VALEDICTORY  ADDRESS
gMrtcal irataate of lartatft (tlitlocrsifij,
MAECH lOth, 1858.
By OLIVER WENDELL HOLMES, M. D.
 
 
       VALEDICTORY   ADDRESS,



                   DELIVERED TO THE



l^rirkal  drahate   of  §arbari)  Snttoiig,



                      AT THE



         ANNUAL  COMMENCEMENT,



               Wednesday, March 10, 1858.
By OLIVER WENDELL HOLMES, M.D.
                     > i»
     PARKMAN PROFESSOR OF AKATOMT AND PHYSIOLOGY.
Re-printed from "The Boston Medical and Surgical Journal."
          BOSTON:

DAVID CLAPP........184 WASHINGTON STREET.

      MEDICAL AND SURGICAL JOURNAL OFFICE.

             1858. 
Vm B
y 752 v
 I Q58
  c, % 
VALEDICTORY   ADDRESS.
   Gentlemen of the Graduating Class,—It is my grateful duty
 to address you a few words in the name of the  Medical Faculty,
 under the auspices of which you have just entered the Medical
 Profession.   In their name I welcome you  to the labors, the obli-
 gations, the honors and the  rewards which, if you are faithful, you
 may look for in your chosen calling.  In their name I offer you the
 hand of fellowship, and call you henceforth brothers. These elder
 brethren of the same great family repeat to you the words of wel-
 come.   The wide community of practitioners receives  you  in full
 communion from this moment.  You are enrolled hereafter on that
 long list of the Healers of men, which stretches back unbroken to
 the days  of Heroes  and  Demigods, until its  earliest traditions
 blend with the story of the  brightest of  the ancient Divinities.
   Once  Medicines  Doctor,  always Doctor Medicince.  You can
 unfrock a clergyman and unwed a husband, but you can never put
 off the title you have just won.   Trusting that you will always cling
 to it, as it will cling to you, I shall venture to offer a few hints which
 you may find of use in your professional career.
   The first counsel  I would offer is this: Form a distinct plan for
 life, including duties to fulfil, virtues to practise, powers  to deve-
; lop, knowledge to  attain, graces to acquire.  Circumstances may
 change your plan, experience  may show that  it requires modifica-
 tion, but start with it as complete as if the performance were sure
 to be the exact copy of the programme.   If you reject  this first
 piece of advice, I am afraid nothing else I can say will  be of ser-
 vice.  Some weakness of mind or of moral purpose can alone account
 for your trusting to  impulse  and circumstances.   Nothing else goes
 on well without a plan; neither a game of chess, nor a campaign,
 nor a manufacturing or commercial enterprise, and do you think
-Mfc3o 
4
that you can play this game of life, that you can fight  this  despe-
rate battle, that you can  organize  this mighty enterprise, without
sitting down to count the cost and fix the principles of action by
which you are to be governed ?
  It is not  likely that any of  you will  deliberately  lay down a
course of action pointing to a low end, to be reached by ignoble
means.  But keep a few noble  models before you.   For faithful
life-long study of  science you will find  no better example than
John Hunter, never satisfied until he had  the  pericardium  of Na-
ture open and her  heart throbbing naked in his hand.  For calm,
large, illuminated, philosophical  intellect, hallowed by every exalt-
ed trait of  character, you will look in vain for a more perfect pat-
tern than Haller.  But ask your seniors who is their living model,
and if they all give you the same name, then  ask  them why he  is
thus honored, and  their answers will go far toward furnishing the
outline of that course I would hope you may lay down and follow.
  Let us look, in the very  brief space at our disposal, at  some of
those larger and lesser rules which might be supposed to  enter  as
elements into the plan of a' physician's life.
  Duty draws the great circle  which includes  all else within  it.
Of  your responsibility to the Head Physician of this vast plane-
tary ambulance, or travelling hospital which we call Earth, I need
say little.  We reach  the  Creator  chiefly through his creatures.
AVhoso gave the- cup of cold water to the disciple gave  it  to  the
Master; whoso received that Master received the Infinite  Father
who sent him.   If performed in the right spirit, there  is no higher
worship than the unpurchased service of the  medical priesthood.
The sick man's faltered blessing reaches heaven through  the bat-
tered roof of his hovel before the Te Deum that  reverberates  in
vast cathedrals.
  Your duty as physicians  involves the practice of every virtue and
the shunning of every vice.  But there are certain virtues and
graces of preeminent necessity to the physician, and  certain vices
and minor  faults against which he must be particularly guarded.
  And first,  of truth.   Lying  is  the great temptation  to which
physicians  are exposed.  Clergymen are expected to tell  such por-
tions of truth as they think will be useful.  Their danger is the
suppressio veri, rather than direct falsehood.   Lawyers  stand in 
                               5

