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Surgeon  General's  Office       §
 
 
 
A
            D  E F  E  N  C'E
                        OF THE

   MEDICAL    PROFESSION
            OF  THE  UNITED  STATES;      /  /
                        BEING                |
A  VALEDICTORY  ADDRESS TO  THE GRADUATING CLASS
                        AT THE
   MEDICAL COMMENCEMENT OF THE  UNIVERSITY OF NEW YORK,

              DELIVERED, MARCH 11, 1846,
            MARTYN J£INE, A. M. M. D.,
Professor of the Institutes of Medicine and of Materia Medica in the University of New York ■
   Member of the Royal Verein fur Heilkunde in Preussen ; of the Medical Society of Leipsic •   '
        of the Montreal Natural History Society, and other Learned Associations.
            Sli&fa. EDITION^'
            wLJBKAJiy %

              NEW YORK :
        PUBLISHED FOR THE AUTHOE, BY
    SAMUEL S. &  WILLIAM WOOD,
           NO. 261 PEARL STREET.
JENNINGS & DANIELS, PRINTERS, 122 NASSAU STREET.
                 1846. 
l%4t»
-£>
 
       PROFESSOR  PAINE'S  DEFENCE

                        OF THE

MEDICAL  PROFESSION  OF  THE UNITED  STATES.
 Gentlemen, Graduates !
   It devolves upon me to congratulate you on the attainment
 of that distinguished honor which denotes a high order of in-
 tellectual culture, and thus to welcome you to the bosom of the
 Medical Profession.
   And this,  gentlemen, I do with greater cordiality, from  my
 general acquaintance with you, and from my knowledge of your
 qualifications for the exalted functions of Doctors in Medicine.
   You enter, my friends, upon your  career, with the certainty
 of immediate usefulness; for although more extended  observa-
 tion of disease will  impart greater confidence and skill,  you
 have acquired a knowledge of those  great principles in medi-
 cine which assemble the facts and the experience of ages, and
 which, especially, are to form your guide in the treatment of
 disease.
   " I have done my part," says Sydenham, " by mentioning the
 indications to be considered,  and pointing out  the time,  and
 manner  of doing it; for the practice of physic  consists chiefly
 in being able to  discover the true curative indications, and not
 medicines to answer them; and they who have overlooked this
 point,  have taught empyrics to imitate physicians."  The illus-
 trious  Senac sets forth the true aspect of this subject in his work
 on Fever.   " For the better  illustration," he  says,  " of the
 method  of cure, I had prepared  for publication a number of
 cases.  But, it appeared best, on reflection, that these should be
 omitted.   There are not two cases of disease precisely alike:
 whence, there are not two in which the same remedies will pro-
 duce precisely the same effects.   It seems more advisable, there-
 fore,  to reduce, to certain general laws, all the facts which ex-
 perience  has brought to light, and from these, to deduce a mode
of cure accommodated to the state and condition of each patient." 
4
   And such have been the conclusions of all the great apostles
 of medicine.  Experience, and facts, in the first place ; and then
 let us have them reduced to principles as substitutes for them.
 I speak, however, of that experience which Zimmerman says is
 "generally considered the simple produce of the senses.  The
 understanding seems to come in for so small a share, that every
 thing intellectual in it is regarded as having as  much materiali-
 ty in it as  the perceptions of the senses.  This," he says, " is
 what I call false  experience.   It is a blind routine, directed  by
 no law whatever,"—and hence, " the old man is generally sup-
 posed to have thought more than a  young one, because he has
 seen more."
   But, says the same eminent philosopher,—" it, has been already
 remarked,  long before my time, that  the increased  number of
 years and patients only serve to remove physicians, destitute of
 genius, farther from true physic.  The more their  practice  is
 augmented, the more numerous and considerable are their errors.
 On the contrary, we  observe, that, by the  aid of sound judg-
 ment and  knowledge, a physician  is  enabled  to penetrate the
 greatest  difficulties, even from his youth ; and that with these
 to guide and support him, he  rises superior to every obstacle."
 It  was the opinion, indeed, of this accurate observer  of man,
 that,—" he, who at thirty years of age  is not an able minister, an
 able general, or an able physician, will never be so."
   It is not, therefore,  my young friends, the great number  of
 undigested cases,  but  the comparatively few that are well ob-
 served, and well considered,  that  contribute,  with the great
 principles of medicine, to form the enlightened and successful
 practitioner.  Hippocrates,  according   to Galen, gathered his
 knowledge in small towns, insufficient to support a single phy-
 sician.  In  this acception he was  only a country practitioner.
 But, as Socrates said of another ancient, "he spent his  time  in
 inquiring, considering, and consulting; " and was thus  enabled
 to lay a foundation which will forever procure for him  the
 familiar  appellations  of " The Father of  Medicine,"—" the
 senex divinus," the divine old man.
   I have thus, gentlemen, stated to you the conclusions at which
 the most  observing and enlightened physicians have arrived in
 respect to the early qualifications of the industrious student for
 the practice of medicine, that I may  do you the justice to which
 I know you are so well entitled; that I may contribute to your
 immediate rank amongst the more advanced  in  professional ex-
 perience ; that I may stimulate the  tardy confidence of society
 in the knowledge  and ability of the young, but well educated
graduate  in  medicine; and that they  may  know from  mature
 ageitself, from the long experience in which their  confidence
has grown  into a sentiment of veneration, that gray hairs and a 
5
furrowed brow are comparatively  insignificant testimonials of
knowledge  and skill, with the credentials of those who  are al-
lowed to be amongst the foremost in medical rank, who are al-
lowed to cherish the science as the most sacred of all the gifts to
man of the Great Wise and Beneficent Being.
  This day, gentlemen,  you have been  officially transformed
from  the pupil into  the teacher,—from the advised into the
adviser,—and he who now addresses you, so late your monitor
at the bed-side of  the  sick, is now on  common ground with
yourselves,  may meet you  to-morrow to deliberate upon the
intricacies of disease, and is bound to yield the same respect to
your  opinions that he may desire for his own.
  You  have been, my young  friends, sifted from the "chaff; "
you have proved yourselves worthy the elevated post which you
now occupy amongst the family of mankind ;  that you are capa-
ble of its responsible  duties; and there is  no act  of  my life
which yields me higher gratification than that I am thus war-
ranted in commending you to the confidence of your  fellow
men.
   And  now, that I have done all this, you  must never forget
that something is due to  him, and  to those, who offer this pledge
of  your professional merit,—never forget  that  it is  in your
behalf,  and through their relations to  the community, that this
demonstration of confidence is made,—never betray your in-
structors, your advocates, your guarantees, by one act that shall
degrade  yourselves, or bring mortification to your early bene-
factors, or one stain upon your Heaven-born  profession.
