THE GOOD PHYSICIAN; BEING AN INTRODUCTORY TO THE COURSE OF LECTURES MATERIA MEDICA AND THERAPEUTICS, MEDICAL DEPARTMENT OF TRANSYLVANIA UNIVERSITY, FOR THE SESSION OF 1842-3, V BY THOS. D. MITCHELL, M. D., PROFESSOR, &c. &c, PUBLISHED BY .THE MEDICAL CLASS. * LEXINGTON, KY., rRINIED AT THE OBSEBVER AND REPORTER OFFICE. 1842. CORRESPONDENCE. Medical Hall of Transylvania University,) Lexington, November 19th, 1842. ) Dear Sir: The undersigned Committee, in behalf of the Medical Class, have been instructed to wait upon and tender you, in their name, an expres- sion of the gratification they derived from your very able and interest- ing Introductory Address. What it is that constitutes the "thorough bred physician," is not only a subject of exceeding interest to the com- munity at large, but of vital importance to the members of that profes- sion, whose respectability and honor are entirely dependent upon the individual possession of those qualities and acquirements which alone can elevate the physician above the character of the empiric. For this reason, it is the desire of the Class to have your address preserved in a more tangible formr that it may stimulate them at least, in the pur- suit of such desirable attainments, when the sentiments it contains might otherwise be forgotten. We therefore request it for publication, if compatible with you* feelings to furnish us a copy. With sentiments of the most profound esteem, We are, respectfully, Your pupils, Win. B. Lenoir, Mo. F. Crumbaugh, Ind; Dan'l Ryan Sartor, S. C. E. T. Jones, Ala. James Boykin, Geo. F. B. Spragins, Va. C. N. Lyman, Ohio. E. H. Jones, N. C. G. Trotter Evans, Ky. Thos. T. Meade, Miss. J. II. Franklin, Tenn. Chas. G. Mitchell, La. T. D. Mitchell, Prof, of Materia Medica and Therapeutics, in Transylvania University. Medical Hall, Lexington, Nov. 24th, 1842. Gentlemen: In reply to your very polite letter of the 19th instant* I have only to say, after returning my unfeigned thanks for the sentiments therein expressed, that a copy of my introductory lecture, given on the llth instant, is at your disposal. Be pleased to accept for yourselves, and: for the class of which you are the representatives, the sincere regard with which I subscribe myself, Very respectfully, Your friend, THOS. D. MITCHELL, Prof Mat. Med. and Therap's. To Messrs. Lenoir, Sartor, &c, Committee. ADDRESS. "Who can be eloquent on Calomel and Jalap?" exclaimed a dry and tedious lecturer on Materia Medica, as an offset to the narcotic dullness of his daily lucubrations. And it must be conceded that the mere study of remedial agents, as objects of natural history, and apart from their therapeutic value, is little more endurable than a winter spell of teazing gout, in the remotest point of the inferior extremities. And if the therapeutic inspiration of the theme be really so indeterminate in its relative power, as some have supposed it to be, of all subjects at- tempted to be taught in the shape of prelections, none can be less ac- ceptable to men of sane minds, than Materia Medica and Therapeutics. Yet, gentlemen, we do verily and most conscientiously believe, that a medical class can be kept wide awake and respectfully attentive, while a teacher is descanting on calomel, or jalap, or aloes, or even assafoetN da. We speak from the assurances of past experience, and cherish no apprehensions for the future. But as there is, notwithstanding, something like dryness and lack of interest, here and there, in the department assigned us, it is gratifying to have this opportunity of pausing on the threshold, for the purpose of presenting to your consideration a theme of more general interest, the investigation of which calls for neither rhetorical effort nor showy parade of learning, while its close association with the affairs of hu- man life, makes it the common property, in a certain sense, of all class- es of community. And, while it may be taken for granted that the speaker intends his remarks, with a peculiar emphasis, for the profes- sion of which he is a member, and for those who are preparing to enter its ranks, he is gratified to have an opportunity of addressing some who do not appertain to the craft, and most of all is he rejoiced that the truths he is about to utter will fall on the ears of so many of that in- teresting class, who, though not technically law makers, often mould the character of society, and exert an influence, almost omnipotent, on the success of the adventurer in the world of physic. However far below the anticipations of his audience the speaker may fall, he ventures to give a pledge, and to redeem it too, that though strictly related, in every aspect, to the profession of medicine, his re- marks will be fully comprehended by all classes and grades of society, within the compass of his voice. The question about to be canvassed in your hearing is, "what consti- tutes a good Physician?" a topic oft discussed, and as frequently mis- understood, because scanned in its outworks, in the drapery and tinsel decorations that an exuberant fancy gives it, rather than in the details of practical life. I do not say that X will, or that 1 can perfectly ana- G lyse the interesting character, for I feel unequal to the task. But, at a venture, I will try to decompose it, to determine its elementary princi- ples, and so array them, under the animating inspiration of truth, as to impress every mind with the inherent excellence of the genuine compound. And in the very probable event of failure to do justice to a theme so important, so fertile in weal or woe, on me let the censure rest, and not on the topic which my feeble powers are inadequate to pourtray. On whatever theme in morals, science, politics or religion, the popu- lar sentiment may have truth for its basis, it is almost sure to err in its estimate