■Mm UNITED STATES OF AMERICA *> . . FOUNDED 1836 WASHINGTON, D. C, Bl9574 INTRODUCTORY LECTURE FOURTH SESSION — OP — TOLAND MEDICAL COLLEGE. DELIVERED JUNE 4, 1867, B"5T HENBY GKEBIBOIsrS. Js^L.lD. PROFESSOR OP MATERIA MEDICA. SAN FRANCISCO: T. G. SPEAR & CO., PRINTERS, N. E. COR. CLAY & MONTGOMERY STS. 1867. Toland Medical College, ) San Francisco, June 12, 18G7. ) To H. Gibbons, M. D, Professor of Materia Medica in Toland Medical College : Sir :—We, the undersigned, Senior Students of Medicine, have been appointed as a Committee to express to you the great satisfaction expe- rienced by the Class, in listening to the Introductory Lecture delivered by you at the opening of the Fourth Session of the above-named Institution. And, furthermore, considering its contents as well worthy of preser- vation, we are desired to reqnest a copy of it, at your earliest convenience, for publication. Very respectfully, J. W. Steely, L. Robinson, A. A. O'Neill, T. W. Shelton, J. J. Hackett. Gentlemen :— In compliance with your request, I take pleasure in presenting you with a copy of the Lecture referred to. Your friend, H. Gibbons. To J. W. Steely, L. Robinson, A. A. O'Neill, T. W. Shelton, aud J. J. Hackett. \ INTRODUCTORY LECTURE. In opening the Fourth Session of Toland Medical College, my colleagues have appointed me to represent the Faculty in a general Introductory Lecture. To the Students exclusively I have nothing to say, further than to give them a hearty welcome to the lectures in prospect, and to all the legitimate enjoyments which their studies will afford, and to promise them quantum suf- ficit, as we say, of lecturing in the future. As physicians seldom have an opportunity of administering to a popular audience, I shall improve the occasion by uttering some things concerning our profession which ought to be known and considered by the world at large. There is no occupation which gives so wide a range as ours to the exercise of man's powers and qualities. First comes the universal duty of earning our bread—universal it should be, though some think themselves fortunate in being exempted from it, by the intervention of a rich father or uncle. Do not envy these exempts—rather pity them, because they have not to pass through the baptism of fire, which disciplines and chast- ens and purifies the children of poverty, and magnifies their vir- tues, and crowns their triumph with an exceeding weight of glory. But the man who would live on bread alone is a miserable ani- mal, and should go on all fours. The true disciple of medicine has much loftier aims. Ambition—aye, ambition—alluring, in- spiring, intoxicating, maddening—yet proper within proper bounds, who but has felt its power !—Who does not own that honor and distinction are worth a hard struggle !—that a good name is better than gold ! What more precious inheritance can we hand down to our children 1 Can one estimate, in hard coin, 6 even counting it by millions, the value of the legacy transmitted to posterity in such a name as Washington—or Lincoln ? In the common view, success in practice means money-making. None of us, I suppose, would object seriously to success in this di- rection. But what a sorry mistake it would be to estimate the merits of physicians by such a standard ! What a small proportion of our craft grow rich !—How few have ever grown rich ! How many of the most deserving have toiled all their lives in adversity, and lain down their heads at last on a pillow of straw 1 Physicians are seldom good business men. They are proverbial as bad col- lectors and poor managers ; and when their patients excel them in financial skill, as is too often the case, alas for the doctor I This state of things presents to my mind a strong argument in favor of a future life. Let the poor doctor cherish faith and take comfort, remembering how the tables were turned on Dives and Lazarus. Now and then a poor, starving doctor sells his birthright, and with his birthright his honor and his soul, by turning quack and diving into the most mendacious and infamous practices. But, to the credit of our profesion be it said, that among the hundreds and thousands who are trotted through our medical schools and marked M. D. almost as quickly as a native Californian would brand his mustang, a very small proportion condescend to that knavery. The teachings and associations of the profession, brief as they may have been, infuse in the character too much honor to admit of so base a betrayal of trust. It is worthy of remark how small a portion of advertising em- pirics have had the least tincture of a medical education. This advertising business is essentially the art of lying, and it is other- wise so vile and infamous that the lying, after all, is the most virtuous part of it. Hence none but bold and brazen men, want- ing in all the finer traits of humanity, embark in it. It would be a curious history, that of our California advertising quacks, and would show, that, so far from having ever studied medicine or ob- tained a degree, most of them never so much as curried a doctor's horse or blacked a doctor's boots. One, who took the lead for years, was an upholsterer and nothing more, until the morning when he was announced in the papers as a celebrated doctor. This fellow had the sagacity to employ a regular physician—a poor devil who had grown ragged on whisky, and who was o-0ad- 7 ed by starvation to sell his services by the month and do the pre- scribing, the patients taking him to be the great advertiser. One of our present advertisers was a paper carrier, and failing to sup- port his family at that, he made himself a great doctor in twenty- four hours by the aid of the newspapers. Having carried the pa- pers, it was but fair that the papers should carry him. The smartest quack who ever figured in California was a shop-boy in a drug store, at $40 a month, prior to his advent as a medical