\853 - ivr- J DELIVERED BEFORE THE CLASS PHILADELPHIA SCHOOL OF MEDICINE. ^ BY WILLIAM RUSH, M. D. «• * LECTURER ON MATERIA MEDICA AND THERAPEUTICS, IN THE PHILADELPHIA SCHOOL OF MEDICINE. PHILADELPHIA: PRINTED BY WILLIAM STAVELY, No. 12 Pear Street. 1833. V! 1833 / INTRODUCTORY LECTURE. It is my intention to-day, gentlemen, merely to offer you a few remarks introductory to a Course of Lectures on Materia Medica and Therapeutics, to be delivered by me in this In- stitution. I need scarcely apologise for appearing before you without a chosen Medical subject, when I reflect upon my inability to cater to your tastes upon this point—already amply satisfied with the rich intellectual viands that my colleagues have re- cently set before you. You have all, however, heard, that in the earlier days of medicine, it was common, by certain pre- scriptions, to prepare the system for particular diseases. So, perhaps, it may be proper, previous to my Course of Instruc- tion, to prepare your minds—not for disease, I trust, gentle- men—but for the reception of medical knowledge, or truth. In other words, you are about to travel with me on a path hitherto much overlooked in the pursuit of the practical ob- jects of medical education. In order therefore to clear away some of the obstructions that oppose you at its entrance, allow me to indulge in a few excursive remarks, illustrating the only effective means by which Knowledge in every department of human pursuit is attained. Nor are these means difficult of acquisition. In fact, you all possess them. Be not dis- trustful of yourselves—for there exists within every one of you, qualities that only require to be thoroughly awakened, never again to slumber upon the true interests of your medical education. They are like the tuneless and neglected harp, that when strung to the proper pitch, will sound in unison with ail that your taste and ear for medical knowledge can desire. 1 What are those means? you will ask. I answer, your Senses and your Reason, unfettered by opinionative authority ; which time or fashion aione has consecrated. Means, which, in our finite condition of existence, form the only bond of union be- tween Truth and ourselves. When Nature called us into ex- istence, she generously bestowed these inestimable gifts upon us; and they vary not in value, save by the difference of proper and faithful cultivation. Mark also her Wisdom, as well as her Benevolence. In her infinite knowledge of the fit- ness of things, she has placed us amidst her outward pheno- mena, and has given us our Senses, as the best, the only means to appreciate them. Her ultimate causation she hides from their scrutiny; but whilst she is ever willing to present us with the great and beautiful drama of her effects, ought we to complain, when she refuses to admit us behind the scenes ? We were born, gentlemen, with greater capacity for know- ledge than we are aware of. In obedience to the dictates of nature, we early and eagerly pursue the knowledge of things, rather than the vexatious study of profitless words. When young, we were all in a measure philosophers; lovers of wis- dom, of nature, and her effects. None of us have yet outlived the remembrance of those busy sports of boyhood; all of them practical illustrations of the principles of natural philoso- phy. Nature, man's best teacher, well knowing our tender capacities, wisely combined amusement with her early lessons of instruction. But we were then unapprised of her wisdom. Her effects were our playthings, and we were delighted with them. We were then intimate with nature ; but errors of education, like false friends, afterwards made mental mischief between us ; and we have since only become reconciled to her, by our scientific acquirements, which offered to us an ex- planation of the principles of these predilections of our childhood. Since, then, the Senses are ourbest, our earliest friends, ought we in after life to desert them? Believe not that instruction, through these humble, though natural sources, is beneath your notice; nor that they offer to you merely a dull or insulated register of facts. In their unassociated action, I grant they are useless; as in the hapless Idiot. But it is of intelligent hu- manity that I speak ; of those, who have within them a power, to which the senses act as sentinels, to take faithful notice of what goes on without: And it is only the infinite and changeful combination of intelligence brought by these sentinels to that power within, which constitutes what I need scarcely tell you is called the Mind. The senses and the mind threfore are inseparably connect- ed by nature. Though from defective culture, they are often at variance with their mutual interests—so much so, that