faculty valedictory OF THE MEDICAL DEPARTMENT OF THE 1MSII! OP NASHVILLE and VANDERBILT UNIVERSITY, DELIVERED BEFORE THE GRADUATES, SESSION OF 1875-71), BY T . A.. A. T C L I I S 6 N , M . 13 ., PROFESSOR OF MATERIA MEDIOA AND Reprinted from the Nashville Journal op Medicine and£ NASHVILLE, TENNESSEE: PRINTED AT “THE AMERICAN” BOOK AND JOB ROOMS. 1876. FACULTY VALEDICTORY OF THE MEDICAL DEPARTMENT OF THE mn B inn mi won man, DELIVERED BEFORE THE GRADUATES, SESSION OE 1875-76, BY T. Al. ATCHISON, M.D., PROFESSOR OF MATERIA MEDIOA AND THERAPEUTICS. Keprinted from the Nashville Journal of Medicine and Surgery. NASHVILLE, TENNESSEE: PRINTED AT “THE AMERICAN” BOOK AND JOB ROOMS. 1876. FACULTY VALEDICTORY, OF THE MEDICAL DEPARTMENT OF THE UNIVERSITY OF NASHVILLE AND THE VANDERBILT UNIVERSITY, Delivered before the Graduates at the close of the Session of 1875-76, BY T. A. ATCHISON, M.D., PEOFESSOE OF MATEEIA MEDIOA AND THEEAPETJTIOS. Gentlemen Graduates—I am delegated by my colleagues to give you the parting' word, seasoned with admonition and counsel. It is usual, on such occasions, to paint the future in roseate hues, and strew your pathway with flowers, but such a course comports neither with my age and experience, nor with my views of life and its duties. I know full well that your paths will not be “ primrose paths of pleasure,” and that clouds will often obscure, for a time, the sunshine of hope. It is best it should be so. We want no doctors “ dubbed on carpet consideration,” but would have you win your spurs by knightly feats of arras. The parchment you hold in your hands only gives you the right to work in the noblest, as it is the most ancient, of professions, and to garner the glorious fruits of your toil; this, and nothing more. I have said that ours is the most ancient of professions, and so it is. It dates “ From man’s first disobedience, and the fruit Of that forbidden tree, whose mortal taste brought Death into the world, and all our woe. ” Our high mission, then, is to prevent or palliate some of the woes incident to man’s fall. And our armies, whose martial tread comes sounding down the ages, were first recruited at the very gates of Eden. True, our march has not been an unbroken triumph. Blind guides have lost us in the wilder- 4 Faculty Valedictory. ness; usurped authority has often led us into dangerous am- buscades; ignorance and fanaticism have trailed our banners in the dust; while unscrupulous camp-followers have hung upon our march, and ever and anon, with stolen fragments of our cyclopian armor, and under some specious guise of ism or pathy, claimed to be the true soldiers of humanity. But I charge you, yield nothing to sect or school. Our profession is the soul of catholicity—every thing, material or immaterial, from the highest heavens to the profoundest depths of the earth, which may contribute to the relief of human suffering, belongs to us. “ No pent-up Utica contracts your powers, For the whole boundless continent is yours.” Then assert your right to every therapeutic truth, whether found in the walks of science, or in the possession of beldame or quack; for truth, like the fabled jewel in the toad’s head, shines the more brightly for its hideous setting. Such has been the audacity of our foes, that, in the recent past,, a self-styled sect of hydropaths attempted to wrest from us that priceless remedy, water—a remedy, I dare say, of more value in the treatment of disease and the preservation of health than the whole materia medica combined. And even now, another sect, with equal effrontery, would usurp the in- herent, right to “do nothing,” when the powers of nature are equal to the task of cure. Allow me, gentlemen, in this connection, to warn you against the evils of poly-pharmacy; in plain words, do not rely too much on medicines, especially spoliative medicines. Whenever you enter a sick-room, and find mantel and tables groaning beneath the weight of prescription bottles and boxes, you may be sure the patient has had a fool for a doctor. Ne- ver forget that every vital organism is provided with the most effective means of resisting its enemies. The ancients called this force vis medicatrix naturae. Without the constant pre- sence and exertion of this force, you will never witness a re- covery. Without it, the race of man, with all his vices, follies Faculty Valedictory. 