THE ANNUAL ADDRESS TO THE GRADUATES OF THE MEDICAL COLLEGE OF SOUTH-CAROLINA, DELIVERED MARCH 23, 1830. AFTER CONFERRING THE DEGREE OF DOCTOR OF MEDICINE. BY THOMAS TT1 SIMONS, M. B. PRESIDENT OF THE MEDICAL SOCIETY OF SO. CA. CHARLESTON: PRINTED BY A. F. CUNNINGHAM. No. 36 Queenst. 1830 ADDRESS. It again devolves upon me to charge the Graduates of the Medical College, and to make such observations as seem most suitable to so solemn an occasion. In the performance of this duty, I shall address you, Gentlemen, as those who are, in due season, to become the representatives of the Medical character of our communities, and, as such, to assume heavy, yet honorable responsibilities. About to launch upon the great ocean of life, the young and ardent imagination beholds every thing brilliant and prosperous; no portending storms are seen, but an unclouded sky, and the sun beaming with radiant beauty and lustre. But the moral, like the physical world, has its changes and vicissitudes—its storms and sunshine. There is no such thing as uninterrupted joy or sorrow, prosperity or calamity. Life is a kind of mosaic work wherein Sy intermixed the miseries as well as the pleasures of existence. Young men, from an ignorance of the world, are generally mor- bidly sensitive, and shrink from the difficulties and rasping trials of life. They are apt to despond, and to believe the obstruc- tions to success too great to be overcome, and thus are oftentimes lost to themselves and mankind. Be not thus discouraged or de- luded. Hold the maxim that nothing is impossible to be attained which is within the bounds of human capacity, and if you do not reach the summit of excellence, you will at least gain an elevated and honorable position. To all who have to sustain themselves by their physical or mo- ral efforts, the commencement of life is peculiarly trying and dis- tressing. But none can feel it so forcibly as the young physician. His first essay may be the most hazardous and important. He has to contend not only with the raging of disease, but with the doubts I Address to the Graduates and fears of his patients and their friends. He has all the awfu) responsibility, with none of the confidence of the veteran prac- titioner. He may be placed in situations where prompt and ener- getic efforts must be used—where no additional counsel can be obtained—where he must wholly depend upon his own resources —and where life or death must be the issue of his proceedings. This is a difficult situation. It is one which should make you feel satisfied that you have used all the means in your power faithfully to perform, and which should urge you to unremitted and contin- ued exertions for improvement and usefulness. Every incentive is offered you for untiring efforts in the cause of Medical Science. The esteem and respect of a community— the pride of success—but above all, the solemn consideration that the health—nay, life of your fellow-creatures are at your dis- posal. The position of the scientific and distinguished Physician is truly elevated and enviable. How beloved and respected! With what grateful and affectionate feelings is he always met! And when he dies, how reverently is his memory cherished! If he has not the splendour or renown of the soldier or statesman, he has the " mens conscia rettV—the heartfelt consolation of doing good—of making moral and physical sacrifices for the benefit of his fellow beings—and of assuaging the pangs and agonies of disease. The triumph of the Physician, although confined to a small circle, is frequently more exquisitely gratifying than the most brilliant victory of the most successful warrior. It is the triumph of the soul. A parent upon whom a lovely family rests—or a child upon whom fond parents dote—or some valuable member of society is snatched from the grasp of death and restored to the endearments of life : such are the victories of the able Physician. In proportion, however, as the Physician who has conscientious- ly performed his trust, is elevated and respected; so, on the other hand, no character is more dangerous, or more deservedly con- temned by the intelligent and the good, than he who is ignorant. He feels not the responsibility of his charge, but is rash, arrogant and dogmatical, and regardless of the opinions of others in the ratio of his miserable incompetency. He is remarkable for his chi- canery and boasting. He endeavors to undervalue all who arc Of the Medical College. o meritorious and worthy of confidence, because he knows he dares not enter into an open and manly competition. He sports with the lives of his fellow-creatures with as much fearlessness and indiffer- ence as if he were pursuing an idle game. The solitude and af- fliction of widowhood—the miseries and tears of orphanage—the pride of manhood drooping under the loss of her who partici- pated in all his joys and all his sorrows—are spectacles with which he is familiar, but which create no sympathizing emotions in his