of the real value and intrinsic nature of the medical character. This mistake has its origin in the almost universal custom of judging persons and things, not according to their intrinsic worth, but in the ratio of apparent or superficial excellence. There is not an individual before me, who has not witnessed instances, without number, of this kind of ex-parte verdict. Have you not seen the man, whose tongue, the nearest approximation possible to perpetual motion, is never still, acquire a character of consequence for no other consideration on earth, than his redundant, down-hill volubility'? And who has not looked with regret on the man of sterling sense, who seldom speaks but as oc- casion demands, whose words are often like apples of gold in pictures of silver, but whose morbid modesty cramps him within the reputation of mediocrity, excepting in the judgment of a few who have learned somewhat of his real character? Thus it is, that the popular regard of the medical character is based, alas how often, on some contingent and not always laudable quality, rather than on the diamond intellect and gelden attainments of the individual. It is scarcely needful to tell this audience, that the evil just adver- ted to, like the rampant polypus, is shooting its roots broader and stri king them deeper, every hour; not only to the vexation and loss of the community in general, but to the sore detriment of young physicians of undoubted worth. Have you never sighed at the wounding of their generous sensibilities, on beholding the most undisciplined ignorance rise to an elevation far more lofty than the castle of its happiest dreams, simply because some superficial gloss that mantled the deformity and destitution within, was mistaken for the precious metal of which it was, at best, an unworthy counterfeit? But this moral malady has a still deeper and broader foundation. The corner stone of the incongruous edifice, is the ignorant and yet self-complacent judgment of parents and guardians, in the disposal of youth entrusted to their care. Survey the face of society, the whole land over, and tell me if I mistake. Has the man of affluence, or even comfortable circumstances, three sons, whose future condition in socie- ty may lawfully claim his deep attention and unceasing solicitude? Does he consult the wisest men in his own circle, to gain their counsel in so important a concern; or is he not, too often, though perhaps un- blest with even a modicum of educational advantages, willing to be the sole arbiter, in a case the most weighty that can fall in bis path? 7 Mark the result, and you will in all probability discern that without any wise reference to mental capacity, or native fitness, one of the trio is doomed to the bar; another finds his way, tortuous though it be, to the pulpit; and the third (for they must all be professional men) is to be inflicted on the public as a doctor. Thus it happens, in instances almost innumerable, that professional disgrace is (he unavoidable consequence of ill-directed parental authority. I will not affirm that in every lottery thus evolved, there is not a single prize; but I appeal to facts, as they are spread out over our country, in attestation of the ground here as- sumed. The well-known practice of the ancient Mexicans, to ascertain the peculiar mechanical fitness of their children, was little less judicious than that to which 1 have referred, as common with those who lay higher claims to civilization and refinement. The sons of these semi-bar- barians, previously intoxicated by ardent spirit, were surrounded by the various tools and utensils of the mechanic arts; and the apparent fond- ness for this or that tool, fixed the destiny of the individual for life. I am free to confess, that in view of the results merely, and aside from the immorality of intoxication, I cannot perceive wherein our more modern and civilized plan has any sort of advantage over the inebria- ting tactics of the Mexican. The character of the man in sealed, in both cases, by the verdict of unmeaning chance, passed in his boyhood, and alike irreversible. Can it excite ssrprise, that false principles, thus applied, or the act- ings out of mere whim without principle, should be so prolific of disas- trous results to the profession and to society? Cause and effect must forever be dissevered, as bearing no relation to each other, if you can account for a very large swarm of the tremendous hive of purely nom- inal physicians that prey upon the vitals of society, every where, on any other principle. It would be the most astounding phenomenon that ever occurred, if the actual results were different. And do any inquire how medical men, grafted on principles so false and pernicious, occa- sionally rise in popular estimation, above some who possess all the elements of professional excellence? Alas! gentlemen, the solution of the problem is by no means difficult. The most palpable destitutions are often compensated by a fascinating exterior, and the social qualities are taxed most heavily, to present a substitute for professional learning and skill. And here, let it not be supposed that I depreciate the value of an affable deportment, of gentleness, suavity and modest carriage— in short, of any quality that should endear a physician to his patients. All these are good in themselves; and without them in smaller or lar- ger measure, few men ever rise to true eminence and lasting respecta- bility. But the error lies in mistaking these for the medical character itself, instead of recognizing them as mere appendages to it. We cite, as another reason for the frequent success of ignorant prac- titioners, the prevalent mistake of regarding the science of medicine as, of all kinds of knowledge, the most easy of attainment. Hence doubtless, it happens that so many