A DEFENCE OF AN INTRODUCTORY LECTURE ON THE " IMPROVEMENT OF MEDICAL EDUCATION IN THE UNITED STATES," AGAINST AN ATTACK BY THE ( BY MART.YN*PAINE, A.M. M.D. Professor of the Institutes of Medicine and of Materia Medica in the University of New York; Member of the Royal Verein Fur Heilkunde in Preiissen; of the Medical Society ofLeipsic; of the Montreal Natural History Society, and of other learned Associations. Republished from the Boston Medical and Surgical Journal.X'/«.. J.J.) BOSTON: D. CLAPP, JR. PRINTER.......184 WASHINGTON STREET. 184 4. DEFENCE OF AN INTRODUCTORY LECTURE. To the Editor of the Boston Medical and Surgical Journal. Sir,—I see by the April No. of the Medico-Chirurgical Review that that Journal, after being long passive under my " Examination of Re- views," has ventured upon a misrepresentation of the objects of my hum- ble Introductory Lecture "On the Improvement of Medical Edu- cation in the United States," delivered before my Medical Class at the session of 1S42-3. The Journal is pleased to complain, in the first instance, of my efforts to counteract the wretched speculations by which Liebig, and such fol- lowers of his as the Medico-Chirurgical, are attempting to overthrow the great fabric of medicine. The Journal is quite welcome to its lament over my successful efforts in that particular; and, having accomplished the task which I had prescribed for myself, I shall pass on to the Re- viewer's misrepresentation of the main object of my lecture. The Reviewer remarks that the lecturer proceeds to consider the "' Im- provement of Medical jErf/wcafion,' by which, however, we very soon found, to our utter astonishment, the learned lecturer means neither more nor less than lowering the standard of professional requirements." Whoever may have read my " Examination of Revieivs " will not be surprised to learn that the foregoing statement is utterly false, and that the objects of the lecture are exactly the reverse. The whole arti- \ cle, turning upon that misstatement, is equally a tissue of rnisrepresenta- * tions. It was, however, a fitting occasion to strike a blow at all my former efforts, by representing me in the attitude of discouraging those profound attainments in medicine for which 1 have so long and laboriously contended. And yet who, for a moment, can believe that one, like my- self, who has devoted his life to the cultivation, if not to the improvement, of medicine, should, after a life of such unintermitting toil, have become,' at last, recreant to the great cause for which he has been thus Ion* an unflinching champion ? The Reviewer is also false in attempting to convey the belief that my remarks on the " Improvement of Medical Education " were designed 3 to be of universal application; whereas they were wholly and expressly limited to the existing state of society in the United States ; nor is there a word said by the Reviewer of a main intention of the lecturer to sus- tain the medical colleges in the interior of this country. No one laments more than myself the difficulties which render imprac- ticable in this country, at the present time, the high professional require- ments which are so noble in some of the Continental schools of Europe. Nevertheless, I have no objection to a comparison between the practical habits of British and American physicians, and it may be a profitable lesson to the Reviewer if he will advert to the sentiments of his own distinguished countrymen upon that subject as set forth in my Medical and Physiological Commentaries, Vol. 2, p. 664—675. And, when I regard the satirical manner in which the Reviewer is pleased to indulge his humor towards the whole profession in the United States, I might, in a spirit of resentment, refer him to many late Nos. of the London Lan- cet for vivid descriptions of the existing state of medicine in Great Bri- tain ; but this is neither conformable to my taste, nor would it comport with my sense of justice towards a large body of British medical phi- losophers. And yet, should I not offer an example of the general bearing of this periodical towards the medical literature of a coun- try whose imperishable glory is largely connected with that literature, and which has so recently derived fresh lustre from many brilliant gems of the " sea-girt isle," it might be imagined that my reference to the London Lancet is without foundation. Let us, therefore, have an exam- ple from that far-famed periodical of its late patriotic exhibition of Brit- ish medical literature. Thus, then, the Lancet:— " First," says its veteran editor, " with respect to works on pathology and the practice of medicine. If we seek among English writings on these subjects for works like those of Andral and Louis, Chomel and Piorry, and a host of other distinguished French practitioners, we shall assuredly seek in vain, finding little that is for a moment comparable with them, either in originality of observation, or richness of materials." Again ; " look, for example, at the state of British physiology. Of what does the great majority of our books on this subject consist ? Of com- pilations ; of old views cooked up as new discoveries; of annotated translations; or, at best, of able and comprehensive digests of materials that were already before the public in other forms. Compared with the profound and original works which are continually issuing from the Ger- man press, how humiliating a contrast is formed by English medical litera- ture."—London Lancet, May 6, 1843. But my present business is with the Medico-Chirurgical Review, which, on a former occasion, I convicted of a coward's falsehood ; for, unlike its associate (the British and Foreign Medical Review) in a crusade against my literary labors, it had not the spirit even to stand by its own corrup- tion, but received, with tacit submission, the brand of infamy. Nor shall I be now restrained from a^ain indicating, by the Reviewer's own admis- sions, the spirit which has hitherto prompted his misrepresentations of the labors of American physicians, and his vituperation of the American 4 medical profession. In the article with which my unpretending lecture has been honored is a reference to a criticism on Liebig's Animal Che- mistry in the North American Review, which has been so perverted by the imagination of the foreign Reviewer, that he is thrown into a parox- ysm of indignation which demanded a nation's atonement. We read, for example, that,— " With respect to Dr. Paine's learned coadjutor in the Quixotic at- tempt to demolish Liebig's theories, whose tirade appeared, if we mistake not, in the North American Review for October, 1842, we shall only say, that its vulgar verbosity, unbecoming personalities, and rancorous hatred of everything British, render it perfectly safe from our notice ; non tali auxilio, nee defensoribus istis tempus eget."—Medico-Chirurgical Review. Although there is nothing of the foregoing nature in the Review which has thus excited the displeasure of our critic, it nevertheless suited his purpose to have it so. And, if the reader will now carry his eye two pages farther on, in the Medico-Chirurgical, he may possibly learn that the Reviewer considered some pretext important to a justification of his own malevolence towards a land from which he has long derived a libe- ral, a generous patronage. We there find, for example, That,— " We cannot but remark with satisfaction the fortunate condition of the University of Pennsylvania. The ' drab-colored men ' may well make doctors of their sons, seeing that they can pay the matriculation fee with other people's money. We only trust that that very fee is not repudiated, and that m that very respectable State there is in their dealings with each other honor among thieves." Perhaps I may now respectfully ask the Reviewer what is his opinion. between a fabrication which imputes to the North American Review "vulgar verbosity, unbecoming personalities, and rancorous hatred of everything British," and the actual vituperation which is perpetrated by the same false accuser towards an honorable profession in the United States ? Here I stop; not doubting that the impartial reader will trust my affir- mation that I remain, as ever, a devoted advocate of the highest culture of medical science ; that my humble lecture has exclusively and ardently for its objects the interests and dissemination of that science ; and, finally may I not express the hope that I may be permitted to go on hereafter in the promotion of those objects without farther molestation, and especially without a rancorous falsification of my arduous labors in behalf of medi- Cin»; ~ l remain> Mr- Editor, very respectfully yours, New York, May 9, 1844. m7rtyn' Paine.