mind. The ennobling characteristics of our profession are by him unknown and unfelt. Such are the men who prostitute and degrade the dignity—nay, the sanctity of our profession. Such are the men who have aroused the satirical denunciations of the poets of all ages, who have justly exposed them to public odium and indignation, whilst they have not failed to sing, in lofty praise, the virtues and the worth of those who may justly, in the language of Holy Writ, be called good and faithful stewards of mankind. I have made these preliminary observations, Gentlemen, not with a design to discourage or depress you, but rather to imbue you with a full sense of the awful and momentous responsibilities you are about to assume, and to urge you to make your exertions in Medical attainment, equal to those responsibilities. I wish you to be enthusiastic—to leave no efforts unexerted which will sustain the moral elevation of our profession or extend the boundaries of its usefulness. To enter upon the consideration of the various branches of a Medical education would not be suitable to the present occasion. You have elsewhere heard them fully discussed, and, I trust, you have felt their importance and value. Think not, however, that your studies are completed. You have an immense field for in- vestigation lying before you. The laborers in Medicine and Sci- ence are numerous, ardent and enthusiastic, and are continually enriching and adorning the tabernacle of knowledge. You must endeavour to emulate them, and be collaborators in their great intellectual enterprises. The Natural Sciences, so peculiarly fas- cinating, open a wide field for mental pleasure and improvement. To the Botanist, the most barren plains present something inter- 6 Mdress to the Graduates esting. The craggy rocks have numerous attractions for the Geologist. The Chemist every where beholds, with proud satis- faction, the triumphs of his Science, and the Naturalist is sublima- ted and enraptured in observingthe various habits of the living crea- tures of the earth. If you have a partiality lor either of these departments of knowledge, you will always find some leisure from your professional avocations, to indulge in them, profitably and agreeably to yourselves, and perhaps advantageously to your country. I must now claim your attention for a few moments, while I bring to your view the value of a Classical Education. I regret to find the Classics, both ancient and modern, so much neglected, and considered of so little importance. They are to the mind what nutriment is to the body—the intellectual aliment which gives strength, and vigor, and power, and which prepares it for fully comprehending and appreciating the different subjects which may come under review. In no profession is there more false reasoning, and where the mind is more apt to be deluded and led away by every new opinion which may be advanced, than in the Medical; and as new opinions are springing up not only in every age, but almost every year, hence the absolute ne- cessity that the mind should have been so well previously exerci- sed and tutored, as to comprehend—to discriminate—to detect speciousness or sophism of argument from truth, as well as to pre- vent it from falling into the error of sweeping generalizations from a few insulated facts. What is so well calculated to accomplish these important ends as a knowledge of the Classics ? By these, however, I do not understand a mere knowledge of the Languages, or of the ancient or modern Poets or Essayists, but a knowledge of Moral Philosophy, Logic, Ethics and Belles Lettres, of Mathe- matics and even of the Natural Sciences. It is not to be expected that you should be pedagogues or pedants, or that any person should have a profound knowledge of these, for either of them would require a life's undivided attention; but the elementary principles should be known, so that the mind may be enlaced and enriched, and its capability for improvement increased. It is not only on this account that the Classics shoidd be made Of the Jledical College. 1 a part of a Medical Education. This is an intellectual age. The press teems with all departments of knowledge, which is shedding her intense and penetrating light through every portion of the civilized globe. Education is not confined to a few, but is becoming universal; and in proportion as communities become more enlightened, so will the standard of excellence in the learned professions be reasonably expected to be elevated. If it is not, they will inevitably sink into degradation and contempt. The com- munity have a right to expect, that those whose pursuits are purely of an intellectual nature, should do their part in sustaining the cha- racter of the social compact; that they should be enlightened in their sentiments and exalted in their purposes ; that they should give the impulse to all moral and intellectual excellence. The Medical profession in every age, has been remarkable for the num- ber