OM^y^iA^, INTRODUCTORY LECTURE DELIVERED AT THE Hahnemann Medical College, OF PHILADELPHIA; BY JOHN C. MORGAN, M. D., PROFESSOR OF SURGERY. (PUgLISHEQ) §Y THE CLjlSS OF 1867-6$. Wilmington, Del. ; ii. & e. v. james, book and job printers. 1867. INTRODUCTORY LECTURE, DELIVERED AT THE Hahnemann Medical College, OF PHILADELPHIA; BY JOHN C. MORGAN, M. D. PROFESSOR OF SURGERY. (PUBLISHEQ BY THE-Q£jl88 OF l$67-6#. Wilmington, Del. ; h. & e. f. james, book and job printers. 186 7 . CORRESPONDENCE. Philadelphia November 6th, 1867. PROF. JOHN C. MORGAN, M. D. Dear Sir: At a meeting of the Students of the Hahne- mann Medical College of Philadelphia, it was resolved that a Committee he appointed to solicit for publication, a copy of your Lecture, delivered hefore us, October 15th, 1867. We therefore respectfully request, that the same may be furnished us, that ive may lay befoi^e our friends and the profession, as well as treasure up for ourselves, the material you gave us-; hoping thereby to call renewed attention to that import-unit branch of our Science-- Homceopathic Surgery. B. FRANK BELTS, Chairman, "1 TSAAC COOPER, „ A. M. STACKHOUSE, \ Committee. \VM. BUDD TRLTES. J Philadelphia, November 7th, 1867. Gentlemen : Your communication of the 6th inst. is received. In reply, I have to say that while I appreciate most highly your request, I regret that my leisure ivill not suffice to enable me to amend my Lecture, as I should desire. Such as it is, however, I cheerfully commit it to your hands; and to the indnilgent criticism of our friends. Please convey to the Class my cordial acknowledge- ment of their courtesy ; and believe me, Very Truly, Your Friend, JOHN C. MORGAN. MESSRS. B. FRANK BETTS, Chairman, i ISAAC COOPER, ' I _ A. M. STACKHOUSE. ,-Committee. WM. BUDD TRITES. LEC TURE. Gentlemen: It is trulv said that he who would iudo;e the i *•■■■ o o present and the future, must study well the examples of the j past. Tracing the threads of history, he shall find where j each began, by whom, and for what laid down; he will esti- mate their mutual bearing and effect thenceforward, and cal- j culating for the present and the future, see what other in- I i fluences, necessarily co-operating with, or else destroying | those older agencies must be put forth to modify and im- I j prove the whole. The history of our Profession is that of Humanity in j general. Virtue and vice, generosity and selfishness, devo- tion and corruption, science and ignorance, progress and stag- nation, servility and independence, benevolence and murder- ous passions, are by turns, in, as well as out of the medical ranks —among physicians no more and no less than among others —the revelation of history. ISTo worse have they proved than mankind in general when cultivated by learning, no better than any others with the same culture of mind and taste.— Not the ogres which superstition would call them, medical men have not been more God-like than their neighbors,— have, in short, no real claim to the position, too often claimed by those who would build up the profession into an over- shadowing body, with a few powerful leaders, able to control, awe and punish its individual members, and coercing to its ends mankind at large. In a word, it may not be pretended, with the heathen, that "the profession" is a caste, born of the head of Deity, while all common people come from his feet; breakers of caste, as homoeopathists, being mere Pariahs, whom it were pollution, even for the lowest to touch. In the profession, and out of it, this self-arrogated su- periority of classes, (especially educated classes,) has ever been and yet is, the fountain of all the oppression under which the human race has been for ages groaning. The history of human 4 progress is a history, wavering indeed, and with irregular, remittent tide—of solemn protest, of indignant resistance, of gradual subversion of class-privileges. The history of medicine, like all other special annals, is a mere part of the general record of human development.— Only where Liberty is the staple of the social atmosphere, has the light of true science any penetrating power. Just so far as man may dare be true to his every conviction, to his individual conscience, rather than to that of professional classes, can the car of progress keep to its broad and firm highway. If a medical or other hierarchy have power to turn it out into their own by-paths, unharness its steeds, and put them to feed in their own stubble-field, science must go afoot, and painfully. Class-privileges! a medical caste ! doctor-craft! what bet- ter are these than are like assumptions of any other combi- nation of human frailty and pride? Where are the Luthers of Medicine? Who shall tear the mask from the medical church—make effective protest against the domination of its apostolic succession—expose the fallacy of its dogmas, the blasphemy of its hierarchy, the emptiness of its pretences ? Am I answered that "of its communion are all the apos- tles of true science?" It is sufficient to meet assertion with denial. No man can long converse with Nature, none can be her priest, who bows his intellect and heart to a narrow dom- ination. Conform, he may, to that which he knows not how to mend, but the soul which learns of Nature, the only teacher of true science, is as the eagle, soaring undismayed above the grovelling worms, and gazing only at the glowing sun ! The pretenders to religious prerogative tell us that there has always been a Church in the world, vested with Divine authority over individual opinion and conscience. The pre- tenders to medical prerogative, once a part of this same re- ligious priesthood, still employ like phrases to sustain their position. Both have their interested partizans, both, their dupes. "There has always been a Medical Profession," with a Divine right of censorship—as real, doubtless, as the Di- vine right of Kings, to rule the common herd. 5 Whence such magnificent pretensions ? Where was the birth-place of this divine being—"the medical profession?