an y INTRODUCTORY ADDRESS, DELIVERED TO THE STUDENTS OF THE MEDICAL COLLEGE OF OHIO, NOVEMBER 3, 1847, J BY JOHN P, HARRISON, M. D„ PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE. CINCINNATI: COLLINS & VAN WAGNER, PRINTERS, CORNER OF PEARL AND WALN0T 8TS. 1847. Cincinnati, November 16th, 1847. At a meeting of the Students of the Medical College of Ohio, held in the College Edifice, Mr. Wm. Guthrie was called to the Chair, and Mr. George Watt, appointed Secretary, when, on motion, the following gentlemen, viz: L. W. Bishop, D. B. Collins, R. H. Ewing, W. H. Smiley, and J. Shank, were appointed a committee to wait upon Professor Harrison, and request a copy of his Introductory for publication. Adjourned. WM. GUTHRIE, Chairman. GEORGE WATT, Secretary. CORRESPONDENCE. Medical College, November 17th, 1847. Prof. Harrison—Dear Sir:—The members of the Medical Class, and others, having been highly gratified by your very instructive Lecture, delivered at the College on the evening of November 3rd, do, through us, their committee, respectfully solicit a copy for publication. With much esteem, yours, &c, L. W. BISHOP, 1 D. B. COLLINS, R. H. EWING, W. H. SMILEY, J. SHANK, Committee. Race and Fourth Streets. Gentlemen:—Agreeably to your polite request, I deliver you my Intro- ductory for publication. I trust that its circulation may, in some degree, con- tribute to the advancement of the great interests of that profession, so noble in its objects, so elevating in its studies, and so purifying in its moral influences, to which we have devoted our lives. Very respectfully, Yours, &c, JOHN P. HARRISON. Messrs. Bishop, Collins, Ewing, }■ Committee. Smiley, Shank, STATE AW PROSPECTS OF THE MEDICAL PROFESSION. AN INTRODUCTORY LECTURE, UELlVERED NOVEMBER 3RD, 1847, BY JOHN P. HARRISON, 31. Ij., Professor of the Theory and Practice of Medicine, in the Medical College of Ohio. Amidst the busy throng, each intent upon the prosecution of his own designs of industry and accumulation, there exists a separate body of men, whose purpose is the preservation of the health of the community. The medical profession is isolated from the great mass of their fellow citizens, in the special and peculiar functions of their vocation. And yet, physicians bear about them no charmed existence, for although it is their high and honorable task, to stand in a protective position to ward off from Society the mortal ills incident to the body's frailty, they are equally with others, subject to the great law of mortality. This universal subjection of human nature to disease, renders the pro- fession of Medicine necessary in all well ordered, civilized communities. Man is liable to sickness,—man is, therefore, subject to medical control. Man everywhere, in all stages of his social progress,—amidst the degra- dation and darkness of his savage life, and in the pride and pomp of a luxarious civilization,—demands, in ruder or more refined forms, the interposition of the art of healing. From the superstitious practices of the untutored "Medicine Man" among our aborigines, to the scientific measures of cure employed by the cultivated Physician among a christian people, there is constantly at work, in a thousand >vays, the resources of mitigation and of removal, for the numerous maladies which harrass, em- bitter, and shorten life. The ratio of sickness in any Society, must van with a variation of external circumstances. Among savage tribes, there is little disease. Sparseness of population, fewness of luxuries, and hardihood of constitution, ward off numerous maladies that infest a thickly populated country—in which a refined and complex scheme of existence has enervated the frame of man, and rendered it susceptible to the injurious action of the various agents which incessantly operate upon the powers of life. But whilst civilization has multiplied the inlets to disease, and enlarged the surface of exposure to the impressions which generate pain, it has conjured up a strong array of means to arrest the progress of the evils in- cidently engendered by its multiplication of physical indulgences, and of mental and social delights. The science of Medicine, commencing with the earliest dawn of civilization, has gone on with the advance of intel- lectual and moral culture, till it has attained its present elevated rank among those branches of human knowledge which reflect glory on our age, and conduce to the happiness of mankind. Thus the medical profession, august and dignified for its'antiquity, mighty in its sway over the earthly destiny of man, and attractive and amiable for its many deeds of benevolence, presents to the eye of observa- tion four distinct, and yet harmoniously blended, aspects. First, the intellectual character which it possesses: Second, its econo- mic condition, or the state of medical practitioners in