it may be made a question, whether that power which makes man foremost in creation, would not have been his enduring curse, had not He who rules the universe from a throne of mercy, sent forth an emanation in the form of Reason, to tem- per and unite these heterogeneous elements. Thus wisely combined, they form a Whole; a Unit, capable of universal ap- plication. It is this unit that makes the Philosopher, the Pain- ter, the Poet, the Mechanic, and the Musician. The human mind, in its wise constitution, like nature in her bounty, affords the means by which all can live, and grow to eminence. What constitutes the ingenuity of the Mechanic ? It is the cultivation of his senses; his reason, and his judgment, pointing out at once the proper adaptation of means to effect his ends. What makes the fame of the Poet? He cultivates his senses, and his judgment well knows how to apply them. Why do his beautiful illustrations find such ready access to your hearts ? And why do you never forget them ? The poet's lesson, gentlemen, is no task to the memory; because his illus- trations are drawn from his senses, and applied to yours : and do they not delight you in proportion as their objects are 6 simple and familiar ? This is what you call his genius—his IMAGINATION. Though the means to attain perfection in these pursuits oi men are the same, their ends are different. The business ot the Mechanic relates to the physical benefit of man. That of the Poet, to his moral pleasure and improvement—but the cause is the same: It is the Mind, modified by opposite ap- plication. Nor is this strange; since your observation of na- ture has taught you that similar causes do not always pro- duce like effects. The spark, which in dreaded contact with gunpowder, blows the stately edifice to atoms, falls harmless on your hands. Such are the laws by which Nature ope- rates; inscrutable in their causation, but manifest in their effects. There are yet two other plain and unostentatious qualities or results of the senses, that I have not mentioned; namely, Past Experience, and Present Observation. These are the simple tools with which science completes her handi- work. They act slowly ; but finally to their purpose. I know that there have lived in the world those exalted geniuses who, neglecting these steady energies, have pur- sued an eccentric and uncurbed career through the regions of imagination, until lost in its mazes. Others, in eager and emulous pursuit of the prize of fame, have followed their fate; and, like Comets in their rapid course, they have left behind them their scintillations of truth, for more patient votaries of science to use at their leisure. There are those who run mad in science, as well as those who are confined within the precincts of a hospital. Indeed, we are at all times nearer to the limits of sanity than we are aware of. Let me ask you, gentlemen, have you not all been madmen in your dreams ? Nay more: look to your waking thoughts—place them on paper as they fly in swift suc- cession through your minds, without reference to reason and judgment, and thus recorded, present them to a jury of your 7 compeers: they will pronounce the verdict of Insanity. At this moment, you are thinking of what I say; the next, per- haps, may transfer you to the remembrance of domestic joys, which many of you have recently forsaken. Yet what is the connexion between these thoughts? None. Are they not like those of a maniac ? Such is the human mind without its proper constitution. It is therefore only by the steady cultivation of the quali- ties which I have incidentally glanced at, that the mind, like a well disciplined army, can hope to achieve the victory of truth. Knowledge, in her slow and cautious progress, is ever beckoned by the hand of Time; and though imagination, on its eagle wings, may soar in high contempt over her grovelling pace, yet these tortoise steps shall first arrive at their destined goal of truth; and in time too, to forget in victorious repose, the taunts of her contumelious adversary. Let me illustrate this by examples. Archimedes, in his glory, boasted that if he had a spot on which to place a fulcrum, he could move the Earth. But, gentlemen, the earth was never moved by Archimedes. This spot existed only in imagination—It was a fiction; but a dream—interpreting what might be the future power of knowledge over nature. Now let me bring you from an- cient fiction to modern fact. What has made Franklin's name immortal? Why is America proud to own him as one of her noblest sons? Why stands his name enrolled upon her imperishable charter of rights, and upon her tablets of science? Why is his memory revered at home, and ho- noured abroad ? For see, in yonder Church-yard, the