professional and technical relations  to  veracity.   Thus, the  clerk
swears a witness to tell the truth, the whole truth and nothing but
the truth.  The lawyer is expected to get out  of the witness not
exactly the truth, but a portion of the truth, and nothing but the
truth—which suits him.  The fact that  there are two lawyers pull-
ing at the witness in different directions, makes it little better; the
horses pulled different ways in that horrid old punishment of tearing
men to pieces; so much the worse for the man.   But this  is an
understood thing, and we do not hesitate to believe a lawyer—out-
side of  the court-room.
   The physician, however, is not provided with a special license to
say the thing which is not.  He is expected to know the  truth,
and to be ready to tell it.  Yet nothing is harder than for him
always to do it.  Whenever he makes an unnecessary visit, he tells a
lie.   Whenever he writes an unnecessary prescription, he tells a lie.
It is audibly whispered that some of the "general practitioners," as
they are called in England, who make their profit on the medicines
they dispense, are apt to be too fond of giving those which can be
charged at a pleasing figure in their accounts.  It would be better
if the patient were allowed  a  certain discount from  his  bill for
every dose he took, just as children  are compensated  by their pa-
rents for swallowing hideous medicinal  mixtures.
   All false pretences whatsoever, acted or  spoken; all superficial
diagnoses, where the practitioner does not know that he knows, or,
still worse, knows that he does not  know;  all unwarranted prog-
noses and promises of cure; all  claiming for treatment that which
may have been owing to Nature only;  all  shallow  excuses for  the
results of bad practice, are lies  and nothing else.
   There is one safe rule which I will venture to lay down for your
guide in every professional  act, involving the immediate relation
with the object of your care;  so plain  that it may be sneered  at
as a truism, but so  difficult to follow that he who has never broken
it deserves canonizing better than many saints in the calendar:  A
physician's first duty is to his patient;  his  second only, to himself.
  All quackery reverses this principle  as  its fundamental axiom.
Every practitioner who reverses it is a  quack.  A man who follows
it may be ignorant, but his ignorance will sometimes be safer  than
a selfish man's knowledge. 
6
  You will find that this principle will  not only keep you in the
great highway of truth, but that if it  is ever  a question whether
you must leave that broad path, it will serve you as a  guide.   A
lie is a deadly poison.   You have no right to  give  it  in  large or
small doses, for any selfish  purpose connected with your profes-
sion, any more than for other selfish objects. But as you administer
arsenic or strychnia in  certain cases, without blame: nay, as it may
be your duty to give them to a patient;  are there not also cases in
which the moral poison of deceit is rightly employed for a patient's
welfare ?  So many noble-hearted and conscientious persons have
scruples about any infraction of the absolute rule of truth, that I
am willing briefly to discuss and illustrate a question which will
often be presented to you hereafter.
  Truth in the abstract is perhaps made too much of as compared
to certain other laws  established by as high  authority.   If  the
Creator made the tree-toad so like the moss-covered bark to which it
clings, and the larva of a sphinx so like the elm-leaf on which it lives,
and that other larva so exquisitely like a  broken twig, not only in
color, but in the angle at which it stands from the branch to which it
holds, with the obvious end  of deceiving their natural enemies,  are
not these examples which man  may follow ?  The Tibboo, when he
sees his enemy in the distance, shrinks into a motionless heap, trust-
ing that he may  be  taken for  a  lump of black basalt, such  as is
frequently met with in his native desert.  The Australian, follow-
ing the same instinct, crouches in such form that he may be taken for
one of the burnt stumps common in his forest region.   Are they
not right in  deceiving, or  lying, to save  their lives ?  or would a
Christian missionary forbid their saving them by such a trick ?
If an English lady were chased by a gang of murdering and worse
than murdering Sepoys, would  she not have a  right to  cheat their
pursuit by covering herself with leaves, so  as  to be taken  for a
heap  of  them ?   If you were  starving on a wreck, would you
die of hunger  rather than  cheat a fish  out  of the water by an
artificial bait ?   If a school-house were on fire, would  you get the
children  quietly  down  stairs  under  any convenient  pretence, or
tell  them the precise  truth and so have a rush and  a  score or
two of them crushed to death in five minutes ?
  These extreme cases test the question of the  absolute  inviola- 
7
 bility of truth.   It seems to me that no one virtue can be allowed
 to exclude all others, with which in this mortal state it may some-
 times stand in opposition.   Absolute justice must be tempered by
 mercy; absolute truth by the law of self-preservation, by the harm-
 less deceits of courtesy, by the excursions of the imaginative fac-
 ulty, by the exigencies of human  frailty, which cannot always bear
 the truth in health, still more in disease.
   Truth is the breath of life to human society.  It is the food of the
 immortal spirit.  Yet a single word of it may kill a man as  sud-
 denly as a drop of prussic acid.  An old gentleman  was sitting at
 table when the news that Napoleon  had returned from  Elba was
 told  him.  He  started up, repeated a line from a French play,
 which may be thus Englished—
                    The fatal secret is at length revealed,