5 and crimes, thick upon his head, would be snuffed out like a candle. You should, therefore, diligently study the natural history of disease. By so doing, you will find that they are not mere accidents, but are regulated by law. They have their periods of accession, acme, and decline, and tend, in a large majority of instances, to recovery, under proper hygienic conditions. The profession of medicine is the happy union of science land art; science points the way, which art pursues, with noise- less step, and gentle touch, and voice of love. Therefore, God has joined together, let no man put asunder. I re- ••'gret'tb\be obliged to admit that the highest resources of our art hay# been criminally neglected. While we have, with most .commendable zeal and success, ransacked earth, air, and ocean, 'for. material agents, we have utterly neglected the vast re- sources of psycho-therapeutics. The Psalmist says “ man is fearfully and wonderfully made.” How fearfully and how wonderfully, who can tell ? Man has spanned the ocean with pulsating cords of thought; he has covered all seas with the white wings of commerce, and harnessed steam and lightning to his triumphal car of progress; and, by the aid of •spectrum analysis, has compelled the sunbeam to write the flaming his- tory of the solar system; yet he knows but little of the in- fluence of his own mind upon the functions of his own body. It is this ignorance, shared alike by wise men and fools, that makes, even the most cultivated, easy dupes to the shallowest impostures. Quacks, nostrum vendors, spiritual- ists, et id omne genus, “ play upon us as upon the stops of a pipe.” It is this ignorance of our own powers which stretches a veil of superstition across our beautiful temple of science. Let it be rent, as was the veil of the temple, when the Son of Man suffered that truth may be made manifest. The evidences of the power of the mind to induce, as well as heal, disease, are too abundant and too well attested, to ad- mit of doubt. Grief and fear—those thunderbolts of the passions—-have often crushed out life in an instant; and even too sudden joy has not been without its victims; while dreams 6 Faculty Valedictory. —those prophets of the night—have pointed thousands, with shadowy finger, to the grave. But these passions may be cu- rative as well as causative. Herodotus relates a striking in- stance of the recovery of speech, from the effects of fright, in the mute son of Croesus, who, seeing a soldier about to shoot his royal father by mistake, shouted, “ Don’t kill the king V7 and ever after retained his speech. Lord Bacon, the greatest philosopher of his own or any subsequent age, tells, naively, of the removal of twenty-one inveterate warts from his own hands by a lady, who solemnly counting them, touching each with her jeweled finger, and then, writing down the number, and folding the paper with great care, seriously assured him that his old enemies would leave him in ten days; and her prediction proved true. Bacon at- tempted to account for it by supposing that some virtue had actually gone out of the lady’s finger. Philosopher as he was, he did not rise above the prejudices of his age—a prejudice still in active force. He failed to see that the Sybilline man- ner and utterances of the lady directed a current of expectant attention to the warts—at first consciously, but soon becoming automatic; the effect of this steady current of nervous fluid was to arouse the activity of the absorbents, and thus remove the excrescences. As his faith, so was it unto him. When faith can be aroused to the therapeutic point, it is irresistible, and disease, drug-defying, and of the gravest type, yields like magic. Such are the so-called miracle-cures since the Apostolic days, the only recognized age of true miracles. That princely priest, Hohenloe, pretending to have received a divine commission to heal, wrought the most instant and as- tounding cures by merely stretching forth his hand and mum- bling a brief prayer. The healing of the king’s touch, and of the seventh son of the seventh son—the efficacy of which is still credited by intelligent people—are but examples of the power of faith to heal. But perhaps the most remarkable exertion of this power was exhibited by the good St. Andrew; he not only healed while living, but the virtue inhered in the sod which covered Faculty Valedictory. 