persons enjoy extensive patronage, 8 who know very little of the profession. Indeed, so thoughtless are the people, generally, as to be quite indifferent to the inquiry whether a man who calls himself Doctor has ever received any sort of medical education. Nay, further: there are not a few, even in the higher walks of society, so strangely deluded as to countenance and patronise the boldest empiricism, with the most palpable evidence of defection staring them in the face. They hesitate not to put their health and lives at the disposal of a man, for whose judgment, on almost any other matter, they publicly avow the most unqualified contempt. His opin- ions on the general interests of society have less weight than the down of the smallest feather; and yet he is held to be the man on whom, above all others, dead, living or to live, the joint mantles of Hippocrates and Esculapius exclusively fell. Talk of delusions as you please, but if you desire the climax, it is here. The ravings of Mormonism and Mesmerism fall infinitely in the shade, when put in contrast with such fanaticism. Do we then affirm too much, in pronouncing the evil be- fore us to be of alarming magnitude; one that despoils the man of worth, and heaps favors and honors upon those who should be spurned from the society of the intelligent and virtuous; an evil that lays the axe at the root of good order and the happiness of mankind? We think not, and our confidence is firm, that the sequel will thoroughly satisfy any who are inclined to be sceptical, that our estimate is neither high-wrought, nor, in any important sense, at variance with truth and equity. The establishment of an acknowledged standard, by which to judge of the medical character, is a desideratum, the attainment of which would go far to remedy existing eviltf. But how can this point be reached, and where may we look for the proper materials, out of which to educe such a standard? In short, is the thing practicable, is it pos- sible? I reply, that the nearest approximation of which it is easy to form a conception, may be gained by faithfully delineating the quali- ties of a well-furnished, well-balanced physician; and by fairly exhib- iting the importance of the profession to the community at large. Allow me therefore to state, with suitable conciseness, what we are to understand by a good physician; to show the value of medical men in some of the most momentous affairs of life, and in this way to depict the folly of those who patronise empiricism, and so bring disgrace and loss to an honorable profession. If any motive, other than the love of truth, has prompted me to this effort, I know not what it is. To dif- fuse correct opinions on this deeply interesting topic, is my chief de- sign; and to the end that truth may triumph over error, and that the profession of medicine may rise higher and still higher in all that is dignifying and great in human science, I venture to plead its cause, to assert its honors and its rights. What then are we to understand, by a well furnished, a properly bal- anced physician? To this query, 1 reply, in the first place, that tho terms now before us, presuppose the possession of suitable natural en- dowments. The man must have a clear head, a discriminating jud^. 9 ment, an aptness to compare, and a promptness to infer correctly. Nor will these qualities suffice, however strongly developed, unless modified and invigorated by the kind care of well directed education. 1 am a- ware that the mere mention of education, in this connexion, may ex- cite in some, a train of reflections by no means pleasurable in their nature. And, perchance, I may be referred to the cases of not a few who have made a notable figure in the profession, and whose fame may be heralded as ample testimony in favor of mere native talent, to hush the claims of education, or at least, to abate their pretensions. But I dare stand on high ground to day, and from the loftiest pinnacle of truth itself, to declare, that no amount of education can be too great for him to possess, who would perfectly understand the mechanism of that noble structure, which the voice of inspiration proclaims to have been "fearfully and wonderfully made". For the full comprehension of all the functions of the human economy, the most erudite physiolo- gist that has ever lived, had not learning enough. This delicate harp of ten thousand strings, whose exquisite adjustments forbid a single touch of rudeness, under the penalty of discord or total demolition, has never to this hour been fully analyzed in the vast profundity ©f its a- rhazing constitution. And yet, there are many in the profession, and more who are preparing to enter its ranks, who dream of ultimate suc- cess, in this momentous enterprise, who have never enjoyed the advan- tages of a collegiate, academical or common school education. And here, permit me to express my gratification at the stand which some of our District societies have taken on this interesting subject. They have made it a condition for the reception of a young man, as a medi- cal pupil, that he give good evidence of possessing, at least, a due ac- quaintance with the English language, the plainer mathematics and the elements of natural history. Yet is this standard too low, in ref- erence to the great objects of medical studies. And while I am pleas- ed to behold an honest desire to elevate the profession in regard to the preliminary studies of its pupils, I am compelled to declare, that we cannot compete with our brethren of the East, in all that is great and ennobling in medical science, until we rise to a level with the ablest of their gifted sons, in all the preparatives that make up a solid founda- tion for the permanent superstructure of professional greatness. But can he be a well furnished and a well balanced