   Assume, therefore, gentlemen, at once, a manly confidence in
yourselves  ; go forth to improve  the general condition of soci-
ety, to minister relief to suffering  humanity, to  warm many a
heart with  the purest and noblest sentiment of gratitude, to
o-ather fresh laurels for yourselves and for your profession, and
you shall find that  the practice of industry, and virtue,  and
benevolence, will  unceasingly urge you on to a strife within
your  own bosoms for greater deeds of  that unalloyed happiness
which awaits the blessed in God.
   But,  although you be now qualified  as  good  practitioners,
you will become better and better as observation goes on, and
as you study the experience  and the wisdom of the past.  As I
said to your  predecessors in my  Introductory Lecture on the
Improvement  of Medical  Education  in  the United
States, " you must aspire at the goal of medical philosophers,
before you "may comprehend or enjoy, in its  ample dimensions,
the philosophy of medicine.
  You  must have willing minds, and steady purpose, before
you will study the elaborate writings of its sages, and bring to 
6
their interpretation, and an exposition of their uses, the requi-
site habits of observation through the wide domain of Nature."
  Nor can I do better, at this time, than to recite another passage
from that Lecture on medical education.
  I said to my audience, that, " when your professional harvest
begins, then is the time for the most salutary stimulus of ambi-
tion ;  and, whoever yields to its spur, will find abundant oppor-
tunity to  carry  his knowledge to  the highest stretch  of his
intellectual constitution.  He has but to remember  that profes-
sional rank can only be acquired by various  learning ; and in
the language of Johnson, ' he, who proposes to grow eminent by
learning, should  carry in his mind at once  the difficulty of
excellence and the force of industry; and never forget that fame
is not conferred but as the recompense of labor; and that labor,
vigorously continued, has not often failed of its  reward.'  These
indisputable precepts  compel  the aspirant at medical renown,
or even at the highest practical success, to limit his enjoyments
to a social intercourse with his patients, to a participation in the
general enterprises of society, to the study of nature, and, lastly,
to all the literature which may elevate the mind.  These should
be his recreations as well as his employment; and as knowledge
flows in,  an inexhaustible fountain of happiness is  acquired,
whose very spray  clouds the gaieties of life, and renders the
pleasures of the intellectual man as circumscribed as the volup-
tuousness of wealth is discursive in its search after sensual  grat-
ifications.   One is a steady, refined,  and unalloyed enjoyment;
the other, gross, discontented, and forever sated with every thing
but the new.  Philosophical happiness, says Burke,' is to  want
little ; vulgar happiness is to want much, and to enjoy much.'
  "A great work," I said, gentlemen,  "is  to be done by the
physician.   But industry, like  love, will conquer  all things.
' Amor vincit omnia^—Industria omnia vincit; and in propor-
tion as deficiencies abound when the physician assumes the
high responsibilities of his  profession, it becomes  him to inves-
tigate well every step of his experience, to employ his hours, or
his  moments, of leisure, by day and by night,  in garnering the
experience which is supplied by the literature of the  profession ;
and, by rendering experimental  observation and theoretical prin-
ciples mutually  subservient,  he shall come, by degrees, to the
attainment of distinguished worth, and the applause of mankind."
  Such; then, were some of the remarks which I addressed to
novices in medicine, that they  might  be early led  to consider
the difficulties which laid before them.  The same remarks are
more  appropriate to yourselves, who are about to assume the
responsibilities of the profession,  and to take an active part in
promoting the advancement and the dignity of medicine. 
7
  And this leads  me, gentlemen,  to consider the objects of the
approaching  National Convention of Physicians in  this city.
and how far the interests of medicine are likely to be  promoted
by this contemplated event.  The present occasion seems pecu-
liarly appropriate for casting a broad glance over the existing
state of medicine  in this country, of considering its defects, and
how they may be removed, and how, in other respects, our noble
science may receive, at the hands of a National Convention, that
impulse which must be  ardently desired  by every enlightened
and honorable mind.  But it is due to my colleagues to say, that
in all which I shall set forth, I am alone responsible,—am alone
aware of the subject which I am about to discuss.
  The project of  this National Convention of Physicians origi-
nated with a young man in the township of Binghampton.
  It may be also  proper that I should premise that he was  sub-
sequently elevated to  the dignity of Chairman of the Commit-
tee of the New  York  State  Medical Society,  by whom his
project had been espoused. To him has been delegated the work
of expounding the contemplated objects of the Convention, and,
unfortunately,  to him  the correspondence with the  Medical
Colleges.
  But, gentlemen, it  is now time  that I should  lay before you
the Circular of the State Medical Society, concerning a general
meeting of the profession.
  That " Circular " sets forth,—that :—
    Whereas, It is believed that  a National Medical Con-
vention would be conducive to the elevation of the standard
of Medical Education in the United States.  And
   "  Whereas, There is no mode of accomplishing so desirable
an object without concert of action on the part  of the Medical
Societies, Colleges, and Institutions of all the States.  Therefore.
   "Resolved,  That  the New  York  State   Medical  Soci-
ety  earnestly  recommends  a  National Medical  Convention
of Delegates from  Medical Societies and Colleges in  the whole
Union, to convene in the city of New York, on the first Tues-
day in May  in  the year 1846, for the purpose  of adopting
some concerted action on  the subject alluded to in the foregoing
preamble.
   " Resolved, That Doctors N. S. Davis, James McNaughton.
and Peter Van Buren be a committee to carry  into  effect the
above resolution.
                             Peter Van Buren, M. D.,
                         Secretary of New-York State Medical Society.
  [Dated,] Albany, February 6th, 1845."
  When I first heard of this Circular, I had hoped much  from
amicable and dignified consultations amongst the Delegates that
might be assembled from  all parts of our Union ;  but, finding, at 
8
  a later period, that the Projector of the  Convention and  Chair-
  man of the Committee was traducing the profession and the Med-
  ical Colleges through  the  medical periodical  press, my hopes
  gave way to apprehensions that the objects of the  Convention
  had not been conceived in  the spirit which had been set forth by
  the Circular.  I had already submitted to the profession my own
  views of the state of medical education in this country, and of the
  embarrassments which it would be required to encounter, till a
  greater diffusion of wealth  should enable us to compete with the
  European States ; and I had hoped that some  mitigating expe-
  dients might be honorably  and amicably devised by which that
  large and poorer class  of medical students might be so aided as
  to enable us to extend  the term of instruction.
    Nevertheless, I demonstrated then, as I  had already done in
  my Medical and Physiological Commentaries, a great  ascen-
  dency in the practical  habits, and in the successful treatment of
  disease, by American over European physicians.  The last expo-
  sition of these views was made in my Introductory Address on
  the '■'•Improvement of Medical Education in the United States."
    Having, therefore, in  that Address, considered  the existing
  defects of medical  education  in this  country,  and the difficul-
  ties it encountered, it would be unprofitable to travel again over
  the  same ground.   My convictions, as then  expressed, have,
  through the light of farther experience,  received the most entire
  confirmation.
