Jf7/// the Compliments of 
H. D. Dll) API A. 
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And Model Patient. THE 
Model Physician. 
A VALEDICTORY ADDRESS, 
DELIVERED IN 
WIETING HALL, SYRACUSE, 
February u)tb, 1875. 
BY HENRY D. DIDAMA, M. D., 
Professor of Principles and Practice of Medicine, in 
Syracuse University. 
SYRACUSE, N. Y.: 
TRUALR, SMITH & CO., PRINTERS. 
1875. THE MODEL PHYSICIAN. 
The victors in the Olympic games were crowned with the 
sacred olive. Thenceforward they were held in high esteem, 
as public benefactors, by their fellow citizens. 
To-night, Ladies and Gentlemen of the Graduating Class, 
your persevering zeal in a prolonged struggle—not of muscle 
but of mind—has been recognized ; and you have received 
your well-won badges of honor. 
Your teachers give you a cordial welcome to the medical 
profession. But the plaudits of the cautious public, and the 
substantial tokens of their confidence, are still unbestowed. 
These are to be deserved rather than sought. Then, should 
they come, they will come to stay. 
Your past efforts, however faithful, however commendable, 
are but an earnest of the labors necessary to attain merited 
success. They are valuable, chiefly, as gymnastic exercises to 
strengthen your mental sinews. 
The ceremonies this evening are but initiatory rites. Your 
real life-work still lies before you. 
To present to you a high standard of excellence, so that 
you may not fight uncertainly “ as one that beateth the air,” 
and that you may not prematurely count yourselves already 
to have attained, I propose to indicate a few characteristics of 4 
THE MODEL PHYSICIAN. 
He is a student. He knows that this is an age of 
search and research ; and that an army of vigilant, thinking 
men, scattered over the entire world, are cultivating diligently 
the field of science; turning up precious subsoil truths, which 
must have remained hidden forever from those who merely 
scratch the surface of the ground ; rooting out the stumps of 
old prejudices ; cutting down and clearing away the rank, 
noxious growth of false facts and barren dogmas ; and bring- 
ing forward to the harvest time a plenteous crop of golden 
ideas and healthful knowledge. 
He loves books. He reads them to satisfy his thirst for 
knowledge, but principally that he may be better qualified to 
benefit his fellows. Human health and life are entrusted to 
his care, and he feels bound, by common honesty, to give his 
patients the benefits of all the discoveries and improvements 
which have been made in the healing art. 
In the world of thought there is now great activity. Dis- 
covery follows discovery in rapid succession ; and he must be 
industrious who would keep pace with the progress of his art. 
He must know the past: its theories, its efforts, its failures, 
its accomplishments. He must know contemporary views. 
He must know the intimate healthy structure of the human 
machine, as revealed by the scalpel and the microscope, that 
he may appreciate the changes wrought by disease. He must 
know the tactics employed by the thousand enemies that at- 
tack the citadel of life. He must be familiar with the multi- 
form weapons of defence, not only the old and efficient, but 
the new and still more efficient ; hygienic weapons to fortify 
the citadel; therapeutic weapons to attack the foe ; weapons 
contributed by the various kingdoms of nature; weapons 
supplied by the four elements of the ancients, fire, air, earth, 
and the waters under the earth ; fire, which stands for sun- 
shine and warmth and electricity; air, which is a symbol 
for oxygen and the anesthetics ; earth, which includes all 
the treasures of the mineral, animal and vegetable worlds,— 5 
from the iron which brings back to the pale cheek the ruddy- 
glow of health,—from the oil which makes the face of the 
consumptive man to shine, to the leaves of the trees which 
are for the healing of the nations; and water, which 
whether in thermal or medicinal springs, or at sea-side resorts, 
whether as a beverage or a bath, is a bounteous blessing. 
Books are the garner in which these results are stored ; 
and here the model physician feasts his intellect and fattens 
his memory; while the mind of him, who, from want of 
appetite or industry, keeps away from the library, shrivels 
into leanness and starvation. 