celebrity. If the histories of all the advertisers in California were written out and published, it would be hard to find a patient in the Stockton Asylum silly enough to take advice or physic from any of them. Some years ago, one of our California quacks flourished an honorary diploma conferred on him by an Eastern school. Such an outrage on the profession led to enquiry, when it was ascer- tained that he had stolen or borrowed a genuine diploma of an European University, and by passing it off as his own had tricked the Faculty out of an honorary degree. A parallel case is related of the University of Erfurth, which made a business, many years ago, of selling diplomas. An Englishman purchased one for a pretended candidate named Anglicus Ponto, with whose name it was filled, and which proved to be his dog ! It is said the Univer- sity thereupon doubled the price of its diplomas. And here let me say, with some pride too, that of the thirty graduates of the Medical Department of the University of the Pacific, from 1858 to 1863, and the twenty graduates of Toland Medical College in 1864,1865 and 1866, all, with a single exception, have proved true to their education and their profession. A large proportion of them are engaged in active and profitable practice on this coast, and not a few are treading the pathway of honora- ble distinction, if they have not already reached the mark. Though it is rare lor a member of our profession to become an advertising charlatan, even under the pressure of low diet, never- theless there are certain halfway houses, such as Homeopathy, Eclecticism, and the like, which have proved more potent in their seductive influence. But, after all, it is not surprising that the jingle of the thirty pieces of silver should win over to such fan- cies some of the weak brethren, who, from dullness or slothful- ness, had failed to earn their bread by legitimate toil. I do not 8 speak of those who were trained in heresy, and never baptized in orthodox medicine. By early training men can be brought up or brought down to anything, even to an honest faith in Homeopathy, though it is hard to find those who honestly practice it. There are two departments of human pursuit in regard to which a large part of mankind are always athirst for novelties—never satisfied with the old, but perpetually craving some new thing ; namely, medicine and religion. New doctors and new remedies, new preachers and new creeds, are always in demand. Doctors are not prone to invade the domain of the priesthood ; on the con- trary, they have sometimes been charged with caring more for the bodies than the souls of their patients, and even with want of re- gard for their own souls. It has even been said, most wickedly, that wherever you see three doctors you see two infidels. To re- taliate for this, many ministers of the Gospel keep a jealous eye on physic, and give their patronage to all sorts of medical here- sies. The cunning charlatan knows the value of a reverend en- dorser, and manages, if possible, to get beneath the corner of a surplice. A donation of a box of magic pills or a bottle of bron- chial syrup to a needy parishioner, with a pot of nicely flavored Ointment of Flattery for the Dominie himself, secure the certifi- cate, which is often given simply in the spirit of accommodation, and without suspicion of the base use to which it will be applied. And thus impostures in medicine are promulgated from the pulpit. No one will understand me as applying these remarks to the clergy in general. On the contrary, and I say it with pleasure, they refer to a small proportion only, of the entire body. There are several religious denominations which furnish scarcely an in- dividual amenable to the censure—whose pastors manifest a dec- orous regard for rational, scientific medicine, becoming to their profession, and are not dazzled and blinded by every specious novelty which assumes the garb of science. And yet the number of clergymen who permit their names to be identified with quack. ery, or lend their influence to meretricious novelties, is sufficient to attract the attention of physicians, and to call forth many severe strictures. I feel the more at liberty to indulge in this train of remark on account of the liberal treatment which the clergy and their fami- lies have always received at the hands of physicians. From time 9 immemorial they have been the protege's and pets of the medical faculty. To run at the call of the minister, or without waiting for his call, to serve him and his wife and children before all others, to decline compensation in all cases, even when the patient is wealthy and in the receipt of revenues from lands and stocks, and the physician feels the res angusta domi, which is often the case—such is the universal law. Neither is there any scrutiny of the claims of the patient to the ministerial character. It is enough that he assumes that character, or that society acknowledges it. The service of the medical to the clerical profession is never re- garded as a labor or a task. Nor have we ever asked any favors in return, or contemplated the slightest obligation imposed on them by our services. We do not even seek or expect any signal exhibition of gratitude. We have done our duty, and there we are content to rest the case. Under these circumstances, whilst many act a manly part and manifest a fraternal regard and make us feel that they are our good friends, there are others who set themselves against us, and become our practical enemies, and appear to study the art of array- ing prejudice against the regular faculty. If the members of the clerical profession, untaught in medicine, had the same respect for education and science in our profession as they expect the out- side world, unschooled in religion, to have for the learning and experience of theirs, they might have greater power to exorcise: the wizards and witches