    It may not be superfluous, however,  for your present infor-
  mation, should I recite a passage from that  Lecture, which com-
  prehends the fundamental principle that  lies in our  way to those
  early achievements in  science which are more common  in the
  wealthy countries of Europe.  I said, gentlemen, in that Lecture,
  as a deduction from my premises :—
    " Thus, then, I destroy the parallel which has been attempted
  between our own and European States,  and show it the merest
  fiction  of the visionary mind.  Exact from our physicians the
\ intellectual culture, and rear in this land the  high standard of
  medical acquirements which are so noble and fascinating in some
  of the schools of Europe, and quackery will reign  almost uni-
  versal from one end of the  continent  to the other.  Is not the
  whole multitude, whether rich or poor, pressing forward either
  for greater wealth, or for the pittance of their daily bread ?   Nay,
  more, do not all our Medical Colleges holdout  the temptation of
  moderate fees, and give, in their annual announcements,  a con-
  spicuous place to the humble charges for the necessaries of life?
  But what are these  compared  with the expenses attendant on
  the prolonged and higher grades of academic and medical learn-
  ing in  some of the European States'?  And  who  does not see
  the inconsistency that  would  hold in one  hand professions of 
9
cheapness to allure the student through  our present  system of
medical discipline, and threaten with the other  augmented fees
and an impossible exaction upon  time?  The  same  principle
runs through all our primary schools, our academic,  collegiate,
legal, clerical and political institutions.  Cheapness of education,
and a corresponding adaptation of time, are found indispensable
to the general condition of society.
   " The question is therefore settled upon the immutable princi-
ples of truth—of a truth which is  founded in the exigencies of .
our country.  We have not the means, we have not the leisure,
to follow the standard of European wealth;  nor can we control ?
our destinies by European legislation.  He, who, in  America,
aims at the profession of medicine, with honors and dignities as
inviting as in the aristocracies of Europe, but less seductive than
the allurements of wealth,  comes from a  class where the blan-
dishments of the latter have no  existence.  He has worked his
way from elementary schools through the higher departments of
academic learning, under  the frigid  discipline of poverty,  and
he enters our halls of medical education with little else than the
hope that his career may not be arrested by insane  exactions,
now for the first  time borrowed  from  the  overgrown  wealth
of Europe, and her old and rich institutions.
   "Raise, therefore, beyond a certain limited poise, our standard
of absolute requirements, and I repeat it, with no fear  of contra-
diction, we shall turn from our  medical schools  most of their
aspirants into more humble  channels, or into  the walks of empi-
ricism.  The  exigencies of American  physicians demand an
early application to the business of life.   If we would cultivate
the field  of  medicine, we must look for an early harvest, or, my
word for it, it will be soon overrun  with weeds.  But  these
necessities by no means preclude the highest advancement in med-
ical attainments."
   So far the Lecture.   But it seems proper that I should state
that it  has  been objected  to  my broad principle,  that there
are professional  men in  the populous towns of Europe, who
have risen to the highest eminence under the most severe pres-
sure of want.  And so, gentlemen, is there an average propor-
tion of the same description in the  United States.   But these
are examples in  which genius displays its greatest attribute,—
examples which have rendered it a familiar proverb, that " genius
struggles with poverty."   They are examples, as the  Chairman
of the Committee  says, of  " minds, so endowed by nature, that
despite of all the contracting and evil influences of our system
of education, will rise superior to every obstacle, and shaking
off one embarrassment after another, will roam  over, and revel
in, all the fields of science untrammeled and free."  But he is
an imperfect observer of man, who  carries the principle through 
10
the community, or supposes  that one  in  a hundred  may be
induced or compelled to struggle with poverty for the sake of
an " elevated standard of science."  Gentlemen, it is a delusion,
which admonishes us of  the  danger  of rendering what is  rare
the general rule.
  It remains now only to consider at this time, how far  the
objects of the Convention, as contemplated by the State Medical
Society,  are likely to be fulfilled under the auspices of that
Society.
  Nothing can be gathered of a specific nature, from the general
Circular,  and we must therefore go for information to exposi-
tions set  forth by the Projector  of the Convention and Chair-
man of the Committee.
  That he  is  duly authorized to make  such Exposure  ap-
pears   not only from the  Circular itself,  but from  an article
from his pen in the November number of the New York Jour-
nal of Medicine and the Collateral Sciences, in which he says,
that :—
  "There is, at present, a fair prospect for  a full and animated
Convention.  This being the  case, we, (the Committee,) hope it
will not bejdeemed out of place, for us to write, and the medical
press  to  publish, a few thoughts on  the present condition
and wants of the profession  in relation to the education of its
members, that the appropriate remedies may be the more clear
and satisfactory."*
  That,  also, I  may  not  be  supposed to have  mistaken  the
origin of this National Convention, and as it may be  useful to
be assured of the fact, I will quote a  passage from the January
number of the same New York Joxirnal of Medicine.  Thus :—
   " We invite" says the editor, "particular attention  to  the
following very just remarks from the gentleman who origina-
ted the plan of a Convention, as recommended by the State
Medical  Society"  The  article  which  then follows is  from
the Chairman of the Committee.  Besides, we have it from the
Chairman himself, in a letter to this Faculty, that  such is his
title to tnat distinguished conception  ; although long before the
subject of discussion by the  profession at large.  In that letter
he says, what cannot be mistaken, that, "the proposition for a
 National Convention was made by  myself."
   And having  now thus settled this preliminary fact,  and as all
 agree that he is the Chairman, and  directs, from Binghampton,
 the movement  of the 40,000,  let us come, at once, to the specific
 objects of  the  State Medical  Society, -as  expounded  by the
 Projector of the Convention  and Chairman of the Committee.
   This  we may  learn,  in  the first place, from the article to
The Capitals and Italics are often mine. 
11
which I have just referred, in the New York Journal of Med-
icine.
  Thus, then, the Projector of the Convention ;—" In regard
to remedies for the present defects in our system of education,"
he  says, "first of all,  and at  the  foundation of all, we place
more care on the part of individual practitioners concerning
the capacity  and qualifications of young men whom they
receive into their offices as students ;  and then more attention to
their education after they are received."
  Now, that such evils exist, I concur with the Chairman;  and
I also agree as to their becoming appropriate subjects for  united
deliberation.   But, I differ with him as to their magnitude and
universality, and the terms in which they are expressed.   Thus,
he goes on :—
  " No one can have failed to notice the almost total neglect
every where apparent in this respect.  Whoever takes a  notion
to study  medicine;  no  matter  if  his  primary  education (I
wish  you to  remark, gentlemen, his primary education)—no
matter  if his primary education should  not  enable him to
write his own name intelligibly,  much less to understand a sin-
gle  branch of Natural Science,  and his intellectual faculties
naturally as  dull as the sleepiest drone in the country; he is
readily  received into  some  office,  shown  a scantily filled
case of  Medical Text-books, and left to while away the time
required by law before he can be honored with the title of Doc-
tor.   This is  a great and all pervading evil ; and it is in vain
to exert ourselves to elevate the  standard of education, until it
is removed.   For so long  as  the  mill is  supplied with  bad
grain, it will grind out bad flour."
