made many discoveries, whilst meU made few from discussions and conclusions of reason." Solomon tells us there is " nothing new under the sun,"—if by this he means that old things are con- stantly recurring, we may find a proof of his truthful- ness in looking upon the theorists of the present day. Like their ancient prototypes they are content with few facts and great conclusions—a little powder and much noise. Some of them have, unquestionably, fine genius and great powers of advocacy; many of their practition- ers are most sensible and worthy men—but when we examine the principles upon which they stand, we cannot believe that Thomson has built firmer than Paracelsus, or Hahnemann than Borelli. All theories must perish sooner or later, in this Science—for Medicine is the child of Experience, and not of Abstract Reasoning nor high Imagination. Yet these theories undoubtedly do a good work in their day. Certain cases they unavoidably meet, and 4 26 certain errors correct. Thomsonianism may, for ex- ample, have checked the too free use of the lancet and Calomel; and Homoeopathy may show to the profession the important fact, that good diet and a strong imagi- nation sometimes produce better effects than a whole drug shop taken into the system. It is a little marvellous how multitudes are capti- vated by the theory uppermost for the time being. They cannot comprehend a broad science working by established laws, and their imaginations are easily in- flamed by nostrums, panaceas and magic cures. One year we have Perkins' tractors—another, galvanic wires, and homoeopathy hydropathy and Brandreth's pills fol- low each other in rapid succession. The infinity of reputed cures, few of which can be closely scrutinized, makes the populace gape in open-eyed wonder. It seems to them as if the philosopher's stone had been discovered, and the age of miracles renewed. And they so love simplicity! "Each new truth is a unit," cry they,—therefore "all Medical truth may be redu- ced to a proposition!" "How captivating," says one, " is the simplicity of Quacks! A gardener has turned physician—he has made the discovery that all diseases proceed from butter-cups. This is his theory: Every man, woman and child eats mutton, beef or butter, or drinks milk—all mutton, beef, butter and milk is pro- duced from oxen, cows, or sheep—every ox, cow, and sheep, eats butter-cups with its grass; butter-cups are rank and acrid weeds—ergo all diseases proceed from butter-cups!" Nay, he proceeds a step farther—he has found a cure for all diseases. " Nature" says he "must place the remedy near the poison, else her 27 economy is at fault. I have observed butter-cups grow near daisies. I have also noted that where oxen, cows, and sheep, have eaten daisies, not more than one in twenty die of disease during that season. Ergo, my Medicated Extract of Daisies, is a cure for all diseases!" And thus our theorists work—each on his own pecu- liar plan; the Hygeist purges — the Thomsonian steams—the Hydropathist washes, with indefatigable industry. Sometimes they cure, and then what a blast fame blows from her trumpet! Sometimes they kill, and then the patient's constitution is, forsooth, declared to have been first ruined by the regular practitioners ! Who does not admire the ingenuity that discovered the wonders of red pepper and lobelia? who is not fasci- nated with the expansive genius of Hahnemann, the author of the paradoxical maxim, "similia similibus medentur?" who does not believe that what will give him a headache, will, if administered in infinitesimal potions, cure it; and that the only way to heal the bite of a large mad dog, is to be bitten by a small one? It is alike the duty and desire of the Medical Pro- fession of the day, to avoid these captivating theories, and make recorded experience their sole guides in the cure of diseases; and we regard this as an infinite step in progress. History has taught them that all other lights are false and dangerous. Bacon assured them that such speculations might be fertile of leaves, but far different means were required to produce fruit. He demanded that all the physical sciences—Medicine included—should be based on the observation of facts carefully discriminated and balanced. Wherever a sufficient number of facts concur, the law is established. 28 Following this method, Astronomy has grown up— Geology has been born—and Chemistry purified; and two hundred years have sufficed to change the visible texture of the world. Men no longer drone along at one-horse speed, but fly on the wings of the rail road car or steam boat. Hand looms and wheels fade before the manufactory and the spinning jenny; and New York and New Orleans hail each other from the extremities of the lightning wire! Mighty was the genius that set the wheels of progress in motion. Well might the Lord of Verulam, standing as Moses did upon Mt. Pisgah, look over the Land of Promise, and, in a proud conscious- ness of the result, write, "I consign my memory to men's charitable speeches, and to foreign nations, and the next Age !" But the application of Bacon's reasoning to Medicine, was of slow growth. Its