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INTRODUCTORY LECTURE
ADDRESSED to the

OF
TH.1N8YLVAM1 UNI VBB81TY,
SESSION OF 1819-50.
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   BY 'II. M. BULLITT, M. D.,
PROFESSOR OF MATERIA MEDIC A AND THERAPEUTICS.
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LEXINGT
PRINTED AT THE KENTUCKY STATESMAN OFFICE.
1849.
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INTRODUCTORY LECTURE,
ADDRESSED TO THE
®Q©^L  ©\L/k
OF
TRANSYLVANIA UNIVERSITY,
SESSION OF 1849-50.
.i.UBk
   BY H. M. BULLITT, M. D.,
PROFESSOR OF MATERIA MEDICA AND THERAPEUTICS.
     LEXINGTON, KY.
PRINTED AT THE KENTUCKY STATESMAN OFFICE
184 9. 
 
CORRESPONDENCE.
                                    Lexington, Kentucky, November 15, 1849.
  Prof. H. M. Bullitt, M. D.
               Dear  Sir:—At a called meeting of the Medical Class of Transylvania
University, held in the Amphitheatre this  afternoon, at 4 o'clock, Mr. William H. An-
derson "was called to the chair, and Mr. Isaac Webb Scott chosen Secretary.
    On motion, it was Resolved unanimously, That the  undersigned be appointed a
Committee to request a copy (for publication) of your very able, eloquent and highly
interesting "Introductory Lecture," delivered before the Class on Monday evening, 5th
instant.  An answer at your earliest convenience is respectfully solicited.
                       Very respectfully,
                                          I. WEBB SCOTT, Ch'm.
                                          R. M. SUTFIELD, Jr.
                                          W. R. EMBRT,
                                          H. P. HITCHCOCK,


                                               Lexington, November 19, 1849.
    Gentlemen:—I have just received your note containing the proceedings of the Medi-
cal  Class  of Transylvania  University, by which you  were appointed a Committee to
request the manuscript of the Lecture delivered by me on the evening of the 5th  inst.,
for  publication.   I cannot well decline  complying with this  flattering request, for the
simple reason that the Lecture was prepared for the use and benefit of the Class, and
became the  common property of those to whom it was  addressed, so soon as it was
delivered.
    I herewith  send you the desired manuscript,  with the hope that you will express
to those whom you  rspresent, my gratification at this evidence of their approval of my
humble effort on the occasion referred to;  and assure them, that I shall spare no  effort
to discharge my remaining obligations to  them in an equally satisfactory manner.
    With sentiments  of highest regard for the Class, and for yourselves individually,
                         I am most truly yours, <fec.
                                                     HENRY M. BULLITT.
  Messrs. I. W. Scott,
          R. M. Sutfield,
          W. R. Embrt, and
          H. P. Hitchcock.
Committee. 
 
INTRODUCTORY  LECTURE.
  There  is nothing which the student of medicine so much needs,
at the outset of his career, as a plain and simple exposition of the
nature and purposes of his profession; an exposition which not only
exhibits to him  what he has to do, but at the same time presents the
motives,  encouragements, and incentives to do it with suitable ear-
nestness.  Such an exposition it would not be practicable to condense
into the narrow compass of an introductory lecture; but I trust I shall
be able to offer  some hints  and suggestions, which may aid you in
realizing the dignity and importance of your undertaking.
  Man never labors well without  some adequate inducement.  To
some  men the strongest incentives to exertion are found in the pros-
pect of private gain; others are urged to effort by the thirst for fame;
and others again by the higher motive of serving their fellow men.
Any one of these inducements—interest, ambition, or philanthropy—
may  urge men on to respectable and successful effort; but it is un-
questionably true, that human  labor is most earnest and most honor-
able,  when the  laborer aims to promote his own private interest, by
endeavoring to accomplish that which may not only commend him to
the admiration  of the  world, but, at the same time, minister to the
good of his fellow men generally.  It would be calculating too largely
upon  human disinterestedness to  expect  men to labor in any of the
various pursuits of life purely for the public  good, and yet it cannot
be doubted that  most men are so constituted by nature, as to require
higher and purer inducements, to sustain them in protracted exer-
tion, than such as are afforded  by purely selfish and sordid  considera-
tions.   The man who labors merely for  money, may delve on, day
after day, and week after week, but if his  mind contemplates nothing
beyond the prospect of accumulation, his labor will be cheerless and
without zest, for it will be  truly "Work  without hope" and "Hope
without an object."  Let, however, the desire to attract the attention
and elicit the admiration of  men be added to his inducements, and he
is inspired with new zeal and increased energy; and if, in addition to 
                              [«]
 these inducements, he gets to be imbued  with the  nobler  and more
 elevated ambition, to become the benefactor of his race, he is render-
 ed equal to the most glorious achievements.