of the present generation. Young physicians born to wealth, are not apt to succeed. With plenty of gold, there is little need of brains. Necessity is the mother of many other good things besides invention. How often does she prove the mother of fortune and of fame 1 How often does she whip into vigorous effort and final triumph, the sluggish facul- ties which would otherwise have slumbered forever ! Resolution, Perseverance, Industry, are the handmaids of Poverty. A physician starts in his career under the best auspices when his living depends on his own labor, and when every dollar of income is moistened with the sweat of his brow. For the rest, let him live on his books and studies. We are in the habit of attaching too much value to riches. In California especially a man's status in society is determined precisely as is the value of greenbacks. The great future will judge by a different standard. To-morrow 10 will ask no questions as to riches. To-morrow will weigh us in a more intellectual b'alance. He that has not written his name on the hearts and minds of his fellow men, will die and be forgotten. The very monument that his wealth may erect over his grave will be a mockery. The importance attached to wealth is a bad feature of our age. Centuries ago, amid the rudeness and ignorance of the times, men- tal possessions were more highly appreciated. In the 15th centu- ry scholars often begged their bread, society acknowledging the obligation to give them a support. But the current of their lives did not always run smooth, notwithstanding the privilege. We read of a nobleman who suspected two of these strolling philoso- phers, and who put their qualities to the test by lowering them down a well in buckets till they should compose some poetry. I do not commend either the begging or the test for present use, though we have great need of some test in these times. Everybody in California is in a hurry to become rich. Impa- tience in this respect marks the character of our entire popula- tion. It must not be expected that physicians should escape the contagion. The first year's practice of Sir Astley Cooper netted him about $25, the fifth year $500, and the ninth gave him but little over $5000. And yet that great surgeon lived to receive $5000 in a single fee, and $100,000 per annum. How many young doc- tors in California, with $25 in pocket as the nett proceeds of their first year's business, would stay a second year in the same locali- ty ! Dr. Physick, in his day, stood at the head of his profession in America ; and yet, according to his own declaration, he did not earn his shoe-leather during the first three years of his practice. I am inclined to think that doctors, when they do happen to be- come rich, often make a better use of their money than other men. We can exhibit some noble examples in this respect—examples of physicians who have won both fame and fortune by their call- ing, and who have gratefully acknowledged the obligation by munificent contributions to the interests of medicine. Thus have Mutter in Philadelphia and Mott in New York written their names on the fleshy tablets of our hearts. They have gone to their long home ; but every disciple of medicine feels that they still live and that their memories are blessed. Our successors will offer a similar tribute to the memory of the Founder of this 11 College. But let us hope that the time for a posthumous offering is not near at hand. It is worthy of note that physicians who pursue their avoca- tion merely for the fees, and who acquire wealth without any other distinction, are not apt to become patrons of science. In the hands of such men the golden stream runs in narrow and self- ish channels, never overflowing its banks nor fertilizing the sur- rounding soil. When they die, they die and are buried. The Practice of Medicine resembles no other occupation in its relation to the exercise of the qualities of the heart. Its first great commandment is, " Thou shalt visit the poor." There is no escape from this service, even if the doctor desire to escape. Too often rewarded by ingratitude and reproach, still he must rise at every call, and be the servant of everybody. Where is the doctor that does not perform more than his pro rata of unpaid service to humanity ? The world knows nothing of the gratuitous labors of the profession, and it cares less for them. I should not be far wrong in assuming that one-half the work of physicians in the United States is done without reward. In European countries arrange- ments generally exist by which the poor are attended by salaried physicians. But in America this is done to a very limited extent, and only in some large cities. Sir James Eyre called one morning on a young physician of London, a friend of his just commencing business, and saw his waiting-room thronged with patients. " Why," said he, " you must be getting on famously."—" Well, I suppose I am," was the answer, " but let me tell you a secret. This morning I have pre- scribed for eight patients. Six of them gave me nothing ; the seventh gave me a guinea, and I have just given the guinea to the eighth." Of all places of business the office of the doctor is the only one where people apply habitually without money. No other class of men in the world are expected to give their time and labor, at every call, without any regard to compensation. Even the minister of religion has the advantage in this respect ; for when he comes at midnight to " shrieve the dying," his ser- vices are within the purview of a contract, and he knows that his bread is sure, though it may not always be buttered. The world can never know what doctors do for humanity. These unpaid labors belong, in great part, to the secrets of the profession. In 12 every community, and under the professional and friendly super- vision of every practitioner, there are families in straitened cir- cumstances, not