But the model physician is not a mere bookworm. He 
studies, at the bed-side, the phenomena of disease, the 
peculiarities of patients, and the action of remedies. Tact, 
experience, skill, are thus acquired. 
The model physician is a teacher, ready and willing to 
impart knowledge. 
He is not the noisy echo, which adopts, with easy credulity, 
and hastens to repeat, without consideration, the latest novelty 
which is uttered He is not the sponge, which absorbs, with- 
out preference, the good and bad alike, and, without improve- 
ment, disgorges them on pressure. He is not even the indus- 
trious bee, which, while it gathers honey all the day from every 
opening flower—from noxious nightshade as well as from fra- 
grant apple-blossom—gathers it for its own use. But he is the 
well supplied and well trimmed lamp, which, from crudest oil, 
liberates and diffuses the imprisoned sunshine. 
He attends the various associations of his medical brethren, 
whose object is mutual improvement in the glorious art of heal- 
ing ; and he is just as willing to impart as to receive informa- 
tion. 
The model physician is honorable. 
He engages to observe the rules of the society to which he 
belongs, and he adheres to his engagements. If he were to 
swear to his hurt, even, he would perform the vow. 
But the Code of Ethics, to which he subscribes, is not the 6 
code of Draco. It is not a collection of illiberal and senseless 
statutes, like the fabulous Blue Laws of Connecticut—which 
many people still believe to have been real enactments. It 
does not impose grievous burdens ; it does not restrain any 
liberty of action which is unselfish and beneficent. 
It is not an effete collection of arbitrary rules ; for, after full 
discussion, it was unanimously re-endorsed, without amend- 
ment, at the last meeting of the American Medical Associa- 
tion, the highest medical authority in the land. It is a wise 
guide and faithful monitor to him who would guard the honor, 
uphold the dignity, and so increase the usefulness of the pro- 
fession. It is broken and contemned, as a galling yoke, only 
by him who, to promote a narrow selfishness, would trample 
under his feet all sacred pledges, all moral obligations, all re- 
gard for the general welfare. Let us glance at some of its 
provisions. 
In the ist Article—The duties of Physicians to their Pa- 
tients—it enjoins attention, steadiness and humanity. It en- 
forces the obligation to observe secrecy and delicacy, not only 
as regards peculiar diseases, but in relation to the privacies of 
personal and domestic life, infirmities of disposition and flaws 
of character. It gives cogent reasons for frequent visits to the 
sick ; and equally powerful ones for a discontinuance of atten- 
tion, when it is no longer required. It denounces the inhuman 
practice of abandoning a patient or sending him olf to die in a 
distant clime, because the case is deemed incurable. It re- 
commends consultations in difficult cases It advises physi- 
cians never to neglect the frequent opportunities, which they 
have, of warning patients against vicious courses, and of 
strengthening good resolutions. 
Certainly these monitions imply no degrading servitude. 
Like the analagous moral precepts : “ Corruption wins not 
more than honesty “ Be virtuous and you will be happy 
“ Do good as you have opportunity,” they merit, as they re- 
ceive, universal approbation. 
Their observance is commendable, but their neglect or eva- 
sion calls for no discipline. 
There are, however, three sections of the code which have 7 
evoked much criticism, principally from those who find profit 
in their violation. This is one :— 
“ § 3. It is derogatory to the dignity of the profession to re- 
sort to public advertisements, or private cards, or hand-bills, 
inviting the attention of individuals affected with particular 
diseases—publicly offering advice and medicine to the poor 
gratis—or promising radical cures ; or to publish cases and 
operations in the public prints, or suffer such publications to 
be made ; to invite layrrien to be present at operations, to boast 
of cures and remedies, to adduce certificates of skill and suc- 
cess, or to perform any other similar acts. These are the or- 
dinary practices of empirics, and are highly reprehensible in a 
regular physician.” 
The diploma of the physician is a notice to the public that 
he has completed a prescribed course of study, and passed a 
satisfactory examination. Presumably he is qualified to prac- 
tice every branch of his profession. If he has a taste or special 
fitness for certain departments of practice, the public will soon 
enough find it out. Transcendent abilities will not lack recog- 
nition. 