   The profession which you have selected, combines, in a remark-
 able degree, all of these inducements to labor; and your success and
 position in life, will be more or less honorable, in proportion as you
 are actuated in the pursuit of it by the more generous and worthy of
 them.  You may pursue the profession of medicine as a mere trade,
 with no higher object than private gain, and you may be successful,
 as the disciples of mammon in any mercenary employment, in the
 attainment of your end;  but if this be your course, you will be false
 to the dignity of your calling, and forfeit many of the purest gratifi-
 cations of which human nature is susceptible.  You may, it is true,
 find  many practitioners  of your art, who  have pursued this course,
 revelling in the luxuries of worldly fortune, whilst men of the highest
 professional and literary and scientific attainments remain compara-
 tively neglected; and in view of this fact, you may, naturally enough,
 ask yourselves, for what end are we required to repeat the daily toil
 and  trim the midnight lamp,  if fortune can be made by  men who
 never study, whilst those are neglected who have consumed their
 time in the pursuit of knowledge, and whose  learning is every where
 admitted?   If I were required to give a brief and conclusive  answer
to this question it would be in the eloquent language of Mrs. Barbould,
that you will find your reward, for all your labor, in the possession of
" a large  comprehensive soul, well purged from vulgar fears and pur-
turbations  and  prejudices; able to comprehend  and interpret the
works of man and God; a rich flourishing, cultivated mind, pregnant
with inexhaustible stores of entertainment  and reflection, a perpetual
spring of fresh  ideas, and the conscious dignity of superior intelli-
gence."   But allow me time to answer at large, and I will convince
you that the question contemplates a  case  which is an exception to
the general fact.  During the solitary hours which, like  most young
men, I have passed in my office, awaiting the long deferred  summons
to professional duty, this very point was often a subject of reflection,
and,  like many others who have fancied themselves neglected, under
the momentary feeling of disappointment  I have  regretted the time
and money expended in the pursuit of professional knowledge, which
seemed so little likely to bring a reward corresponding to the cost of
its acquisition.   But circumstances forced me to bide my  time, and
subsequent observation has fully satisfied me, that no well instructed
physician  will fail to triumph over  an  unlearned rival,  provided he
devote*  himself to his profession with ordinary diligence and atten- 
                               m
 tion.  It is sometimes the error of the well educated man in our pro-
 fession to expect the world to become cognisant of his merits, and his
 claims to patronage, by a sort of intuition, or instinct, and hence to
 avoid rather than seek the society of his fellow men, lest he should be
 suspected of courting their favorable notice.  This reserved and in-
 communicative manner is mistaken  for indifference, and  even when
 taxing himself to the utmost, in thought and reflection, at the bedside
 of his patient, he  may seem to be destitute of sympathy and feeling,
 to a degree absolutely revolting to the tender sensibilities  of the suf-
 fering  patient,  as well as  his  sympathising friends.   On the other
 hand, the uneducated man, conscious of his own deficiencies, and con-
 vinced that if he  succeeds at all it must  be by the exercise  of vigi-
 lance, kindness and devotion, obeys  every call with alacrity, nurses
 his patients with assiduity;, makes a display of sympathy and of in-
 terest in their behalf which  rarely fail to win the hearts, if they do
 not satisfy the minds of his patrons.   The modesty of true merit will
 generally realise the sentiment of Shakspeare,
               " It is the witness still of excellency;
                To put a strange face on his own perfection."
 And I would be very far from advising you to assume the boastful
 swaggering air, or to practice the time-serving sycophancy, or solici-
 tation, which are the distinguishing attributes of the empiric.  But it
 is your especial right, and your  becoming duty, to suffer the humane
 and benevolent impulses, which are natural to the human heart, to
 unfold  and develope themselves in the exercise of a humane  profes-
 sion.  It is your right, and  your proper duty, to avail yourselves of
 legitimate means of becoming known in your calling; and you owe it
 to yourselves, and to your profession, to be uniformly kind, gentle and
 conciliatory, in your intercourse with the sick.  This much is demand-
 ed of you, by  considerations as well of philanthropy as of interest,
 and may be practiced without the slightest violation of professional
 honor, and in strict conformity with the most rigid decorum.   Let the
 educated man pursue this course, and he will never have occasion to
 complain of the results of competition with his illiterate rivals.
   But there  are other and  higher  considerations, than this  one  of
 personal advantage, to influence you in the prosecution of your pro-
 fessional studies;  and foremost  amongst  them,  is the  gratification
 which  is derived from the  ability to comprehend  and interpret the
phenomena of disease.  There is no  pleasure so satisfactory, as that
of looking  into  the  operations of nature,  with a clear  conception of
their character and purposes.  Akenside, himself a physician, tells us,
that the rainbow never  appeared so beautiful, even to his poetical 
[8]
eye, as when he first beheld it after studying Newton's theory of light
and colors:
                                   " Nor ever yet
               The melting rainbow's vermeil tinctured hues,
               To me have shown so pleasing, as when first
               The hand of science pointed out the path
               In which the sun-beams, gleaming from the West,
               Fall on the watery cloud, whose darksome veil
               Involves the orient."
Whoever practices medicine in ignorance of the principles of medical
science, and without the aid of the lights which modern investigations
have thrown upon its path, is necessarily a stranger to all such grati-
fication as is here depicted by the poet.  But he who  has thoroughly
and maturely  studied the profession and mastered its peculiar philos-
ophy, is daily  encountering  opportunities of reading from the book of
nature,—where alone they are written in clear and intelligible char-
acters, the laws which control and regulate morbid processes, as well
as the rules by which he can interpret the signs which indicate the
proper means  of arresting  them.   He has thus placed within his
reach, by the  "hand of science," a species of knowledge, from which
he can extract pleasure, even when contemplating human suffering in
its most appalling shapes; because, by its exercise, he not only recog-
nizes the presence of disease, but at the  same time comprehends its
nature, and applies the remedy which his knowledge teaches him will
arrest its progress, rescue his patient  from impending death, and re-
store him to health and usefulness,  and the fond embrace of despond-
ing friends.   On the other hand, to one uninitiated into the mysteries
of our art, all  cases of disease are mere blanks, upon which he can
find no legible  characters, and in the management of which he must
of necessity play the part of the blind man in the fable—"Nature is
fighting with  disease; a blind man, armed with a club—that is the
physician—comes  to  settle  the difference.   He  first  tries  to  make
peace; when he cannot accomplish this, he lifts his club and strikes
at random; if he strikes the disease, he kills the disease; if he strikes
nature, he kills nature."  Now this is precisely the part enacted by
every ignorant practitioner of medicine.   In what different degrees,
then, must the  ignorant and the educated partake of the highest pleas-
ure of our profession; that  derived from the  consciousness of doing
good.  In the case of the  ignorant, there is none of the gratification
which  accompanies the enlightened exercise  of the healing art; be-
cause all  the  results of his interposition are merely fortuitous.  He
prescribes or administers in the dark, without  any rational expecta-
tion as to consequences.  True, his  very  ignorance may save him
from many most distressing emotions, which are so frequently awak- 
[9]
ened in the mind of the enlightened physician, by the discovery of the
existence of fatal disease in persons who have never suspected their
danger; and in this single instance, in our profession, it may seem that
"ignorance is bliss."  But  so far from its being "folly to be wise,"
these are often the very  cases in which professional forecast and skill
are most needed, and most thankfully appreciated; and as an offset to
the painful duties which  are discharged by the enlightened physician
on such occasions, he has his moments  of intense happiness, when, as
not unfrequently happens, he  can, by the  exercise of a similar fore-
cast, detect in cases in which recovery has  long been dispaired of, the
signs of returning health, and thus raise  the  drooping spirits of his
patients, and  give  them the benefits of well founded hope;  which oft
times may prove a better restorative than any afforded by the materia
medica.