reference to wordly circumstances: Third, the social respect and consideration in which 6 society holds the profession: and Fourth, the moral elevation maintained by Physicians in their secular matter?, and professional connections. The intellectual character of the profession is shown in the literature of Medicine, and in the attainments, general and technical, possessed by living Physicians. In the works of out profession the most ample and diversified evidences are afforded, of a rich and varied intel- lectual culture. The pages of Boerbave, Haller, Linneus, Gregory, (Jul* len, Pott, Good, and numerous other medical writers, attest to the truth of our declaration. Nor have the illuslrious dead of American Medicine been deficient in their devotion to literature, or failed in leaving behind them contributions to the great cause of human knowledge. Ramsay, Rush, Wistar, Hosack, Barton, Furry, Eberle, Godman, and other dis- tinguished physicians, whose lives were devoted to deeds of active benevolence, and whose memories are hallowed by the recollections of many whom their skill saved from a premature grave, shine with glorious lustre in the firmament of American Medicine. But what is the present state and prospects of our profession.'as regards its intellectual character ? Is it stationary, or has it retrograded, or ad- vanced? Are there patent, substantial proofs, that the present race of medical practitioners are the legitimate offspring of the illustrious men who have preceded them, and whose names stand conspicuously enrolled upon the annals of history? There are three points of view in which the mental culture of the profession may be considered. In the first place, we should advert to the preliminary education of medical students. In the second place, inquire into the extent and kind of attainments made necessary to graduation. And lastly, endeavor to ascertain the advance- ment made by practitioners, in professional knowledge. Two questions meet us, respecting the preliminary scholarship ofyoung gentlemen desirous of studying medicine. The one is, what isthemaxi- mum of acquirements proper to constitute a due preparation for thestudy of medic-il science. The other question is, what is the absolute minimum of scholastic training which a wise judgment would barely tolerate in a young man about to enter upon the prosecution of the study of medicine. On the one hand, it is urged that the dignity and respectability of the profession are compromised by lowering the requisition of previous disci- pline and instruction, and therefore it behooves all who hold dear the exalted position which the science of medicine should occupy among the educated and refined portion of society, not to abate in the smallest degree, the standard of preliminary education. On the other side, we find distinguished individuals in the profession,, who contend that to insist up* on a very exalted grade of preparation, the inevitable result would be the prevention of many worthy and moderately gifted young men, in restricted circumstances, entering the regular profession. It is clear, that if the question of abstract excellence were the one to be solved, that if we were called upon to decide, not simply what is practicable, but what is most ap- proximative of ideal perfection, we ehould unhesitatingly declare, that the preparatory education of medical students should partake of the most varied, and thorough, and comprehensive scholarship, which the most elaborate system of protracted college exercises could confer. Let every young man who intends to prosecute the study of medicine, acquire as much classical learning as his opportunities will permit. There is not the remotest danger to be apprehended.that his menial powers will ever be encumbered, or his future professional knowledge at all embarrass- ed, by the amount and accuracy of his Greek and Latin, and maihemati- caljacquirements. There is no physician in our country that suffers damage to his intellect or reputation, by too much classical learning.— Many distinguished men among our ranks possess fine literary tastes, and 7 they have never regretted that they "drank deep of the Pierian Spring," or that their "lips were wet with Castalian dews." A thorough scholastic training of the faculties subserves four important ends. First, it affords a praxis, or method of mental action, which great- ly facilitates the faculties in their future search after truth. Second, by such early discipline, the mind is trained and accustomed to patient in- quiry. Third, by familiarity with the highest examples of literary excel- lence, the fervor of the soui is kindled to an emulous exertion of its best capabilities. And fourth, by a knowledge of the dead languages, the medical student has a key put into his hand, by which he may unlock the vocabulary of the science, with a