 and fell senseless in apoplexy.   You  remember  the story of the
 old  man  who  expired  on  hearing  that  his  sons  were crowned
 at  the  Olympic games.   A worthy  inhabitant of a  village in
 New Hampshire fell  dead  on  hearing that  he was chosen  town
 clerk.
   I think the physician  may, in extreme cases, deal with truth
 as he does with food, for the sake of his patient's welfare or exist-
 ence.  He may partly or wholly  withhold it, or, under  certain cir-
 cumstances, medicate it  with the deadly poison of honest fraud.
 He must often look the cheerfulness he cannot feel, and encourage
 the hope he cannot confidently share.  He must sometimes con-
 ceal and sometimes disguise a truth which it would be perilous or
 fatal to  speak out.
  I will tell you two stories to fix these remarks in  your memory.
 When I was a boy, a grim old Doctor in a neighboring town was
 struck down and crushed by a loaded sledge.   He got up, stagger-
 ed a few paces, fell and died. He had  been  in attendance  upon
 an ancient lady, a connection of my own, who  at that moment was
 lying in a most critical position.   The news of the accident reach-
 ed her, but not its fatal character.  Presently the minister of the
parish came in, and a brief conversation like this followed.—Is the
Doctor badly hurt ?—Yes, badly.—Does he suffer much ?—He does
not • he is easy.—And so the old gentlewoman  blessed God and 
8
went off to sleep;  to learn  the whole story at a fitter and  safer
moment.   I know the minister was a man of truth, and I think he
showed himself in this instance a man of wisdom.
  Of the great caution with which truth must  often be  handled, I
cannot give you a better illustration than the following from my
own experience.   A young  man, accompanied by his  young wife,
came from a distant place, and sent for me to  see him at his hotel.
He wanted his chest examined, he told me.—Did he wish to be in-
formed of what I might discover ?—He did.—I made the ante-mor-
tem autopsy desired.   Tubercles;  cavities; disease in full blast;
death  waiting  at the  door.   I  did not  say this, of course, but
waited for his  question.—Are  there  any tubercles?—he  asked
presently.—Yes, there are.—There was  silence for a brief space,
and then, like Esau, he lifted up  his voice  and wept; he cried
with a great and exceeding bitter cry, and then the twain, husband
and wife, with loud  ululation and  passionate wringing  of  hands,
shrieked in wild chorus like the  keeners  of an Irish funeral, and
would not be soothed or comforted. The fool!  He had brought a
letter from his physician, warning me not to give an opinion to the
patient himself, but to write it  to him, the medical  adviser, and
this letter the patient had kept back, determined to have my opin-
ion from my own lips, not doubting that it would be favorable.  In
six weeks he was dead,  and  I never questioned that his  own folly
and my telling him the naked truth killed him  before his time.
   If the physician, then, is ever authorized  to tamper with  truth,
for the good  of those whose lives are entrusted to him, you see how
his moral sense may become  endangered.  Plain speaking, with
plenty of discreet  silence, is the rule;  but read the story of the wife
of Caecinna Paetus, with her sick husband and dead child, in the letters
of  Pliny  the  Younger  (Lib. ILL XVI.),  and that of good King
David's faithful wife Michal, how  she cheated Saul's cut-throats
(1  Samuel, XIX. 13), before you proclaim that homicide is always
better than vericide.
   If you can avoid this most easily besetting  sin  of falsehood, to
which your profession  offers such peculiar  temptations,  and for
which it affords  such facilities, I can hardly fear that  the  closely
related virtues which cling  to  truth, honesty  and  fidelity to  those
who trust you, will be wanting to your character. 
I)
   That you must be temperate, so that you can be masters of your
 faculties at all times;  that you must be pure, so that you shall pass
 the sacred barriers of the family circle, open to you as to none
 other of all the  outside world, without  polluting its sanctuary by
 your presence, it is, I  think, needless for me to urge.
   Charity is the eminent virtue  of the medical profession.   Show
 me the garret or the cellar which its messengers do not penetrate;
 tell me of the pestilence which its heroes have not braved in their
 errands of mercy; name to me  the young practitioner who is  not
 ready to be the servant of servants in  the  cause  of humanity, or
 the old one whose counsel is not ready for him in his perplexities,
 and I will expatiate upon the claims  of a virtue  which I am con-
 tent to leave you to learn from  those who have  gone before you,
 and whose footprints you will find in the path to  every haunt of
 stricken humanity.
   But there are lesser  virtues, with their  corresponding failings,