recognized in society as poor, but whose means are barely sufficient for their support. And where is the physi- cian who would demand a fee from such a family ? or who would for a moment think of the want of compensation in prospect, when summoned to their aid ? In Philadelphia I was accustomed to visit the patients of an aged physician, now deceased, during his sickness or absence. On one occasion, as he handed me the list, he designated a certain family as the object of especial attention. Expecting to encoun- ter a wealthy patron of my friend, what was my surprise to find, instead, a humble and poverty-stricken household ! Conversing on the subject afterwards the doctor remarked : " I have attend- ed that family gratuitously ever since I began practice, nearly forty years ago. I have always regarded them among my best friends." Not less than four or five thousand dollars, as profes- sional services are estimated, cheerfully bestowed on a single family ! And yet this was only one case among many. And what physician but has had the like experience ? Such labors are never accounted burthensome. If the sick have no money to give their doctor, his willing services can always be commanded by a rea- sonable amount of gratitude or courtesy—But what shall we say of those who have the means and pay grudgingly, or not at all if they can escape ?—who always find your bill steep ?—who always insist on an abatement, no matter what the figure ?—nay, who would cheat you out of everything even when you consent to an abatement ? If there is a vein of meanness in the human charac- ter, the doctor's bill brings it to light, as surely as the leaden bul- let is detected by the probe of Nelaton. What a flowery path would physicians have to tread if they could practice medicine altogether on the score of philanthropy ! -or if they could live off one another, as they are supposed to do m consultations !-or if they could feed themselves and their little ones on air !-or if they were paid from the public treasury ! How much more potent would be our medicines !—more lasting our cures 1-more enduring our friendships ! How steadily would the streams of gratitude flow in upon us from the hearts of our patients ! 13 Whilst the study and practice of medicine bring us face to face with the cares and duties of life, and foster the sentiment of ben- evolence in the heart, they surpass all other pursuits in their rela- tion to mental discipline and intellectual culture. By the very nature of medical studies, all the faculties are exercised and de- veloped, and a healthy balance maintained among them. Some departments tax the memory, Anatomy, for instance ; some, as Physiology, the reasoning powers ; whilst by others the percep- tive faculties are sharpened and perfected. What a school is ours for the development of the image of God, in all its likeness to the divine Architect ! In scanning the histories of our great men, men who have served the world as patriots, as legislators, as philanthropists, as lights in general science, the influence of a medical education shows forth conspicuously. A very large portion of the benefac- tors of humanity have been trained in the school of medicine. Foremost in defense of popular liberty and the rights of man—in works of charity—in reformation of abuse and error—in the edu- * cation of the young and the general diffusion of knowledge,— physicians are found at the head and front of progress in all direc- tions. Through electricity and chemistry and comparative anato- my and microscopy and mental philosophy, the whole vast range of natural and intellectual science is opened to the medical stu- dent. There is no natural limit to his enquiries short of Omni- science. Only the necessities of a business life set bounds to his march. Take away at once from science all who have entered through the portals of medicine, and darkness would overspread the earth. The loss of any other class of men would soon be re- paired. But the sudden abstraction of the support given by the medical fraternity would roll back the tide of time a thousand years. And in this the regular and legitimate school of medicine stands forth in proud pre-eminence over all other schools or systems. Divided as physicians have always been.into sects and parties holding diverse views on many questions, theoretical and practi- cal, there is nevertheless a common bond of union, felt if not de- fined, both by them and by their enemies. And there are outside systems and sects rising from time to time, whose status is equally marked. In the last half century we have Hydropathy, 14 Homeopathy and Eclecticism. Hydropathy came down at first like Niagara, threatening to wash all the doctors, with their pills and potions, into the abyss of oblivion. But, unlike Niagara, it has dried up ; or, at most, trickles along in a chance streamlet, making less noise in its course than astrology or clairvoyance or psychology. And right in the face of this doctrine, which came to baptize the world in cold water, whisky has become a current medicine, and with many enthusiastic individuals a daily food, on philosophical principles. It is a wonder that the Hydropaths, or some other sect of medical reformers whose hobby-horse has broken down, do not adopt whisky as their motive power and uni- versal medicine. A school of toddypathists would find an immense mob of disciples ready made to hand. The Eclectics have been more successful—at least in the in- crease of family. They are Choosers—Selectors—that is to say, they choose to discard most of the old, active medicines, and to get up new ones. Their doctrine seems to be that there is no medicinal virtue in any article known at the date of their advent, but that a special and exclusive revelation of the qualities of medicines has been made to them. Accordingly, their materia medica is much restricted. In rejecting many of the old