26
          THE PAST,
THE PRESENT, AND THE FUTURE
         - O F THE

(V
IN THE UNITED STATES OF AMERICA;
BEING
    J dtneral fiiirflkcfatji
              TO THE
COURSE OF LECTURES IN THE THIRD SESSION OF THE
     KENTUCKY SCHOOL OF MEDICINE,
          DELIVERED BY
    THOMAS D. MITCHELL, M.D.,
Jrofessar 0f % %\mi mxa |kariia of fftriiiriM,
        NOVEMBER 2. 1852.
PUBLISHED BY THE CLASS.
CouistuUe:
HALDEMAN & CO., COUKIER OFFICE.

         1852 
CORRESPONDENCE.
                                            Louisville, Nov. 3d, 1852.
Prof. Thomas D. Mitchell:
        Dear Sir:          In behalf of the  Medical Class of the Kentucky
School of Medicine, we respectfully solicit for  publication, a copy of your in-
troductory ad dress. delivered on the 2d instant.
  Hoping our request may meet your approbation, we remain,
                                        Your obedient servants,
Wm. Hughs, Ky..
John Sutton, Tenn.,
T. M. Abernathy, N. C.
H. M. Prothro, S. C.
W. J. Card well, Sec'y.
  A. B. Cook. Pa.,
  Andrew Lemon, Ind.,
  J. L. Ross, Mo.

E. H. LUCKETT, Pres't.
                                        Ormsby House, Nov. 6th, 1852.
    Gentlemen:
                  I respond to your polite note of the 3d instant, by placing
in the hands of the Chairman of your Committee, a copy of the lecture referred
to.  Be pleased to accept, for yourselves, individually, as well as for the Class
whom you represent, my most hearty wishes for your health and prosperity.
                        I am, gentlemen, very respectfully yours. <fcc,
                                              THOS.E). MITCHELL.
Messrs. Luckett,      Cardwell,
       Hughs,        Sutton,
       Abernathy,   Prothro,
       Cook,        Lemon,
       Ross. 
LECTURE.
  The crowning paradox of earth,  is man.   Filled to over-
flowing with inconsistences and contradictions, he presents a
more than chamelion variety of shades, and yet glories in the
identity and perfection of his moral, mental and physical na-
ture. Now elated to the stars, and anon sunk almost out of the
ken of vision—to-day on the verge of a terrible explosion, by
reason of intense excitement, but to-morrow courting seclu-
sion, quietude, repose—what  is he less than an enigma even
to himself?   How many millions of human minds have been
agitated and convulsed to the farthest limit of endurance by
the high-pressure excitement  of the political tornado that has
this day swept the land from  Maine to California!  Diffused
over the almost illimitable tract that separates the new world
of the Pacific  from  the  ancient  steady  habit region of the
Puritans,  operating on all grades of mind and on all phases
of character, it might have  been imagined that the fury of
the storm would have left behind  it the lasting impress of its
wrath, ineffacible  b} time.  Not so, however, with happy,
thrice happy America.  The  sparkling eyes and the beaming
countenances  before me to-night,  are most eloquently annihi-
lating such an inference.  If the terrific lightnings  and thun-
ders of the tempest have shot their lurid flashes and sent their
angry roar athwart the region beyond the eastern slope of the
Alleghanies,  the trumpet voice of the storm-king has been
heard here also; and yet, how promptly has the high political
fever subsided at the gentle bidding of reason, common sense,
or the higher guidance of religious sentiment.
  The great question that has upheaved this whole nation
for months, has this day been settled forever.  And whether
Scott or Pierce shall hold the mighty helm of State, it is our
country still, great in its glory  and glorious in its greatness,
over which the one or the other is to preside.   And although
our Calhouns,  and our Clays, and our Websters, go down to
the grave, the   God of Washington  and  my country cannot
die.  In the full assurance  of a doctrine  so cheering  to the
heart, allow me, for  a short season, to divert  the current of
thought from the  turmoil of politics to the  more congenial
theme of medicine.

  The past, the present, and the future, of medical  science
in the United States  of America, is the theme for contempla- 
4
Mitchell's introductory.
 tion in the present hour.  To a bird's-eye view  of this vast
 subject, your attention is respectfully invited.   Its details are
 too copious  to allow  of more than a glance at the surface,
 during the brief period allotted to us, on such an occasion.
   The designations of past,  present, and future, demand a
 passing explanation   It suits our  purpose best,  to assign to
 the first, and also to the second, the term of forty years,  allow-
 ing to the third, any scope that its own nature may indicate.
 Although it be a matter of history, that the public medical
 tuition of our country  goes back to the year 1765, as its start-
 ing point, it is  equally certain that the war of the revolution
 induced so large a chasm, as to contract the interval from that
 era to 1813, to the period of forty  years, as already named.
 We are, 'therefore, quite safe in affirming, that, prior to the
 year 1813, there were not more than  forty operative years
 devoted to the public training of young men for the profession
 of  medicine.  From the year 1813 to 1853, we have another
 period of like duration, unbroken by any contingency.   And
 as  each of these periods in the history of American medicine,
 has marked  peculiarities  that may  well claim our study, it
 will be a chief aim of the present address, to exhibit those
 peculiarities in such an aspect as to augment your respect for
 the profession  of your choice, and to inspire  you with  the
 laudable ambition of winning its highest and most enduring
 honors.
  How small  were the  beginnings  of the eaiiy history of
 American Medicine ! with what difficulties had it to contend !
 When we ponder  the facts of the case, our astonishment is
 not, that the tender plant did not sooner swell its dimensions
to the capacity and  majesty of the  giant  of the  forest, but
 rather that it had vitality enough  to  insure a certain and
 abiding growth.  Stunted, as it was indeed, by the paralysing
 influence of a protracted  war, its fresh budding into  active
 life, when the storm was over  and  gone,  proved nothing so
certainly as the undying viability of a germ, animated by the
same  sort of deathless  ardor, that in the end gave victory to
our arms.   The same  omnipotent  energy  that  buoyed  our
father's hopes, high above the angry  flood that threatened
their destruction, stimulated the great men of our profession,
in the  days of its extremest  feebleness,  to look  ahead, and
 spy out a  glorious future in the distance.

           A little  particle of rain,
            That  from a passing cloud descended,
          Was heard thus idly to complain,
             " My brief existence now is ended.
          Outcast, alike, of earth and sky,
          Useless  to live, unknown to die."
          That little drop is now a gem.
          Fit for the world's proud diadem. 