7 his remains—for it is said there were enough crutches and splints left at his tomb, by those who were restored to their proper faculties, to build a monument to his memory as high as the spire of St. Peter’s. But we need not go from home to find proofs of the power of faith, lifted to the height of expectant attention, to break up morbid organic or functional processes, and restore normal action. Our New Hampshire friend, Dr. Elihu Perkins, with his metallic tractors, curing paralysis and many nervous dis- eases of long standing, is a striking illustration; when, how- ever, the London surgeons experimented with tractors made of wood, of the same size and appearance, and obtained like results, the charm was broken, and exeunt tractors. The same power energizes the worthless trash sold under such pretentious titles as “ Catholicon,” “ Indian Cholagogue,” “ Liver Regulator,” “ Pectorals,” u Globe Flower Syrup,” and the like, heralded by flaming advertisements of wonderful cures, and backed up by a stunning array of certificates of governors, judges, and ministers of the Gospel. By the way, many of our good friends among the ministry have a wonder- ful penchant for appearing in the doubtful role of certificate- makers, considering the courtesies which have ever been ex- tended them by our profession. It is this same inherent psychical force which potentializes the dynamic infinitesimals of which we hear so much now-a- days. These proofs might be multiplied ad infinitum, but enough has been said to justify the assertion that psycho-therapeutics should be advanced to the front rank in the healing art, and that, in all the neuroses, psychical may well supercede somati- cal remedies, while they should be made to cooperate in all diseases. You will infer, from what I have said, that your first duty is to get the confidence of your patients ; to this end, several things are necessary— First. You must win the confidence of the community in which you reside, and especially of the ladies, who are ever 8 Faculty Valedictory. forward in good works; indeed, they are the autocrats of the sick-room and the repositors of the popular pharmacy, If your prescriptions do not accord with their views, they will often give you a piece of their mind, and sometimes the whole of it. You must ever be deferential, polite, and assiduous, for, as Colonel Sellers would say, “ there is millions in it.” There is another class whose confidence you must not only win, but merit. I allude to the clergy. Make them your allies in every critical case. I have often dated convalescence from the visit of the minister; indeed, they are better psycho- therapeutists than we, for there is no febrifuge like prayer, no anodyne like the loving tones of some good old hymn, and no tonic like hope, born of the promises of God. Second. You must cultivate the closest and most friendly relations with your professional brethren. You must guard their professional reputation with the same jealous care that you would your own ; never aggrandize yourself at the expense of another. In short, let your code of ethics be, “ Do unto others as you would have them do unto you.” These combined influences will at once enable you to com- mand the confidence of the sick, which you can only hold by exhibiting a thorough knowledge of your profession, a sym- pathetic heart, and a hand tireless in gentle ministrations. It is not alone in the sick-room that the influence of the physician should be felt. He should be forward in all public enterprises looking to the elevation and advancement of the race; and chief amongst these is preventive medicine, or public hygiene. For this great work, the magnitude and importance of which dwarfs all other human interests, your education, habits, and duties of life, peculiarly fit you. This is no new thought, born of the pruriency of the age in which we live, but a conception of the oldest civilizations of the world. The sesthetic Greeks chose Hvgiea, the blue-eyed and rosy-cheeked daughter of Esculapius, as the type of phy- sical perfection and beauty, and, as the Goddess of Health, decreed her divine honors. They also paid like homage to her father, because they esteemed him the founder of the Faculty Valedictory. 9 science of medicine. Thus gracefully did this wonderful peo- ple recognize the value of health and the means of its preser- vation. The Romans, less poetic, but more practical, constructed, at vast expense of toil and treasure, aqueducts of hewn stone, adequate to the supply, daily, of three hundred gallons of pure water per capita of population, while the most favored cities of the United States and'Europe must be content with thirty- three. They did not stop here. For the removal of effete matter and poisonous exhalations, they constructed immense cloaca, or sewers, which are, to this day, marvels of architec- ture. The Jews were but little behind the Romans in their ample and costly means of water-supply, as the magnificent pools of Solomon attest. But the aqueducts of Rome and the pools of Solomon, vast though they were, fade into insignificance compared with those the ruins of which have been found upon our own continent. In Peru, an aqueduct, built of solid masonry, three hundred and fifty miles long, and large enough to receive a horse and his rider, has been found in a state of good