physician, who starts in his career, with a destitution, almost total, of the force and import of the English language, and alike ignorant of the elements of academi- cal studies? Never, never. Some there are, and I most heartily applaud their motives, who would exclude from the study of medicine, all who are not good schol- lars in the amplest sense. It cannot be denied, that for the right un- derstanding of many of our technicalities, a knowledge of the Latin and Greek languages is essential. Yet 1 am unwilling to urge an ac- quaintance with these as indispensable to the student of medicine, until wc have gained the vantage ground of a thorough conviction on the part of medical preceptors, that an English education should invariably 10 be the initiatory step to the regular study of our science. Let tis make sure of the lesser blessing, before we venture to grasp the great- er and more valuable boon. No man will more heartily rejoice to be- hold the happy day, when it may be justly affirmed that all medical pupils are good scholars in the broadest sense, than he who now ad- dresses you. But in the mean time, be it our purpose, to imbue the entire population of the West, with the absolute necessity of making English scholars of all the youth who are destined to swell the Escu- 1 apian roll. However reluctant some of us may be, to dispense for the present with an acquaintance with classic lore, as a preliminary to medical studies, there are few, perhaps none, within the sound of my voice, who will not concede the necessity of a good English education. That every pupil should be able to write bis native tongue correctly, and to comprehend the import of all the words employed in medical litera- ture, is a proposition so obviously true, that none will venture to make it a point of debate. Yet it must be confessed, that not a few who are now in course of preparation for the honors of the profession, fall very far below this meagre standard. May we not indulge the hope, that the recent formation of district medical Societies, will powerful- ly impress the public mind, with the imperious necessity of a thorough reform, in this important department of the profession? If this end be accomplished, the skill and labor of those who have been most efficient in making these organisations, will have been abundantly rewarded.— If it fail, through the apathy or neglect of those who profess to regard it as a desideratum of the highest importance, all our resolutions, and plans, our discussions and efforts of every name, will be worse than in vain. Superadded to natural qualifications and the advantages of a sound English education, it is essential to the formation of a well balanced •and amply furnished physician, that the period of medical pupilage be devoted to the investigation of the entire range of topics that appertain legitimately to the science. It will not suffice, to acquire a tolerably full acquaintance with the elements of the several departments. This kind of knowledge is indispensable; but it must be followed by a care- ful study of standard authorities, a vigilant supervision of every varie- ty of the periodical literature of the profession, that may be accessible. I know that the curriculum of studies now suggested, will at once ex- cite an inquiry, as to the length of time that ought to be devoted to ,pupilage. And while I am compelled to regret the change that has passed over the profession throughout our whole country, in this import- ant particular, I hesitate not to stand forth as the fearless advocate of the good old way. Even in the short period of my own history, the time has been, when the majority of the pupils in attendance on medi- cal lectures, had more than completed three years of regular study, be- fore they ventured to offer as candidates for the honors of the school.— And is the field of investigation more circumscribed now, than it was thirty years ago? Where is the man, versed as he should be, in the 11 outline, at least, in the varied improvements of every department of science who does not know, that more is to be learned by the medical pu- pil, as well as by the practising physician, now, than the most untiring industry could have accumulated, a quarter of a century ago! It would seem as though we had but just passed the threshold of a mine whose treasures are absolutely inexhaustible. In the dim twilight of our im- perfect researches, the brilliancy of a dimond here and there, and the lustre of the precious metals, in quantity almost too minute to be ap- preciated,have suddenly burst upon our vision, and their overpowering charms have struck us mute in astonishment, and perchance we have fancied, that our survey of the rich treasure was complete. Escorted only by the dim rush-light of our own fancy, or by the glimmering ta- per of some splendid theory, baseless as the fabric of a vision, we have not seen the thousandth part of the rich treasure, that lay almost with- in our grasp. Who would thus preposterously essay to explore even the Mammoth cave of Kentucky? With blazing torches shedding lustre on all the glittering grandeur of its dark labryinths, the intrepid lover of nature's gorgeous drapery moves on with cautious step, measuring intuitively as he passes, the inimitable crystal drops, the beauteous massy gems, that arch the rude vault, and speak out in tones that none can fail to comprehend, "the hand that made us is divine". But what is even that wonder-speaking cave, compared with tbe deep, the broad, the almost fathomless mine of medical science? And dare we venture within its vast dominions, guided only by the dim light of theory, of vain speculation, of false or bewildering systems? Toexplore it is our duty; but at our peril, we enter its enclosure, unless conducted by the torch of truth, resolved that the