Mitchell's introductory,               5
   The contentions of our early professional history, operated
 most disastrously, by procrastinating the desired  results, at
 which all good men were aiming.   There were parties, even
 then, arrayed against each other, and that too, when the uni-
 ted effort of  the whole profession was imperiously demanded.
 Add  to all this, the  difficulty of procuring the right kind of
 materials for the work of instruction, as well as the necessary
 instruments,  apparatus, &c. &c, and a suitable place for
 conducting the operations of a medical school.  Our country
 was in its infancy, and her institutions could  claim  scarcely
 more than embryotic vigor.   Her  educated physicians were
 very  few, and far between, and only one, here and  there, of
 the little band, seemed to be  fitted  to the  responsible task of
 teaching the  science of medicine.   Who can fail to perceive,
 under such a state of things, how likely some  of those select-
 ed to teach,  would prove deficient in the qualities essential to
 such  a service ?  In truth, we have often wondered  that the
 early efforts  to establish medical faculties in the city of Phil-
 adelphia, were not a thousand fold more  unsuccessful, than
 the issue  proved them to have been.  Well  may  our hearts
 beat  high, and our bosoms swell with all that is  pure  in pa-
 triotism, when we recollect that Bond, and I&ebm, and Ship-
 pen, and Rush, and Physick, and Wistar, were not only able
 teachers,  but American  physicians. Ot  some of  these woi-
 thies, we  know nothing more than their names and their his-
 tory.   But we did know Rush, and Physick, and Wistar,  and
 we have yet  to hear of any school in this country, or in the
 wide  world, that has ever enjoyed the instruction of  a nobler
 trio.   Their  names have gone out on the wings of the wind
 to every clime, and their influence  is felt and acknowledged
 in all civilized lands.   These  men were the glory  and  the
 pride of our  profession, not only in the first forty years of its
 remarkable  history, but they are to be its chief glory to the
 end of time.
   Few, in the present day, are prepared to form a just esti-
 mate  of the  value of the labors  of the  great luminaries of
 American medicine, whose names have been repeated on this
 occasion.   It is needful to know  something of the disadvan-
 tageous circumstances that for many years environed  them,
 and which might have almost paralysed the  efforts  of other
 men.   Had they such ample edifices for the accommodation
 of their classes and themselves  as we enjo3r, or  were their
 means in  this respect even suited to the smallness of the  au-
 diences that  listened to their instructions?  Far  otherwise.
 So late as  the  year  1800, the  lectures of the University of
 Pennsylvania were given in several distant places  in the city
 of Philadelphia, some of which were difficult of  access, by
reason of  the want of paved footways.   For a series  of years, 
6
Mitchell's  introductory.
the anatomical lectures and dissections were  carried on, in a
cramped, unsightly house, where nothing presented to encour-
age the student, but the indomitable  ardor of his teachers.
  But there  were other defects incident to the early history
of the profession in America,  and  these were  palpable in
other places besides Philadelphia.   There was  a scarcity of
books, and an entire  absence of diagrams, and  plates, and
model*, all of  which  are  now in common use, and deemed
essentially necessary, as  appurtenances of medical schools.
We are aware that in respect of the defects  adverted to, sig-
nal changes for  the  better were  realized,  prior to the year
1813; yet these were \'ew and small, contrasted  with the ap-
pliances put in requisition subsequently.
  In addition  to the  statement made, it is perfectly fair to
say, that  during nearly the entire term of forty years prior to
1813, there  vvere  only five professors  in  the University of
Pennsylvania,  while in the schools, the number was even less.
It must be obvious to all reflecting minds, that if five teachers
faithfully dischargeAthe entire  duties of  a faculty, their task
must have been one of real professional labor.   They worked
industriously  and  perseveringly, and hence  their success.
Their term of collegiate  service  was four months, and the
whole  period  was  made subservient to the  grand design.
Pupils were  more  regular in attendance  all the  while, from
the first to the last day of the course, during the  forty  years
now under review, than at any subsequent period.   Then the
lectures  in Philadelphia  began at nine  in  the morning and
continued until two  o'clock; and at three  in the  afternoon,
there was a renewal of the exercises. I very well remember
that Rush and Wistar, in  addition to their stated lectures,
gave one gratuitous hour, daily, during nearly the whole of
February.
  But you will be disposed to  inquire,  what were the  fruits
of all the disadvantageous circumstances herein  detailed?
Those of you  who have read the early history of our profes-
sion, are  aware,  that  the  classes and graduates  were very
tardily increased.  The graduation of ten young men in 1768,
we may  presume, induced the fond expectation that  a still
larger number would be sent forth in the years  immediately
following.  But all such  anticipations were doomed to reite-
rated disappointment.  The average yearly  number of gradu-
ates from 1768 to 1798, was a fraction less than five, falling
as low as to four, three,  two, and one.   Who, but the very
men selected  by a wise  Providence lor  such an emergency,
could have triumphed over such defeat?  Down to the close
of  the session of 1812-13, there were only seven hundred and
three graduates in the University of Pennsylvania, making
 an average of less than eighteen for each vear.  We have 
Mitchell's introductory.
7
but to contrast this result with the graduations in the same
school, in the subsequent forty years, to learn a little of the
discouragements that  met the pioneers of medical education
in America.  From 1813 to 1853, the number of graduates
may be fairly set down, as at least five thousand, or one hun-
dred and twenty-five for each year.
   Let us for a moment look at some of the practical  results
of the first period of forty years,  in respect of medical teach-
ing, and I think it will appear, despite of all the defects and
disadvantages of that epoch, that in no period of our history,
have the fruits  been  more honorable to  teachers.  Nearly
thirty of those who  graduated prior to 1S13, were selected to
teach in the schools  that  have  sprung up in our land, and
many of them are yet engaged in this occupation.   We have
only to  name a few  of the persons alluded to, in order to as-
sure you that they were the right kind of pupils, not only, but
also, that the  teaching of the first forty years in the Univer-
sity of Pennsylvania,  was of  the very best grade.   Charles
Caldwell, Walter Ctianning,  Nathaniel Chapman, John Es-
ten Cooke, Eiisha DeButts, William P. Dewtes, John Syng
Dorsey, Benjamin Winslow Dudley, John Eberle,  Geo. Hay-
ward, Samuel Jackson,  James Moultrie, Reuben D, Mussey,
Daniel  Oliver. Nathaniel Potter, James Woodhouse, are names
that next to Rush, and Physick.  and Wistar, have  exerted
an influence on the American and professional  mind, unex-
celled by any other sixteen graduates of any period in our
history.  To the latest generation, the student of medicine
may proudly  place his  finger  on this  galaxy, and exclaim,
"these are among my country's jewels."  The broad world
over, the writings of Caldwell, and Channing, and Chapman,
and Dewees, and Uorsey, and Dudley, and Eberle, and Jack-
son, and Oliver, and Potter, are  read  and  appreciated, be-
cause they deserve  to be.