preservation. It sweeps in unswerving line across yawning chasm, through darkening tunnel, and over undulating plain, an imperishable monument to the grandeur and glory of a prehistoric people whose very existence has faded from the traditions of men. With these colossal and enduring records before us, no one can doubt the high estimate in which the ancients held public hygiene. When man’s social instincts first drew him from his nomadic and savage life into communities, three great socio-logical pro- blems must have forced themselves upon his attention. I mean government, currency, and the public health, because they underlie all human progress. For thousands of years they have engaged the attention of the profoundest thinkers. Different forms of government have arisen and faded away, like the moving scenes of a panorama, until the culmination of the sublime spectacle, in our own country, of a free and self-governing people. Is our boasted republic, “ the land of 10 Faculty Valedictory. the free and the home of the brave,” destined, like the old empires, to fall beneath the weight of official corruption and unhallowed ambition ? God knows—I do not. The second great problem is no nearer solution than the first. The want of a uniform standard of values must have been coeval with the race; yet man, in his most advanced civilization, has never been able to supply the want. Every conceivable substance has been, in turn, tried and abandoned. The base as well as the precious metals, skins, bits of leather, feathers of birds, paper, the wampum of the Indian, and the beads of the African, all have been, in times not remote, clothed with the functions of money. And how is it to-day with the most powerful nations of the earth ? France has her paper assignats and rentes; England has her paper consols and pounds; our own country her greenbacks, and not enough at that; promises, all—hollow and deceitful as the Dead-Sea ap- ple, turning to ashes on the lip of want. But since the science of optics has thrown a flood of light upon the primordial forms of life, and chemistry, now advanced to the position of an exact science, has revealed the laws and relations of matter, public hygiene (or, as it has been aptly called, State medicine,) has awakened to a new and vigorous life. Already have the active causes of some of the most de- vastating epidemics been brought to light, and the means of prevention successfully applied. Asiatic cholera and yellow fever, those insatiable cormorants, have been met, upon their fierce march of death, by the blue-eyed “ Hygiea,” and hurled back, defeated, or obliged to seek other and unguarded passes. The city of New York, with its admirable sanitary system, successfully resisted the approach of cholera in 1866 and 1873, while New Orleans has had like success, for a period of ten years, in excluding both yellow fever and cholera from her borders. Failing to break through her sanitary cordon, they held their unobstructejd way up the Mississippi River, until they reached the borders of our own lovely State, where they held a carnival of death. Dare our law-makers, State and Municipal, allow the horrors Faculty Valedictory. 11 of 1873 to be repeated? If they do, in the face of the de- monstrated knowledge of their preventibility, thejr ought to be hanged as high as Haman. Why, our organic law, which they are sworn to support, guarantees to every citizen the en- joyment of life, liberty, and property, and yet they have never lifted a hand in defence of this the most sacred of our inalien- able rights. Not alone has this cordon sanitarium proven successful in arresting the march of epidemics. St. Louis, Louisville, Cin- cinnati, Chicago, and other cities, have demonstrated the prac- ticability of stamping out cholera by segregation and disin- fection, after it has gained admission. Malaria, another zymotic poison, annually spreading itself over two-thirds of the habitable globe, and swelling the sum of human suffering and death to a fearful extent, has, I verily believe, met its antidote in the Eucalyptus Globulus, the great fever tree of Australia, sole surviving giant of a giant age. Already has forest-planting of this magnificent tree banished malaria from the deadliest portions of the African coast and the Spanish peninsula. It is, therefore, no longer an hypo- thesis, but a proven fact. Let us, then, importune our citi- zens and authorities, State and Municipal, to encourage the extensive growth of a tree which gives salubrity to the fairest and most fertile portions of earth, superior wood to our indus- tries, grandeur to o,ur landscapes, and a balm to the air sweeter than the breath of violets. Wherever the conditions are fa- vorable to the production of malaria, there, too, will the Eu- calyptus Globulus grow and flourish. What ,has already been accomplished is only a prelude to other victories of preventive medicine, if properly aided by the civil arm. Acute minds long since conceived the idea that all zymotic diseases, and especially the cyclical epidemics, owed their ori- gin to a causcim vivam, a living germ, which, like the grain of wheat in the catacombs, may remain dormant for a millenium, but, on meeting with conditions favorable to development, springs into astonishing activity, and multiply by myriads. 