correctness was acknowledged, but its rigid application required too much labor. Men preferred gathering a fact here and there in memory, and reasoning upon it, to noting down each in regular and constant progression. Bacon declared that a man might as well attempt to " achieve by memory, the computation of an almanac," as to build up science by facts thus obtained. His philosophy demanded that physicians should keep written tables, in which they should note down every patient—his disease—the remedies administered—the variation in symptoms— the progress and termination of the illness. These are the data upon which Pathology and Nosology are founded. Thus it is ascertained with precision, in what diseases consist, and how they differ from and resemble each other. I will illustrate this point, by 29 reference to the Black Plague, which I have before cited. The Physicians of that day, do not appear to have made observations of this kind regarding it. They framed subtle and mysterious theories founded on the movements of the heavenly bodies—gave some simple advice, and let the disease go on its destructive mission. But let an unknown disease appear at the present day—as the Cholera, for example—and what is the result ? The first case strikes the Physician as new—he marks down its symptoms—prescribes medi- cines, which meet like symptoms in diseases with which he is acquainted—and notes the effect. As his patients increase, he goes on making his observations by these numerical tables, and, casting their average, arrives at his conclusions. Now this method may not always enable the practitioner to ascertain absolute cures. But it is certain, that if any mode will do it, it is this. A disease becomes thus geographically marked out, and the practitioner knows precisely what is to be done, and how to do it. The most eminent Medical writers, of the last half century, have adhered strictly to this plan; and upon a continuation of this method, undoubtedly depends all great advance in this branch of the profession. Do you ask me for the fruits of this progress, so far as tested? Their name is Legion. I will only refer to a few examples. There are those now before me, who remember the day when Pneumo- nia could not be distinguished from Pleurisy and Bron- chitis — when " Inflammation of the Brain," embraced affections now known to be entirely distinct—and dis- eases were called by the common title of "Cardiac Palpitations," as widely different as organic and func- 30 tional alterations. Now these diseases are distinguished with almost absolute certainty, and the success of their treatment, has increased in a corresponding ratio. It may here be objected, however, that the Faculty are " slow in adopting New Lights in the Profession." The fallen theories we have touched upon, show how futile it is for them to examine, particularly, imaginative speculations, when the same Nature that has answered so long, and truly, still waits to be interrogated. As to what are commonly called " Patent Medicines," they are intended only to reach certain symptoms of the patient — and as these symptoms rarely exist unmixed, even the best of such specifics are likely to do as much harm as good. The cough, perchance, is improved, but the stomach is disordered, and the cough soon returns upon a weakened system. As regards the opposition sometimes manifested to real improvements, the Medical Profession are but men. They belong to the same race that crucified Christ, imprisoned Gal- lileo, mocked at Columbus, and ridiculed Fulton. All new truth finds a strong barrier to overcome in the fixed prejudices and notions of men. I think we may safely say, that the Medical Faculty of the day, are as free from its chains, as any set of men who have devoted themselves to a single study; for single studies, long pursued, incline us to believe them perfect, and make us loth to imagine that anything could be added by another to what we, ourselves, attained with such difficulty. However, at this day of rapid improvement and discovery, it is the duty of all men — and espe- cially those entrusted with so important a charge — to 31 enquire concerning all things impartially and freely, and to " hold fast to that which is good." Gentlemen, I trust enough has already been said, to sustain the truth of the position advanced. I put it as a candid enquiry, whether the facts of the case, show that want of Progress in the Medical profession, with which it has been charged; whether, on the contrary, they do not satisfactorily prove an advance in this science as great, at least, as in any other; an advance highly creditable to the Progressive Age of which it is a constituent element! Medicine can never be reduced to the rigorous cer- tainty of a mathematical science. As we advance from concrete and inert masses, upwards through the ex- tended and beautiful chain of Progressive Being, to vital organization and functional display, uncertainties are increased, and causes and effects developed, which human reason is inadequate to comprehend. To un- derstand their forces, man must grasp the undiscovera- ble secret of life, and read the natural history