  Here  I arrest my quotation, for the present, that  you may en-
joy a repetition of its closing metaphor, varied a  little in the
elegance of its phraseology, and  as  submitted in a letter to the
Medical Department of this University.
  " If," says the Chairman, " we put bad grain into the hopper,
(meaningyou, gentlemen,) we expect bad flour to come through
the bolt."
  Perhaps, gentlemen, we  have  now seen  enough  of the im-
puted prevalence of the radical evil;  perhaps  you have heard
enough  to abandon so unworthy, such a degraded  profession,—
scarcely advanced beyond that of Chili, of  which Zimmerman
says its  members " blow about their patients, and think that they
know enough  when they know how to blow."  But I will ven-
ture to define  yet farther the views of the  Projector as  to the
extent of this delinquency, that you may the better comprehend
who they are  that are to meet together in convention and casti-
gate each other into sometliing better than merely bloicing about
their patients, and teaching each other how to  blow.  Here it 
12
 is, then, fresh and pungent, from the  Chairman himself.  In
 the November number of the New York Journal already quot-
 ed, the  Projector says:—" There may, indeed, be found here
 and there, a mind, so endowed by nature, that despite of all the
 contracting and evil influences of such a system, will rise supe-
 rior  to  every  obstacle,  and shaking off one embarrassment
 after another, will roam over, and revel in, all the fields of
 science  untrammeled and free.   And it is such that constitute
 the ornament and honor of our profession.
   "But far  otherwise is  it with the great mass;  the
 ninety nine out of every hundred.   With  no practical
 knowledge of chemistry and botany; with  but a smatter-
 ing  °f anatomy and physiology, hastily  caught during  a
 sixteen weeks' attendance  on the anatomical  theatre of a
 Medical College ; with still less of  real pathology ; they
 enter the profession, having mastered just enough of the
 details of practice to give them the requisite self-assurance
for commanding the  confidence of the public ; but without
 either an adequate fund of knowledge, or that  degree of
 mental discipline, and habits of patient study, which will
 enable them ever to supply their defects.  Hence they plod
 on through life, with a fixed routine of practice, consist-
 ing  of calomel, antimony, opium, and the lancet, almost as
 empyrically  applied as is  cayenne  pepper, lobelia, and
 steam,  by another class of men.  And  how can this ever
 be  otherwise,  while  medical students, without  regard to
 their previous qualifications, are shut  up three years  in the
 office of a country or village physician, sent out to one or
 two  courses of lectures, and then honored with the title  of
 M. D.  ? y-  " Indeed so radical are the defects  in our
 present system of medical education, and so glaring are
 their effects  on the condition and usefulness of the pro-
 fession, that  no  observing man will charge  us  with ex-
 ageration in the foregoing statements."
  Such, then, is the portrait of the medical  profession in the
 United States,  as drawn by the official hand of the Projector of
 the National Convention and Chairman  of the Committee of the
 New York State Medical Society.
  I mean, gentlemen, the portrait of " ninety-nine out of every
 hundred" of the medical profession in  this country, or  39,600
 out of 40,000; which reduces the number of worthy members
 to 400.   It may be  also proper  to say, that the articles from
 which I shall have quoted were before the community prior to 
13
the meeting of the State Medical Society in February last, and
that the same aspersions of the profession and of the Medical
Colleges were then made by the Chairman, and by others of the
Society.
  Now, gentlemen, the interesting question comes up, as to the
composition of the approaching Medical Convention. You, and
I, have too much modesty to believe that we can be allowed to
form a fragment of that small number of whom the Chairman
says, they " can rise superior  to every obstacle, and roam over,
and revel in, all  the fields of science untrammeled  and free."—
 We must, in all  humility, go with the " great mass,"—with the
39,600; and it is now, therefore, for  us to decide  whether we
will meet in convention and thus endorse the calumny, or give
it up to the hundredth man who is said by the Chairman to be
alone competent  to the work of reformation ?
  But  perhaps there may be  some  Medical Colleges who  may
not fully comprehend the rank which they are assigned amongst
the 40,000 ; and  I will, therefore, through you, call their atten-
tion  to the subject, that they  may come hither the  more under-
standing^.
  The Chairman employs the device of contrasting the state of
the profession in  this country when we had scarcely a medical
college, with its degraded state under the auspices of our thirty
medical schools.  Thus :—
  " Not a few," he says, in the Journal aforesaid,  " educated at
that period, with their heads silvered over with age, possess a
degree of mental discipline and sound learning, which should
put  to the  blush  thousands of the  graduates who  now
yearly emanate from our numerous well-endowed  schools
of medicine."
  We  have often heard much of this clamor about the " thou-
sands" who are  annually let loose from the Medical Colleges, to
carry havoc into the chambers of the  sick.
  But, in  sober  truth, probably not  more than one thousand
receive medical degrees annually, from the whole thirty schools
together; and a large  proportion of these obtain* their diplomas
from such  men  as the Ja<cksons,  Hare,  Caldwell, Dunglison,
Ware,  Bigelow,  Silliman,  Horner,  Nathan   Smith,  Gallup,
Chapman, Dudley, Gross, Channing,  Meigs, Mutter, Haywood,
Drake,  Yandell, Warren,  Aikin,  Bartlett,  Gibson, Muzzey,
Hodge, Harrison, and some others of not inferior note, whom I
have thus hastily  designated as controlling the " hopper " to
which most of the " chaff'9 is sent, but who, I take it, the Chair-
man  will  feel obliged to concede  belong to  the  400 who are
worthy a place in the American Medital Profession.  To whom
else,  gentlemen,  can  he advert, if he  exclude from the four 
14
 hundred, those men who sit in judgment upon  the  qualifica-
 tions of most of the  medical graduates in the United States ?
   These are they,  gentlemen,  who are denounced as sending
 forth " annually  thousands" to inflict the mischief of abject
 ignorance upon a helpless community, and then are asked  to
 come here  and sanction the ignominious reproach.   Why.
 gentlemen, what inconsistency.   The Chairman cannot hesitate
 to allow that abler or more  honest men cannot be found in the
 ranks of the profession ;  and yet he says that these  very men
 dispense their  approbation, the highest honors of  medicine,
 upon ignorance and stupidity.  Nevertheless, gentlemen, they
 are, what the State  Medical Society, through the Chairman  of
 their Committee, must admit to be amongst  the best ornaments
 of the profession  in this country ;—aye,  gentlemen, without
 superiors in the  best of  European Seminaries,—the Dii im-
 mortales of our profession.
   In the hands of such men, our profession, our country, are
 safe!  But what would be the destinies of  that profession, the
 honor of that country, were they to fall into the hands of those
 who can see nothing in " ninety nine out of every hundred "  of
 their professional brethren but abject ignorance  and  its cruel
' dispensations ?