   Some of the names here recorded, were pupils in Philadel-
phia, when the  advantages of a medical school were so ex-
ceedingly limited by circumstances  already  hinted at, as to
demand double, or even treble  the  efforts  that pupils have
now to put forth, and this fact may account  for their exalted
reputation.   They  were not the men to be appalled by in-
convenience  or  embarrassment.  A high and  commanding
purpose stimulated  them,  and hills were leveled, and valleys
elevated, at their bidding.  If they lacked text books, and the
hundred  appliances  that  have  since  rendered the study of
medicine an easy task, they studied the more.  If art failed
to lend its illuminating  influence, nature  was investigated
with incessant vigilance.   The powers of the mind were de-
veloped,  invigorated,  matured  by the difficulties that filled
the pathway of  the student, and hence his enduring success. 
8               Mitchell's introductory.
To all this must be added a fact that should be pondered se-
riously by every future aspirant for esculapian  honors;  we
mean the very common custom, forty years ago, of studying
medicine three or four years, under the care of a respectable
practitioner, and of attending three full courses of lectures.
This protracted reading and hearing could hardly fail to im-
bue the entire mind of  an intelligent man, with all the valua-
ble principles of medical  science, and so to lay the founda-
tion of substantial and enduring excellence.
  The  scarcity of books  has been alluded to, as part of the
history of the first forty years of our medical schools, and it
is an item of considerable  importance.   The  young man
who can now make his  election between Wistar, and Horner,
and Pancoast, and Quain, and Wilson and a dozen more au-
thors of treatises on Anatomy,  may be a little amazed, per-
haps, to learn that Fyfe's duodecimo and Cheselden were the
only works at hand on  this topic, forty or fifty years ago.   It
will be strange news to him, to hear that the speaker procured
the  first edition of Wistar''s Anatomy,  (the earliest American
work on that subject,) in  numbers of fifty pages, and  that
something like  a year had transpired  before  the whole was
issued from the press;  so  that the subscribers, at five dollars
in advance, who vvere  not exceedingly careful of their num-
bers, had soiled and defective volumes at last.  In this very
scarcity of  books,  however, was an obvious advantage.  In-
stead of flying from one  author to another, and then to a
third, a fourth, or a fifth, to study Anatomy, we  fastened on
Fyfe, or on Wistar, and we read them carefully, and  so read
as to understand.  Besides all this, be it remembered,  that
the  student of Anatomy was not a proxy dissector, in those
days.  With Fyfe  or Wistar in one hand, and his scalpel  in
the  other, he went to work like  one determined to know all
that could be learned by patient investigation.  Not content
with looking on  at others who  were  dissecting, and at the
same time comparing their explorations with their text book,
he was the industrious  operative, who was sure of his reward,
because he relied mainly on his own energies.
  Far be it from our purpose, to find fault with the multipli-
cation  of good books on any topic.  Yet, we have witnessed
the  tendency of the human mind to be satisfied with a mere
glance at many volumes on the same topic, rather than study
with diligence, the contents of a single book, and the result
has generally proved to be undesirable.   Men thus  learn  to
be satisfied with the superficies, and give themselves little con-
cern about the  deep, abstruse realities of science.   Thus it
was not with the giants of our profession who grew up under
the auspices of Shippen, and Rush, and Physick, and Wistar.
  Perhaps it will not be inappropriate to allude, as we pass, 
Mitchell's  introductory.
9
to the extreme paucity of the anatomical preparations of the
museum, and the mere show of chemical apparatus of former
times.   Wistar and Woodhouse taught Anatomy and Chemis-
try with unsurpassed ability and success,  with a  smaller
amount of  appliances suited to their departments, than you
may see in the  most recent schools of our country, whose pe-
cuniary means  are too deficient to justify a rapid augmenta-
tion.   The late  Judge Cooper, of Pennsylvania,  afterwards
President of South  Carolina  College,  taught  Chemistry in
Philadelphia  more  ably, with an apparatus that would not
twice fill a wheel-barrow,  than some of later times, whose
surplus articles would more  than load a dozen drays.  All
the extrinsic appliances on earth,  will not, can not constitute
a genuine  teacher.   If the Professor be the man he should
be, his reliance  will be less, infinitely  less, on lecture-room
appendages,  than on his own inherent powers of develope-
ment  and research.  One of the most turbid  teachers of
Chemistry  this country has ever  produced,  was  literally
crowded in the spacious apartments allotted to him, by the
absolute profusion  of glittering utensils, while some of the
most lucid  and useful instructors in America, were so stinted
in apparatus, that a first course pupil might be tempted to in-
fer, that they were not competent to  teach.
   There is yet  another item in the early history of American
medicine,  that  seems to be worthy of notice  in this place.      ,
Our allusion is to the undeniable fact, that there was then a     /  .  '
purer,  more  rational, and more available  sort of  ehe-mieal  ;Mtyu<
medicine in fashion, than that which has been more  recently
a candidate for patronage.  Students, resident in rural dis
tricts, were in  the habit of seeing, and even taking charge of
many cases that could not  be regularly attended by their pre-
ceptors, and so a large amount of practical skill was acquir-
ed.  In city and town locations, hospitals  and dispensaries
were frequented for the purpose  of  inspecting disease in its
true character, and watching the result of treatment, and in
this way, the  industrious student made acquisitions of un-
speakable  value.  In thus applauding the clinics  of olden
time, we do not intend to denounce, by wholesale, the mod-
ern  contrivances of colleges, in  virtue of which, all sorts of
cases, small, and not quite so small,  are brought up  for pub-
lic exhibition, first in the amphitheatre,  and then in the col-
lege periodical.  That the  college clinic (as it is styled) may
be of some service to an inquiring  student, we do not deny,
while we most  positively  affirm,  that, in our judgment, the
hospital and dispensary attendance were far more profitable.
The patients there inspected, were more like those to be seen
in after life, and the whole display, if display it could be call-
2 
10              Mitchell's  introductory.
ed, was far more in accord with  nature, than  very much of
the detail that finds its way into a modern college clinic.