quick and pleasing facility. Although we urge these advantages of a classical education, we would not erect the dead languages into an exclusive standard of p-eparation for the study of medicine. The German and French tongues confer greater benefits on the modern physician than the ancient languages; for there is a vast mass of the most valuable contributions to medicine, and the auxiliary sciences, in these highly polished languages. Still the study of the French and German does not so discip'ine and invigorate the intellect as a classical education. Aside from the higher preparation afforded by classical erudition, for the study of medical science, there is one point on which every educated, enlightened physician will concur in opinion. All strenuously contend for a good English education. All agree that no medical student should be ignorant of his vernacular speech, his mother tongue. That he shall be able not only to give articulate utterance to his ideas in well selected, grammatically constructed, and correctly pronounced, English, but that the student be capable of communicating his ideas in a scholarly way through written composition. Besides, in our conception of an English education is included an acquaintance with the lower branches of the mathematics, a thorough acquaintance with arithmetic, and some a miliarity with the rules of logic. There is an obvious improvement in elementary education in the pro- fession, within a few years. A still more enlarged scheme of preparatory instruction would confer great advantages upon us; would quicken our march along the road of professional knowledge-, elevate the tone of men- tal and moral excellence; and attract toward our ranks many gifted minds, that glow with honorable emulation after the rewards of an activity devot- ed to the good of mankind. The second feature of the intellectual aspect of the medical profession is seen in the extent and variety of scientific attainments possessed by physicians. A wide scope of intellectual effort is presented in the science of medicine. The spirit of the age, the wants of the sick, and the honor of the profession, call for a full consecration of the highest powers of the mind in this field of labor. Whilst all around is full of life, and the buoy- ancy of onward movement, shall medicine remain a stagnant collection of antiquated notions? Whilst renovation is awakening into new forms of existence, all departments of human effort, shall physicians not "pursue the triumph and partake the gale!" In no portion of the medical world is there a larger amount of sov.nd practical sagacity exhibited in the employment of remedial resources, than is shown by American physicians. Much disparagement has been vainly attempted of our medical practitioners, by ignorant opponents of the re- gular profession, because in cases of severe illness reliance is placed on heroic remedies. There are simplicity and earnestness, and directness, in the measures of clinical interference, brought to bear in severe attacks of sickness, which partake of our national character, and reflect glory upon the beoeficient control of the healing art. The American physician 8 feels, when summoned to the bed-side of a suffering; fellow being, that his profession is not a mockery and a lie. J^o ! he is assured that nature, oppressed and crippled in her energies, is incompetent to the task of her own rescue from the load of disease which presses upon her, and that art, "enlightened by science and guided by philanthropy, must come to her deliverance. Let the mere naturalist physician practice his expectant plan of non-resistance to morbid action at the bedside, and day by day visit his unhappy patient, to note down the varying symptoms, and specu- late on the probabilities of endurance on the part of nature to withstand the ravages of disease—and then smile at the credulous reliance of the sick man on his do-nothing course. Thi* .cold, and cruel, calculation of the powers of nature, may well comport with a selfish and sceptical turn of mind, which fits its possessor to be an indifferent spectator of the un- assisted woes of other men, provided private advantage may be gained.