of the soul. But there is an elevated point at which human reason can arrive — a hill top from which she can behold, if she cannot touch the stars. That the Medi- cal Science of this day is in the path leading to that eminence — that indeed she has already wound her way up far from the valley, enough has been already stated to convince you. That she will still go on " con- quering and to conquer," let us trust in the labor and ambition of her children to achieve. The fruits of the past furnish no ground for slothful inactivity, but rather for increased exertion. A great battle has been fought — a great victory won, but the campaign is not 32 yet ended. Adventurers have brought back golden trophies and pearls of great price, but still before lies unexplored the great empire of truth. Are you ready to invade it ? Here are honors more proud than the Norman Conquerer promised his Barons — rewards more desirable than the wealth of Crcesus — monu- ments more durable than those of marble erected over the graves of Heroes. Who will seize upon them ? Let the men of strength and activity — men able to bear toil and unwearied by thought advance! To them will the great Sphynx of Nature read her riddle — to their questionings will she reply. Each disco- verer of a new law or a new remedy will be enrolled among the benefactors of his race. His name will be written for distant posterity to admire. He shall be crowned with Jenner. He shall be embalmed with Abercrombie; and beneath such hands the Medical Science will rise up, a time defying pyramid—a me- morial of noble exertion, which the blessings of man- kind will consecrate, and the corroding waves of ages prove ineffectual to destroy. Pardon me for infringing upon your time, but my remarks would be incomplete without a few wrords relative to the individual attainments and character of Medical men. The Physician of this age should be a man of large and general scientific knowledge, for he has to do, at sometime during his career, with nearly every physical science. He should be a good chemist and botanist, and with the various branches of his own profession, of course, perfectly familiar. He ought also to under- stand the laws of mind, which are acknowledged to 33 have a powerful influence upon the body—and to be ready at all times, by study and observation, for the " occasion sudden, the practice dangerous." In the languages, Greek and Latin are necessary, not only to train and elevate his mind, but to enable him to fully understand the technical terms of his profession, wThich have been introduced mainly from those tongues. French should be learned to give the student access to the vast amount of medical lore enshrined in that most popular of modern languages, and German and Italian .would not come amiss. Those who possess not the means of obtaining these last named advantages, should endeavor to compensate for their loss by a more strict improvement of such as they have; for, after all, it is zeal, industry, and practical good sense that must form the basis of professional success. Another matter which should not be overlooked is the cultivation of the professional man. He should not be satisfied with learning and skill, if he accompa- nies it, as has sometimes been the case with eminent practitioners, by coarseness and brutality. The physi- cian is, or ought to be, the most intimate friend of the family he visits—and how important it is to them that his manners should be courteous and his heart sympa- thetic. A dear member of the family circle lies upon the bed, perhaps of death. They "----Watch her breathing through the night, Her breathing soft and low; As in her breast the wave of life Keeps heaving to and fro: " What a ministering angel does the kind physician seem! how they hang upon his every word and action! What 5 34 blessings overflow their lips if he can heal the suf- ferer; but if this cannot be, how delightful if as a christian he can breath the last consolation into the ears of the dying, as a man of sympathetic heart, alle- viate the woe of the living, and by the exercise of a practical common sense advise in emergencies which so often succeed the departure of a head of the family! The value of an Institution like that whose anniver- sary we this day celebrate, in qualifying young men for the arduous and elevated duties of such a station, is too obvious to require notice. Every good citizen— every lover of his country and mankind, must bid it Godspeed! Enlightened sentiment and sober convic- tion alike teach us to take an abiding interest in its success, to guard its reputation with eager jealousy, and to be always ready, when occasion offers, to serve it, ac- cording to its need and our ability. Young Gentlemen of the Graduating Class: — Permit me to say a few words to you before I close. You are candidates for the honors of that Profession whose Dignity and Progress it has been my object to describe. That I should do the subject justice, was not to be expected. Could one, like him, whose vene- rated form and massive eloquence gave dignity to your last anniversary* have addressed you now, then indeed the theme had