   Again; I  hardly need  remind you that your social rank, as well as
your  standing as physicians,  will depend  in  good  measure, on your
professional attainments.  Literary and scientific men, it is true, will
be apt to estimate you by your  general scholarship;  but the world,
generally, will be governed in its  estimate of you, by the  degree of
consideration and attention which you receive from your  professional
brethren.  If your acquirements are of a high order, and your knowl-
edge of disease accurate, you will command and receive the most
respectful  consideration  from your professional brethren.  Men will
judge of your merits more by the deferential treatment which you re-
ceive from your rivals, than by the opinions which they may publicly
express of you in  words.  You need  have no fears, therefore, that
your acquirements will  be overlooked; on  the contrary, medical men
will always appreciate you according to your deserts, and as they ap-
preciate you,  generally speaking, so will the world.
   You have  every inducement, therefore, to engage, with zeal and
energy, in the study of your profession.  I have shown you that it
will be to your  advantage,  in a pecuniary point of view,  to acquire  a
thorough knowledge of  medical science; that  this knowledge will be
fruitful of pleasure  to you;  that you will  secure by its  acquisition  a
two-fold gratification—that which  is derived  from its  possession, and
the higher gratification derived from the consciousness of ability to do
good to your  fellow men: finally, I have shown that your social and
professional  standing, will be fixed and graduated by the standard of
your attainments.   These  are inducements  which  should call forth
the fullest exercise  of your faculties,  and, I  repeat that your future
success, in reaping the rewards of your profession, and in administer-
ing its blessings, will be just in proportion to the  industry  and zeal
with which you now labor. 
                              [10]

   Again;  you may  not  unfrequently find yourselves  discouraged,
 and have  your interest in medical attainments impaired by hearing
 your art denounced, for its uncertainty.  You will often hear it stated
 that its principles and its practice are continually changing; that what
 was taught, as established, a few years since, is now discarded as ob-
 solete;  and that  the  doctrines  of to-day will  soon be superseded  by
 other and entirely different ones; that the science, in fact, is in a state
 of such rapid  transition,  that  the student, who labors to master its
 present pathological and therapeutical principles, will in a short time
 have all his work to do over again, with the additional trouble of dis-
 encumbering himself of old fashioned acquaintances.
   Such  reflections are  well  calculated  to discourage the zealous
 student, and to confirm the indolent in his habits of inattention and
 idleness; and I therefore  deem  it my duty to endeavor to remove
 from }-our minds  all excuse for indulging in any such doubts as to the
 profitableness of  present labor.
   Medicine is unquestionably a  science of progress;  but its rate and
 method of  progression must not be  determined by the countless an-
 nouncements of new  modes of cure, with  which the newspaper press
 is daily filled;  nor by the proclamations of discovery contained in the
 ephemeral  Medical Journals.  We can scarcely take up a newspaper
 that is not  the herald of some new and infallible cure for one or more,
 or all the diseases to which "flesh is heir."   And  we  are constrained
 to admit that our Medical  Journals are not  always superintended by
 men of sufficient  research and discrimination, to secure them against
 participation in proclaiming as new, things which are venerable  with
 age—as valuable, things which are wholly useless—as truths, hypoth-
 eses which  have been "weighed and found wanting"—as logical,con-
 clusions which prove, on examination, to be utterly absurd.
   There is a class  of medical journals, devoted to the  advocacy of
 particular interests, whose conductors care  less  for  the permanent
 good of science than for the advancement of temporary purposes; and
 it is sometimes the case that the  temporary purpose to be subserved
 by them, requires a reckless support of some false system of patholo-
 gy and practice.  That this is the case, is evidenced by the existence
 of Homoeopathic, Hydropathic, and Eclectic journals; and I fear it
 would be claiming too much  for the  regular practice, to doubt, that
journals have been established,  in times past, if indeed they do not
 now exist, for the  especial purpose of maintaining and propagating
 the systems of their founders.   That such journals can be fair expo-
 nents of the progress of medicine, it would be unreasonable to con-
 tend.   As well might it be maintained, that the empirical publications 
                              [11]

of the Brandreths and Morrisons of our day, are fair indications of the
actual state of Pathology and Practice.   In forming an estimate,
therefore, of the progressive  character of the profession, you can, by
no means,  rely upon the account  of its ongoings,  which you may
gather from either the  newspaper press, or the  ephemeral medical
journals.