— But the plain, straight-forward path of the decided and prompt physician, whose heart sympathises with the afflictions of his patients, leads to a far different goal. Having studied his profession well; having made himself master of the principles of medical science, and been thoroughly instructed in the best therapeutic resources, the conscientious, efficient man of physic goes to work in earnest, and leaves no means untried which a sound ex- perience warrants for the delivery of his patient from the sufferings and peril of a violent seizure of disease. Decisive measures of medication constitute true economy in attacks of sickness. They save the patient from sufferings endured in a protracted struggle of nature with disease, and thus evince true, practical benevolence. They save that time which would be consumed in the slow restoration of the sick, when left to the tardy, uninterrupted agency of nature. And they often save a patient from some lingering, perhaps incurable, form of chronic disease, which is so apt to follow acute attacks that are not controlled by judicious medica- tion. Doubtless energetic methods of cure may be pushed too far—they may be abused by ignorant presumption—but surely the abuse of a valu- able thing is no legitimate argument against the thing itself, in the cor- rect applications of its influence. The very existence of a capability of useful application of any of the powers of nature, or of art, evinces at the same time, and to the same extent of action, a liability of abuse spring- ing from a misapplication, giounded on ignorance and presumption. There is an obvious improvement in the regular medical profession, within the last twenty years, in these very interesting and important points. There is on augmented spirit of generous emulation abroad in the whole body. There is an increase of professional reading. And there is a more decided independence of mind manifested towards the entertain- ment of any universal system of doctrine, and exclusive scheme of therapeutics. As the result of these important meliorations, our profession is gaining every year in intellectual and moral power. It is acquiring a gradual in- crement of internal force, and revealing, by fresh developements, clearer demonstrations of usefulness. As to the economic state of the profession, it is for from being forlorn. Let our croaking, discontented, splenetic malcontents say what they may about "neglected merit," "impostures of quackery," and "shameful in- gratitude in the public," still as a body we are not 60 badly provided for, nor so depressed by low living as to be incapable of lifting up our heads in society, or of mingling in social circles with the cultivated walks of life. It is all a mistake, that in our highly favored country, real merit in the medical profession is not discovered, and liberally rewarded. It would be a blot, a foul stain on the fair reputation of our land, to witness the degra pation of as enlightened and humane a body of citizens, of which, as we 9 feel assured, the medical profession is constituted; and that physician re fleets discredit on his country, who allows his mind to reach'such "a re- trograde conclusion and sad mistake" as to imagine that he belongs to - olass of men who are tabooed by the public, and given over, by an evia destiny, to poverty, disparagement, and aversion. Never have we knownl an enlightened, virtuous physician fail in arriving at a good support, if not wealth, in his profession, where he adhered to three rules of conduct;— First, not to abandon his profession for another pursuit, but to persevere in a strict devotementto its duties. Second, to settle in an appropriate place, and there remain, till some very nrgent considerations induce a removal.— Third, to live peaceably with all men, especially with his professional brethren. Observant of these three rifle?, success, eooner or later, will crown his professional career. But the physician, to sueceed, must be well imbued with medical knowledge, be devoted to his calling, and not be de- based by vice, nor alienate the kind regards of his fellow citizpnS by ec- centric or offensive manners. The medical praclitioner, in all parts of our common country, is held in high esteem; his presence is greeted by the most cultivated portion of society, and by proper attention to his own private affairs, he will never sink into destitution, but will gradually at- tain to competency, if not opulence. Let us, therefore, ever abide satisfied with our profession, always en- tetain a manly, cheerful, active frame of mind; repress the risings of dis- content; rebuke with the spirit of philosophy, the idle musings of selfish sntimentalism, and cherish, from hour to hour, a filial trust in the guardian care of that Supreme Father, who directs all events to the furth- erance bf man's highest moral interests, when we do not prove recreant to he solemn irusts put into our keeping. The moral character of the profession has undergone, within the last thirty years, as personal observations have assured us, a great and happy improvement. Scepticism, and even declared infidelity, were at that period not uncommon; the doctrines of materialism, as taught by Darwin andr Priestly, were very generally relied upon as the true theory of the soul, and drunkenness was hardly a discreditable matter. Now, a firm re- ligious faith is very frequently witnessed among physicians; an avowed disbelief of the christian religion, is rare, and the degrading habit of inebriation, which