possessed a worthy advocate. As it is, I can only hope, at best, that an attempt faithfully to fulfil the duties, the invitation of your Faculty has de- volved upon me, will save me from the severity of a too critical censure. Rev. Dr. Hoge. 35 Gentlemen, your eyes have followed the steps by which your benevolent art has climbed from ignorant obscurity to its present elevated eminence. You have beheld it bringing forth from chaos and darkness the elements of usefulness and power. To obtain instru- mentalities in its blessed work it has subsidized every department of science and every branch of knowledge. It has dissected the minutest fibres of the human frame— probed the inmost recesses of bodily and mental dis- ease—searched the three Kingdoms of Nature for remedies, and, finally, all but mastered the laws of that Vital Activity which mechanical and chemical skill strives in vain to fathom. It has brought life from death—health from sickness—given eyes to the blind, limbs to the halt, and clothed the crazed and desolated soul in the light of reason and hope. These are its noble aims, these its beneficent results. The track behind is clothed with brightness—the vista before opens full of promise. Much has been done, but more remains to be accomplished. To the active pursuit of such a profession I am ready to believe you need no stimulus, and see no difficulties too great to overcome. If any of you are poor, thank God that you are so,— for the lives of our public men assure us that nothing makes professional success half so certain as poverty. If few of you possess genius, remember, the most emi- nent and useful of your profession have become so rather by industrious habits than brilliant talents. Above all things remember the awful responsibilities investing him who experiments upon human life—how culpable he is for ignorance, carelessness or inefficien- 36 cy; and then turn to the lives of those eminent practi- tioners who have gone before you for encouragement: " Lives of great men all remind us We can make our lives sublime, And departing leave behind us Footprints on the sands of time ! Footprints which perchance another, Wandering o 'er life's weary main, Some forlorn and shipwrecked brother Seeing may take heart again !'' Harvey and Cooper are in the "clear upper sky," but their examples remain for you to admire and emulate. The light they have thrown upon the past, it is yours to reflect upon the future. Let the young men of this age be men of science and activity, severe study and practical usefulness—then will they build them- selves a monument in the esteem of mankind, and when they are called away, the heavens will be enriched with constellations as glorious as any that have pre- ceded them! A thought in another connection and I have done. During the past year Death has been busy among you. " Pallida Mors, equo pulsat pede pauperum tabernas Regumque turres ! "—Hon. lib. i. Your honored founder has been called hence to that bourne whence no traveller returns. Scarcely had he completed his munificent donation before he received his summons to join the shades of the departed. It is meet and fitting that on this occasion we should pay a tribute to his memory. He came to the West, a young man with scanty means and a delicate constitu- tion. By dint of a clear head and iron energy he 37 amassed an immense fortune, of which you are the partial recipients. For this he claims your gratitude and esteem. His virtues, it is your especial duty to emu- late. If he had failings, remember his temptations were great, his restraints few, and he but a man. In founding this Institution he laid his brightest and most enduring monument. When the rest of his large for- tune, meeting the accustomed fate of similar donations', shall, in the common distributions of time, have grad- ually passed away to strangers, and " Like the baseless fabric of vision Leave not a wreck behind," This institution will rise to meet the morning, and teach to future generations the name of its founder. It will rank him with Harvard and Yale, Williams and Phillips, Williston and Hollis, Appleton and Lawrence; names dear to every American scholar, and embalmed with the grateful blessings of mankind! Here will re- sort the intelligent and gifted, the ambitious and be- nevolent, and as often as they look upon this pile, their hearts will do him involuntary homage. Long may it stand to extend its streams of blessed and be- nign influence! Long may the first sunbeams crown it, and the stars of night hover and sparkle about its summit! In view then of his munificent donation, and the re- sults it is to realize—in the name of the sick and af- flicted who are to reap the rewards of his labor—in the name of the Great West which he has enriched by so noble an offering—in the name of these young men to whom he has opened an avenue to ambition 38 and influence—in the name of the city which feels his benefaction, and of the widows and orphans who are to receive the reflected light of his bounty, permit me to conclude by uttering a sentiment, to which I trust every heart will respond: " Honor to the memory of Lyne Starling ! "