   If you  would judge the claims of medicine fairly, you must trace
the history of its progress as it developes itself in the higher class of
periodicals; such as have lived through more than one generation; and
in the formal treatises on the various branches of the science, which
have emanated from the pens of the different medical writers who are
recognized as the guiding lights of their respective epochs.  It is from
these sources alone that  any  thing like a truthful account of the chan-
ges which the doctrines of the , profession have undergone from time
to time, can be obtained.  From such authorities you will learn, it is
true, that there have been changes of doctrine, as well as of practice;
but you will also learn that these changes  have not been so frequent
nor so revolutionary in their  character,  as  is  asserted by those who
talk so much about the uncertainty of medical science.  You will, in-
deed, even learn that the peculiar endowments and attainments which
made Hypocrates, and Sydenham, and Cullen, and John Hunter, emi-
nent in their several generations, would make distinguished  practi-
tioners of the present day.  That  is to say, that if  these men were
now living, and practicing medicine just as the they did practice when
they did live, that they would compare favorably with a large majori-
ty of the  practitioners  of the present time.  But  when we  come to
compare the general state of medical practice, in their several days,
with that  of the present  age, we find the difference greatly in our fa-
vor.  And I cheerfully admit that when  we  compare those shining
lights of former days, with the  illustrious names of our own time, the
advantages of our own time appear still more clearly.
   In all ages, the general practice of medicine has been considerably
behind the actual state of the science;  and  I  doubt if there has ever
been a period when  this was more strikingly the case than at the
present time.  For, although the general practice of the present time
is much better, and much more rational than at any former period, it
is, nevertheless, far from being as much in advance of the practice of
the last century, as is the actual state  of the science in advance of
the science of that  day.   Any estimate, therefore, which  we might
form of the existing state of medical philosophy,  from observation of
the results of general practice, would  be essentially  faulty; because
the insufficiency of education and  the want of thorough discipline <>i 
                             [12]

mind, render the mass of general practitioners incapable of observing
with that correctness, and of reasoning with that precision, which are
absolutely indispensable to enable them to practice medicine in such
manner as to make all of its resources  available.   To do so, indeed,
requires an  extent of primary and professional education, and a de-
gree of training in the arts of observing and theorising, and, withal, a
force  and compass of mind, which are rarely to be  met with.   It is,
hence, in our profession, as in all other pursuits which require the ex-
ercise of a high order of talents, only occasionally, that we  encounter
one of those remarkable minds, gifted with the particular  faculties,
and possessed of the particular  acquirements which fit it in  all re-
spects  for its peculiar mission.   But, we much more frequently meet
with the faculties, than the acquirements.   Bolingbroke has justly re-
marked, "The faculty of distinguishing true  from false, right from
wrong, and what is agreeable to nature from what is repugnant to her,
has not been given with so sparing a hand as we are apt to believe."
Most men, indeed, who  engage in the study of medicine, have  suffi-
cient capacity to enable them to become ministers of infinite  blessings
to the communities in which they may practice; but it is to be feared,
that too many  of them, acting upon the  idea, "Plebs amat remedga"
cease to study so soon as they have acquired knowledge sufficient to
enable them to dispense  medicines with a moderate degree of safety.
   There is  no pursuit in life, which can  boast  a larger proportion of
high minded, honorable, conscientious, faithful followers, than the pro-
fession of medicine; and it must be admitted, that  much of the  popu-
lar distrust, which  we  encounter, has been engendered by  the vain
boastings and false promises of ignorant pretenders.
   But we cannot conceal the fact, that our profession wrould command
a much larger share of the  public confidence, were the acquirements
of medical  men generally commensurate with the present advanced
state of medical science.
   I would not delude you with the pretension, that medicine is one of
the certain sciences.  On the contrary, it  has  already been  admitted,
that it is a science  of progress; and, as there can be no  progress be-
yond perfection, it is of course imperfect,  and to a certain extent, un-
certain.  But I would guard you against the fatal error, of  attaching
any such importance to this admitted uncertainty, as might  tend to
impair your confidence in the value of medical  learning,  or  lessen
your zeal for its acquisition. So far from the  imperfections and de-
fects of the  science being of a character to do away with the necessity
and advantages of study, their very existence renders it of vital im-
portance that you should make yourselves masters of all of its aseer- 
                             [13]
tained truths.   Were it an entirely certain science it could be reduced
to the form of general  propositions and special formulas, which might
be applied in the  treatment  of disease, in the absence of any ac-
quaintance with the  tedious  and  laborious processes of observation,
experiment and theoretical  analysis,  which were necessary to their
discovery and establishment. But since this is not the case, it becomes
necessary for you to be familiar, not only with its  ascertained facts
and principles, but also with the means by which a knowledge of them
has been acquired, that you may be able to distinguish  that which is
positive from that  which is only probable, and that which is only prob-
able from what is purely conjectural;  but  an acquaintance with the
methods of acquiring knowledge  in medicine is more especially de-
manded, because much of the information, which is necessary to the
successful management of disease, must be acquired at the bedside, at
the very moment when the resources  of therapeutics are to be called
into requisition.
  Taking it for granted, that you have left your several homes and
repaired to this institution, with the  determination to devote your best
energies to the acquisition of medical  knowledge, I must detain you a *
few moments longer with a brief examination of the nature and extent
of the work which is before you.