and well- known remedies, they act much as a carpenter who would insist on doing all his work with one or two tools, or a farmer, who, dis- covering that he could make his cows plough, would refuse there- after to use horses. The Eclectics, however, are progressive. T hey have their schools and their literature. Some of their lead- ing men might pass for regular physicians, if it were not for the name. Before many years the head of the column of Eclectics will be prepared to fall in with the army of regulars, and to cast off the body and tail of the column. Then we have numerous guerilla bands, allied to the Eclec- tics, such as Botanists and Electro-Thermalists and Physio- medicals and the like, most of whom expect to immortalize themselves by playing on the one-string fiddle—" All minerals are poisons." Some of them, if they are smart enough, will wake up to the fact before they die, that the most virulent and the most abundant of poisons are " botanical." The Homeopathists came in with their one idea of similia similibus, the chief value of which in their own estimation seems to be 15 that it is one of the old cast-off notions of the regular school. Their materia medica is still more limited, consisting of four arti- cles—Faith, Imagination, Nature, and sugar of milk. They have been at work industriously for half a century. They have their schools, their institutes, their congresses. But what have they ever done for medical or general science ? What name have they given to history ? But all these systems and devices have their place. The world, in its fallen state, would not be complete without them. There are certain parasitic animals of bad repute in human so- ciety, but whose existence leads to personal care and cleanli- ness. So, science has its parasites, and is all the better for them. I have said that regular medicine holds a proud pre-eminence over all these extraneous systems, by virtue of its progressive character and its relations to general science. See what it has done in a few years 1 Behold the wonderful revelations of the mi- croscope—the new world it has developed and is developing in re- lation to cell-life, and the intricate physical structure of the body and the changes made in it by disease 1 Look at the revolutions in Physiology and Pathology, making them new sciences ! See the rapid advance in Diagnosis, bringing us into a better know- ledge of the nature and hidden springs of disease 1 And witness the march in the collateral sciences, pari passu with progress in departments more strictly medieal. Count, if you can, the thous- ands of great names which regular medicine has given to the world since the oldest of us were born—names which shall live forever in the annals of human society ! And what have the outside schools and systems been doing all the while ? Hydropathy never pretended to have a philosophy and a literature. It never proposed to make discoveries beyond cold water and cracked wheat. It was altogether practical, whilst its machinery was too cumbrous for common use. It re- quired for each passenger a coach and six—a retinue of naiads —and patience to undergo six months soaking and parboiling. Why, there is not fresh water enough in the world to treat all the sick Hydropathically in an extensive epidemic. The grand sys- tem of Hydropathy, which came over us, a few years ago, like a summer cloud, has left in memoriam one single name—no more —that of Priessnitz : and even that one name might not be cor - 16 rectly spelled by one pupil in a hundred of our grammar schools. As to his history, it is already mythological, and he looms up faintly in the remote past as some illegitimate son of Neptune. And what has the Eclectic school accomplished beyond devising a short cut to the doctorate, by which the standard of medical ed- ucation is lowered, and boiling down the juices of a few herbs and putting them to trial ? Our American Pharmaceutists have done much more and much better work in the preparation of medicines- The scroll of Fame bears no record of the name of an Eclectic to be handed down to posterity. The scientific world has no know- ledge of such a sect. Still more insignificant are the claims and achievements of Ho- meopathy in the general field of science. Ignoring Pathology and Physiology in the treatment of disease, and resting on a single dogma, and adopting the preposterous notion of increasing the power of medicines by diminishing their quantity, the disciples of Hahnemann have built about them a Chinese wall, impervious to the light of science. They have numbers—they have intellect. Many of them would shine in the sphere of legitimate pursuits. They have had fifty years of opportunity, in the golden age of the hu- man mind, when the earth has trembled beneath the universal on- ward tramp of discovery ; and this greatest half century of history they have spent in watching the twitchings of an eyebrow or counting the feathers in the wing of imagination. They have charmed the sensibilities of some intelligent ladies, good judges of crinoline, and they have taken captive a few divines of a poetic turn. But what name have they given to the world as a legacy to posterity ? Even the few distinguished men of the regular pro- fession who went over to their ranks and were received with shouts of exultation, were never heard of afterwards. They too died and were buried. So it is, my young friends, with all these sects and factionists, who repudiate regular, rational medicine, and seek to build up their systems on popular ignorance, or popular prejudice. If you play for money, it is possible you will succeed better outside of the true church than in it—especially if conscience is lost in self- ishness, and wisdom in cunning. And the lower you aim the more certain your success. The quack who can lie the best will make the most money. 