   Since, therefore, it must be conceded on  all hands that the
 professors in the principal medical schools of this country are
 eminently able and honest, do you not believe that  they would
 sooner surrender their  lofty and responsible trust  than allow,
 according to  the allegations of the Chairman, so much "ehaff"
 to slip through the " hopper ? "
   We can, therefore, only hope that the profession will continue
 to supply the colleges with the same " sort of chaff,"  till better
 can  be produced, and we will engage to  turn out a quality of
 "flour"  that shall pass for the best in  any  European market;
 quite as good, at  least, as any that is manufactured  by the
 Censors of State  or County Medical  Societies; and perhaps,
 therefore, it might be well for the country if a little more '< grist"
 were brought to the  " hopper."  Perhaps it would not be amiss
 if even the " thousands," so appalling to the  State Medical Soci-
 ety,  were annually turned out of the collegiate " hopper."
   And  after all, gentlemen, may it not be, is it  not  probable,
 that the  choice few, the 400 out of the 40,000, those scattered
 "  ornaments of the profession  who roam over, and revel in, all
 the fields of science, untrammeled and free," are quite as likely
 to have been " bolted" at the  collegiate mill,  as in  the  "green
 room" of the "holier" Censor?
   And this leads me, reluctantly, to notice the remarkable fact,
 that amidst all  the  outcry about Medical Colleges, not a word
 has  been ever alleged against those numerous " hoppers " whieh 
15
exist in the shape of " Censors " of State and County Medical
Societies.
  Not a word, gentlemen ;  for that would be the " outs " against
themselves,—against the aspirations of a noisy few, and against
that plentiful "toll" which is deducted from every " licentiate "
before he is allowed to run through the accommodation "hopper."
   And now, perhaps, we shall have no difficulty  in  under-
standing why it is so earnestly desired to extend the term of
instruction in our Medical Colleges and also as a preliminary
requisite  to  admission into these  institutions.   There is  an
aristocratic feature in this movement of the worst omen, how-
ever the spirit by which it is prompted may belong to the Agra-
rian policy.   It is oppression towards the  poor, for the sake of
crippling the principal Medical Colleges. You, andallofusknow,  '
as I have already said, that the " great mass " of professional men
in this country, Lawyers, Divines, and Physicians, belong to the
poorer class of society; and should the wire-pullers effect an
extended term of  education it must exclude a large proportion
of  the " great mass "  from the advantages  of collegiate instruc-
tion ; whilst  the aristocratic feature will be rendered still more
offensive by limiting  the  attendants at Medical Colleges^ to the
few who may spring from families of wealth.   If such be the
principles of republicans, if such the basis of our institutions, of
learning, their founders were less conscious of their objects than
they who would degrade the poor by oppressive exactions.
   I shall not, gentlemen,  discuss this  small  affair any  farther
with the State Medical Society, who speak to us through their
organ, the Chairman of their Committee ; but I  will read to  you
a paragraph which occurs in the same number of the Journal of
Medicine, from which I have made a quotation  from  one of the
Chairman's animadversions upon his profession, and which  has
the merit of following, almost immediately, the  article contribu-
ted by the Chairman.  It  is an extract from Percival's Medical
Ethics; and, gentlemen, whether you remain members of the
profession, or seek other employment, I trust the sentiment  will
be  forever the foremost amongst your hallowed obligations.
Here it is, brief,  as it is sacred:—" Every man," says Percival,
" who  enters into a  fraternity engages, by  tacit compact,  not
only to  submit to the laws, but to promote  the honor and the
interest  of  the  association, so far as they are  consistent with
morality, and the general good of mankind. A physician, there-
fore, shoidd cautiously guard against whatever may injure
the general respectability  of his  profession; and  should
avoid all contumelious representations of the faculty."
   I say, gentlemen, that I trust,—I have no doubt, that that  sen-
timent has become as intimately incorporated with  your  very
nature as is your soul with your organic fabric. 
16
    I said, gentlemen, that I did not intend to discuss this subject
 any farther with the State Medical Society.  But, as a member
 of that "great mass" of the profession, the "ninety nine out of
 every hundred," who have been presented to the world as a rot-
 ten excrescence, I shall state to you  what had been my  own
 views of its condition before I icas elevated to a professoriid
 chair, and which it is now my happiness to  confirm by greater
 observation, and by the contribution which the Medical Depart-
 ment of the University has this day made to the general weal.
 This  is due, at  least,  to myself as  one of the "ninety-nine"
 designated by the  Chairman, and I trust will not be ungraciously
 received by my companions in ignominy.  In my  Medical and
 Physiological Commentaries, published in 1840, there occur the
 following remarks:—
   " With these habits and means of information, I am now pre-
: pared to say, that it is the result of no little  investigation  that
 American Physicians greatly surpass  all other nations not
 only in the  decision, but in the success  of their practice.
 They have followed the Hippocratic rule, that  {severe diseases
 require extreme and exquisite remedies,'  and so in  proportion
 through all their gradations: nor do  they adopt the expectant
 plan, till there is a manifest disposition in nature to  take  upon
 herself the completion of the  cure.   And here I  may say her
 suggestions are equally regarded.
   " I have  already justified these conclusions as they respect
 many of our most prominent writers.  Other, and ample records
 exist to sustain the statement  which I make ; and placed in  a
 right position by a  charge of imbecility  by the morbid anato-
 mists, to illustrate the doctrines and practice of Hippocratists, it
 has been necessary  to contrast their results with  those of the
 school who derive  their indications of cure from the debris of
 the body.  And, that I am right as to the  neglect of all efficient
 remedies by the school of morbid anatomy, in a general sense, I
 appeal to what I have already stated in other places, to what will
 appear in my Essay on the Writings of Louis, and, may I not add,
 to what is proverbially known of the present " expectant" treat-
 ment in France, and of the " stimulant"  and expectant in Great
 Britain.
   " In America," I also said, that,  " practice is  not only heroic,
 but remarkably coincident in relation to the same diseases ; which
 farther shows that  our indications are taken from  the proper
 source."—"There is only a limited school which approximates
 the Brunonian, in America ; and I have adverted to its tenets not
 only upon  principle, but to sustain the comparison I have drawn
 between practical medicine in Europe and these United States
 I know  of no instance, nor  have I ever  heard  of one in 
17
 this country, where a practitioner has been addicted to the
 ' expectant* plan of treatment."