  The science of medicine, in its most comprehensive sense, embraces
all  those branches of knowledge which are necessary to the  proper
understanding  of the healthy and diseased states  of the human or-
ganism; as well as those which are necessary to the just appreciation
of the relations which subsist between the organism and all external
agents, whether therapeutical or toxical.   Human anatomy, human
chemistry, human  physics, physiology, pathology, materia medica, and
therapeutics, are branches of knowledge  absolutely indispensable to
the practical pursuit of your profession.  Some of these consider the
organism in repose; as anatomy, chemistry and physics.   Anatomy is
divided into special anatomy, which  takes  cognizance  of the organs
in their conformable condition, and into general anatomy, or histology,
which analyses them into their constituent organic elements.   Chem-
istry takes the organic elements from the hands of the histologist and
determines their chemical composition, by reducing them to the con-
dition of inorganic elements. Human physics  considers those forces
and properties of  the  organism, and its different parts,  which  belong
to them in common with other matter, and which they enjoy indepen-
dently of their peculiar mode of existence.
  Phvsiology and  pathology, on the other hand, consider it in action.
Physiology regards the phenomena, modes of action and uses, of the 
 healthy organism, indeed, all the conditions which are peculiar to nor-
 mal organic existence.   Pathology, on the contrary, takes cognizance
 of the abnormal, or diseased, state of the system; and arranges itself
 naturally into the pathology of repose, or morbid anatomy, which con-
 siders the results of morbid processes as they are disclosed on " post
 mortem" inspection;  and the  pathology of action, which studies the
 phenomena, tendencies and essential nature, or  modes  of  existence,
 of morbid action in the living body.
  Materia Medica embraces the consideration of the origin, natural
 history, modes of preparation and exhibition, of all those external
 agents which are capable of exercising  a sanative influence upon the
 body; as well as the chemical,  physical and vital relations which they
 bear to the organism: whilst therapeutics is the art and science  of
 applying these different agents, in the prevention  and cure of disease.
  I have not  spoken of surgery  as a distinct  branch of medical
 science; because  the  knowledge used by the surgeon is  embraced  in
the branches already designated.   A good knowledge of anatomy and
of human physics, of pathology, materia medica and therapeutics,
will  provide  the  surgeon with all that is peculiar to his  art; materia
medica  embracing, properly, the consideration not only  of medicinal
substances, but of all agencies and appliances, which are employed
in the prevention and cure of disease.   Were we to regard surgery as
a distinct branch  of the healing art, we should be compelled to confine
it to the manual and  instrumental processes, wdiich are demanded in
the management  of injuries, and in the  removal of morbid products :
but as all attempts to separate surgery  from medicine, are irrational
and  unnatural, the schools  of this country very wisely require of the
candidate for the  honors  of the doctorate, a knowledge as well of sur-
gical as medical therapeutics.   For purposes of convenience, there  is
a separate professorship  of surgery in all the  American schools; but a
licence to practice surgery simply, is never granted.  W7hoever would
practice  surgery, must be qualified to practice medicine also, before
he can obtain the sanction of this or any  other American school.  And
even in  countries, where it is customary to  grant license for  the ex-
clusive practice of surgery, or medicine,  the licentiate is required to be
familiar with all the branches  of medical science, to which I  have just
called your attention; and, in reality, the distinction  between surgery
and  medicine is kept up  mainly for the  purpose of perpetuating cer-
tain corporate privileges  which enure to the benefit of individual cor-
porators, and  not to the  advantage of the profession generally.  No
man can  be a good  surgeon who is not a good physician, and if the
converse of the proposition is not  true, it is  simply  because the sue- 
                             [15]
cessful practice of surgery requires a certain manual dexterity, which is
not necessary in the management of what are called medical diseases.
But in the management of the very diseases, for the  treatment  of
which  this manual dexterity may be needed, all the knowledge and
skill of the most accomplished  physician  may be demanded also.
Whether it be your desire, therefore, to distinguish yourselves as sur-
geons, or as physicians, you must, in either case become masters of
the whole circle  of the medical sciences.
  In carrying  out the plan of this lecture, it now becomes proper for
me to offer a few suggestions, in reference to the modes of acquiring
a knowledge of the  various branches of the science; but I shall be
compelled  to treat this part of my  subject with much  more brevity
than comports with the importance of its topics.
  Observation, experiment and theoretical  analysis,  are the  means
which  we use  in investigating  the  subjects  belonging to the medical
sciences.
  By observation, we ascertain the phenomena  of nature as they pre-
sent themselves when uninfluenced by the interference of art.
  By experiment, we reproduce these phenomena artificially, or de-
velope incidental phenomena, wdiich depend upon the reactions that
take place between the organism and external agents.
  By theoretical analysis, we arrange and  classify phenomena, ac-
cording to their  natural relations, and deduce from them the  general
principles, or truths, which they warrant.
  To observe  the phenomena of nature, with entire faithfulness and
accuracy, requires  the  exercise of the utmost care and attention.
Hasty and incomplete observation has done much to falsify conclu-
sions in medicine.  Observation is truly an art, the exercise of which
cannot be  safely practiced, without a thorough  training of the percep-
tive faculties of the mind.   False facts have done more to retard the
progress of medicine than false theories, and hence a thorough educa-
tion of the powers of observation, is more important to  the physician
than any other species of mental training.  The recorded observa-
tions of one who has not served a sort of apprenticeship to the art of
observing, can never be relied upon in any branch of natural science,
and there is no science in which accuracy of observation  is so essen-
tial, as it is in medicine.   In  examining the facts of our art, the ca-
pacity of the observer, by whom they were recorded, is  the first thing
to be considered; for unless he possesses peculiar  fitness for the task
of observation, his facts are to be doubted.