   Belonging, as he does, to the first period of  forty years in
our professional history, the speaker feels justified  in thus
speaking out, for what he has ever regarded as the palmy era
of American medicine.  His partiality for the  teachers, and
for many of the taught of those  days, will, he  hopes, be ex-
cused, if a foible at all,  as one of those commendable frailties
of our nature, that is not likely to harm any one, save him
who cherishes it.
  To all that has been  advanced, to account  for the excel-
lence of much of the first fruits of American medical educa-
tion, we may append the conceded fact, that those who were
intended for the profession of medicine, fifty or sixty years
ago, were, for the  most part, substantially  educated in Eng-
lish literature, and not  unfrequently in the Latin language.
Thus a good foundation was secured,  upon which might be
erected  an enduring and useful superstructure.
  The most serious and effective agency in the deterioration
of the  medical profession, had scarcely a beginning  prior to
1813, its pernicious  workings  having been reserved for the
subsequent  forty  years of our history.   We need hardly to
announce the character of this deleterious  agency, as every
one who is conversant with the facts, will readily understand
our allusion to be, to the rapid multiplication of the schools,
and the consequent laxity in collegiate discipline, and in pri-
vate teaching.
  When we entered on the study of medicine, such a thing
as a medical school  was not in being, in all the great West.
It is true that vast domain was then but in  the  incipiency of
settlement, and no one  dreamt  even of the mighty tide of
emigration, that was so  soon to convert its hundreds into mil-
lions.  But who can wonder that some of the adventurers
from Kentucky, who traveled  on horseback to Philadelphia
in 1805, to enjoy the  advantages  of the  parent  school of
medicine, should have cherished  the fond hope at that early-
day, of  establishing a western  school for the convenience of
the sons of the forest land ?  Dudley, and Richardson, and
Overton, and others who were among the early  pupils of the
West in Philadelphia, had, no doubt, often mooted this very
question, in the temporary exile from their own firesides, and
longed for the day when the openings of Providence, might
prepare the way for the  realization  of an  object so  dear to
their hearts.  They well knew that very many young men of
talents were deterred from following their example, by all the
difficulties peculiar to a new country, and the perils that  en-
vironed so long and lonely a journey.   Men were not then
transferred from place to place, a thousand miles apart, by 
Mitchell's introductory.              11
electricity or steam, in a few hours.  To avoid the dread en-
counter of the red man, the pioneers of civilization, who ven-
tured to make a journey of six weeks along foot paths, beaten
out by savage  feet, were compelled to congregate at given
points, then known as stations, whence they took up the line
of march in company.
  In view of facts  like these, which are by no means tinged
by fancy, who wonders that so many men of undoubted talent
should have settled in the West, as practitioners of medicine,
with no other  qualifications than  could be furnished in the
office of  a faithful preceptor, possessed of  a very meager li-
brary?   Some  of the most successful  physicians I have ever
known, were dependent on no other agency than that advert-
ed to, backed by their own indomitable assiduity, for all the
character they ever acquired as members of the medical pro-
fession.  To use-their own phraseology, "their backs had
never  rubbed a college wall,"  for their  circumstances, and
the state of the country utterly  annihilated every germ of a
hope, that one  day or  other, their ears might be saluted by
the  voice of professional instruction, in  the  far off city of
brotherly love.
   Scores of physicians, of the grade we have ventured to de-
scribe, were busily engaged in  the  truly arduous duties of
professional life, for many years anterior to the establishment
of the first  medical  school  in the West.   I am well aware
that several abortive efforts were made, from time to time, by
the governing powers of Transylvania University, to convert
the  aspirations of the fathers  of  western  medicine, into a
tangible  reality.  Their printed  records show, that  Samuel
Brown, M. D., was appointed Professor of Theory and Prac-
tice, and of Chemistry, in 1799.  But that  did not constitute
a faculty, nor establish a medical school.   The next appoint-
ment, viz., of the Rev. James Fishback,to the  chair of Theo-
ry and Practice, in 1805,  was alike unavailing.  Brown had
graduated in Edinburgh, and Fishback had been a faithful
pupil in  Philadelphia ; but what could they accomplish, in a
new country, alone?  I knew them both,.and doubt not their
capability,  with  suitable associates, to have  conducted a
medical school with credit and  success.  Their resignation
in 1806,  was incjicated by common sense, and excited no sur-
prise.  In the same year, the Emeritus Professor of Surgery
and Anatomy,  of the Kentucky  school of medicine, received
his degree  of  Doctor of Medicine in Philadelphia, and in
1809 the same degree was awarded to James Overton, of
Kentucky.   These gentlemen,  in connexion with Joseph
Buchanan, and Elisha Warfield, were constituted a faculty,
with obvious imperfections, in the year 1809.  Unapprized,
as we are, with all the facts as they could then have been de- 
12
Mitchell's  introductory.
 veloped, we have no hesitation to affirm, that this effort was
 deemed the very best that could then have been made, and
 it serves to indicate the unabated purpose of former years,
 to establish a good school of medicine, far away in the region
 of the woods.  For the information of the junior portion of
 this  audience,  who  have not had access  to  the records, we
 present the actual  constitution  of the  faculty of 1809,  in
 Lexington, Kentucky.
   Benjamin Winston Dudley, M. D., Anatomy and Surgery.
   Joseph Buchanan, A. M., Institutes  of Medicine.
   James Overton, M. D., Theory and Practice.
   Elisha Warfield,  Surgery and Obstetrics.
   There are several points worthy of remark in this compo-
 sition of the first western medical faculty.  We are  not in
 possession  of any  data, to  assure us certainly,  that these
 gentlemen  ever officiated as a faculty.  The pamphlet from
 which we quote, was published in 1826, and gives the year  of
 appointment, and the year of resignation, of the several pro-
 fessors  in  the  various  departments of the University, with
 the exception of those who continued  after the issue of this
 document.   Of the  four  Professors of 1809, the first con-
 tinued until 1850, the second withdrew in 1810, the third  in
 1818, and the  fourth in 1809.  The fair, and perhaps  neces-
 sary inference from these facts  is, that these  gentlemen did
 not give instruction as a medical faculty, and that those who
 held over, did so in the expectation of being assisted by others
 in consummating a desideratum as fondly cherished by many,
 who  were only spectators of what seemed to be idle efforts to
 secure an unattainable object.