17 Yon will observe one remarkable trait in the conduct of these schismatics and charlatans, who denounce the^ regular school and vilify its practitioners as poisoners and butchers. They are all devoutly ambitious of the distinction and honor attaching to the regular Doctorate. They would almost give their lives, if necessary, for the parchment-evidence that they had once been in contact with good society, and enjoyed the fraternity of those whom they de- nounce. Perhaps they have read of seven women who should lay hold of one man and say—We will eat our own food, we will wear our own apparel, we will use our own physic ; only let us be called by thy honored name to take away our reproach and hide our tricks Or they may have taken lessons from those gentry who, unable to rise above crackers and cheese at a free lunch, repair after- wards to the steps of the Occidental to pick their teeth. Why do not physicians take measures to protect themselves and the community from impostures, by exposing them, or by seek- ing legislative action ? This enquiry is often made. As to expos- ing charlatans, it is what they want. Notoriety serves their pur- pose, and ill fame is as good as any other, because it is as profita- ble. We had a lawsuit for libel, a few years ago, between two quacks in San Francisco, of whom it was always suspected that they got it up by arrangement, for advertising purposes. Legislation against quackery is doubtful policy. In Europe, where the people have somebody to take care of them, stringent laws exist for the protection of society against medical impos- tures. But in America, where they look out for themselves, the field is generally open to fools and knaves of all shades, who would prey on the pockets and lives of the sick or silly. Years ago there existed in many of the Atlantic States laws against quackery. But they were inefficient and have been mostly aban. doned. It appears to be the general feeling of the profession not to interfere with the tastes of people in this particular, but if the sovereigns desire to be wheedled out of their money by clairvoy- ants or astrologers, or mediums, Teutonic, or Celtic, or Saxon, or Mongolian, to allow them the luxury. In our fatherland laws on this subject are still in force ; and yet Great Britain is known of old as the paradise of quacks, and it is the school which has produced the most accomplished knaves in California in this line. Never a session of our Legislature passes without an effort from 18 some quarter to procure legislation against quackery. My own sentiment has been for many years hostile to every movement that can be construed into an attempt on the part of the profession to protect itself from empirical rivalry. If the people, through their law-makers, choose to legislate for their own protection, let them do it. They may open their blind eyes and see their true inter- ests sooner in this regard if left to themselves, than by any inter- ference on our part, which is sure to be attributed to the most selfish motives. The great American idea of education now is, that society should educate the children and fit them for the purposes of life. Selfishness, if no better motive, prompts to this course. Children, if not trained to usefulness, will be trained to vice. For its own protection, therefore, society must educate the rising generation, at the general charge. Such is the popular theory, under which the great republic is to be reconstructed. The workmen have had a grand quarrel over the building, and the result has been that the old corner-stone of slavery has been knocked from under, and the edifice well nigh tumbled into ruins. And now they are building it up with universal education as a corner-stone, and we are all hop- ing that they will get it done as soon as possible, so that we shall have a quiet and comfortable home once more. Among the children thus to be schooled and trained for their and our future good, some will have charge of the health and lives of the people. The doctors of the year 1900 are now in our public schools. Has society any special interest in their educa- tion as physicians ? A ship is about to sail from San Francisco for China or for Pan ama, freighted with passengers. There must be a physician on board. What man will take his family without ? He must be the right kind of a doctor, too. Suppose it were announced that among the provisions for the security of passengers to embark on the Colorado for Hongkong, the Steamship Company had engaged the famous Li-po-tai for physician ? or an astrologer ? or a clair- voyant ? or an imposer of hands ? or a medium ? or any other one of the rather extensive and diversified class who glorify them- selves in the newspapers ? Such mountebanks are well enough on land, where there are always regular doctors to fall back on. But the voyage over the trackless waste, where the whole world 19 outside the ship's walls might as well not exist, brings men to their senses and causes them to appreciate true science in its rela- tions to human life. May I not apply the comparison to society at large ? The com- ing generation—our children—are embarking on the ocean of time, and we, of the present, are getting up their outfit. They must be supplied with the best defenses against disease and death which science can furnish. Is it not reasonable that the State should provide such defenses ? that it should educate, at its proper cost, the guardians of its children's lives ? Be this enquiry answered as it may, all will agree that the State should throw no legislative impediment in the way of medi- cal education, but that, on the contrary, it should remove all im- pediments as far as possible, and provide facilities.