  By experiment, we undertake to test the correctness of observation;
and in many of the  natural sciences, as chemistry, and physics, we 
                             [1G]

may succeed in doing this.   But in medicine, we can rarely succeed
in reproducing phenomena, which may have been incompletely ob-
served; and hence we are compelled to wait  patiently  upon nature,
and profit by such occasional opportunities of repeating our observa-
tions, as  may chance to present themselves.  And even when we
attempt to develope peculiar phenomena, by the action of foreign
agents upon the living body, we have still to wait and watch, that we
may be certain of the existence of the same condition of vital activity
which may have been present at a former experiment.   Neither ob-
servation nor experiment, therefore, can be safely trusted to the hands
of a tyro.   Both require, for their successful exercise, a long and faith-
ful apprenticeship, and both are  indispensable to the farther progress
of medical science;  as well as to the  successful application of that
which is already understood.
   Theory, again, is as necessary in the practical pursuit of medical
science as the observation  of facts; neither  indeed  can be of  much
avail without the aid of the other.  The term theory, is from the Greek
word which signifies  to behold or look at, and this is the sense in which
it should be used.  To look  at, or examine, facts, that we may arrive
at the conclusions which  they warrant, is the whole business of theory.
I am not ignorant  of the fact, that it  has  been the fashion, of late
years, with the adherents of the  numerical school, to decry the use of
theory  in medicine, and to regard it as  one of the chief  impediments
to  the advance of rational therapeutics; but it is the abuse of theory
and not its proper use, against which denunciation should be directed.
Let it be remembered, that the proper use of theory is to arrange and
systematize the deductions of experience; to facilitate the progress of
knowledge, by classifying facts and explaining  the unknown by the
analogy of the known; in fine, to enable man to anticipate the future,
by referring the past to general rules."  Let it be employed with these
rational views, and their  can be no danger that it will ever hinder the
progress of our art.   On the contrary, when thus used, it constitutes
the distinguishing  and crowning excellency  in  the character of the
philosophical physician.  But like every good thing it is liable to be
abused, and hence, it must  be admitted that medicine  has been re-
tarded  in its progress by hasty and presumptuous theory.  Men have
erred in their  theories in all ages, and in  our profession we have to
contend with so much speculation, which has only hypothesis for its
foundation, that it is scarcely  surprising that prudent and over-cau-
tious men  are disposed to use with trembling  hand, a power,  to the
proper control and direction of  which, many of  the  mighty minds of
past ages  proved inadequate; even to turn their backs  upon all pro- 
                              [17]    /
gress, rather than countenance the exercise of a dangerous faculty.
It would be far better, however, for the cause of truth, were such men
sedulously engaged in pointing out the sources  of error in the theo-
ries of the past, and in teaching the methods of  avoiding them in fu-
ture;  that the march of improvement might cease to  be obstructed by
such impediments.  It certainly is not wise to reject the aid of theory,
in perfecting a system of Philosophy, because vain and presumptuous
men have filled the world with  idle speculation, conjectures and hy-
potheses, and miscalled them theories.  There are vain men, who, re-
fusing to recognize any limitation to their own wisdom, build up sys-
tems  of philosophy to  relieve  their minds of doubts, and to gratify
their  self love, which would not be satisfied with  any  thing short of a
claim to universal knowledge.   There are presumptuous men,  who
                             "Fancy that they feel
                  Divinity within them, breeding wings
                  Wherewith to scorn the earth:"
But the wild and crude vagaries of such characters c?n constitute no
valid argument against the judicious  use of theory,  to the dominion
of which, indeed, all discoveries of facts  and principles must be sub-
jected, before they can be made available to  the advantage of true
wisdom.  Many of these abuses of theory are so gross and palpable,
as to be entirely harmless, because they offend our common sense, by
presenting propositions which are  utterly absurd.   Others, on the con-
trary, are so plausibly and beautifully elaborated as to strike the fan-
cy with almost irresistible  fascination, and  often lead the mind into
error, by inviting it to  take  the high ground  of "a  priori" reasoning,
when, in reality, the premises upon which they rest may have no foun-
dation, save in the dreamy imagination of their authors.  Such base-
less speculation can tend to no good result—can  never, indeed, be in-
dulged in, in our profession, without  positive injury to the cause of
truth.  But speculation of this character is widely different from that
better and wiser use of theory by which we "arrange  and systematize
the deductions of experience;"  or, "facilitate the progress of knowl-
edge  by  classifying facts."   Let the f: cts which are gathered from ob-
servation, or elicited by experiment, as well as such as are obtained
from books and teachers, be subjected  to the severe  and rigid  analy-
sis which the judicious use  of theory exacts, and you cannot widely
wander from the  path  of true  philosophy.  But  if you undertake to
draw  upon your imaginations for your data, no reliance can be placed
upon  your deductions;  and you will find your fondly cherished dreams
fade away,  under the  rigorous  scrutiny  of searching analysis, "like
frost before the morning sun."  If you have  suffered preconceived
opinions, or opinion;- formed prematurely, and on inadequate data, to 
                             [18]

take root in your minds, now is the time to eradicate them.  As the
first great lesson of true wisdom, you must learn to sacrifice the cher-
ished dreams of your noviciate, as well as your pride of opinion, upon
the altar of science,  and prostrate yourselves before her shrine, even
to the earth; that,  Antaeus like, you may draw your truest  strength
only from your extremest humiliation.  With minds thus purged and
purified, and divested of the "vain wisdom" and  "false philosophy"
which are so apt to find a  congenial soil in the active and susceptible
imaginations of early life, you will be prepared to make the "slow and
toilsome ascent of  patient analysis," so imperiously demanded in the
prosecution of investigations in medical science.