  It  merits notice, also,  that the faculty of 1809 made no
 provision for Materia Medica, nor Chemistry, while it is even
 more remarkable, that it established,  as far  as an appoint-
 ment could operate, a  professorship of  the  Institutes  of
 Medicine.  That this was the first attempt in the United States
 of America, to incorporate the Institutes with the other depart-
 ments of medicine, is thus a matter of history,  that cannot be
gainsayed.   The gentleman selected for this important post,
 was  not a graduate  in medicine, but simply a Master of Arts,
and we feel at  liberty to make the inference, that he and his
colleague Dr. Warfield, had been pupils in the parent school
for one session, but  did not persevere so far as to obtain the
diploma of the University.  We do not entertain a doubt, that
 this imperfect faculty could have given a  full and very in-
structive course of lectures,  since it is more  than probable
that the  departments unprovided for, could  have been tempo-
rarily filled, as has  often been  done  in later times, under
similar circumstances.   It would seem that nothing was want- 
Mitchell's  introductory.
13
ing, save a suitable provision for the chairs of  Materia Medi-
ca and Chemistry, to have made the infant school of Lex-
ington in 1809, more  perfect in its organization, than even
tha parent  school  in Philadelphia,  which lacked a chair of
obstetrics, and had no separate provision for the Institutes of
Medicine, when I was one of its pupils.
  Some may be disposed to express surprise, that while these
imperfect developements were evolved in Lexington, without
a realization of the end in view,  other  regions in the  West
did not take the hint and plant a well arranged medical school
in some suitable locality, where western young men might
enjoy all the advantages to be found in Philadelphia.  But it
must be  borne in mind, that more individuals,  and especially
more men of talent and enterprize had been sent from Ken-
tucky to be educated at the parent school, than had been fur-
nished from any other State west of the mountains. These gen-
tlemen returned to their homes, burning with a commenda-
ble zeal to give to their countrymen all the  truly  valuable
helps that an eastern school could furnish, to fit the student for
an active and honorable professional life.  Having been per-
sonally conversant for  eight months with the actual workings
of a school of medicine, they might presume to be able  to es-
tablish, successfully, a similar institution  in Kentucky, and
hence their  failure, even  for a long period, did  not provoke
others, less  likely to succeed, to make an experiment else-
where.
  The demand for a Western school did not cease because
of reiterated defeats in attempts to plant one of the right
stamp.   The journey to Philadelphia was as costly, hazard-
ous and protracted  as ever, nor was there any  prospect of
improvement in these  respects.  Hence it happened that, in
1815, another effort was put forth by the selection of Cole-
man Rogers and William Hall Richardson, to fill important
places in the projected school.  In 1816, the Chair of Mate-
ria Medica was filled for the first time, and in 1817, the Chair
of Chemistry was in like manner provided for.  In 1818, the
first degree of Doctor of Medicine  ever conferred in a west-
ern school was given to John Lawson McCullough, of Lexing-
ton, the only graduate on  that occasion.
  The written records of the proceedings of the medical de-
partment of Transylvania  University,  do not furnish any
account of the faculty  organization, prior to the year 1819,
from which date the register, with a few exceptions, is appa-
rently complete.   The faculty then consisted of Professors
Dudley, Brown, Richardson, Caldwell, and Blythe, by whom
a full course was given on all the departments.
  From this period,  the desire to multiply schools of medi-
cine,  was evinced in various  sections of our  country,  and I 
14
Mitchell's  introductory.
need not tell you, how abundantly that desire has been grati
fied   It is not for me to censure nor to laud the feelings that
prompted to this result; but it is impossible to resist the con-
viction, that the augmentation of numbers has not been met
by a corresponding Improvement in the science, or profession
of medicine.   The phrenzy of competition has been disas-
trous not a little, to the steady and  permanent  growth of the
profession, in all that appertains to its true dignity and value.
  It is  worthy of remark, that the early, and even part of  its
more advanced history, found the school of Lexington  very"
deficient in what we  now hold to be essential appliances, in
the management of a school.   The gentlemen  who filled the
professorships, were  practical, working teachers, and pupils
were taught to  think for themselves.  Hence the notorious
fact,  that this first western school, like its eastern prototype,
has sent forth a goodly number of able men, to fill the posts
of public teachers  in kindred institutions.
  This is a proper time to speak of a  rule, first established
by the  school of Lexington, and adopted  by all the institu-
tions that have  succeeded it in the West, and which, for a
time, was denounced in the East, as calculated to work pro-
fessional deterioration.  We refer to the provision, in virtue
of which gentlemen  who  had been  engaged  in reputable
practice  for at least  four years, were permitted to be candi-
dates for graduation, after  attendance of one  full course of
lectures.   We  have  ever regarded this as a wise and neces-
sary  ^arrangement, and one  whose  practical operation has
rarely been discreditable to the profession.   It was denounced
by the  eastern faculties, as unfair in respect of older institu-
tions, whose laws required  attendance of two full courses of
lectures, as preliminary to offering for a degree.   It was even
averred, that the western device was intended as a decoy, and
was therefore disreputable.
  A very brief analysis of this problem, will, we doubt not,
place the matter in its true light.   The peculiar circumstances
of the  whole west,  then a new region in the common par-
lence of the day,  rendered the rule  in question, a necessary
provision.  It was notorious that many very respectable phy-
sicians were scattered abroad in Kentucky, and the neighbor-
ing States,  whose  circumstances had  utterly prevented at-
tendance on the lectures in Philadelphia, then the only school
of medicine, and who had never heard a medical lecture any-
where.   These  individuals were  men of reading, reflection,
and study, and had turned the advantages  actually possessed
to the best practicable account.  The faculty of the  Lexing-
ton school, aware that this state of things  had  not been met
by any suitable expedient in the East, determined to fill  an
obvious chasm, by  the adoption of this rule.   The candidate 
Mitchell's  introductory*              15
was required to present proof, satisfactory, that he had been
a respectable  practitioner  of medicine during the term of
four  years,  having previously  studied medicine under  the
guidance of a regular member of the profession.   To expect
such persons to abandon a lucrative practice in  two succes-
sive winters, or in two  winters  with an interval more  pro-
tracted, was too Utopian for actual  experiment.   Had such
a plan been adopted on paper, it could not have been carried
out to any considerable  extent, and many,  who, under the
rule  as enacted, became respectable graduates,  would have
remained as irregular practitioners to the day of their death.
This consideration, alone,  was too important to be overlook-
ed, in the decision of the case.
   But it is well to look at  the  actual  operation of the rule.