— Whence the purple and fine linen, the frankincense and I myrrh, the bed of ivory, whereon it first saw the light of an unworthy world? What constellation first shone in heaven in honor of its nativity? Where is the legend of its advent? On what tables of stone did the All-Wise write its charter? What Moses received them, and in the presence of what august witnesses ? Or, if its claims be, alas ! but those of ar- rogance and pride, what has it to show of the Divine power, save the leprosy of those, who, not content to minister in the tabernacle and at the altar, would be also rulers and lords of God's people ? Let all true men—all good physicians—all real priests of Nature, beware of the leprosy of pride—the plagae of medical caste! I need scarcely add to the indignant and hearty denun- ciation of a great counterfeit and sham, any apology for the genuine priesthood of Nature, either religious or medical; the lovers of humanity, the devotees of true science. I am I free to say, that not all such can be found in our own or in any other ranks. Many, indeed, have we; but whatever be his name, he is the true physician who, with zealous devotion, followeth the light vouchsafed from Deity to
), the origin of disease. His spiritual pathology, however, led him away, far away from both the "single remedy," and the "minimum dose;" so that we may easily see the fallacy of the argument that spiritual pathology leads to refined practice, and materialized views to crudity, as some pseudo-prophets of Homoeopathy would have us believe. Five hundred years after the Christian Era, Alexander, of Tralles, was distinguished for the treatment of fractures, and affections of the eye. His use of charms, in accordance with the spirit of his age, is illustrated by one given for quotidian ague. This was an olive leaf inscribed thus, "KA. POJ. A."—to be worn by the patient. I am reminded by this of a woman whom I once met, and who got well of ague, after a similar expedient. With some persuasion, she informed me that she counted the number of chills she had had, and going into her garden, dug a little hole, held her hands over it, pronounced the 12 word "chills," once for every time she had suffered a parox- ysm, and finally refilled the hole with earth, as if burying her ague in it. Surgical mechanics made in these early days slow progress; but its advances were much more rapid, than were those of Therapeutics. Indeed, I have not the least doubt, that the 3Iethodies were the most successful of ancient physicians, and far superior to the Galenists; and that Galen is entitled to reprobation only, for his influence in subverting the school of Themison. Crude as was his doctrine, it yet contained the germ of an indispensable truth, viz : that special diseases exist only by permission of the status of the general system in its totality—which, corrected, the disease must vanish—the same idea which pervades the practice of pure Homoeopathy. And again, the classification of those morbid states by Themison, corresponds quite nearly with those which we all recognize as distinguishing otherwise similar cases, in which we use such drugs as Nux Vomica and Pul- satilla, to wit, "Constriction" and "Relaxation" of the mus- cular fibre, etc. Brown, Rasori, Dickson, and others, evident- ly are the modern imitators of Themison. After Alexander of Tralles, we find Paul of JEgina employing his finger, passed into the rectum, as a sound for the detection of stone in the bladder—removing cancerous disease of the breast by crucial incision, and performing embryotomy, as well as treating fracture of the patella. At the close of the 8th century, the middle ages are fairly brought to view. Then, a hospital existed at Bagdad, which boasted 6000 persons who sought instruction, in- cluding many Christians. Its governor was Caliph Haroun. Medicine and surges now passed into the hands of Musselmen—of whom several achieved lasting fame. Rhazes, who commenced the study of medicine when past forty years of age, described and treated spina bifida and spina ventosa, and recommended the cautery in poisoned wounds. Avicenna, A. D. 1000, employed the flexible catheter. and the metacarpal saw ; and distinguished between true and false cataract. A century later, Albucasis pointed out the 13 effect of blood-clotting in arrest of hemorrhage, wrote of venereal diseases, etc., treated fistula lachrymalis, introduced the cataract-needle, the suture in wounds of the intestines, the excision of tonsils, the removal of polypi, female lithotomy, the lateral operation on the male, and the operation for chronic hydrocephalus ; and practiced obstetrics after a fashion. Not being permitted by custom to touch a woman himself, he employed the hand of a midwife to do his bidding. The Arab school made no progress in anatomy and physiology,—rather retrograding. Medicine and surgery found their way gradually into the monasteries of Christendom, and each