 which will bear a few words of counsel.
   First, then, of that  honorable  reserve with reference to the  his-
 tory  of his patients,  which  should  belong to every practitioner.
 No high-minded or even well-bred man can ever forget it; yet men
 who might be supposed both high-minded and well-bred have been
 known habitually to violate its sacred law.  As a breach of trust, it
 demands the sternest  sentence which can be pronounced on the of-
 fence of a faithless agent. As a mark of vanity and egotism, there is
 nothing more characteristic than to be always babbling about one's
 patients, and nothing brings a man an ampler return of contempt
 among his fellows.  But as this kind of talk is  often  intended to
 prove a man's respectability by  showing that he attends rich or
 great people, and as this implies  that a  medical  man needs some
 contact of the kind to give him position, it breaks the next rule I
 shall  give you, and must be stigmatized as  leze-majesty toward
 the Divine Art of Healing.
   This next rule I proclaim in no hesitating accents: Respect your
 own profession !  If Sir Astley  Cooper  was ever called  to  let off
 the impure ichor from  the bloated limbs  of  George  the  Fourth, it
 was the King that was honored  by the visit, and  not the  Surgeon.
 If you do not feel as you  cross  the  millionaire's  threshold that
your Art is nobler than his palace, the footman that lets you in is
                   2 
10
your fitting companion, and not his master.  Respect your  profes-
sion, and you will not chatter about  your " patrons,"  thinking to
gild yourselves by rubbing against wealth and splendor.  Be a lit-
tle proud—it will not hurt you j and remember that it  depends on
how  the profession bears itself whether its members are the peers
of the highest, or the barely tolerated operatives  of society, like
those Egyptian dissectors, hired to use their ignoble implements,
and  then  chased from the house where  they had exercised their
craft, followed  by curses and volleys of stones.   The  Father of
your Art treated with a Monarch as  his  equal.   But the Barber-
Surgeon's Hall is still standing in London.   You may hold  your-
selves fit for the palaces of princes, or you may creep back to the
Hall of the Barber-Surgeons, just as you like.  Richard  Wiseman,
who  believed that a rotten old king, with the corona Veneris encir-
cling his forehead with its copper diadem, could  cure  scrofula by
laying his finger on its subject,—Richard Wiseman,  one  of the
lights of the profession in his time, spoke about giving his patients
over to his  " servants " to be dressed after an operation.  We do
not count the young physician or the medical student as of menial
condition,  though in the noble humility of  science to  which all
things are clean, or of that  " entire affection " which, as Spenser
tells  us, "hateth  nicer  hands,"  they stoop  to offices  which the
white-gloved waiter  would shrink from performing.  It is not here,
certainly,  where John Brooks—not without urgent solicitation from
lips which still retain their  impassioned  energy—was taken from
his quiet country rides, to hold  the  helm of our Imperial State;
not here,  where Joseph Warren left the bedside of his patients to
fall on the smoking  breastwork  of yonder  summit, dragging with
him, as he fell, the curtain that hung before  the grandest drama
ever acted on the stage of time—not here that the Healer of men
is to be looked down upon from any pedestal of power or opulence !
   If you respect your profession as you ought, you will respect all
honorable practitioners in this honored  calling.   And  respecting
them and  yourselves, you will beware of all  degrading  jealousies
and  despise every unfair art which may promise to raise you at the
expense of a rival.  How hard it is not  to undervalue  those who
are hotly  competing with us for the prizes of life  1  In every great
crisis our instincts are apt suddenly to rise  upon us, and in  these 
11
exciting struggles we are liable to be seized by that passion which
led the fiery race-horse, in  the  height  of a  desperate  contest, to
catch his rival with his teeth as he passed, and hold him back from
the goal by which a few strides would have  borne him.  But  for
the condemnation of this sin I  must turn you over to the tenth
commandment, which, in  its  last general clause, unquestionably con-
tains this special rule for physicians—Thou  shalt  not  covet  thy
neighbor s patients.
   You can hardly cultivate  any sturdy  root  of virtue but  it will
bear the leaves and flowers  of some natural grace or other.   If you
are  always fair to your professional brethren, you will  almost of
necessity encourage those habits of courtesy in your intercourse with
them which are the breathing organs and the blossoms of the virtue
from which they spring.