world shall be the better for our labors, and not the worse. The foregoing remarks may suffice to give an idea of the value pla- ced by the speaker, on a thorough course of medical studies. Whether the attainment of this end be realised from laborious research and pro- found thinking in the private study, or from the patient and persistent attendance on medical lectures, daily, for many months in close succes- sion, is not at this moment, a question for debate. We are contemplating the character of the well balanced, and thoroughly furnished physician, and in forming our estimate of the component parts of such a charac- ter, we are compelled to give a prominent place, to the necessity of lay- ing broad and deep, at an early period, the foundation of true medical science; and this can be done only by combining with observation and experience, the perusal and attentive study of the best writers in all the departments of medicine. No where in all the broad range of literary, philosphic or profession- al enterprise, is the well known language of poetry more emphatically true, than in the profession of medicine. "A little learning is a dangerous thing, Drink deep, or taste not the Pierian spring." Under the inspiration of this vital doctrine, we affirm, that the man who ventures to the study of medicine, without a determination to 12 know every thing that ought to be known, and that can be acquired-, mistakes his calling, wrongs himself, and cannot rise to permanent re- spectability. Such a man, though his years be extended to three score and ten, will never be a well furnished physician; and as a necessary consequence, he cannot be a well balanced physician. The practition- er, whose views in medicine are ever vacillating, and like the point of the weathercock, here and there and every where, between the rising and setting of the sun, is almost invariably half educated or even less, in the mysteries of the healing art. Nor is it surprising that such is the fact. His foundation is at best, part rock, part sand, and part noth- ing; and no wonder, if the crazy edifice totter and shake, like a drun- ken man, when the storm plays upon it with all its fierceness. He is as a ship at sea, driven and tossed, because it has no anchor, or one too feeble to resist the peltings of the pitiless hurricane. Do you not, once in a while, meet such men in consultations, in difficult and obscure ca- ses? Where are their moorings in these critical junctures? The best that can be affirmed of them is, that they have no opinion at all, in ref- erence to the case, because they have no basis for one; or if they ven- ture, presumptuously to break silence, it is only to awaken pity or con- tempt for an amount of ignorance, that seems to be almost without the pale of forgiveness. To call such an one, a well-balanced physician, would be a palpable violation of truth. There can be balance, when the weight is all at one end, or on one side. He who is but half read on any question, is absolutely imbecile in respect of a decision on the merits of the case. JVbra compos mentis, is for the time being, and for the special matter, graven on his forehead, and a true verdict is palpa- bly impossible. Making all due allowance, for cases of great eccentricity, that may properly have place among the lutus naturae, we state our firm convic- tion, that he will prove the best balanced physician, and most likely to attain to high distinction in the profession, who, to a good share of na- tive endowment, has superadded the crowning advantages of moral, lite- rary, intellectual and professional furniture; and whose solemn vow re- corded on high, prompts him to be a student to his dying day. These are some of the items in the inventory of that significant, though oft misconstrued phrase, a good physician. He has aimed through past life, to be master of every difficult problem in physic, to understand all that human intelligence could comprehend; and for the time to come, ho pledges the powers of his mind for the elevation and advancement of his profession. He scorns the mercenary trader in medicine whose ambition, not more ennobling than that of the humblest artisan in society, measures his attainment and his fame, only by the num- ber of bank notes or dollars, in his possession. His is a loftier aspiration. He aims at the good of society, and identifies his in- terests, his toils, his joys with the beings that surround him. He lives for his country, for the world. You find him in the darkest hours of his country's peril, when a foreign foe threatens to annihilate her, a patriot of the highest order, ready if need be, to give his life a sacri- 13 fice on the altar of liberty and independence. Does pestilence, like a sweeping flood, desolate the city, and hurry thousands into the dark con- fines of the narrow house? Lo! foremost in the front and fury of the etorm, periling his life to save his friends, stands the good physician. the thoroughly furnished, the well balanced physician. The immortal Warren, on Bunker hill, and the immortal Rush on the plains of Phil- adelphia, in the pestilence of 1793, will live in the story of America, as well as in the history of American medicine, while a remnant of civil liberty shall remain in this goodly land, to claim for its defenders, the generous sons of the noblest sires, of any country or of any age. It may have occurred to some of my audience, that the moral quali- ties have been too much overlooked in our estimate of a well balanced and thoroughly furnished physician. But I am happy to be one of the number who have long entertained the deep and abiding convic- tion, that a true mental equipoise cannot exist where the party indul- ges, habitually, any sort or grade of dereliction from the straight line of moral rectitude. That a man may possess a giant intellect, and yet debase his moral, mental & physical nature by the worse than brutaliz- ing witchery of the bowl, will not be doubted; and it is equally true, that the common sense of the world has placed its veto on the strange perversion of right reason, that in other years, was wont to invest the drunken or the infidel Doctor, with more than ordinary inspiration.