   Again, after referring in my Commentaries to the same kiitd of
 obloquy upon the American medical profession which the Chair-
 man of the Committee, in behalf of the State Medical Society, has
 heaped upon " ninety-nine out of every hundred "of the American
 Faculty, and when contrasting the success of their treatment of dis-
 ease with that of the English and French nations, I said,—"Such
 is the practice of hundreds in our wilderness. But, they do more,
 and more wisely.  They abjure bark and wine, and carry out a vig-
 orous treatment of inflammations, and of their terribly prostrating
 fevers, by the lancet. And may I not inquire, also,howall this com-
 pares with the dominant treatment, in France, of the same diseases
 by ' gum potions/ 'a decoction oftriticum' or of the '•five roots,*
 ' bullock's gall.' e millipides,'  'magnetized steel,'  i a pinch
 of chervil,' ' aromatic fumigations  under the  bed-clothes,'
 as set forth  in my Essay on the  Writings of Louis.   Or, is it a
 less efficient system than the treatment of " the worst forms of
 fever by table salt," as commended and practised by some of the
 mostdistinguishedofthe British Faculty? "If such patients," says
 one of their own commentators, the eminent Beddoes;—" If such
 patients  had a Rush by the  side of their bed, they  would
 not be  transferred from  it to the grave."
   ' The pleurisy,' says the same  English philosopher, ' which I
 am informed was so destructive among our soldiers and sailors
 till the lancet was used With a boldness almost totally abandoned
 in this country, proves that it is  not  American  diseases  and
 American Constitutions only that require such treatment.'
   'But our  own!' exclaims Beddoes, 'The first existing!—
 Well, then, our own, some of our own, scandalized  at the dis-
 grace of the common art, (just as now with our  State Medical
 Society,) did begin to give lessons amain across  the Atlantic.
 The lessons, indeed, were received as the irrelevant effusions of
 men who set themselves to harangue against facts. And Amer-
 ican pride was destined ere long to have a* fearful revenge.
 Gibraltar, Gibraltar, is pitted against Philadelphia!'
   " I need not tell you  what fearful odds  drew  from a Briton
 the  honest  declaration,  that, — 'After all British reproaches
 against the American government and American physicians, for
permitting the yellow fever to commit such ravages, this yellow
 fever made incomparably greater proportional ravages in a Brit-
 ish garrison, where the authority of medical police was unlimit-
 ed.'  'And  yet again,' he says:—'In  the West Indies, on  the
 Continent of Europe, at home, wherever the British Army was
 posted  during the last war, its history of health has offered not
 only pretexts to a challenged rival, to scorn the arrogated supe-
                            2 
18
 riority of the British modern medical practice, but also reasons
for an impartial man to pause upon the claim"
   Such, it  appears, was  the  admitted  superiority of American
 over  British practitioners of medicine,  admitted, too, by the
 most able and eminent of the  British profession,—by Beddoes,
 Robert Jackson, and others of equal  renown,—when  there was
 only one  medical school in all America,  entitled  to any consi-
 deration, and but few practitioners who had received the honor
 of a diploma.
   There was, therefore, gentlemen,  in  those halcyon days, no
 rankling jealousy, six only of the 180 professorial chairs for the
 watchful eye of envy, no extensive superiority to be adjusted to
 the Agra-i.in system.   But, we have now some thiity excellent
Medical Colleges scattered over the land, whose chairs are filled,
in numerous instances, by some of the  ablest men who adorn
the medical  profession.  And what  is more, and  more to  the
honor, and welfare of our  country, these thirty institutions are
annually contributing ibout one thousand well educatednien to
the ranks of the profession, whose light sparkles in ever^namlet,
and exposes the darkness which is now rolling itself into'a.mut-
tering cloud.  Or, shall it be entertained, with the  Chairman of
the Committee, in behalf of the  State Medical Society, that know
ledjre recedes in proportion to  its means of multiplication ?
  Gentlemen, in justice to myself,  and the gensral  cause which
I advocate, I must be permitted to make one quotation more from
my Medical and Physiological Commentaries.
  " It cannot be denied," I have there said, '• that the Faculty of
America, in  a general sense, have neglected the literature of the
profession, and have been even hurried by the necessities of life
into its most responsible occupation  without those preliminary
qualifications which accomplish the minds of Europeans.   Th s
may seem to conflict with what 1 have said in another place of the
advantages of learning.  But,  it is in no  respect an argument
against us.  Much is owing to the  national character of Ameri-
cans, which  is early  formed in  the most active scenes of life, and
renders each in  his place a subject of irresistible impulses in all
practical  pursuit?.
  "The influence of such habits on the physician I have already
shown.   American  physicians, also,  are generally conversant
with the writings of those illustrious observers whom I  have
mentioned as their chief counsellors in the interpretation of na-
ture ;  and it is only  within a brief period that their attention has
been at all directed to those physical  theories of life which  have
so extensively supplanted the Hippocratic and Hunterian philo-
sophy in  Europe.  No obstacle, therefore, having been interpos-
ed to divert him from his habits of observing nature, and having
no leisure for ambitious views,  the American physician has  gone 
19
on with his former conceptions of the vital nature of disease, and
of the operation  of remedial agents, and would as soon wait for
the plough to move itself in the furrow, as to adopt the expect-
ant  treatment.   I agree, therefore, that a more extended and
varied knowledge  of true science would have exalted him even
higher in the  scale of philosophy, and the practical pursuit of
his calling.
   " In the mean time, let  us  go on as  we have been going,—
1 gathering, like the bee, from abroad,  but digesting  that
which  is gathered by his own virtues,' still  leaving the nu-
merical system,  and all others like it,  Ho spin out, like the spi-
der  all its own  bowels,' and thanking ' the empyrical philoso-
phers, who, like  pismires, only lay up and use their own store,'
for  any proportion  of their harvest  they  may be willing to
spare,—being ever willing to receive from the anatomical school
their" continued castigations for our undaunted  energy  in the
treatment of disease, or their maledictions for waiting upon na-
ture when art has won its triumph.   Esto perpetxia!
   " I will not cp.rry out my conclusions beyond the limit of prac-
tical habits and results which I had proposed as a test of medical
philosophy.   It  is certainly humiliating that I should be so far
compelled to depart from any becoming modesty ;  but, truth must
not be suppressed where the most vital  interests of the healing art
may demand its  promulgation.  It is right that I should thus in-
quire into the practical habits  of an almost entire profession de-
voted to the Hippocratic mode of observing nature, and contrast
them with the fruits of that philosophy which is founded on the
ruins of nature,  or seeks  an interpretation of her vital phenom-
ena  in the crucible of the chemist, or through the glass of the op-
tician."
   So far the Commentaries; and when, gentlemen, I delivered
my Introductory Lecture on Medical  Edxication in the  United
States, in 1843,  little did 1 suppose that I should so soon realize
a far more important application of a remark which occurs at
the  close of that  Lecture.   The  remark is in the following
words :—
   "Well may we, therefore, spurn the imputations of practical
inferiority which have been sometimes heaped upon us even by
those who derive their principal title to consideration from being
born in the midst of so much  enterprise  and worth.  It  is the
jealousy of narrow ambition, or the envy oi  more selfish, or of
weaker minds."