   And now let me add  various suggestions relating to matters of
conduct which I cannot but  think may  influence  your course,  and
contribute to your success and happiness.  I will  state  them more
or less concisely  as they seem to require, but I  shall utter them
magisterially, for the place in which  I  stand  allows me to speak
with a certain authority.
   Avoid all habits that tend to make you unwilling to go whenever
you are wanted at any time.  No over-feeding or drinking  or nar-
cotic must  fasten a ball and chain to your ankle.  Semper  pa-
ratus is the only  motto  for a physician!
   The necessity  of punctuality  is  generally well understood by
the profession in  cities.  In the  country it is not unusual to  ob-
serve a kind of testudinous  torpor of motion, common to both man
and beast, and which can hardly fail to reach  the medical practi-
tioner.  Punctuality is so important, in  consultations especially, to
the patient as well as the practitioner, that nothing can excuse the
want of it—not even having nothing to  do—for the busiest people,
as everybody knows, are the most punctual.  There  is another
precept which I  borrow from my wise friend and venerated in-
structor, the Emeritus Professor  of Theory and Practice: and you
may be very sure that he never laid down a rule  he did  not keep
himself.   Endeavor always  to make  your visit to  a patient at  the
same regular time, when he  expects you.  You  will save  him a 
V2
great deal of fretting,  and occasionally prevent  his  sending for
your rival when he has got tired of waiting for you.
  Your conduct in the sick room, in conversation with the patient or
his friends, is a matter of very great importance to their welfare and
to your own reputation.   You remember the ancient  surgical
precept—Tuto, cito, jucunde.   I will venture  to write a parallel
precept under it, for the manner in which a medical practitioner
shall operate with his tongue;  a much more  dangerous instrument
than the scalpel  or  the bistoury.   Breviter, suaviter, caute.  Say
not too much, speak it gently, and guard it  cautiously.  Always
remember that words used  before patients or their friends are like
coppers given to children;  you think  little of them, but the chil-
dren count them over  and over, make all conceivable imaginary
uses of them, and very likely change them into something or other
which makes them sick, and causes you to be sent for to clean out
the stomach you have so unwittingly filled with trash;  a task  not
so easy as it was to give them the means of filling it.
  The forming of a diagnosis, the  utterance of a  prognosis, and
the laying down of a plan of treatment, all demand certain particu-
lar cautions.   You must learn them by your mistakes, it may be
feared, but there are a few hints which you may not  be the worse
for hearing.
  Sooner or later, every body is tripped up in forming a diagno-
sis.  I saw Velpeau  tie one of the carotid arteries for a supposed
aneurism, which was only a little harmless tumor, and kill his patient.
Mr. Dease, of Dublin, was  more fortunate in a case which he bold-
ly declared an abscess, while others thought it  an aneurism.  He
thrust a lancet into it and proved himself in the right.  Soon after,
he made a similar diagnosis.   He thrust in his lancet as before, and
out gushed the patient's blood and his life with it.  The next morn-
ing Mr. Dease was found dead  and floating in his own blood.  He
had divided the femoral artery.  The same caution that the surgeon
must exercise in his examination of external diseases, the physician
must carry into all his physical explorations.   If the  one can be
cheated by an external swelling, the other may be deceived by an