What kind of pupils  came to  the school, under  this novel
provision?  Were they the rash, the giddy, the  thoughtless,
the immature  persons who sometimes find a place in medical
classes?  On the contrary, they were  men who had by daily
intercourse  with  all grades of society for several years, ac-
quired a common sense character, a  steadiness of purpose,
a talent of concentration, fitting them  for rapid improvement
by the daily culture of a well organized school.   They knew
the value of time too well  to trifle with it, and they had fami-
lies at remote points, who, sighing for  their return, would ex-
pect irom them a fixed devotion to the object that had led to
a temporary expatriation.  And as a general rule, it has turn-
ed out, that these men of one course of lectures, have almost
invariably passed the most satisfactory examinations, for the
degree of Doctor of Medicine,  and have ultimately become
valuable members of the profession.
   At the present day, when almost every State in the Union
has its medical school, and when in some of them,  we  may
count at least half a dozen institutions devoted to the work of
making doctors,  there is far less propriety  in retaining the
rule of which we have been speaking, than there was in its
first enactment.   Then, it was  devised  because  of the scar-
city of medical schools, and the difficulties that beset the
path of him who sighed for the  doctorate.  But now  that
these  institutions are so easy of access, it is the opinion of
many judicious men, that it is hardly  necessary to retain the
regulation on our medical statute books.  Most assuredly,
the schools of Philadelphia, where the  rule is just as fash-
ionable as it ever was in the West, can present no valid rea-
son for perpetuating it.  They graduate practitioners of four
years' standing, after attending one course of lectures, know-
ing that the  pupils go from places in the West, not twenty
miles from well known schools of medicine, where they could 
16
Mitchell's  introductory.
 have attended a course of lectures with far less sacrifice, than
 is incurred by a resort to an eastern institution.
   Twenty-one years have rolled away, since the speaker gave
 his first introductory  lecture in  the West.  At that moment,
 the entire country on this side of the  Alleghanies,  and south
 of Mason and  Dixon's line,  contained  only  five  regular
 schools of medicine, and two of that number were  exceed-
 ingly feeble.   How many, think you,  have been added to the
 list, in four years less than a quarter century?  Were you to
 make twenty the maximum of your conjecture, there would
 be a surplus  whose exact  numerical  force,  cannot now be
 given with certainty.   The territory, of which mention has
 been made, has  gained (if it be  a gain) at least one medical
 school for every year since 1831.  In  this estimate,  we do not
 include the Eclectic, Botanical, Thompsonian, and Infinites-
 simal things that now dot this great valley, only one of which
 had even  a nominal existence,  twenty-one years ago.  We
 are quite  willing that any of the Malthusians  in this respecta-
 ble company shall take our place, in calculating the pertinent
 question,  " has the supply been  equal to the demand  ? "
   We have thus surveyed, in a somewhat discursive manner,
 the past history of the profession in these United States, and
 we come  next to inquire,  what  are the peculiarities of the
 passing period.   The  whole of  this' era, according to a pre-
 vious intimation, extends from 1813 to 1853,  but as we have
 somewhat entrenched on its boundaries in the preceding re-
 marks, we shall  confine our observations mainly  to the last
 ten or fifteen years, including, of course, the present time.
   Let us make a flying survey of this portion of the  profes-
sional field, and spy out, if we can, its leading peculiarities.
These are—
 1st.  A rabid propensity to multiply  medical schools.
2d. Devices of various kinds to  decoy pupils ;  such as tick-
  ets at a reduced price, with long  credit in place  of cash,
  low priced  boarding, accommodation  as to attendance of
  the lectures, and a guarantee of the diploma.
3d. Very general disuse  of the ancient practice of training
  students at their homes, in the offices of preceptors
4th.  Annual conventions for the ostensible purpose  of ele-
  vating the profession, the chief managers of which, feel it;
  to be quite  legitimate, to denounce the schools, for not pro-
  longing their sessions to six months,and for refusing to re-
  linquish the examination of candidates for the doctorate,
  while  it is notorious, that very  many of the complainants
  are incompetent to conduct such an examination.
  It is not our present purpose to speak  particularly of the
first and second of the  peculiarities just stated, for the very
obvious  reason, that in some parts of  the country they have 
Mitchell's  introductory.
17
 been matters of public notoriety  for many  years, and will
 scarcely be controverted.   The third and fourth items are too
 important to be disposed of in the  same summary way, and
 we design to be somewhat explicit in respect of both. Nei-
 ther of these is invested with  the charm of novelty, the third
 being in our judgment the most deleterious of all the perni-
 cious agencies that are now at  work in  the profession, and
 although of mature  age,  waxing  worse  as it advances  in
 years.
   The almost  total  neglect of office examinations may  be
 fairly stated, as a marked peculiarity of the present  period.
 That it came into fashion after the year 1813, is, if I mistake
 not, a fact that needs no  special proofs.   There are those
 no.v living, who well remember the regularity with which they
 were examined by their private preceptors, forty or fifty years
 ago, and they can hardly  forget the happy  fruits of the exer-
 cise.   It seemed to be just as  necessary a preventive of men-
 tal apathy on medical topics, as is motion of the body to
 guard against  a general torpor of the muscular system.  Yet
 in very many regions where pupils abound, such a thing as a
 catechetical examination has not been known for years.  In-
 deed, the  student would  be alarmed, if his  (so called) pre-
 ceptor ventured to interrogate him in respect of any medical
 topic, saving the compounding of a prescription, or the an-
 swering calls for the doctor, or something of that sort, which
 an intelligent servant could do quite as well  I have heard
 medical pupils, almost without number, affirm that they were
 never so interrogated  during  the  entire period of pupilage.
 It seemed  to be quite enough, by way of preparation for at-
 tending lectures somewhere, to have been called a student of
 medicine, to have looked  at a few medicines on  the shelf,
 and to  have glanced at a medical dictionary, or  some old
 and imperfect work on practical medicine.
   As a  part of this  system of neglect,  we name the utter
 recklessness of the profession, in respect of the mental, mor-
 al, educational, and other qualities of young men, who de-
 sired to be regarded as students of medicine.   As daily  or
 weekly examinations ceased to constitute a part of the train-
 ing, it soon came to be  equally  unimportant whether the
 pupils could write the English language correctly, or compre-
 hend works of  the profession, if ready for their perusal.  Of
 no  importance  was it to  ascertain the  peculiar bias of the
 mind, the  probability of  adaptedness to the calling of the
 practitioner, since it was  presumed that all this, and much
 more, fell within the special province of the medical faculty,
to whose care the pupil was destined to be committed. If a
young man of known  immorality of character,  including
profanity, falsehood, and intemperance, offered at the private
        3 
18              Mitchell's introductory.
office, the heavy  purse of his father more than outweighed
all these palpable defects, which should at once have barred
the door effectually against admission.