—Now, mark the application : A knowledge of Anatomy is absolutely essential to the practice of Medicine and Surgery, and that knowledge can- not possibly be obtained otherwise than through dissections of the dead. What aid does the State afford to this first step in the art of preserving the lives of its subjects ? I shall not stop to argue the necessity of dissections. That man is a fool who needs argument on the subject. Take an individual as nearly brainless as possible not to require a guardian to feed him with a spoon, and suppose him to stand in need of an opera- tion—the amputation of a leg, or an arm, or even a finger ; or the excision of a small wen ; or the opening of a simple abscess. A surgeon, so called, approaches him, instruments in hand, ready to do the work. At this juncture, our patient is informed that his surgeon never so much as dissected a single dead body. Would he submit himself to that sort of surgery ? Or would he not ex- claim : To die or to be killed—that is the question ! Let me state the case on a broader basis. An emergency lately occurred, in which the nation was required to summon a million of her sons to her defense. This multitudinous host had to encounter all the enemies of life—pestilence in all forms at midnight and at noonday—bayonets gleaming around them, and whirtling missiles darkening the air. To guard the hygiene of the camp__to ward off the insidious miasm—to extinguish the consum- ing fever—to staunch the gushing life-blood—to amputate the man- gled limb__thousands of trained and skillful men are needed. 20 There is no time for preparation or study. Minute men, or none at all ! The conflict is over ; and one-fourth of the million of men arc laid low. A higher degree of skill and ability was never brought to bear on the battlefield and the hospital. The surgery of the war reflected honor on the American name. And yet how many failures ! AVhat suffering and loss of life from ignorance and inex- perience ! And how much of the mischief was the result of that cruel and superstitious and barbarous hostility to dissections of the dead which prevails in society, and which is fostered rather than counteracted by the general tenor of legislation 1 As soon as people adopt rational views on this subject—as soon as they realize the fact that if physicians and students have no opportunity of dissecting the dead, the living must suffer—that themselves, their wives and their children must be the victims, then they will not only exact from every practitioner of Medicine and Surgery an adequate knowledge of Anatomy founded on prac- tical dissections, but they will provide the means for dissection. A few States of the Union, rising above the standard of Chinese legislation, have legalized dissections, by providing that the bodies of persons dying in public institutions without relatives or friends to claim them, shall be at the disposal of physicians for dissection, under proper conditions and restrictions. We have a law in California to that effect. Such statutes are salutary, for the rea- son that they remove all incentives to the desecration of the grave- With this statute in force, the friends and kindred of persons in- terred in our cemeteries may banish from their minds all appre- hension of disturbance of the bodies. Such apprehensions however are not well founded anywhere, under ordinary circumstances : for the public institutions of large cities always furnish ample material for anatomical examination. Besides, the risk of detection is too great, the consequences too serious, to admit of the invasion of private cemeteries. It is a great mistake to suppose that practising physicians and surgeons are in the habit of dissecting, and that " subjects" are in demand among them. The common people ought to know that dissections are not performed at the houses or offices of physi- cians ; that not one in fifty ever dissects a dead body after pro- curing his diploma ; that it is only in connection with the educa- 21 tion of students in medical schools that cadavers are needed ; and that a very small number are sufficient for all purposes. It is by no means creditable to the newspaper press, considered as an instrument for diffusing light and knowledge, that its in- fluence is very generally directed so as to foster the foolish and barbarian prejudice against anatomical dissections. The story of a dead body in a box found on its supposed way to some doctor's garret, makes more noise than an earthquake. It is dressed up with every possible horror, and passed round through all the pa- pers, as if to frighten people into the belief that a corpse is never safe in the grave, but that the doctors arc prowling about all the cemeteries, like hyenas. There is no intention in this to impede scientific enquiry ; only, such items are too valuable to be thrown away in making up a newspaper. Not many years ago a famous trial took place in Boston, the result of which appeared to depend in a great degree on the fact that the slayer, for the purpose of concealment, had cut up the body of the victim and burned a portion of it. Such a deed was enough to overshadow all palliative doubts in regard to the cir- cumstances of the homicide, and to shut out the prisoner from all hope of mercy. The mutilation of the corpse was held up to the jury with telling effect. The same irrational prejudice which would prohibit all dissec- tions of the dead body, also interferes with examinations after death, for the purpose of ascertaining the seat and nature of dis- ease. Physicians should strive to educate the popular mind on this point by making examinations whenever practicable. There is but little difficulty in the intelligent classes of society. Reflect- in0" persons have sense enough to know that diseases run in fami- lies more or less, and that the inspection of the lungs, or the heart, or the stomach of one member of a family, dying with disease of those important organs, may furnish the means of saving the life of some of the surviving members. The fault is often with the physician himself, who makes no proper effort, or worse still, no effort at all, to procure an examination, even in cases of great in- terest and importance. Sometimes the objections can be readily overcome by the clergyman of the family. Ministers of all de- nominations will almost invariably aid the physician in this re- spect. 