— Intemperance, profanity, licentiousness and all the forms of settled or vacillating opposition to the pure principles of religion and virtue ever have been, and will never cease to be, so many blemishes in the Hercu- lean powers of him who tolerates them. The mental sensitive plant shrinks, though unconscious, from the polluting touch, till the last ves- tige of sensibility is extinguished forever. Truth and error, right and wrong, good and evil are eternal antipodes. As God never joined them, be it our glorv to aim at their perpetual separation. But a very important part of my task on this occasion, is yet to be performed. I am to adduce evidence to show the value of a good phy- sician, in the most momentous affairs of life—not in the ordinary course of medical practice, but in scenes that bring to light, clear as the bla- zing sun of mid-day, his vast superiority over all the lesser lights of the profession, whose occasional but ephemeral phosphorescence may have, for a moment, and in the estimation of the ignorant, eclipsed his splendor, and be-dimmed his well-earned fame. In the seclusion of the family circle, the real merit of the truly ex- cellent physician is often overlooked; while the arts and tricks of the professional demagogue, his impudent officiousness, and ostentatious parade of effort, win for him the confidence and patronage which are the legitimate property of modest worth. But it is not so on the grand arena of more public life. There are spots too sacred for the half edu- cated and unfurnished mind, to make even an effort. And if you would behold, in striking contrast, the physician of high order, and ths prac- titioner of meaner grade, enter the court of justice, where the tenure of this mortal life, in respect of the prisoner at the bar, hangs on the 14 breath of medical testimony. Let the advocates of the all-suffiiciency of nature's teachings enter the consecrated enclosure and hear the whole story. Let the pleaders for a partial education to qualify men for the tremendous responsibilities that appertain to the medical charac- ter, constitute part of the interested auditory. And above all, let the prisoner at the bar, charged with the black crime of murder, by the administration of a deadly poison, be the only son of the loudest and most influential declaimer against the regularly and fully educated prac- titioners of the healing art; and let this father, incased with all his pre- judices, take his seat in the solemn assembly. Now for the issue. Life or death must be the verdict. These are solemn scenes, in which truth and honesty will be heard, if any where on this side yon judg- ment bar, that is to fix the destiny of men forever. Look at the prom- inent parties in the case. Who are they? The sovereign people, on the one hand, crying for vengeance because one of their number has fallen suddenly, by the hands of violence and blood; and, on the other, the youthful prisoner, with his aged father at his side, well-nigh press- ed to earth with the weight of infamy that even in advance seems to rest upon the head of the accused, yet sternly denying the charge, and resolved on exculpation. Examine the whole case, and notice its deep- ly interesting details. A man, apparently in good health before, haa been seized with symptoms of great violence, and in a few hours the tragedy is over. Was he killed by the prisoner at the bar, or did he fall a victim to some severe and quickly fatal malady? And here, the points of resemblance between certain forms of disease, and the effects of poison, are subjects of close and vital investigation. No one saw the prisoner in the act of administering any thing to the deceased, and no kind of poisonous substance is found in his possession. Yet are the circumstances of the case so strong as to fasten conviction of his guilt on many minds. Follow the case a little further, and you find what high importance is attached to the examination of the dead body. The whole course of the alimentary canal has been inspected with untiring vigilance, and all the results noted with the most perfect accuracy. Especially have the contents of that canal been scrupulously investigated; not only in respect of existing appearances, but in reference to the nice, critical and decisive operations of the practisal chemist, whose varied processes have rendered absolutely certain the fact, that a most deadly poison was present. And now it is palpable that the cloud gathering around the head of the prisoner is waxing darker and more dense. His able counsel dis- covers one prop at least, on which he hoped to rest the cause, entirely gone. If the fatal poison was really extracted from the contents of the stomach, the pretence that death resulted from a sudden and violent onset of disease, falls to the ground. What then remains, on which to concentrate his legal ingenuity, and all the powers of his eloquence to save his client? I have supposed a case, as you perceive, in which the examining 15 iphysicians, in all they attempted, in reference to the detection of the poison, as well as the post-mortem researches, were well qualified by education and study, for the arduous and responsible task entrusted to their care. But what if the facts were otherwise? The duty may have been performed with the most inflexible integrity, to the full meas- ure of the ability of the parties. And yet they may have been incompe- tent to its right discharge. The prisoner may