en- vied path which strangers tread, that leads to his modest tomb. What takes them there ? For " No sad tear upon his grave is shed, That common tribute, of the common dead; But there, the wise, the generous and the irate, With God-like envy sigh for such a grave." s What were his original claims to distinction? Was he clothed in the robes of riches or authority? Did the busy breath of popularity blow him, like some of its paper puppets, into worldly notice ? No. In early life he was poor and friend- less; but he had within him treasures, the price of which posterity will pay. What were these treasures ? His senses; with knowledge of their use and application ; observation and experiene as their results. He cultivated his senses, and acquired knowledge of things and their effects. He saw their resemblances; classified these ; and when he per- ceived disagreement between them, as he would have done with quarrelsome men, he separated them. He cultivated his sense of hearing by attention to sounds; so that when an agreeable succession and modulation of them struck his ear from a single or combined source, he acquired knowledge of melody and harmony; thence he became a Musician. He studied men and their minds, but he looked at th em as things; he saw their incongruities, their want of proper classification or arrangement ; but having more power over things, than he had over men and their minds, he smiled at them, and often by apt analogies drawn from the exercise of his senses, publicly, though delicately, ridiculed them. This was his Wit, his Imagination. And lastly, gentlemen, when he saw want of agreement, or resemblance between the sta- tion, and pecuniary circumstances of his neighbour, he pro- posed the proper remedy; and was wont, as you all remem- ber, to quote an analogical admonition, drawn even from his childish experience, to wit: " that his friend was paying too much for his whistle." Thus, Franklin was an Economist. These were among the treasures that Franklin possessed in early life; and when he sought the road to science, he knew too well their value to leave them behind. Let us next in- quire what did he do, thus to merit the unlimited eulogium of the world ? Nothing else, but endeavour to perfect by proper 9 education.those qualities which the God of nature bestowed upon him. Of the means I have already spoken, and what was effected as their end. He observed the phenomena of lightning, and recorded these as experience: He. was also familiar with the effects of electricity; and marking their re- semblance, as you would in the countenances of your com- panions, he classified them together, and thus, with the uni- versal consent of science, established or discovered their identity. This is the secret of Franklin's scientific fame, and immortality is the reward that posterity will pay him for the discovery. Thus I have humbly endeavoured to draw from human example, a hasty sketch of the means by which you may acquire Knowledge, Power, Fame and Affluence;—for Frank- lin finally possessed them all. But, gentlemen, the means of his fame shall now with me subserve another purpose. I offer them as a moral lesson for the improvement of Medicine ; for I hope to convince you that the same means which, in Franklin's hands, brought strokes of lightning harmless down from heaven, in yours may raise our science to the pinnacle of truth. Pontius Pilate once asked, " What is truth?" The ques- tion was not answered; but Philosophy has since replied,—it is a Unit; unchangeable, everlasting; and has added in a simple rule, that the means to reach it, in one department of knowledge, are the same to arrive at it in another. To Mathematics, Natural Philosophy, Chemistry, and Me- chanics, you will admit these means may be successfully applied; but to our science, you will not. Why ? What evil hath Medicine done to deserve such exclusion? Why should she be an outcast from their privileges? What is the subject of medicine? Is it a chimera; an essence, or notion ? Something beyond the analysis of the senses, and their proper constitution ? No ! It is the human body ; a B 10 material object, exhibiting phenomena, or properties, con- stantly to our senses. I have but one insinuation to cast upon medicine, and it is, that she neglects her rjationaj advantages. Am I not sup- ported in this assertion, by the fact, that she possesses many more than the science of Astronomy; for which of her vo- taries has more than seen the order and motions of the pla- netary system, and this effected too, by the ingenuity of man with his senses ? Yet how far beyond comparison in certainty, is this celestial science with medicine! Such means, you will reply, cannot in our science detect her intricate and hid- den