22 If disease should invade the farm-yard and begin to carry off the cattle, how soon would the husbandman see that an examination be made of the dead cow or horse, for the benefit of the living ! Even hogs and dogs would seldom be permitted to suffer for want of dissection of their dead comrades, to ascertain the cause of death. But when it comes to human beings, to the children and the family, a foolish prejudice interposes against their health and lives ! Persons are apt to entertain erroneous and often absurd notions as to the extent and manner of necropsic examinations. Care should be observed in asking consent, to correct such errors. Sometimes it is not necessary to examine further than the abdo- men or the chest. I have frequently overcome objections by urg- ing the advantage to the preservation of the body, of removing the contents of the bowels, as it is here that decomposition com- mences. Where it is desirable to keep the body several days be- fore interment, the introduction of an antiseptic into the cavities, which is a sort of embalming, may be absolutely necessary. Let me urge the propriety of making post mortem examinations in all cases where consent can be obtained. To young physicians is this especially important. It familiarizes them with the use of the scalpel, and perfects their knowledge of Anatomy, to some ex- tent. It imparts knowledge, positive or negative, in regard to disease. It familiarizes the popular mind to a great necessity of science. Many important problems in Physiology, which could never have been solved in any other way, have been determined by ex- periments on the living bodies of inferior animals. Attempts have been made on the score of humanity, in England and America to prevent vivisections. In the City of New York a society for the prevention of cruelty to animals has arraigned Professor Dalton before the public on this ground, and also appealed to the Legis- lature to prohibit the practice. A French journal notices the movement, and remarks that the New York society says nothing about the many thousand cattle which are slaughtered every year in Brazil to supply the New York market with raw-hide whips. Physicians have frequently sought to abate the prejudice against dissections by requesting that their own bodies should be dissected or examined after death. Old Dr. Monsey, who 23 died in 1788, at the age of 95, the favorite physician of Chester- field and Robert Walpole, went so far as to direct that his body be dissected, and the remains of his carcass, to use his own lan- guage, "be buried in a hole, or crammed into a box with holes, and thrown into the Thames." His body was actually dissected, according to his instructions, and a lecture given upon it to the students of Guy's Hospital. I have known many instances of physicians requesting post mortem examinations, for the purpose of determining satisfactorily the nature of their disease. One case of a very different character fell under my observation. A physician dying of an obscure organic affection, the necropsic in- vestigation of which would have been highly instructive and use- ful, said to me with great emphasis, when he felt his end to be nigh—" Under no circumstances am I willing that my body shall be opened after death." His wish was complied with, of course ; but the diploma of such a man ought to be cancelled. Civilization demands that the lifeless body be treated with de- cent respect; but veneration for it belongs to Paganism. To burn it and preserve the ashes was once the highest honor. In modern times it is buried in the earth. The Chinese in California are content to secure the bones and transport them to their native land. These things are governed by usage. Our custom is to clothe the body carefully, to deck it with flowers, to lay it in a well-wrought casket ; and then it passes forever from view. Its putrefaction and decay we do not then behold. If we did, the probability is that we should begin to enquire whether it is not better to burn it and preserve the ashes in a sacred urn. I hope the day is not far distant when it will be considered a slight and a dishonor to a dead body to bury it, like a dog, without scientific inspection. Inert and lifeless, a tenement deserted, a form with- out the soul which so lately inspired it, it is nevertheless a mira- cle of Divine workmanship. And there is more respect shown to its Creator, in reading from it a lesson of the wisdom and skill of the Architect, than in committing it, unimproved, to silence and to dust. The great enemy of rational medicine is popular ignorance. From this source come the obstructions to education, the failure to ap- preciate merit and the success of folly and imposture. Physicians 24 stand on trial before a judge and jury composed of the people. Until the people are educated to the capacity of judging correctly, their verdict is unsafe and uncertain. But the world moves. Faith in man and faith in God inspire|(us with confidence in the final triumph of truth over error. The District School is molding the popular mind as it never yet was molded ; but many years must elapse before the full fruition of its influence. Meanwhile we must learn and labor with diligence. There must be no laggards in our ranks. If we would reap honors from our profession, we must honor it by our industry and devotion. And let us gather inspiration from the thought that Rational Medicine is an integral part of the philosophy and science of the world, and that it is identified with the great interests of humanity. MeA. Hist, 3.70 c.l i" 7 4"'.2 '. ■■:: .;:;>:>.■ • r.:s-.'r.9(;il ms^m AKMKD f UKC1S RifcDrCAL U:?iUKY