have been guilty, but per- adventure their lack of qualification may insure his escape. Is there a doubt on this poiut of the subject, and will not the prisoner seize it with all the intensity of a death-grasp? And what think you will the ifather do, he who has, in other scenes, laughed at the pretensions of the regular and learned members of our profession? Will he call to his succour, in this dire extremity, when life hangs by the finest silken cord that insect ever spun, the illiterate or half educated practitioner? Is that his resource, think you? Oh no! The best read, the most thor- oughly practiced and intelligent physician, he who has ranged the whole field of poisons, as well as of ordinary medicine, is the man, whose clear, full, accurate testimony in reference to the symptoms in- duced by poisons, their effects on the animal economy perceptible after death, the various expedients for detecting their presence in the body, and the numerous points that may properly invalidate and nullify the experiments of those who have only a partial acquaintance with the subject—he is the man, and only he, upon whom confidence can re- pose. And as his testimony proceeds, new light breaks in upon the case. The flaws of the whole previous examination are shown to be so numerous and palpable, as to render it of no value, as evidence for a court and jury. And as a matter of necessity, the verdict is rendered in favor of the prisoner. Do not imagine that the speaker is pourtraying a mere fiction before you. In a neighboring Commonwealth, a case of poisoning was tried, not many years ago, in which an acquittal was obtained for the prisoner, although in all probability guilty of the crime, merely because the manner of conducting the chemical investigation of the facts was so defective, that no reliance could be placed upon them in an issue involv- ing life. Nor is the importance of correct medical testimony restricted to a single species of poison. There are points connected with the toxico- logical features of Arsenic, prussic acid and corrosive sublimate, so subtle and nice, that even the ablest experimentalists are sometimes exceedingly perplexed, not only in the' endeavor to satisfy their own minds, but even more so when summoned to the bar to be critically ex- amined and cross-que%tioned by an attorney who has carefully studied the best authorities on poisons. Of all places in the wide world, that would seem to be the least inviting to the half-educated physician; and did he realize his deficiencies, as he should, never would he be seen there, on such an occasion, unless coerced by the strong arm of the powers that be. Look at him, as he trembles on the stand, and watch the quivering of his lip, as the keen glance of the advocate meets his 16 eye, and the keener gripe of his scrutiny fastens on the confused re- sponses that he utters; and well may you fancy that in the overflow- ings of his perturbation, he parodies the well known lines of the mel- ancholy poet: Oh for a lodge in some vast wilderness, Sonie boundless contiguity of shade, Where noise of poisons, and of lawyers too, Might never reach me more. For the purpose of corroborating our leading position more fully, it is proper to cite a case that occurred during the administration of the great and good Washington, and which excited a deep and general in- terest throughout the entire community. Two men wore condemned to die for the crime of high treason against the laws of the United States, and soon after their confinement in the Philadelphia prison, one of them was reported to be mentally deranged. In consequence of the increasing currency of the rumor, and its influence on public opinion, the President commissioned three eminent physicians to examine the prisoner, with the view of deciding the point in question. The persons commissioned, were the late venerable Drs. Shippen, Rush and Griffitts. After some considerable investigation of the case, it was discovered that the pulsations of the radial artery were 20 above the usual stan- dard of health, and this deviation was such as is often met with in maniacal patients. One of the Commission suggested that this in- crease might be the effect of fear; and therefore it was deemed proper to examine the pulse of the other prisoner, also under sentence of death. His pulsations were 20 fewer in the minute than those of his companion. This disparity, in connection with other circumstances, confirmed the suspicion of insanity, and induced a report to that effect, which resulted in a respite to both prisoners. At the termination of the period of respite, popular clamor had so far subsided, ?hat a full pardon to both met with but little opposition. To give greater effect to the agency of this commission, it is proper to atate that an ordinary practitioner, who examined the prisoner at an earlier date, declared that no symptom was present to warrant a suspicion of mental hallu- cination. It is scarcely necessary to add, that a pardon to such a con- vict, based on the opinion of three illiterate physicians, would have given birth to a political convulsion. But aside from questions which involve life, and in the decision of which, medical testimony is mighty for weal or woe, there are points now and then agitated in society, that put in jeopardy even a more cost- ly jewel. Character, that most sacred possession-^-that peerless, price- less boon, dearer than all the treasures of earth Ijeside, and sundered from which man sinks lower than the beast—is liable to be blighted, ruined, by the evidence of a physician. Ah! in such an emergency, where is the father, where the friend, that would trust a cause dearer to him than his own life, to the illiterate, the self-taught, the undisci- plined physician? It is not without sufficient reason, that the common