brings discredit upon the standing of any man in society, is seldom found among medical practitioners. It is, on the contrary, a high and honorable distinction, won by the profession in the temperance reform, that this great and noble cause has teen most essentially aided by the personal example and professional efforts of physicians. The prospects opened up to the contemplative mind, by the recent move- ments in the medical profession of the United Siates, are of the most cheering and exciting character. Among the most auspicious of these movements is the National Medical Convention, first held in New York in May, 1846, and in Philadelphia in May, 1847. At this last place, there were in aitendance t wo hundred and thirty-three members, representing twenty-three States of the Union—fourteen Southern and Western, and nine Northern, Middle, and Eastern. Twenty-eight out of thu thirty- seven medical schools of the United Stales, sent delegates, and sixteen State, seventeen county, and eight city, medical societies, were represent- ed. This Convention has been justly described in the recent Circular of the Medical Department of the University of Pennsylvania, in the follow- ing words: 'It is believed, in relation to its numbers, and the standing of its individual members, the late (Convention has never been equalled by any assemblage of medical men on the continent. The recommendations of such a body are entitled to the highest respect; and though it may not be practicable to carry them immediately into full effect, yet as they have 10 the general good only in view, it would appear rncumbent on all, to enter into their spirit, and by cordial efforts to prepare the way for the ulti- mate attainment of their object." Governed by a warm solicitude to promote the laudable purposes which led to the formation, and which actuated the doings, of the National Medical Convention, we shall endeavor to give an abstract of their pro- ceedings. After various topics of discussion were disposed of, the Convention re- solved itself into a National Medical Association, to meet annually, the place of meeting never to be the same for any two years in succession.— Delegates, from Medical Societies, Medical Colleges, Hospitals, Lunatic Asylums, and other permanently organized Medical Institutions of good standing, in the United States, are entitled to membership. Members by Invitation, are to receive their appointment by special invitation, and Permanent members are to consist of those who have previously served in the capacity of Delegates. There are, a President, four Vice Presi- dents, two Secretaries, and a Treasurer, with eight standing committees— viz: 1, on Arrangements; 2, on Medical Societies; 3, on Practical Medi- cine; 4. on Surgery; 5, on Obstetrics, 6, on Medical Education; 7, on Medical Literature; 8, on Publication. The venerable and illustrious Prof. Chapman, was elected President, who, upon taking the Chair, made the following remarks, which we select from the report given of his short and glowing speech: "He loved his profession, and should be ungrate- ful if he did not; whatever he possessed in this life, had been bestowed by its favors; when he forgot it, or deserted it, or its disciples, he remarked with great emphasis, may Almighty God forget and desert me." Among the most prominent topics discussed and acted upon by this dignified body, were the following: the Preliminary Education of Medical Students; Standard <>f requirement for the Degree of M. D.; Code of Medical Ethics; the Union of Teaching and Licensing in Medicine; and the Registration of Births, Marriages, and Deaths. Great ability, discretion, and discrimination, mark the Reports made upon the above named subjects, and the disposal of the interesting ques- tions involved was characterized by much calmness, decision, and moderation. The Convention proceeded with a prudent yet firm deter- mination toward the pregnant and momentous issues debated. We shall, as briefly as possible, sum up the conclusions at which they arrived. And first, in reference to medical education, the following points were decided on: "That practitioners should satisfy themselves before receiving young men into their offices as students, that they are of a good moral character, and that they have acquired a good English education, a knowledge of Natural Philosophy, and the Elementary Mathematic Sciences, including Geometry aad Algebra; and such on acquaintance, at least, with the Greek and Latin languages, as will enable them to appreciate the technical lan- guage of Medicine, and read and write prescriptions." "That it be required of candidates for the degree of M. D., that they have steadily devoted three months to dissection." "That it is incumbent upon Perceptors to avail themselves of every opportunity to impart clinical instruction to their pupils, and upon Medi- cal Colleges, to require candidates for graduation to show that they have attended upon Hof the physician, is selfish in its plans and employments, and treats with con- temptuous disregard, if n.