  Do any inquire why physicians were  willing to receive pu-
pils, without proper investigation as to character and qualifi-
cation,  and very often without  a fee?  We reply, that the
number of students in an office has been made the measure of
the doctor's practice, and thus every new hand in the shop
was expected to add to the calls for  medical aid.   To such
an extent has  this delinquency  been carried, that the evil
seems to be without remedy.  Having brought the  profession
to such a low condition by their own fault,  these  men turn
round very deliberately,  and charge  the entire degradation
on the  laxity and incompetence of the medical  professors.
And I verily believe  if the facts could now be spread out
shorn of disguise, that it would appear, that a very large pro-
portion of those who clamor the loudest  about professional
deterioration, would prove to have been among the most de-
linquent in  the selection and training of their own  office-
pupils.   That there  are  many honorable exceptions, I well
know, but much do I fear that the truth is to be  found just
where I have attempted to locate it, in respect of the majority.
  The fourth peculiarity of the present era came as a sort of
expedient, that many supposed to be indispensable, and well
calculated to remedy existing evils, if remedy were possible.
We allude to conventions of physicians from every  part of
the United States, to be held annually in different  places, for
the avowed purpose of elevating the  profession.   Nor do we
doubt that some  who have embarked most heartily in this
enterprise, have been moved by the best motives.   Far be it
from us to think otherwise.  Yet there are too  many living
facts on record, to permit  us  for a moment to doubt, that
very many of the primary agitators  were governed by the
most selfish considerations,  not the  least of which was  a
marked propensity to exonorate themselves from blame, and
to criminate others who have demeaned themselves far more
honorably in respect of the great professional interests with
which they are identified.
  Never have we doubted that well  organized medical asso-
ciations, and even great national conventions may have their
uses.  They serve to revive the most pleasant associations
of early life,  and to bind the brotherhood together  in the
bonds of a professional  affection that should ever be cher-
ished.   And were it not,  that in every great family, there are
some cynical country cousins,  whose repellencies  forever an-
tagonize a result so  auspicious, we might  hope to realize, as
one of the fruits of those annual convocations, that cordiality
and unity which led a spectator of the smiling crowd at the 
Mitchell's  introductory.
19
late supper of the State Medical Society of Kentucky to ex-
claim, " behold how these brethren love one another !''   But,
unity  and  cordiality, however desirable, cannot accomplish a
thorough medical reformation, nor is it possible for this work
to be effected by the labors of societies or conventions, unless
the efforts be directed mainly to the characters and qualifica-
tions of students.   Old trees  are seldom, if ever improved,
while scions, and especially good scions may be so grafted
as to yield the best  kind of fruit.  We do not hope to erect a
lasting pyramid, by placing the apex down and the base up;
nor can we reform our  profession by  any code of rules to
straighten old and crooked sticks, but rather by moulding the
pliant twig aright,  and teaching the young idea how to shoot.
   We have scanned  the operations of some of the associa-
tions  and conventions referred to, with  not a little interest,
and,  as the result of  our scrutiny have  been pained to  find,
that the mammoth  evil in the way of the restoration  of lost
dignity, has been comparatively untouched, while the far less
momentous topics  of prolonging the  sessions of the schools
and the  ordeal of  final examination  for degrees have  been
prodigiously magnified,  until what was at all natural about
them, has been invested with some of the worst attributes of
monstrosity.  On another occasion, we dwelt at some length
on this topic, and do not feel disposed now to enter into de-
tails.  Suffice it to say, that multiplied as the schools  have
been, and palpable as the  defects  of some of them are, the
remedy is not to be found  in  prolonged sessions, nor in a
radical change in the examination of  candidates,  but  in a re-
turn to the ancient habits in respect of scrutinizing the  char-
acter and qualifications of young men, for the place of office pu-
pil, and the  daily or tri-weekly examinations in order to ascer-
tain the amount of progress in the studies assigned. Often have
we affirmed, as we  now do with all sincerity, that the  private
preceptors of this  country hold the destiny of the profession
in their own hands.  Let them reject every unfit or unworthy
young man  who sighs to be a student of medicine ; let them
carefully  direct the studies of those actually under their su-
pervision, examining them as frequently as circumstances
will allow,  and they  will  furnish  the  schools with the best
material  that professors can desire, and the final products
will be honorable to  the private, as well as to the public in-
structors.
   We desire to be  informed in what way six months' sessions
can improve the ,profession,  apart from the rectification of
the errors first noticed in respect  of private tuition.   Does
any sane man really  believe, that attendance on lectures du-
ring the entire year,  if it were possible  to enforce a requisi-
tion to that effect,  could compensate  for the reckless neglect 
20
MITCHELL'S  INTRODUCTORY.
  to which allusion has been made, in relation to the selection
  and training of pupils ?  Is it  practicable,  by any extent of
  attendance on medical  lectures  in the  best  school  in  the
  world, even to seven lectures per day, for seven years, to infuse
  intelligence, energy, and discrimination  into a youth,  how-
  ever amiable, who is semi-demented by nature, and in whose
  behalf the most untiring and well-directed efforts have been
  unavailing?  No one can  reach such  a conclusion, without
  the previous act of self-stultification.   The tree must be of
  the right kind, or you will  look in vain for the right kind of
  fruit.   Men do not gather figs from thistle bushes now, any
  more  than  they did in  times of  yore,  and  they never will,
  plainly, because it  is impossible.   Let the  young men who
  enter our offices, be good men and true, intelligent, energetic,
  well educated, moral, conscientious,  and a guarantee need
 not be demanded, that the  schools will send out intelligent,
 upright, competent physicians.  In no operation of natuie or
 art, is there a more  manifest relation between cause and  ef-
 fect, than in the right training  of the  right kind of medical
 pupils, and  the ultimate results.
   We are told that  the custom  of some of the  schools with
 sessions of four months, and seven lectures per day, did vio-
 lence to the human constitution, and ought not to be tolerated.
 But having  had nearly twelve years experience,  under pre-
 cisely  such  a state of things, we feel at liberty to speak out
 in its  defence.   We hazard nothing in the affirmation, that
 scores of the ablest  and  most distinguished living physicians
 of Kentucky, Tennessee, Alabama, and  the  entire South,
 were trained in Transylvania University, under this very state
 of things, insufferable and ruinous as some have  proclaimed
 it to be.   And if it be alleged that discoveries in science have
 enlarged the domain of teaching, so as to render a four months'
 session too brief, let me say, for  I can do  it most truthfully,
 that a wise expurgation of things, obsolete, and of no value,
 would make ample room for  all  the new things that are true
 in every department of medical science. If medical lectures
 were so revised from year to year, as to eject all the  stereo-
 typed nonsense that has no sort  of claim, save its antiquity.
 there  would  be time enough for  a properly condensed, yet
 lucid presentation of all  truly valuable  discoveries, in such
 sessions as I have had the temerity thus  to defend.