sense of mankind n has attached to our profession a kind and degree of responsibility, that is indefinable and immeasurable. Its ramifications find their way into the very heart of society, and its influence is unlimited. If these consid- erations will not suffice to stimulate the medical student to seek the loftiest attainments in the profession, it were vain to make,an effort to rouse within him the honorable and laudable ambition to excel. But, gentlemen, we hope better things of you; and our heart's desire is, that you may pursue the objects now before you, with all the zeal their im- portance is calculated to inspire, and that here and hereafter, you may realize that your labor has not been in vain. If the character of the good physician, has been fairly exhibited on this occasion, if the vast importance of such a character, as an in- tegral part of civilised society, has been satisfactorily made out, are we not solemnly bound, by regard for our own welfare, and the hap- piness of man, to put forth every honorable effort, to secure to posteri- ty, the services of the best instructed and most accomplished physi- cians? If this be true, let every one resolve and act in such a way, as to accelerate the result. To this end, we invoke not the penal sanc- tions that emanate from a hall of legislation. It is not by these means, that we hope to gain the long sought desideratum. Let us endeavor by example, as well as by precept, by living acts, and not by dumb resolutions, to imbue society with the true policy. Let us aim at the rectification of public sentiment, by reason, by argument drawn from the best interests of humanity; and if, after all this, our eyes shall not be permitted to greet the happy day, when fruit, even to an hundred fold shall be rewarded, we will not be denied the sweet privilege of a conscience void of offence, and our example will 1 ive, and its influence be felt in the future triumph and glory of the profession. I am addressing not a few, who hope ere long to enjoy the highest honors of this school of medicine, and on such would I urge the ap- peals of the present occasion, if possible, with the eloquence of De- mosthenes. Pitied indeed should he be, whose aspirations, pent up in the narrow limits of a bit of parchment, are not prompted, every mo- ment, by the inspiration of a well grounded consciousness of qualifica- tion. He who justly appreciates the high responsibilities of the medi- cal character, and who hopes to attain the lofty pre-eminence of the good physician, will aim to procure his diploma as a matter of right, and his bouyant energies will be marshalled with untiring zeal, to ac- complish the object. But the spirit that soars not to the proud height, attainable by merit only, and can be content with the inglorious portion of the graduated empiric, is delighted to receive a parchment on any terms. "Get rich honestly, if you can, my son, but by all means, get rich," was the advice of a father to his boy, on the eve of setting out in search of fortune. The ignoble son of Esculapius, too often adopts the same sentiment. "Make sure of a diploma honorably, if it be possible, but by any means, get a diploma." With Dean Swift, he will not scruple to aver that the Speciali gratia, endorsed on his sheepskin to denote that it came by special favor, was intended to stand out as 3 18 the sign and token of special merit. These are the men, who constitute every where the most odious excrescences that mar the symmetry of our profession, and degrade it in the estimation of the world. Mark well the young man who has graduated with honor, because amply provided with intellectual and professional furniture, and you will be a witness of frequent acknowledgments of ignorance, as he pro- gresses in further studies. He realises that his work is not yet con- summated, that he is even now at school, a patient pupil in the great University of Nature. But watch, I pray you, the motions of his rival, who, having hardly squeezed through the forms of an examina- tion, felicitates himself, that he is the man of wisdom, and that knowl- edge will die with him. His studies, if that term ever had any sort of application in his case, are terminated. He has already reached the goal, andsianding as be fancieson the hill-top of the profession, he surveys the whole field with an intuitive glance. Whoso wise, so learned as he? Avery Encyclopedia of medicine and Philosophy in general, he whiles away the bours of day with untiring efforts at the smaller pro- motions in the profession; and his sleep is disturbed by dreamy vis- ions of supplanting the grey headed and dignified Professor. A stranger to the spirit of benevolence that warms the soul of the true philosopher, his happiness has self for its centre and self for its circumferance.— Who can doubt, which of the characters here presented, will ever en- joy the enviable fame of a good physician? Has it been your lot, as it has been mine, to gaze on the living realities, whose portraits 1 have endeavored to sketch on this occasion? Survey them again, and again; scrutinize their features with carefulness; learn to imitate the one, and to abjure, now, henceforth and forever, all sympathy and fellowship -nth *he spirit of the other. TO MEDICAL STUDENTS. A Course of Lectures, for May, June, July, September and October, Will be organized forthwith, provided 25 pupils will enter into the arrangement. Three lectures will be given daily, and the cost of the whole course will be fifty dollars. The October Course of Lectures will be continued, as heretofore, without charge. The regular winter course will open on the first Monday in Novem- ber, and close on the last day of February. Cost, $105. Professor Mitchell will give private instruction to six or eight pupil", during tha recess, or for a longer period.