>t with bitter sneer, all the suggestions and at- tempts of others for the improvement of medical science. The agitation of progress enlarges, liberalize, brightens the soul: the agitation of personal dissaiisfaction dwarfs, perverts, and darkens the fa- culties;—the one moves through a wide territory, in an atmosphere of light, and joy, and activity; the other grovels in a dim and circumscribed circle of ignoble aims and selfish ends: the one realizes the the truth of the poet's thought, "Wo live in deeds, not year?. He most lives. Who thinks most—feels the noblest—acts the best." The other resembles, "Ocean into tempest tost, To waft a feather, or to drown a fly." The physician, who is controlled by'the agitation of personal discontent disparages the profession in the eye of the public,—like Caliban, he moves in growling reluctance to the performance of his duties, and unceas- ingly utters his maledictions upon his fate:—but the physician whose soul is inspired by the generous ardour of professional progress, reflects credit 16 and honor upon his calling, and by a noble impersonation of professional seal and industry, sustains the character of medicine in all its varied dis- closures of scientificjresearch, therapeutic skill and philanthropic power. Our profession needs more of tuis lilegiving, awakening, enkindling spirit of progress—let us nurture it, till we all feel—"Sjuriius intus alit, totamaue infasa per arias m-'.ns agitat molem, et tnagno se oorpore miscet." •'One mighty soul Inspires and feeds and animates the whole; This active mind, infus'd though all the space, Unites and mingles with the mighty mass." This agitation, though impulsive to high efforts of mind, is yet a sound, discriminating power. It delights not in pulling down, but in building up. Does not urge on the changes, which the times demand with reckless haste, but with steady hand removes obstructions, and opens a way that facilitates the access, and shorten's the route to the temple of Medical Science. Nor does this healthful spirit of progress boast itself of the great things accomplished by its agency, but with the modesty that ever becomes true science, takes no congratulations to itself for the victories won, but looks forward to more signal discoveries of truth, and is constantly cheered with assurances that yet higher, and richer, and more glorious displays of nature's wonders, and o? the de- velopements of human skill, will be revealed to the (longing, enraptured eye of philosophic curiosity. Gentlemen, we confidently believe that your minds sympathise in the great events now in progress in the medical profession,—that our repre- sentation has kindled within you—if already you were not in possession of it—a portion of this spirit of improvement which, with such moving, stirring agitation, is felt in quick vibration and onword motion,throughout the profession. Led on by the desire to fit yourselves for the prac- tice of a responsible avocation, you have assembled here to listen to our prelections, witness our demonstrations, and avail yourselves of the facilities and opportunities presented in our hospital, for the acquirement of a sound practical knowledge of the science and art of preventing, mitigating, and curing, the numerous maladies which afflict mankind, Dedicate yourselves in singleness of purpose, to this good work; gather up, in one earnest collectedness of mind, your energies to the accomplish- ment of the enterprise in hand; and let not the future find you repentant over lost time, nor heaven frown in deserved retribution upon—nor mourn- ing friends upbraid you—when death seizes the sick consigned to your charge. Be instant in season to catch the rising chances of professional knowledge; assiduously wait upon the tide as it flows; and with firm re- liance upon your own manly arm, plunge your bark into the stream. It waits for you, '.he fountain is now at hand, the waters are rising; see, they burst up on every side,—the channel is free! will you not take to your oars, and push forward your successful career ? The heavens above smile in approving serenity, the bright stars are reflected in the crystal stream, the winds are filling the sails with a prosperous breeze: have you the compass and the chart ready, the rudder manned, the sails all set, the ves- sel tiim, the timbers sound, and all hands onboard? May heaven give you a prosperous voyage, and a safe anchorage in the desired haven of professional knowledge; there may you receive the greetings of friends, and be gladdened with the retrospect of the hours here dedicated to the study of a noble and beneficent profession.