of its votaries pre-eminent in Literature and the Sciences, who have obtained for it the high rank of being the most learned of all professions. In short, our country expects us not merely to go through the ordinary routine of a practical Physician, but to give her a Medical Literature—and how can this be accomplished if Classical Literature becomes neglected ? It is evident that if we do not keep up with the progressive im- provement of the age, we must fall from our high estate. Man is naturally indolent, and if a little learning can accomplish-his purposes, he will be content with that little. We are too apt to imagine that we have ascended the summit of excellence, and rest contented with our situation, when we have really taken but the first step in the noble ascent. Our profession is now crowded to excess—the spirit of competition, and I fain hope, of generous emulation is awakened—and that the only true way to success will be found in meritorious exertions. Better far direct your mind to any thing but the profession you have now become members of, than be satisfied with the knowledge you have obtained. Remem- ber that a Medical Degree is of no value unless he who possesses it proves himself worthy. Gentlemen, bear with me, when I presume to offer to you, as I did to your predecessors, some admonitory precepts; and receive them, I pray you, in the spirit in which they are offered. a Address to the Graduates Young men, when first entering upon the duties of life, have new scenes presented them. Relieved from scholastic discipline, they become masters of their own actions, with oftentimes very little practical knowledge of man or the world. They are naturally sanguine—too often conceited ; and fresh from institutions where they have stood high with their peers, and full of theories, the truth of which they have had no opportunity of confirming or disproving, are apt to estimate the capability of their elders in the exact ratio of the approximation of their views and practice to the doctrines which they have been taught, and hence become dogmatical and perhaps insulting to those who are entitled to their respectful consideration. Such feelings and dispositions have often proved fatal barriers to the success of young men who are otherwise meritorious. A moment's consideration will prove to you the folly of such conduct. In behaving contumeliously to your elders in the profession, you are forgetful that those gentle- men, in the course of their education, have had equal opportuni- ties of instruction with yourselves, with the addition of valuable experience, and the hard-earned confidence and respect of a community; you are, therefore, uselessly contending under great disadvantages. How much better—how much wiser—how much more consonant with a just sense of duty—to be respectful, that you, when you become advanced, may meet with the same res- pect. I would, in no manner, recommend servile adulation, or a forgetfulness of self-respect, or of the high responsibilities you have assumed—and yield your opinion obsequiously to the mere " ipse dixit" of any one, however elevated his station; but to offer your opinions firmly and modestly, and pay respectful deference to the opinions of others. An impatience of getting into business has often hurried young men of generous feelings into littleness of conduct which ill be- came them ; but believe me, that in ours as in all departments of life, honesty is by far the best policy, and there is no surer method of undermining or degrading yourselves, than in efforts to un- dermine others. High-toned feelings of etiquette and decorum in our intercourse with our professional brethren, will have a salu- tary influence upon ourselves and mankind. Men who are res- Of the Medical College. 9 pectful and exalted in their feelings and conduct, always receive admiration and respect, never degradation or insult. In your intercourse with your patients, a great deal depends upon yourselves. To be selected in preference to others, is in itself complimentary; and although you may encounter many unpleasant things in your professional intercourse, yet always remember, that no one sends for a Physician with the intention of insulting or injuring him, but rather to receive his services, to inspire in him an interest towards them, and to bind him in friendliness of feeling. Be not, therefore, too sensitive, and ima- gine disrespect without you have unequivocal evidence. Make every excuse for the anxiety and apprehensions of friends, and for the agony of your patients. Your business is to sooth these feelings—to comfort, and not to cavil; and it would be unmanly and ungenerous to be harsh, either in your conduct or expressions, to those who are in need of your kindliest sympathies and conso- lations. It is not the mere prescriptions and detection of disease which render a Physician successful; but the power to win esteem and respect, and inspire unbounded confidence. When the Physician