  Lord Bacon says,  "If a man will begin with  certainties  he shall
end in doubts, but if  he will  be content to begin with doubts he shall
end in certainties."   It is,  hence, the part of true philosophy to be pa-
tient under the doubts and uncertainties, by which you will find your
path  beset, at the commencement of your studies.  Gradually, but
steadily, the mist will  disappear before the brightening rays of ac-
cumulating knowledge; and you will find yourselves emerging slowly,
but firmly,  from darkness into light.  What now  seems obscure and
difficult to  understand, will, in time become clear and of easy  com-
prehension; and where, at present, there is nothing but darkness and
confusion and  discord, you will discover, as you advance, light, and
order, and  harmony.   You must not, therefore,  be discouraged by
present difficulties.   You  have  engaged in a profession which opens
before you  a wider field of research, than  any other you could  have
selected; and if you would  cultivate it profitably, you must go to
work  in good earnest.  The labor which you  have to undergo, will
tax your zeal  and industry  to the utmost degree; but you must re-
member that you have voluntarily taken upon  yourselves to become
the guardians of the health and lives of your fellow-men, and there is
nothing left for you but to stand up, heroically, to the duties  and re-
sponsibilities thus assumed, or retreat ingloriously from the field.
There is no half way ground,  upon which you can honorably fall back.
You can offer no apology for incompetency or ignorance.  The public
has a right to expect of you  the complete mastery of your sacred art,
and nothing short of this  will enable you to satisfy the  demands of
your  own  consciences, or cancel the obligations to  society under
which you have voluntarily placed yourselves.
  It will be the business of your teachers to point out to you the re-
liable sources of information, and to indicate the ascertained and well
established facts and principles  of their respective departments of the
science.  Instead of attempting to amuse you with beautiful words 
                              [19]

and well turned sentences, or to entertain you with dashes of humor,
or effusions of poetry, or to surprise you with bursts of eloquence, or
flashes of wit, it should be their endeavor by a studious simplicity of
speech to compress into  as limited compass as possible the positive
knowledge, wdiich may be made available in the practice of your pro-
fession.   It would be worse than useless for them to bring before you
the dusty tomes which are the repositories of the antiquated lore of our
forefathers, and force you to burthen your memories with their fanci-
ful superstitions, and luxuriant  formulae, which are no longer inter-
esting save as curious reliques of a barbarous age.   It would be most
unprofitable, if, indeed, it would  not be mischievous, for them to en-
gage your attention with  all the vague and baseless theories and the
plausible conceits  with which modern speculators have confounded
themselves and disgusted philosophy.   Such a course would only in-
volve your minds in greater doubt and uncertainty than properly be-
long  to your profession, and would leave you in the  condition of the
proud but  fallen spirits,  who, though they could still reason high of
providence and fate, yet
                   " Found no end in wondering mazes lost."
   It  is justly remarked by a celebrated teacher of medicine, that "the
object of lectures is to convey to the student in a condensed manner,
that  knowledge in  abstract which will  enable him to understand what
he sees at the bed-side."   In accordance with this view, it should be
the aim of every teacher  to present what he has to impart in the most
concise  and preceptive form.  Unnecessary  amplification  on topics
which are the subjects  of conjecture or groundless speculation should
be avoided, as  calculated to create too great  a love  for novel and
startling theories.   Irreparable mischief  may be done by such  a
course, since the youthful  mind is always  too prone to be  fascinated
with beautiful  speculation, and too apt to become  confirmed in the
evil  habit of cruising in  the regions  of the ideal.  The ascertained
facts, established  principles, and generally recognised truths of the
profession, then, should be the objects  of especial attention; and when
these have been mastered, you will be in no danger of being led off
from the path of  true philosophy  by the captivating, but  visionary
fancies, by which the science of medicine is so much encumbered.
   In conclusion, I  trust you will hold me  excused, for  taking advan-
tage of the present opportunity, to express my thanks  to the trustees
of the University,  as well as to the faculty of this, its medical depart-
 ment, for the honor which  has  been  conferred  upon me, by the ap-
 pointment to the post in assuming the duties of which I now address
you.  Several years since, I received from the trustees of the medical 
                              [20]

 department of the St. Louis University, a similar  honor; and for two
 years occupied the chair of physiology and pathology in that institu-
 tion; with what success it is not for me to say.   Notwithstanding the
 strong inducements to remain in St. Louis afforded by the  rapid and
 almost unprecedented growth of the city; the bright prospects of the
 school—the class of which was nearly as large again the second win-
 ter of my connection with it as it was the first; and the agreeable and
 entirely  satisfactory character  of my relations with my colleagues,
 all of whom were accomplished and popular teachers; notwithstanding,
 I say, all of these inducements to remain, such was my unwillingness
 to abandon  my native state, and  rend  asunder the various ties of
 early association and kindred, which bound me to her, that I deter-
 mined to give up  my position and  return to Kentucky;  and without
 the remotest expectation of being called upon to teach in any existing
 institution  within her borders, I quietly resumed the practice of my
 profession.   But just one year had  passed away when I received an
 intimation  from a member of this faculty that, with my permission, I
 would be nominated by the faculty, as a candidate for the  professor-
 ship which I  now hold.  I here  frankly admit, that there were consid-
 erations which forced me to hesitate about the  advantages of such a
 connection.  Foremost amongst these considerations  was the  fact,
 that, for  several years past, the classes of Transylvania have been
 declining in  numbers, whilst several of  her sister and neighboring
 institutions were  rapidly  advancing.  But when I came to analyse
 this  difficulty, I found that it was  of a  purely selfish  character—a
 mere question of dollars and cents; and that I had,  on the other hand,
 inducements  more  than  sufficient  to silence every such  objection.
