ORATION 
delivered before 
THE ALUMNI ASSOCIATION 
OF THE 
MEDICO-CHIRURGICAL COLLEGE OF PHILADELPHIA, 
ON THE EVENING OF 
Thursday, April 7, 1887, 
BY 
DUDLEY S. REYNOLDS, A.M., M.D., 
LOUISVILLE, KY. 
REPRINTED FROM 
THE MEDICAL REGISTER, 
OF PHILADELPHIA. 
1887. ORATION 
DELIVERED BEFORE THE ALUMNI ASSOCIATION OF 
THE MEDICO-CHIRURGICAL COLLEGE OF PHILA- 
DELPHIA ON THE EVENING OF THURSDAY, APRIL 
7TH, 1887, 
BY DUDLEY S. REYNOLDS, A.M., M.D., 
LOUISVILLE, KY. 
COMING to the chief centre of learning in the 
United States to discuss questions of education, 
I know requires some degree of boldness, not to say 
self-assurance, lest the memories of Rush, Physick, 
Meigs, and Gross may rise up in the minds of those 
who are assembled in this temple of learning to con- 
found my speech and make my poor utterances seem 
contemptible in comparison. 
The importance of my theme, and the interest I 
naturally hope to awaken in the minds of this audi- 
ence, embolden me to make the attempt to discuss, 
in a few brief sentences, some of those great questions 
which have occupied the greatest intellects in the 
busiest moments of their most important and benefi- 
cent enterprises. 
When anatomy was studied in a few of its meagre 
outlines merely, and for the most part in secret, there 
came forth a man named Monroe, in the great city of 
Edinburgh, where Benjamin Rush, Ephraim McDow- 
ell, Walter Brashear, David Hosack, and Ben Dudley 
received their first medical training, and with the force 2 
of great eloquence and a thorough mastery of what ap- 
peared at that time all of the details of anatomy, in- 
vesting the dry bones of the skeleton with a fascination 
but little less forcible than that with which the im- 
mortal Shakespeare has clothed the cowardly assassin 
of Duncan, Scotland’s famous king. Monroe was so 
great in his style and manner of teaching that the 
medical school at Edinburgh became for the time the 
leading medical institution of the world. From that 
day to the present the study of anatomy has been 
rendered simple and easy. 
An ambitious physician of that time, jealous of 
Monroe’s great success and reputation as a teacher, 
built a hall in Edinburgh and established therein a 
museum of anatomy. To his amphitheatre he invited 
the students and practitioners of medicine to hear him 
lecture and witness his demonstrations. He rattled 
the dry bones before his audience with such energy, 
and spoke with such eloquence, that he soon robbed 
the great university of all its students at the time of 
the usual lectures on anatomy. This man’s boldness 
in exhibiting the skeleton, and even the cadaver itself, 
for purposes of demonstration aroused great excitement, 
but the earnestness with which he prosecuted his work 
finally won for him that success he so much deserved. 
This may be said truly to have been the very be- 
ginning of illustrative methods in medical teaching. 
It was a long time, however, before other branches of 
the curriculum advanced beyond the prevailing theo- 
ries of a few leading men. 
On the 9th of July, 1790, Dr. Benjamin Rush stood 
in the hall of the College of Physicians in this city 
and delivered an eulogium upon the life and character 3 
of William Cullen, the author of a new system of 
medicine. Said Dr. Rush : “ This illustrious physi- 
cian was the preceptor of many of us ; he was, more- 
over, a distinguished citizen of the republic of medi- 
cine, and a benefactor of mankind; and, although like 
the sun, he shone in a distant hemisphere, yet many 
of the rays of his knowledge have fallen upon this 
quarter of the globe. Dr. Cullen possessed a great 
and original genius in discerning the relation of dis- 
tant truths by the shortest train of intermediate prop- 
ositions. His imagination surveyed all nature at a 
glance, and, like a camera obscura, seemed to produce 
in his mind a picture of the whole visible creation. 
His knowledge was minute in every branch of medi- 
cine ; he was a great anatomist, and an ingenious 
physiologist; he enlarged the boundaries and estab- 
lished the utility of chemistry ; he stripped materia 
medica of most of the errors that had been accumu- 
lating in it for two thousand years and reduced it to 
a simple and practical science. ’ ’ 
At the time Cullen made his appearance as a teacher 
the doctrines of Boerhaave were universally prevalent; 
Boerhaave believed all diseases depended chiefly on 
the presence of certain acrid particles in the fluids of 
the body, and in a departure of these, in point of con- 
sistency, from the natural state. 
Says Dr. Rush : “ Cullen’s first object was to ex- 
pose the errors of this pathology, and to teach the 
public to seek the causes of disease in the solids. ’ ’ 
Cullen’s theories concerning the nervous system so 
impressed his eulogist that he boldly proclaimed ‘ ‘ no 
man would ever unravel the operations and the whole 
nature of the nervous system without being forced to 4 
acknowledge that the foundation of his successful in- 
quiries was laid by the discoveries of Cullen.” 