internal disease.  Be very careful; be very slow;  be very modest
in the presence of Nature.   One special caution  let me add.  If
you are ever so accurate in your physical explorations, do not rely 
13
too much upon your results.  Given fifty men with a certain fixed
amount of organic disease, twenty may die, twenty may linger  in-
definitely, and ten may never know they have  anything the matter
with them.  I think you will pardon my saying that I have known
something of the arts of direct exploration, though I wrote  a youth-
ful Essay on them, which, of course, is  liable to be considered a
presumption to the contrary.   I would not, therefore, undervalue
them, but I will say that a diagnosis which maps out the  physical
condition ever so accurately, is, in a large proportion of cases,  of
less consequence than the  opinion  of  a sensible  man of experi-
ence, founded on the history of the disease, though  he has never
seen the patient.
  And this leads me to speak of prognosis and its fallacies.  I have
doomed people, and seen others doom them, over and over  again,
on the strength of physical signs, and they have lived in the most
contumacious and scientifically unjustifiable manner as long as they
liked, and some of them are living  still.  I see two men in  the
street, very often, who were both as good as dead  in the  opinion
of all who saw them in their extremity.  People will insist on liv-
ing, sometimes, though manifestly moribund.  In Dr. Elder's  life
of Kane you  will find a case  of this sort, told  by Dr. Kane him-
self.   The captain  of a  ship was  dying of scurvy, but the crew
mutinied, and he gave up  dying for the present to  take  care  of
them.   An old lady in this city, near her end,  got a little vexed
about a proposed change in her will; made up her mind not to die
just then;  ordered a coach; was driven twenty miles to the house
of a relative, and lived four years  longer.  Cotton Mather  tells
some good stories which he  picked up in his experience, or out  of
his books, showing the unstable equilibrium of prognosis.  Simon
Stone was shot in nine places, and as he lay for dead the  Indians
made two hacks with a hatchet to cut his head  off'.   He got well,
however, and was  a lusty fellow in  Cotton Mather's time.   Jabez
Musgrove was shot with a bullet that went in at his ear and came
out at his eye on the other side.  A couple of bullets went through
his body also.  Jabez  got well, however, and  lived many years.
Per contra, Colonel Rossiter,  cracking  a plum-stone with his teeth,
broke a tooth and lost his life.  We have seen physicians dying,
like Spigelius, from a scratch; and a man who had had a  crowbar 
14
shot through his head alive and  well.  These extreme  cases  are
warnings.  But you can never be too cautious in your  prognosis,
in the view of the great uncertainty of the course of any disease
not  long watched, and the many unexpected turns it may take.
   I think I  am  not  the  first  to utter the  following caution :—
Beware how you  take away  hope from  any human  being.   No-
thing is  clearer than  that the  merciful  Creator intends to blind
most people as they pass" down into the dark valley.  Without very
good reasons, temporal or spiritual, we should not interfere with
his kind arrangements.  It is the height of cruelty and  the ex-
treme of impertinence to tell your patient he must die, except you
are sure  that he wishes to know it, or that there is some  particular
cause for his knowing it.  I should be especially unwilling to tell a
child that it could not recover; if the theologians think it necessary,
let them take the responsibility.   God  leads it by the hand to
the edge of  the precipice  in  happy unconsciousness, and I would