   And now again, gentlemen, for  the  third  time, I  stand  up
alone, in the  broad expanse of America, in  an open  defence of
the honor and dignity of the profession of which I am a humble
member.  I stand  up to contribute my feeble effort in loscuing
my country from the degradation to which its own citizens, they, 
20
to whom are committed  the honor and respectability of its no-
blest pride, would consign it in the estimation of the world; and,
that I may render this service more effectual, it is  my design  to
incorporate an abstract of this Address  in a Sketch of the His-
tory of  the Medical Department of the University, intended
for publication when  I  shall  have " gone  hence to  be here no
more."
  Nor shall I have discharged the office which I  had assigned
to myself till  I  also place on record who they are that malign
"the  great mass" of  American physicians, who are  rendering
more  service to the  cause of humanity than any equal  propor-
tion of the same profession in the  most favored states  of Europe.
  It is not the man  who has officially promulgated the views of
the State  Medical Society, nor the Journals through which the
contumelious representation of the profession is circulated, that
should be held responsible any farther than as they, also, hold
an influence over the  public  mind, and according,  also, to the
animus, and the extent in which  that influence may be exerted.
We must rather go to  the fountain from which it emanates, and
with acids and caustics try its purity.
  We must go to the State Medical Society itself,  interrogate
the general character  of those who annually convene at Albany
during the very opportune session of the Legislature,  inquire
how far, and in what  ways they contribute  to the dignity of the
profession, and advance  the interests of medical science.
  Nor would I invite  an investigation of this nature for the same
reasons  that  I have  quoted from Percival's Medical  Ethics,
were  those members of the State Medical Society, who annually
convene at Albany, and do the mining operations, more than a
bare handful of the " outs," and were  they not so erroneously
supposed to represent  the voice of the profession.   But, that they
do not thus convey to the world  the sentiments of their "out-
side" brethren, is sufficiently evident from what I have quoted
from the organ of the Society.  That there are members, how-
ever,  of this Association who properly regard the transactions of
the few, and  who leave to  those few the practical existence of
the Society, 1 am most happy to know ; though we must lament
the necessity which is thus imposed by self-respect.
   But,  it may be useful to understand, also, who he is  that has
thus  spoken  in behalf of the Society; since we shall the better
understand the qualifications of those in whom the Society  re-
poses its greatest trust, and thus, also, become more enlightened
as to those members by whom the sacred trust is delegated to
individuals of their own body.
   Of the Chairman of the Committee and Projector of  the Con-
vention, then, I know nothing but from report, and from what
I hare  seen  and quoted from medical  periodicals, and from 
21
his correspondence with the Medical Faculty of this University.
Perhaps my quotations are enough to enlighten you upon the
whol6 merits of the man and his associates at Albany ; but since
he puts himself forth as the Projector of  a National Convention
for the reformation of universal abuses, and pronounces "nine-
ty-nine out of every hundred," of the American medical profes-
sion as deficient in the elements of an English education,—so
deficient, he says, that when  admitted as medical students, it was
" no matter if their primary education shoidd not enable them
to write their  own names intelligibly," it becomes worth our
while to ascertain how far qualified may  be the Chairman of
the Committee of the  New  York State  Medical Society to be
entrusted with the solemn duty of pronouncing judgment even
upon the "primary education"' of our medical graduates.
   This, fortunately, I have it in my power to do by an official
letter from the Chairman to  the Medical  Faculty of this Univer-
sity, and which I now  hold in my hand.  I  shall, therefore, read
to you a short paragraph from  that letter, and then leave the
matter to your own conclusions.   Thus:—
  "The above Circular," says the Chairman,  "is  an  Extract
from the proceedings of the New York State Medical Society at
its last anual meeting in Feb.,  1845.   The object of the pro-
posed convention is  sufficiently  indicated  in the preamble and
resolution itself.  The Committee, in the discharge of their duty,
have corresponded with the Medical Societies and Colleges in all
the States  where such institutions exist, and the replies which
have been received are unanymously in  favor of the proposed
convention.
   "Indeed, several Colleges have already appointed delegates;
consequently, there is no longer any doubt but that a convention
xoill be held.  If the  subject has  not  already been before the
Faculty of the Medical Department of the University, will you
not, without further delay, bring it  to their notise?
            (Signed,)                      J. N. Davis,
  Nov. 25, 1845.             Chairman of Com., 4-c, Binghampton, N. Y."
  Now,  gentlemen,  there  certainly appears  nothing  very re^
markable in the extract which I  have just read.  And yet, be*
yond doubt, however enigmatical it may seem, there is something
latent in that extract which shall raise your  admiration, and
prove to you  how well qualified the Chairman may be to sit in
judgment upon your  " primary education."  There are, O tern*
pora! in that brief extract not less  than three familiar words
whose orthography is wrong.   " Unanymoxisly" is written with
two ys; "notise" with an s; and annual  is spelt "a-n-u-a-l,"-—
the  Chairman having derived  the last  from the wrong Latin
word ; which shows, also, the extent  of his professional fami-
liarity with that language of which he accuses " ninety-nine out 
                            22

of every  hundred"'  American  physicians  with being utterly
ignorant.
  That this orthography is not accidental appears not only  rom
the frequency with which it occurs, but  also from a similar evi-
dence respecting "a primary education" in the Chairman's s cond
letter to the Faculty ; where, besides other errors, the word an-
nual is again dishonored by a single n.
  Here, gentlemen, I leave  this subject; for although I would
be just to you, I would be merciful to your accuser.  But, there
will be no want of commiseration  for the champion and favorite
of the State  Medical  Society,  if  I prove to this audience, and
through them to  the world, by your  own  hand writing, that
more than one in  a hundred of you are  able to write your own
names, as denied  by the Chairman.  But I mean, gentlemen,  to
prove also, by the same  inductive process, far more than that.
The  hand writing, especially of one's own  name, when made
under special circumstances, is an index to the  mind  itself,  to
its acquirements, to its native vigor.  You all know how much
has been inferred of  the talent, and firmness, and conscious so-
lidity of knowledge, from the autographs of the  Signers of our
Declaration of Independence.
  Now, it so happens, whether providentially or not, I am enabled
to prove to the world  by a single momentary demonstration, that
not only every one of you can write your own names, but that
they are generally better written than even the autographs which
are  appended to the Declaration of Independence.  They were
written too, under even more embarrassing circumstances ; writ-
ten  in a standing posture, and when reputation, and your future
calling, and happiness, were at stake ;—for they  were written  at
the moment before I began my examination of each one, respec-
tively, upon the Institutes of Medicine,—the most difficult and
profound of all human inquiries.