cathedral had its hospital and botanical garden. Both Mohammedan and Christian hospitals were sustained by the offerings of the wealthy, who sought! thus to expiate their crimes. Before the end of the twelfth century, the profession of medicine and the church had become one, so far as Christendom was concerned. But now they were divorced by the council of Montpellier. The ascendancy of ecclesias- tical influence was, however, in no wise relaxed—and medical practitioners were little else than another order of priests. The popes founded universities upon the pre-existing episcopal schools, and the majority of the present European Universities had such an origin. An interesting feature of progress in this age was the introduction by Theodoric, of anaesthesia by narcotic juices, inhaled from a sponge, and the use of vinegar as an (homoeo- pathic) antidote. The College of Surgeons, of Paris, was founded in 1270, under the guidance of Pitard. Near this time lived two noted surgeons, John of Gaddesden, and Gilbertus Anglicanus. And now the Cesarean section for removing the foetus in difficult cases, came prominently into notice. Ecclesiastics, even of the medical sect, although the only learned men, to a great extent eschewed surgery. Thus it degenerated, and largely fell into the hands of the barbers. So late a directory of this city as that for 1830, records the name and address of more than one of these so-called "barber 14 surgeons," and to this day, many barbers are also cuppers, bleeders, and leechers. In 1350, Guy de Chauliac was the author of a work which became the surgical code of Europe. Ambrose Pare, in the 15th century, was a most noted military surgeon. He wrrote on gunshot-wrounds, and the twisted suture for hare-lip, and introduced the ligature for wounded arteries. Such was his reputation, that it is said his appearance among the soldiers was worth as much as that of a favorite general; "for," said they, "now we shall not die —Pare is here!" Taliacotius also was distinguished for plastic surgery,— especially rhinoplasty—the formation of a nose from the skin of the arm, being known as the Taliacotian operation, because resorted to by him to obviate the loss of that organ. At the beginning of the 16th century, flourished the celebrated Paracelsus. His family name was Hohenheim, and by this he is sometimes spoken of. Professor Hering differs essentially from most other authors (admirers of Galen), concerning this undoubtedly great man. No name is too harsh to be applied to him in "respectable" medical circles; but Dr. Hering, who has collected immense materials for a biography on which he has been employed, believes that he can prove that he was a genuine improver, as well as reformer of medicine, with no vices that were not in his day universal. He was an alchemist, and seemed to possess some inkling of Homoeopathy. He was both a surgeon and a surgical author. About this time also appears Fabricius—later, Harvey, his pupil, who demonstrated the circulation of the blood. Fabricius was a noted surgeon, and made important im- provements in surgical instruments. In the middle of the 17th century, we find the great eclectic, Sydenham, with learning and patience, collecting the scattered literature, remodelling and systematizing, and gain- ing for himself enduring fame. Improvement now becomes rapid, at least in comparison with that before Paracelsus. In 1730, Desault published a work on Surgical Anatomy. In 1752, the Pennsylvania Hospital of this city, was instituted. 15 Its earliest surgeons were Physick, Parrish, Hartshorne and Barton. In 1765, the University of Pennsylvania was founded. In Great Britain and France, as well as Germany, etc., great names have arisen in surgery; as the Coopers, the Hun- ters, Liston, Fergusson, Simpson, Larrey, Dupivytren, Vel- peau, etc. On this side the ocean, Physick, Barton, Warren, Post, Mott, (Gibson, McClellan, Mutter, etc., and in our own school, Gardiner, Beebe, Franklin, Helmuth, and. many others, have adorned the surgical profession. As for John Hunter, wTho does not know the story of his surgical life? Yet his advice to Jenner, on love-sickness, is a specimen of practical sense, less known. He diverted him by inducing him to dissect hedge-hogs ! In our own day, various systems of therapeutics have been promulgated. The principal of these is, I need not in- form you, Homoeopathy, which, year by year, decade by decade, has been gathering force in Christendom, in arith- metical ratio, altogether in excess of increase of population, until now our physicians have come to be counted by thousands, and our supporters by millions; and only needing to be a little more elaborated for the comprehension of the liberal-minded, in order to become an accepted medical doctrine everywhere. Hereafter it must rapidly become dominant. The doctrine of the Chrono-Thermalists, as stated by their leader, Dickson of London, declares that all disease is Intermittent Fever, and is to be treated in like manner, (as in the practice of the ancient Methodics) with relaxents in "paroxysmal" conditions, ("constriction,") and with tonics in "apyrexial" conditions—("relaxation.") To watch perio- dicity, they hold to be therefore the prime duty of the practitioner—giving the remedies as stated. Homoeopathy has also its attention most carefully directed to not only periodicity, but also many other equally important minutiae, having to do with the states of the general system which may co-exist with, and assist in maintaining local disease. 