12 Faculty Valedictory. Being infinitely minute, invisible, and imponderable organ- isms, they lurk in the crystal drops of water which we quaff, or are borne on the “ viewless wings ” of the air which we breathe, and tints finding ingress into our systems, they behave precisely as all other forms of life are known to do—they enter upon the battle of life by appropriating everything in their reach adapted to their wants. This happens to be our elixir of life—our blood—which is thus ruthlessly spo- liated, corrupted, and rendered unfit for the performance of its office in the vital economy. Analogy, drawn from the study of the habits of fungi, parasites, and ferments, furnishes proof in support of this theory almost amounting to demonstration. It remains, then, for us to ascertain the conditions favorable for the evolution of the causam vivam of scarlatina, cerebro- spinal meningitis, diphtheria, typhoid and typhus fevers, and, by removing, prevent. Indeed, much has already been ac- complished in this direction, and unless the world is remanded to another millenium of intellectual night, I dare predict that, before the close of this century, epidemic diseases will be banished from all countries where the science of preventive medicine is permitted to guide the hand of civil power. Will the State stand by us? That is the pregnant question. Ultimately it will. Dr. Henry D. Baker, in his very able report to the American Medical Association, touching this subject, says: “ Surely it needs no argument to prove that the very highest function of a government is the protection of the lives of its people; for the highest interest of each indi- vidual citizen is in his own life, and in the lives of those dear to him. No question of finance, of taxation, of class monopo- lies, of civil rights, or even of personal liberty, can, for a moment, compare with the question of health; for without health there can be no degree of happiness.” And Mr. D’ls- raeli hits the nail squarely on the head when he declares that “ sanitary reform is the great question for the statesmanship of the day.” But our task does not end here. Preventive medicine com- prehends the removal of every cause which retards human Faculty Valedictory. 13 progress or diminishes the sum of human life. Prominent among these causes is alcoholism, or the habitual use of alco- holic stimulants as a beverage. To such colossal proportions has this great social evil attained, that, comet-like, it has drawn in its long and blackening train the moral nebulae of crimes diabolical, official corruption unprecedented, hopeless pauperism, stolid ignorance, suffering without pity, and death without the hope of mercy. How much responsibility at- taches to the medical profession for this appalling picture of human misery ? I answer, much; for we, as a profession, have encouraged it, both by precept and example. If we would rise to the true dignity of our high mission, we must hold no uncertain language upon this subject, but boldly de- clare the truth, that alcohol is never food, rarely therapeutical, but evil, and evil only. Marriage is one of those sacred relations, half human, half divine, which would seem too holy for the profane touch of science; and yet, through this channel, the healthful fountains of life have been tainted with the dark current of disease and death to an appalling and ever increasing degree. It becomes our duty, then, to “ cry aloud and spare not,” against the con- tinued violation of physiological laws, which threaten to en- gulph the race in one wide ruin of hereditary disease. The laws of crime is another subject with which we must grapple. To politicians and law-makers it has proved an in- soluble problem. They have cried, “ out, damned spot!” but it would not “ out ” at their bidding; and, in spite of fierce Draconic laws, it has continued to fester in society, now flam- ing out in epidemic horrors, and anon shrinking back to its normal proportions. The “ powers that be ” needs be taught that harsh punitive measures are not always, nor generally, the remedy; that crime is often