  It has been my practice, uniformly,  throughout the five ses-
sions of this  School,  to solicit the autographs of the  candidates
for  graduation,  at the moment  preceding  my examination;
partly with a  view to pleasant reminiscences, and in part, that I
might be thus aided  in reading the mental  condition.   Here is
the large  folio volume in which  all are written, and which  is
open to  the inspection of those who are seated around me. They
shall  bear me testimony, that nearly every autograph proves
how little competent is the Chairman of the Committee to ap-
preciate any advance beyond "an elementary education," how
undeserved his rebuke of Medical Colleges, how extraordinary
his  slander of the almost entire profession from which he, and
the State Medical Society, derive their livelihood and their stand-
ing in the community, and, as I doubt not, with the special object
of degrading those few who are contributing their time and their 
23
 best efforts, and sacrificing health, and enjoyments, and profes-
 sional business, not only for the advancement and diffusion of med-
 ical knowledge, but in promoting the general interests of science.
   If there be here and there, though rarely,  indeed,  a name
 amongst the multitude of autographs,  which betrays a  faltering
 hand, time will probably show what their destiny has been, and
 how true it is that the autograph of a medical student made  a
 the moment which precedes  the crisis that is to elevate or de
 grade his rank, tells us of the state of the inward man.
   Gentlemen,  the ever sure revolution of time has brought  us
 to the close of another session,—it has brought us near to the
 last moment when you, and I, and all of us, are about  to start
 upon  new scenes, and on other duties ; though, God be praised,
 we have a common avocation, through which mutual  recollec-
 tions, and mutual sympathies, shall daily, hourly, maintain us as
 a band of brothers, and,  in the  language of organic science, as
 one united, harmonious whole.
   Aye, my  young friends, the pursuit of  medicine  to cultivated
 minds is what the sympathetic nerve  is  to the various parts of
 organic life.   What  is felt by one is thus felt by the rest; and
 whether healthy or deleter ous  causes may affect the condition
 of any part,  it  is enjoyed, or suffered,  by  all the rest.  Each,  in
 its  turn, and all together, conspire in recuperative effort for the
 good of any member that may sustain  aught of evil.
   Gentlemen, we part; but it is only  to cultivate and enjoy the
 magnificent law of "remote sympathy" and to  feel  that, how-
 ever distant from each other, we are still but parts of a common
 whole, and  that the most remote  member  is as near to the whole,
 and can as speedily reach  the whole by a glance  of the mind, as
 the heart can light up a glow of  joy through that same mind in
 its connection with organic sympathy.  And should any rude
 cause offend the "sensibility" of your Alma  Mater, the great
 nervous centre,—the censorium commxme,—then shall the " mo-
 tor poxoer "  as quickly brace every arm to her vigorous  defence.
  For the present, we part to enter upon the great duties of life,
 and to carry out the final causes of our being.  What an elevated
 sentiment to know that you are  so well prepared to answer the
 intentions of Providence in his greatest dispensation of benevo-
 lence to suffering humanity,:—to know that you have entered a
 field of nature untrodden by other men,—that you  are so far  in
 advance of the rest of your race,—which places all others, for'
 weal or for woe, under your magic power,—which assimilates
 mind and its attainments,  more than all things else, to the char-
 acteristics of the Great First Cause.
  With what cheerfulness should you pursue this noble employ-
ment,—with what  ardor should  you strive to enlarge its boun-
daries,—with what gratitude should you contemplate the power 
24
 which you have acquired over the sufferings  and wretchedness
 of your fellow men.
   Gentlemen, I  part  with you with reluctance.  Let  us part,
 however, as it becomes  men who have pressing duties  before
 them.  But let us first interchange pledges of mutual friendship.
 Let us pledge ourselves to each other, that we will co-operate in
 the great work of medical  knowledge ;  nor leave one effort un-
 attempted which may  promise a new fact for the  great  cause of
 humanity, or  which may enlarge  still farther our conceptions of
 Almighty  Design in the  stupendous  system of organic nature.
 And, finally, gentlemen, when you shall  have reached the hall
 of refreshment, and your weariness, after my long discourse, shall
 have subsided into the merriment of song, let a glass be devoted
 to your Alma Mater, and a voice  go forth that shall strike dis-
 may into every heart that meditates her wrong.
   I could wish, gentlemen, to have seen more of you,  to have
 cultivated  more intimately the ties of friendship, and  to have
 been often made happy by more social intercourse.   But, gentle-
 men, the advice which  I have g-iven to you, I have ever adopted as
 rule  of action for myself.  lVersate  nocturna manu,  versate
 diurna,' and through sixteen long years of unabaling disease, has
 been my hourly precept to myself!  I have toiled both night and
 day,antf more for the public than for myself.   We have little time,
 therefore, for" other intercourse than as we meet on the highways
of life.  Here  we greet each other in terms of amity ; and our em-
 braces over, we hasten away to do—"whatsoever our hand findeth
 to do, with all our might; for there is no work, nor device, nor
 knowledge, nor wisdom in the grave."   Happy, however, shall
 I always be to often  renew our pledges of friendship, and fo-con-
 fer with you on the  events of life and on the interests of medi-
 cine. I hope, too, that we may maintain our social relations, as
 well by correspondence, as by personal  intercourse; and  such
 of you as may be disposed to address me by letter will always
 find me a prompt and thankful correspondent.
  Finally, gentlemen,  you know your duties to society,  to your
 profession, to your Alma Mater,  to each other.

          To tour brethren  be just, and to mankind at large,
          Be ye faithful to all,  and all duty discharge.
          To each one let's be kind, to each one yield his right,
          On all other topics, let each one try his might.
          To superior claims you should gracefully yield,
          But only to merit sprung from honor's green field.
          To age be respectful, to its faults ever blind,
          To your equals be courteous, to inferiors kind.
          To woman be gentle,—with  a smile greet the child,
          And honors shall crown you, and your griefs shall be mild.
THE  KNDi 
PROFESSOR PAINE'S
F
JKrfcfral |lrofes$ton
UNITED STATES.
SIXTH EDITION.
- • -^fK-- •■-. ■■■■
 
 
EXTRACT  OF  A  LETTER
From Charles Caldwell, M.  D., Professor  of the Institutes of  Medicine in the
  Louisville  Medical  Institute.
                                            " Louisville, Ky., April 5, 1846.
  "Mr Dear Sir—Allow me to commence'my letter by asking your acceptance
of my  thanks for a copy, received a few days ago, of your  very  earnest and  able
' Defence of the Medical Profession of the  United States.1
  " On perhaps every point of your unsparing career through your task, from begin-
ning to end, my sentiments accompany you, and probably on one, at least, leave you n
little in the rear.  I allude to the practical superiority, which the  physicians of our
own country  hold, in general, over  those of Europe, and I presume also, of course,
over every other portion of the  globe."
  " I am  not apprised  ot your having stated that the American youth can be much
better educated in medicine in their own  country than in any foreign one.  Yet is
the fact unquestionably true.   I mean  that  it  is a fact, and not  a narrow-minded,
selfish assertion.  The real proximate elements of medicine are  more thoroughly
taught in some American schools than  in any European ones I have ever visited.
This is especially true  in  relation  to  the Principles or Philosophy of Medicine;
without an acquaintance with  which, the practice of the profession is rank quackery." 
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