16 The Water-Cure. the Movement-Cure, the educated Thomsonianism, called Eclecticism, all have arisen in our time, and deeply affected the art. Even the am-ien regime, yielding inch by inch, is no longer the bold supporter of Galenic absurdities, but seeks a more positive foundation in physiology. Homoeopathy meets Alloeopathy on this ground. Here she demands and will receive a rigorous and scientific scru- tiny; . and she will triumph—aye, conquer and rule in this domain, the undisputed expounder of the mystery of life ! Nay, more; it is not mere vaporing to say, that the future Newton of Medicine, so eloquently - promised by a recent teacher, must of necessity be a homoeopathist! As yet, however, the medical guild would fain with bonds constrain her fair limbs, and impede her progress. History, it is said, repeats itself. The old intolerance of cathedral and mosque has had unbroken transmission through the boasted "regular" succession. The Egyptian bondage of authority—and the monastic bondage of medical caste, still envelop the willing souls of the medical leaders, fetter the unwilling steps of the rising generation of physicians, and by show of great learning, impose the same chains as of yore on a too submissive and admiring public. But even as we speak, the world moves on to the inevitable overthrow of all tyranny, of all class-privileges. The nineteenth century teems with startling and rapidly succeeding events. The history of Homoeopathy is itself a marvel. A hundred years ago it was not, except in the mind of Deity. It was reserved for the present century to witness the rise of this, the most refulgent star that has ever blazed in the medical firmament. Samuel Hahnemann, only a few years ago announcing the law of cure, thus illuminated the page of Therapeutics and brought real and logical order out of a philosphical chaos. Already, marks of maturity appear. To realize the fulness of that maturity, we must follow him ; not blindly and credul- ously, but wisely and logically. As moves the world, so do we, in all the departments of medical science. The future of Surgery verges toward the pathway of Homoeopathy, coincident with the career of the one healing art. The collateral sciences—Physiology and Pathology, can surely go no farther in real development, but in harmony with the prodigious work of our school, Pathogenesis by drugs! This contribution of positire experiments with the materia medica, already something magnificent, (if indeed rather chaotic as to mere arrangement,) this is our charter to scientific recognition, in an age of scientific experiment and research. To avoid this conclusion by discrediting the experiments, is mere supercilious affectation on the part of any opponent. Surgery, having its foundation (in common with other departments of the healing art,) in the collaterals, has there- fore no future from which Homoeopathy is wanting. In "medical surgery" she is even now pre-eminent. Operative surgery must, ere long, in deference to her requirements, revise its rules, and correct its statistics; must accept her guidance, and, in both preparatory and after-treatment, acknowledge the supremacy, as well as the potency, of her therapeutic law. The future of Surgery, like all the other medical sciences, is, I repeat, part and parcel with the future of this great system of Therapeutics, which, founded on the sure basis pointed out by Lord Bacon, to wit: that of experimen- tation and inductive reasoning; already, while its pioneers and apostles are yet with us, has acquired a force before which its foes are compelled sometimes to bow, and to which, ere the lapse of another generation, they will, by the logic of history, as well as the necessity of science, be obliged to succumb. You, gentlemen, must play a part in the history of that generation. Upon you must fall the mantle of the Fathers; vou will carry on the struggle—you will participate in the triumph ! With such a goal, your incentives are unequalled. With such considerations to urge you forward in your career, I know you will do your whole duty, both to yourselves and to Homoeopathy. c : 18 The studies on which you now enter, arc the commence- ment of that career—the inception of the struggle in which you engage—the foundation of the triumph of which you are to be a part. I honestly believe that your opportunities in |] this college, for laying that foundation, arc entirely adequate j to your need; and thus believing, I confidently say to you that, with the favor of Divine Providence, the future is ! absolutely at your own disposal. The arbiters of your own destiny ! Solemn reflection ! You may not, then, idly fioat on the current of life, waiting j' for fate, the playthings of circumstance ! He is the hero, who makes his own circumstances .' \ My faith in you is assured—you will do your duty. No endeavor which may aid you, shall be wanting on our part. For myself, I may say, my ambition is that when our Alumni shall leave these halls to assume the responsibilities of practice, they may have in possession such a knowledge of in v own cho- sen branch, that the most daring caviller they may meet shall admit that, they being its representatives, Homoeopathy pro- duces good and thorough-going, scientific surgeons. This ambition, it is not I trust, presumptuous to say, I expect to realize; and if your present zeal be any augury of the result, the realization will be part of your own future record. j