a neuropathy—a disease, not seldom hereditary, often acute and emotional—a psycho-pathological condition, the re- sult of preventable causes already named. Our American system of public education is an inviting field for your labor. “ As the twig is bent, the tree is in- 14 Faculty Valedictory. dined/’ is a plain and pertinent truth; and yet our whole scholastic system, (if that can be called a system which embo- dies only the three ideas of cramming, flogging, and sala- ry,) is directed mainly to the object of bending or breaking our tender little twigs of humanity. Ill lighting and ventila- tion and over-crowding of school-rooms (a common occur- rence), is a double-acting engine of death; on the one hand are withheld those vital stimulants, pure air and sunshine, upon which depend the healthful performance of the animal functions, and on the other, carbonic acid gas (a deadly poison) is forced back upon the respiratory organs. But the evils do not end here. Little mercurial children, to whom motion is not only the poetry, but the law of life, are often glued by fear, for hours, to a hard and inflexible bench, to the immi- nent risk of spinal and pelvic injury; and still, in spite of aching limbs and throbbing temples and swimming eyes (the fruits of physical restraint and foul air), there stands the awful pedagogue, unloving and stern, cramming with words—mean- ingless words—which the memory, and not the mind, must appropriate. And, added to all the horrors of childhood, but too often comes the harsh rebuke or degrading blow, for the sole and supreme oflence of being a child. Think what a price humanity pays for its shallow and pre- tentious education! — hecatombs of slaughtered innocents, whose death had been falsely charged to scrofula, colds, and fevers; millions fitted for the career of criminals, by the utter extinction of the divine sentiments of love and mercy, under the cruel sting of the master’s lash ! Think of it, mothers!— think of it, fathers!—when you are leading your little ones as lambs to the slaughter, think of it; and then ask, “ How long, oh! School Boards and teachers, will you abuse our pa- tience ?” I am proud to recognize the fact that there are many noble teachers, who have exchanged brute force for the law of love; but still the truth remains that our system of school government is a legacy of barbarism injected into the Christian civilization of the nineteenth century. Neither time, nor the proprieties of the occasion, will per- Faculty Valedictory. 15 mit a fuller amplification of the subject, and we cannot do better than close our somewhat extended remarks with the following quotation from a paper read by Francis Bacon be- fore the American Social Science Association, held at the Lowell Institute, Boston : “ These cities of the future, with sunlight and fresh air and pure water coming to every citizen ; with no man standing in his neighbor’s way; Avith no noisome or pernicious occupation suffered within their limits; with all rainfall and water waste carried quickly away to the unharmed river, while all refuse, at once more dangerous and valuable, goes with due dispatch to the hungry soil; with preventible diseases prevented; and with inevitable ones skillfully cared for; with the vigilant go- vernment, that does not stand apart and look coldly at ruth- less greed and needy ignorance, and utter only an indifferent 1 caveat em.ptor,’ but says to the butcher, ‘ This trichinous pork, this pathological beef, goes to the rendering vat, and not into the mouths of my children ’; and to the brewer, " Burn this coculus indicus and lobelia, and let me see no bitter but hops hereafter ’; and to the apothecary, ‘ Successor of Herod, you shall not poison my infants at wholesale with your narcotic soothing-syrup’; and to the water company, 1 Your reservoir shows foulness this week to my microscope and test-tube; let it continue at your peril.’ These cities of the minimum death-rate, shall they not be our cities? Are these things of impracticable costliness ? say you. Nothing is so cheap as health; it is the truest economy ; it is cheaper—than dirt. Dirt cheap. What an abuse of language ! Dirt means waste and disease, widowhood, orphanage, pauperism, high taxation, costly production. Nothing costs so much. Besides, the ob- jection, even if it were not unfounded, is unworthy. ‘ All parsimony in war is murder,’ is the judicious maxim of the Marechal de Belleisle. Not less, I say, when we fight against an impersonal foe of mankind.” And now, gentlemen graduates, it only remains for me to wish you that measure of success which waits on merit, and that wealth of health and happiness, the fruits of temperance and virtue.