causations. These are the rocks upon which the true. interests of medicine for ever split. The former, our senses may be taught to unravel; with the latter, we have as yet nothing to do, any more than with the rewards of paradise, until we have deserved them. Reflect, what observation and experience have effected in Astronomy, and let us anticipate their satisfactory results when properly applied to Medicine. Why should not the diseased conditions of the human system be as familiarly taught, and as easily understood, as the natural functions of the heavenly bodies ? It is true, Astronomy tells her stories of distant planets inhabited by man, and imagines his man- ners and his customs; but with senses ever active, she talks in her sleep—Remember she travels to a far country, and is tired—she hath a right to sleep—aye, and have pleasant dreams too, as a reward for her labour. But medicine is at home; in her own house, as it were, sleeping away the morning of her strength, whilst her intelligent and wakeful visitors, the Senses, are loudly knocking at her doors to court her envied acquaintance. But Science, gentlemen, always opens her gates to evident causes->-&\ich as will lead the mind to correct conclusions, and invariably closes them upon such as are imaginary, or 11 hypothetical; for, like thieves, they would come in and rob her of her treasures. These few remarks, which 1 have hastily thrown out, will, I trust, prepare your minds to believe, that the means are the 6ame to acquire knowledge in every department of human pursuit. How are you taught Anatomy, Surgery and Che- mistry ? By observation and experience. How ought you to be taught the Practice of Physic ? By the same means. This last named department of medicine has its phenomena, and relationships to be observed, and properly classified, or else it exists not as a subject of scientific investigation. These are the means, therefore, gentlemen, which I shall mo- destly use in my endeavour to give you the elements of me- dical instruction; and I will submit it to your judgment to determine whether I have effected the purpose. By your ver- dict here, I am willing to fail, or shall be proud to succeed. Come not with Prejudice, in favour, or against this mode of instruction. I am too young to be entitled to either— but throw aside these mantles, and " listen to the Stranger, Truth." How came you by it? I hear you ask. With instruction I found it every where. Its principles have been gathered from amidst medicine's baneful errors, just as you have often plucked beautiful flowers from contact with most poisonous weeds. There is not a modern work on medicine that does not contain them. Yet the senses, from want of proper cul- ture, do not perceive or apply them. I could show them to you, here and there, like stars through the clouds of night— and it shall be my humble aim to collect these scattered rays of intellectual light into a sun-like focus, to guide you on your path of practical knowledge. I do not wish of modern systems of medicine, as Nero did of the human race, that they had but one head, that I might cut it off. They are too rich in the scattered gems of in- 1-2 tellect, to part with. Read them, and attentively too; but with Nature always at your elbows: she will correct their mistakes, and teach you to distinguish their true from their counterfeit coin. They all contain Truth, but inseparably connected with Error; so much so, that like the blending of colours, you cannot tell where one begins, or the other ends. The system of instruction that I propose to offer to you, if you will listen to it throughout, draws a faithful line of de- markation between them. Nor is it medical novelty in which I would endeavour to interest you. It is as old as observation; and it is only a subject of surprise, that they who formerly lived by medical teaching, did not perceive it. Newton was neither the author of the Apple, nor of its downfall to the Earth; he saw the phenomenon, and rea- soning upon it, deduced the principle, called Gravity, and no other cause has yet been assigned for it. Newton's system was observative, yet its objects existed from the foundation of thp world. 1 have said the system I intend to teach you, is old. Let not this be its sentence of condemnation. Nature is old ; yet she wears well withal. Truth is old. Truth was young ; Truth is eternal. Heed it, therefore, gentlemen, wherever you hear it. Honour it, in medicine, when it proceeds from the venerable head—and reject it not, though uttered to you by the lips of Youth : for remember, the sun that arose upon the morning of creation, is the same in its nature, the same in its effects, as that which, I trust, will smile upon you all to-morrow. NLM032887810