  It is just to the profession  at large, to  state here, as I now
do emphatically, that the only attempt to carry out the recom-
mendation for  a six  months' session,  has  been a failure.
 Ihis position will, doubtless, be gainsayed, by those whose
interests may  seem to prompt that way; yet I know it to be
 a verity, and  they know it also.   Let  us  look  at the facts.
in the city of Philadelphia where an honest effort was made 
Mitchell's  introductory.
21
 to accomplish this innovation fully, pupils have been received
 without a demurrer, who did not reach the city until five, six,
 or more weeks had elapsed after the week of introductories.
 These delinquents were matriculated just as though they had
 entered on the first day of the session.   In  addition to  this
 well  known fact, it is  equally notorious, that at least one
 third (and some say one-half) of the class finds it convenient
 to bid adieu to the school, when their friends connected with
 the other medical institutions are about to  depart.   As this
 event occurs at the close of February, or in the first week of
 March, it is plain that,  excepting the candidates who  must of
 necessity remain, the throng has dwindled to a handful, where-
 by, nearly a month of the session is lost.  The delinquents
 in the opening of the session, are usually second course pu-
 pils,  while those who  leave late in February, are in  attend-
 ance for the first time.  Could we reach a just average of loss
 thus actually sustained by both grades of pupils, it would be
 seen, that at least one-third of the entire  class, fails to enjoy
 the advantages of a term exceeding four months.  And if we
 contrast the University of 1852 with the same  University of
 1812, it will appear, beyond all controversy, that the boasted
 improvement of  a prolonged session, is not  even  a nominal
 gain, in point of  time.
   In  1812, the lectures opened at nine  in the forenoon, and
 held on till two.   After the  dinner  recess, the class met at
 three to hear an  afternoon lecture,  which was occasionally
 followed by an extra lecture by some Professor who had de-
 sired an addition to his regular hours.  And, as we have be-
 fore intimated, two of the  Professors gave gratuitous hours
 of instruction, during part or the  whole of February, as we
 personally  knew to be the case.  But  in the phrenzy of re-
 form  that has  come over the professional  mind,  there has
 been  a retrograde motion in this  respect, most manifestly.
 In place of opening at nine,  the schools have adopted ten as
 the starting point; and the lectures on some of the depart-
 ments which were formerly given on every day of the week,
 save  Sunday, have  been, in nearly all the schools restricted
 to Monday, Tuesday, Thursday, and Friday.   Who that can
 work a very  simple problem in Euclid, can fail to discover in
 these backward reforms a positive loss, instead of the vaunted
 gain of which so much has  been said ?  In view of  the  ad-
 ditions annually  made to some of the departments of medi-
 cal science, one would suppose, that at least as many lectures
 would be  required, in order to give any thing Jike  complete-
 ness to a  course of six months, as were given in Transylvania
 University, in its palmiest days, with  the oldfashioned ses-
sions of four months.  We sadly mistake, if in this respect,
the advantage is not decidedly on the side of the old  regime
of the west. 
22              Mitchell's  introductory.
   We have thus, gentlemen,  beguiled your time with desul-
 tory reflections on the past and the present of our profession.
 But, what of the future?   Who can tell ?   Is its deterioration
 to keep pace  with  the  swell  of population, that  is soon to
 cover the almost boundless  territory  of Oregon and  Califor-
 nia, whose cities, and towns,  and  villages, shall send forth
 scores and hundreds of the sons of  all nations under Heaven,
 to fill the halls of medicine,  that are destined to bestud the
 far off wilderness, over whose soil the proud flag of America
 shall wave, it may  be,  till time shall  be no more?   Or,
 will the  present generation seize the golden opportunity of
 regenerating, dignifying, establishing on a basis, that shall
 bid  defiance,to  corruption and  decay, the venerable art of
 healing,  i*nd thus demonstrate that they are not degenerate
 sons of the  immortal sires of the profession ?  I tell  you,
 young  gentlemen, the s-elootion of the momentous problem is
 most intimately identified with your conduct and your desti-
 ny.  If you form the iron  resolve,  inflexible as fate, to  imi-
 tate the  high and  pure  example of the  great men, whose
 names have been uttered in your hearing to-night, by patient
 devotion to study in the time of your  pupilage  not on?y, but
 in after life amid the bustle and toil of  professional duties, you
 will do well.  Better still will  you act your part, if you stern-
 ly refuse to take young men into your offices to study medi-
 cine, who are not well educated, of undoubted  moral char-
 acter, decidedly intelligent, conscientious, and obviously suit-
 ed to the peculiar duties of the practitioner, determined  that
 if unceasing vigilance in the oversight of their daily studies
 can avail, you will  furnish the schools of medicine with no
 material that cannot be  transformed  into a very respectable
 physician.   If you and all the pupils  now congregated in the
schools of America, will  make this grand, noble, indispensa-
ble purpose, an abiding  element of future life,  carrying out
with unwaning energy the  doctrines herein set forth,  the
coming destiny of the profession will shine forth illustriously
pure and clear as the sun in his brightness, and the immortal
lustre of  the  days of Rush, and  Physick,  and Wistar, once
more glow on  our horizon.
  If our  profession  has  waned,  beca ise of ignorance  and
disqualification,  marked  and palpable in the pupil,  is it af-
firming too much to assert, that it has lost more by the lack
of integrity, of pure, incorruptable honesty in some who
boast of their Esculapian sonship ?  Let us all from this hour,
resolve to do our duty, as if the  entire issue  hung on indi-
vidual effort, under  the solemn  conviction that we are one
day to account rigidly for the talent entrusted to our care. 
Mitchell's introductory.
" Ask you, what makes the true nobility?
   Not wealth, nor name, nor tinsel pomp, nor power.
 Fools have them all, and vicious men may be
   The idols and the pageants of an hour.
 But 'tis to have a true and honest heart,
   Above all meanness and above all crime;
 To  act the right and honorable part
   In every circumstance of  place and time.
 He who is thus, from God his patent takes,
   His Maker formed him the true nobleman;
 Whate'er is low and vicious he forsakes,
   And  acts on rectitude's eternal plan.
 Things  change, but changes touch not him,
 The star that guides his path fails not, nor waxes dim."