The pathies and isms arose, and flourished for the 
edification of imaginative people. The few facts per- 
taining to every branch of medical education, except- 
ing anatomy and botany, were so scattered as to defy 
ever}' attempt at establishing principles, until finally 
Billings came, and the new pathology of Simon 
opened up new fields for speculation and experiment. 
Dissection became a recognized part of the cur- 
riculum, and was openly announced as part of the re- 
quirements in all the best schools. 
John Hunter’s great thirst for experimental knowl- 
edge had now well nigh taken hold of the world, 
when Jenner came as the apostle of a new creed, 
based upon the experiences of the humble dairy- 
maids. Vaccination as a protective measure against 
the small-pox remains an unexplained fact. 
Presently instruments of precision began to be em- 
ployed ; vivisections of inferior animals were made, 
and the science of biology began to receive fresh 
attention ; the humoral pathology, homoeopathy, 
Thompsonianism, and all the “isms” and “pathies” 
paled into so many dim shadows over the fields of 
former conquests. 
The medical student now, instead of sitting pa- 
tiently by the hour listening to the beautiful sophistry 
with which individual theories and hypotheses con- 
cerning the nature and character of disease were sup- 
ported has, at length, come to the point where 
demonstration of the theories and illustrations of the 
methods of practice are demanded. 
The growth of medical education, it may be said, 5 
has been slow. Twenty-five years ago there were, 
indeed, but few schools in the country where clinical 
and laboratory instruction formed anything like a 
prominent feature of the curriculum. The result of 
these practical methods of inquiry and the substitu- 
tion of the few demonstrated facts applicable to the 
study of disease has been wonderful. A great and 
new science of pathology is now established upon the 
ruins of Cullen's popular theory. 
The great Pancoast comes no more to stand before 
you‘with burning lips and irresistible arguments, to 
convince you of the superiority of his method of treat- 
ing wounds ; in his stead, the gifted son invites you 
now to the dispensary and to the clinic-rooms, that 
you may see for yourselves the masterly touch of his 
cunning hand in the adjustment of fractured bones, 
or witness his skilful methods of staunching the flow 
of the crimson tide in wounded arteries. You are not 
asked to believe upon the mere statement of your pro- 
fessor of chemistry’, whose beautiful experiment of the 
consuming powers of oxygen and the frigid powers of 
carbonic acid gas are, upon the one hand, the life-giving 
force in the atmosphere we breathe, and on the other, 
the death-dealing force in the dark recesses of subter- 
ranean caverns. He does not content himself with 
telling you that carbonic acid gas is evolved from the 
mixture of sulphuric acid and carbonate of lime ; but 
proceeds at once to the demonstration, and, with the 
magical processes of his art,- he compels ever}’ mem- 
ber of the class to become practically familiar. 
In the pathological laboratory’, which is an institu- 
tion of comparatively recent dey’ice and origin, you 
now study in the dead subject the nature and extent 
of those changes yvrought by disease. 6 
Experimental research has at length brought to 
light the startling fact that nearly all of our diseases, 
and especially the contagia, arise from specific micro- 
organisms, which, although their life histories have 
been studied with great minuteness of detail, cannot 
with certainty be classified as animal or vegetable in 
their nature. A minute rod-shaped body, called by 
its discoverer, Dr. Robert Koch, the chief of the great 
“ Gesundheits Amt.” of the Prussian empire, the 
bacillus tuberculosis, is now universally recognized as 
the cause of all tuberculous processes in man and the 
inferior animals. It has likewise been discovered by 
experiment that this bacillus is wafted in the air; 
that it grows in lymph by preference, and when in- 
oculated or injected beneath the skin, it passes into 
the blood-current, and there seizes upon the germinal 
matter, or sarcode of the white blood-cell, arresting 
the cell instantly in its course, causing it to assume 
enormous dimensions, interfering in that way by ob- 
structing the blood stream, and, presently, when it 
ruptures to discharge its myriads of spore-cells, to at- 
tack in like manner contiguous leucocytes, until the 
current of blood in that tube is arrested. This of 
course speedily brings on those changes characterized 
by heat, pain, redness, and swelling. 
Now, when the bacillus is breathed into the air 
passages, if the whole of the respiratory membrane be 
sound upon its surface, the bacillus will not grow, but 
will find a temporary lodgment in the mucus, and 
presently be snuffed up and hawked out, or coughed 
up and expectorated. If, however, these bacilli or 
their spore-cells lodge upon an abraded surface, where 
they gain ready access to the lymph-tubes, they 7 
colonize and grow there, and, by slow invasion, the 
whole pulmonary lymph system may be destroyed. 
With these facts, we are at once prepared to appre- 
ciate both the means and the reason why tuberculous 
disease generally invades the respiratory organs first, 
and why tuberculosis as an inheritance generally 
proves fatal to the infant. 