who has gained this ascendancy over his patients, enters a sickroom, see how the countenance, before haggard and depressed, brightens with hope, and how cheerful and prompt is the acquiescence in every thing he recommends. How is this to be obtained 1 By kindness—respectful attention and delicacy of feeling and conduct, with a knowledge of your profession. You must remember that you have to keep the mind quiescent, if you wish to restore the body to its healthy functions. I cannot impress upon you too strongly, nor should you ever forget it, that every thing which confidentially transpires between your patients and yourselves, should on no condition, be divulged. You should hold it as sacred as your lives and honors, and let no consideration, however powerful or important, make you waver an instant in your determination. If confidence in your honor and integrity on this point has once been shaken, you can in no man- ner be restored to the estimation of the noble and high-minded. You will awaken distrust, and justly too; for you may in this man- 2 10 Address to the Graduates ner, wantonly become the moral assassins of your fellow-beings' reputations. The force of public opinion is so strong against Intemperance, that it would appear unnecessary to call your attention to this subject. We are frail, like other men, and are exposed to a mul- titude of temptations. Our acquaintance with mankind is more intimate and extensive than that of any other profession, and we require, therefore, to be particularly circumspect. At any time your services may be required, and to be found in a condition which incapacitates you for the faithful performance of your duties, and when you may do incalculable and irremediable injury, is a con- sideration sufficiently powerful to make you particularly cautious how you indulge in the pleasures of the table. In vain are your hopes of success, if a fondness for conviviality be much encoura- ged. You will become negligent and indifferent to your profes- sional obligations ; and all your friends, even those who pressed you to join in their revels, will desert you, and your last resort, in the desperation of feeling, will be to seek in the horrors of inebria- tion, the forgetfulness of what you are, and what you might have been. You who are destined to practise in the country, are peculiarly exposed to the temptations of intemperance, and should, therefore, be always on your guard. Many young men, with prospects as brilliant—perhaps more brilliant than yourselves— with moral and intellectual excellencies which would have adorned any station—have, from the effects of this insidious and accursed vice, fallen from their enviable condition to that degradation, when, with remorse more terrible than the adder's sting, they deplore their folly—weep over the chains in which they are so irresistibly enthralled—and well may cry out, "Now none so poor to do me reverence !" We are too apt, Gentlemen, to pride ourselves upon our moral strength, and to think we will escape the thousand quicksands which have engulphed our fellow-creatures. Be not too confi- dent, however; for you may suffer under a fatal delusion. The vice of intemperance slowly and gradually, like the spider, throws its net-work around, until it so firmly binds, that all resistance be- comes impossible. Read the history of mankind—from the Hero Of the Medical College. 11 of Macedon to our present age. Look into any community, and see how many—from the most exalted to the most humble—from the most intellectual to the most ignorant, have fallen prostrate to this Hydra—this leveller of all distinctions—this author of all that is monstrous or degrading inhuman nature. In the course of your anatomical and physiological investigations, you have become familiar with death and its consequences ; but, I trust, none of you have been led to the astonishing conclusion of some Physicians, that man—like the plants or the beasts of the fields—is a mere creature of organization, and with his physical dissolution, is total annihilation. This proposition—so revolt- ing—so debasing—so calculated to make us shrink with hor- ror and appalled with awe—is maintained by contractedness of views, limited comprehension and miserable sophism: That with the developement of the organic structure, are intellectual developements ; that when the physical power decays, the intel- lectual powers diminish; nay, further, that in proportion to the perfection of organization, is perfection of mental capacity—may all be admitted. But do these admissions warrant the extraordi- nary corollary, that the Soul—that something immaterial, which gives impulse—action—power—to our wonderful frame—must, with it, perish forever 1 Does it prove any thing more than an intimacy of association between the physical and moral system, without which, our structure and existence would have been vain and nugatory] Does it prove any thing more than the mysteri- ous economy of Nature ? What, shall