 When I  reflected, that I was  called upon to become a teacher in the
 oldest medical school in the valley of  the Mississippi; a school which,
 whatever may be the size of her classes, enjoys  a reputation through-
 out the length and breadth of the Union, equal, to say the least, to
 that of any other  west of the  mountains, and that this reputation
 was  identified with the fame of the illustrious  surgeon, her honored
 founder, whose name and achievements were known and admired co-
 extensively with the enlightened exercise of the healing art;  I could no
 longer doubt  that it would give me a degree of consequence, amongst
 the medical teachers of the country, far above  my deserts, to be an-
 nounced as one of her professors.   But independently of this consid-
 eration, which addressed itself chiefly to my vanity, I could not escape
 the conviction  that her reputation  rested upon  a  solid  and enduring
basis.  I knew that the superior claims of her  instruction  in the im-
portant department of practical surgery, were so firmly and immova- 
                             [21]

bly established, as to contribute much  more than the proportional
share of that department to the  maintenance of her renown; and  I
knew, too, that her reputation in this respect, was of no bubble charac-
ter, inflated  into  unworthy  dimensions by the fulsome puffings of
newspaper scribblers; but  that it rested securely on the gratitude of
the multitudes of men and women, dispersed throughout the Union,
who have either experienced in their own persons, or witnessed in the
case of friends or relatives, the  inestimable benefits  of the matur-
ed judgment and  superior skill of her  distinguished surgeon; that it
reposed proudly upon the impregnable  basis of deeds, which, like the
achievements of the  military chieftain, were fast anchored in the
memories of men, by ligaments  of strength sufficient to defy all the
disparagements of rivals  and the calumnies of the envious.  And I
knew full well that the duties of all the other departments  were dis-
charged with a degree of ability  and efficiency  not surpassed in any
other school  of which I had any knowledge.   I knew too that she
had, scattered broadcast over the the south and west, a larger number
of alumni than any other western school, all, more or less, interested
in her success, inasmuch as all who practice under the  sanction of her
diploma must desire  to see  her prosper and grow in  renown; or, at
least, maintain her hitherto proud position amongst her sister institu-
tions.   And knowing these things, I could  not well avoid the conclu-
sion, that the decline of her classes was but temporary, and that by a
little exertion on the part of her friends, she could readily recover her
former patronage.  It cannot be doubted, that  by a suitable appeal,
she can bring to her aid the larger portion of her numerous graduates;
who, by virtue of their position as successful practioners and popular
preceptors, have it in their power to render the most  substantial as-
sistance.   And if she can once succeed in awakening into activity the
latent affection of her accomplished alumni, and enlisting them in her
interest, she may not only regain her former classes, but even realize
a degree  of prosperity which she has  never yet enjoyed.   She can
never call upon her sons for any other aid than  such as is entirely
compatible with full justice to her cotemporaries.  She would not, if
she could, build herself up, by pulling down others.   She is utterly
incapable of disturbing, by any act of hers, the  laurels which encircle
the brow of a neighbor.   She asks nothing but  fair  and  honorable
competition—competition prompted and sustained by the principle of
emulation; not that which is animated and kept alive by the ignoble
spirit of rivalry.  Indeed, if I understand  her  aright, she desires and
invites the emulation which may stimulate her cotemporaries to over-
take or surpass her in the  race of improvement, or to exceed her in 
                             [22]

 the more thorough and complete education of their pupils; or even to
 excel her in the interest and attractiveness of their style of teaching.
 These are all legitimate ends of honorable competition, and if we are
 excelled in these respects, I am confident no member of this faculty
 would feel otherwise than satisfied, if indeed he wrould not be pleased
 to know that the schools which surpassed us in merit also exceeded
 us in  patronage.  We  are entirely  willing to  see other institutions
 elevate themselves by honorable exertion, to a degree  of excellence
 far above our own standard; or rather we would not cherish, for such
 institutions, any other than feelings of  admiration; however much we
 might be stimulated by their example.  But  when we have to contend
 with the envy, jealousy and hatred, engendered by the spirit of rival-
 ry, which seeks to divert the natural  affection even of our own alumni
 from  its appropriate  channel, by means  of  malicious disparagement
 and detraction, or positive misrepresentation of our condition and ad-
 vantages, the case is widely different.  Instead  of regarding with
 interest, or  complacency,  the growth  of institutions which  seek to
 build themselves up by such  unworthy  means, it becomes  us to be
 vigilant of their  movements,  and to counteract the effect  of their
 calumnies, by exposing their motives and designs to  the public  gaze,
 that they  may be visited by the just measure of  scorn and contempt
 with which all honorable men  must regard  them.  Such competition
 is every where to be condemned; but it is especially  reprehensible in
 the case of medical schools, since its tendency is to hinder rather than
 assist  the progress of improvement.  No medical school should be
 sustained, in this enlightened age, which is not struggling to contribute
 something to the general  advancement of medical science.   Schools
 which have been established as schemes of speculation, and which are
 carried on and sustained as mere business or money making concerns,
 will generally prove the least worthy of  support.  But  by reason of
 their  unworthiness, of which there will be a lively consciousness in
 the bosoms of their presiding  genii, they will be found, in season and
 out of season, disparaging all established competitors,  and depreciating
 the creation of others which  might be at all likely to  interfere with
their mercenary plans.
   Such is not the character of the school which rests  its claims to
 patronage upon the intrinsic excellency  of its instruction.   Desiring
 nothing so ardently as the  promotion of the true  interests of science,
 it will be found pursuing the even tenor of its way, rejoicing as much
 in all the  honorable achievements of her cotemporaries, which tend
 to advance the  cause of truth, as if they were the  work of her own
 hands.  And this is as it should be.  The unseemly spirit of rivalry 
                            [23]
should be suppressed and the laudable spirit of emulation encouraged.
Envy and jealousy and hostile antagonism should  be everywhere
frowned down, whilst honorable competition should be invited and
extended. 
 
1