The specific cause of suppuration in wounds has 
recently been brought to light in the discovery of 
microbes, which collect in groups, and which, when 
assembled in large numbers, present a golden-yellow 
tint. This is called the ‘ ‘ staphylococcus aureus, ’ ’ 
and to some recent experimental researches of Prof. 
Cornil, of Paris, and Prudden, of New York, we are 
indebted for the demonstration that suppuration in 
wounds is invariably the result of the presence of 
this microbe. 
Scarcely less brilliant have been the discoveries in 
chemistry and physiology. Merck, of Darmstadt, 
has at last succeeded in producing, by synthesis, 
many of our most valued therapeutical agents, and 
in 1879 he brought forth a new product by this 
agency, which is now known and prized by every 
ophthalmic surgeon in the world. 
In testing the refraction of the human eye it is 
necessary to suspend the focusing power, in order to 
secure accurate results. For this purpose the sul- 
phate of atropinia, long in universal use, required, 
in many cases, from three to five days’ constant use 
of the drug to bring on complete suspension of the 
accommodation, and then from twelve to fourteen 
days were required for the patient fully to recover 
from its effects. The hydrobromate of homatropinia, 8 
made by the synthetical method of Merck, whilst at 
the same time free from toxical effects, is speedy and 
more uniformly efficient in suspending the accommo- 
dation than any drug hitherto employed for that pur- 
pose, complete suspension now being possible within 
the brief space of an hour and a half, and all signs of 
its effects disappearing uniformly within thirty hours. 
It is likewise powerful in the relief of pain, and may 
be instilled into the eyes of children with perfect im- 
punity in solutions of the same strength as are used 
for adults. 
Further, the manufacturing chemists now separate 
the active principle from the crude drug, and prepare 
our most potent medicines in granules, triturates, and 
compressed tablets, all divided for convenient use. 
With the exact knowledge now conveyed to the 
student of medicine in the clinic rooms and labora- 
tories of our colleges, the minutiae of scientific pro- 
cesses must be mastered, and the graduate, armed 
with these powerful weapons of so many exact 
sciences, goes forth to practise in communities where 
general intelligence makes closer discrimination as to 
the qualifications of the medical practitioner than 
were made in former years. The aid of legislation 
has in recent years come forth as a thunderbolt from 
the people against empiricism and quackery. 
In this great commonwealth your legislative au- 
thority has wisely ordered that no man shall practise 
without a diploma, duly signed by one of the law- 
fully constituted faculties of instruction in a regu- 
larly established medical college in Pennsylvania. 
In the old State of Virginia, and in some other 
States, diplomas are no longer recognized as license 9 
to practise medicine, but are demanded as prelimi- 
nary to the examination of the holder, who is an 
applicant to practise in such States. 
Now, with these powerful agencies of the law en- 
couraging the efforts of able and earnest teachers in 
the regularly established medical colleges of this 
country, there is no danger that too many people will 
qualify to practise the art of healing. There are of 
course many commercial schools throughout the 
country pretending to give instruction in medicine. 
These are found in most every State, and the holders 
of their diplomas may be found in our cities, driving 
the street-cars, washing bottles in suburban drug- 
stores, and, in many cases, pointing horseshoe nails, 
or gently guiding the brush of paint over cold brick 
walls of our houses. With the rapidly growing pop- 
ulation of this country we have no excess of medical 
colleges, and there is, like Webster said to the stu- 
dent of law, always plenty of room in the higher 
walks of the profession. In the lower grades you 
shall gradually witness the decay that ignorance al- 
ways suffers in the presence of scientific research. 
Do not understand me to say that the practice of 
medicine itself shall ever reach the dignified plane 
of an exact science. The uncertain tenure of life, 
and the varying degrees with which the vital forces 
operate in the economy, taken together with the 
varying conditions in which they operate, make it 
impossible ; yet, by the aid of experimental study, 
the present generation has witnessed the discovery of 
the cause of nearly all the infectious contagia ; and, 
in their treatment, the ounce of prevention may now 
wisely be ordered. For most of them the pound of 10 
cure has not yet been isolated. May we not hope 
that some one of these young gentlemen just ad- 
mitted to the ranks of the profession this evening 
shall achieve this great goal for which we are all 
striving ? May we not hope that, great as have been 
the giants in the medical profession in this metropolis, 
greater genius is now being bent into the same chan- 
nels, and that the march toward perfection shall not 
be abandoned by a single one among them until the 
devotees of medicine shall be able to establish a uni- 
versal science ? 
Fortunate are you, gentlemen, to have enjoyed the 
high privilege and distinguished honor of receiving 
your medical education in this noble institution ; 
fortunate to have lived in this age of discovery ; and, 
deriving your first lessons at the centre, may you 
march through every inch of the circumference to a 
brilliant and noble career.