man, so fearfully and won- derfully made—with intellectual power to grasp and encompass all physical phenomena—to control all animal and physical pow- ers, and render them subservient to his purposes, and which makes him vie almost with divinity—be a creature of a day, and like the butterfly, flit a few idle hours and perish forever 1 That all things however beautiful or wonderful in structure, is the mere effect of chance; and that there is no great First Cause—no Supreme Creator—but a continual revolution of organization, life and des- truction—all originating out of chaos ? Such opinions, however philosophical in the estimation of some short-shighted men, only prove their littleness and weakness. No; man's finite vision, with. 12 Address to the Graduates all his intellectual capacity, cannot grasp infinite objects. When he presumes to make such a lofty flight, he is lost in clouds and dark- ness. Yes; there is a God, and an immortality. To this, all Nature cries aloud, with universal accordance. Go into the chamber of sickness and see life ebbing fast and friends and rela- tives hanging around—and tell me what gives consolation to the mourners and the dying. Where do they seek for comfort 1 In the wild speculations of the sceptic? No; it is in the glorious blessings of religion—that pure and holy emanation from God himself. It is this which calms, like oil upon the waters, the ra- ging tumult of the soul. It is this which elevates them above all earthly considerations; makes them look with exalted hopes to a future existence ; and bear, with fortitude and humility, the afflic- tions of humanity. Who, then, would dare, even if religion be a delusion, presume to dispel it, when such are its happy and salu- tary influences 1 Gentlemen, from the experience which I have had in the course of my professional duties, of its benign, its celes- tial influence upon the conduct and happiness of mankind, I feel myself justifiable in declaring that any one, who would attempt to lessen its power, is deserving of public indignation and abhorrence. Well might the immortal bard, in a strain of lofty enthusiasm, ex- claim, If Chance awaked inexorable power, This frail and feverish being of an hour Doomed o'er the world's precarious scenes to sweep, Swift as the tempest travels on the deep ; To know delight but by her parting smile, And toil, and weep, and wish a little while ; Then melt, ye elements that formed in vain, This troubled pulse, this visionary brain, Fade ye wild flowers, memorials of my doom ! And sink, ye stars, that light me to the tomb ! Gentlemen, in concluding the ceremonies of this day—ceremo- nies of peculiar moment to you, and of interest to us all—I be- seech you to bear in mind the awful responsibilities you have assu- med, and the arduous duties you will hereafter have to perform. Our profession has sometimes been called divine, because its offices are of the most humane kind. Our Saviour thought it one of his most holy duties to heal the sick and afflicted ; and it is our peculiar prerogative to assuage the pangs of disease, and to be Of the Medical College. 13 his humble imitators in this sacred cause. I have endeavoured to prove to you, Gentlemen, that it is not only necessary that we should have a knowledge of our profession, but that it should be associated with the nobler attributes of the heart; that you should identify yourselves with your patients; that you should remember that the highest confidence is reposed in you; and that you are in a manner, the arbiter of life, to which we all cling, and death, which we from our very nature dread. It is true we have many personal sacrifices to make ; we are exposed to all the inclemencies of weather; to privations of our rest and domes- tic enjoyment; and to the whims and caprices of mankind. Our time can never be called our own; we are emphatically the ser- vants of the public. We have to exercise the highest degree of moral courage; to stand firm amid the ravages of epidemics, while the stoutest hearts are struck with terror and dismay; to be surrounded with a loathsome and pestilential atmosphere; and behold misery in all its most degrading and appalling forms; but if there be an avocation allotted man, by which he can unfold the higher attributes of moral loveliness and excellence, it is our own. When the world forsakes ; when health is gone, and poverty and disease in all their terrors, present themselves; when all save hope is lost; 'tis then the Physician comes to offer his mite in the cause of afflicted humanity. Gentlemen, if these are our high trusts and destinies, you are imperatively called upon, by every principle of honor and con- science, to use all the means within your power faithfully to per- form them. And I charge you, by every feeling of humanity and justice—by your hopes of success in this world and reward here- after—regard not lightly or thoughtlessly the duties which you, from this day, are privileged to exercise.