not open its eyes to  what he wisely conceals.
   Having settled  the  cautious  course to be pursued in deciding
what a disease is, and what its course is  to be; having considered
how much of your knowledge or belief is to be told, and to whom
it is  to be imparted,  the whole question   of treatment remains to
be reduced to  system.
   It is not a pleasant thing to find that one has killed a patient by
a slip of  the pen.  I am afraid our barbarous method of writing
prescriptions in what is sometimes fancifully called Latin, and with
the old astrological sign of Jupiter at the head of them to  bring
good luck, may have  helped  to swell  the list of casualties.   We
understand why plants and minerals should have technical names,
but I am  much disposed to think that  good plain English, written
out at full length, is good enough for anybody's use.   Why should
I employ the language of Celsus ?   He commonly  used none but
his own.   However, if we must use a  dead language, and symbols
that  are not only dead, but damned, by all  sound theology, let us be
very careful in forming those medical quavers and semiquavers that
stand for ounces and drachms,  and  all  our other enlightened hierog-
lyphics.   One other rule I may venture to give, forced upon me by
my own experience.   After writing a recipe, make it an  invariable
rule to read it over, not mechanically, but with all your faculties wide 
15
awake.   One sometimes writes a prescription as if his  hand were
guided by a medium—automatically, as the  hind legs of a water-
beetle strike out  in the water  after they are  separated from  the
rest of him.  If all of you will follow the rule I have given, sooner
or later some one among you will very probably find himself the au-
thor of  a homicidal document, which but for this precaution might
have carried out its intentions.
   With regard to the exhibition of drugs as a part of yonr medi-
cal treatment, the golden rule is, be sparing.   Many remedies you
give would make  a well person so ill that he would send for you
at once if he had taken  one of your doses accidentally.  It is  not
quite fair to give such things to a sick man, unless it is  clear  that
they will do more good  than the very considerable harm you know
they will cause.  Be  very gracious with children  especially.  I
have seen old men shiver  at the recollection of the  rhubarb and
jalap of  infancy.  You may depend upon it  that half the  success
of Homoeopathy is due to the sweet peace it has brought into the
nursery.   Between the gurgling down of loathsome mixtures and
the  saccharine  deliquescence of  a minute globule,  what  tender
mother could for  a moment hesitate ?
   Let me add one other hint which I believe will approve itself on
trial.  After proper experience of the most  approved forms of
remedies, or of such as  you shall yourselves select  and combine,
make out your own brief list of real every-day prescriptions, and
do not fall into the habit of those extemporaneous, fancy-combina-
tions, which amuse the physician more than they profit the patient.
Once more : if you must give a medicine, do it in a manly way, and
not in half doses, hacking but  not chopping at the stem  of the
deadly fruited  tree you would  bring down.  Remember this  too;
that although remedies may often be combined advantageously, the
difficulty of estimating  the effects  of a prescription is  as  the
square of the  number of its ingredients.  The deeper you wade
in polypharmacy, the  less you  see of the ground on  which you
stand.

  It is time to bring these hurried and crowded remarks to a close.
Reject what in  them is false, examine what is  doubtful, remember
what is  true; and so,  God bless you, Gentlemen, and Farewell 1