It is eminently fit for the vain-glorious mountebank to boast 
of his skill, and parade his surgical exploits, and advertise the 
infallible remedies which he has invented, for the cure of can- 
cer, consumption and other obstinate diseases. 
But the physician who is jealous for the honor of his 
profession, who regards it as something more than a mere 
trade, and who would preserve his self-respect and deserve 
the respect of his peers, is careful to avoid even the appear- 
ance of this advertising evil. 
Ours is a learned profession. In usefulness it is not, in 
dignity it should not be surpassed by any other human calling. 
The excellent, in any profession, do not advertise their 
superiority. 
Walt Whitman may brag ; but Bryant and Longfellow 
modestly wear their unsought laurels. 
The better lawyers do not write commendations of their 
own adroitness and eloquence. 8 
The better clergymen shrink from sensational announce- 
ments of theatrical religious services. 
Agassiz did not boast. 
Newton regarded his vast acquisitions but as a few pebbles 
cast up by the boundless ocean of truth. 
“ Equally derogatory,” continues the code, “ is it for a 
physician to hold a patent for any surgical instrument or 
medicine ; or to dispense a secret nostrum.” 
Ours is a beneficent profession. The discoveries and 
inventions of all the wise and worthy are freely contributed 
to the common stock. 
Jenner procured no letters patent for vaccination. 
Simpson did not peddle chloroform as a secret nostrum. 
Nelaton’s probe, Dieulafoy’s aspirator, Sims’ speculum, the 
hydrate of chloral, the bromides, and hundreds of minor 
devices and remedies are unrestricted by concealment or 
royalty. 
The physician, who employs, without cost, the invaluable 
discoveries of his medical brethren, and then seeks to secure 
to himself, by a patent, some petty invention or improvment, 
is not worthy to belong to a generous and self-sacrificing 
fraternity. He should go out from it, because he is not of it. 
He, who is made welcome to the bounteous repasts, 
furnished by the profession, cannot charge an admission fee 
to the paltry cold lunch which he may be able to spread. 
The propriety of the sections of the Code, which condemn 
advertising and patents, is acknowledged, not only by the pro- 
fession, but by the well-informed portion of community. 
But the provision relating to consultations has been the 
the theme of not a little acrimonious discussion. This sec- 
tion declares that 
“ No one can be considered a fit associate in consultation 
whose practice is based on an exclusive dogma, to the rejection 
oi the accumulated experience of the profession, and of the 
aids actually furnished by anatomy, physiology, pathology, 
and organic chemistry.” 9 
The irregulars, alluded to in the section, have railed at it; 
certain newspapers, departing from their usual prudence and 
cool deliberation, have inveighed against it; and the luckless 
doctor, who is dismissed for breaking the regulation, and 
breaking his word at the same time, is paraded in the market- 
place, profusely decked with a hero’s laurels and a martyr’s 
crown. 
Let us see whether he deserves either. 
The regular profession is both liberal and progres- 
sive. 
It tolerates diversity of opinion and practice. It invites 
discussion. It encourages experiment. It examines, patiently, 
every new theory in pathology and therapeutics, which does 
not ignore reason, and shock common sense, and contradict 
wise experience. 
It gives a hearty welcome, and subjects to a thousand un- 
prejudiced tests, every newly discovered medicine, and every 
new application of time-honored remedies. 
It eliminates, every day, some old errors of faith and 
practice. It aims to prove all things, to hold fast that which 
is good. 
The irregular practitioner claims to have better methods 
and better results. 
He rejects the accumulated experience of the past as 
worthless. 
He contemns the established principles of the profession as 
false, and their practice as injurious. 
He swears allegiance to some exclusive dogma, or he nails 
his faith to some panacea. 
Whether he be right or wrong in his assumptions, it is not 
necessary here to discuss. It is sufficient that, 'between him 
and the members of the regular profession, there is an irre- 
concilable difference. There is no middle ground on which 
the parties can agree to stand. Compromise is impossible. 
A consultation, held under these circumstances, can be of 
no avail to the patient. And the physician, who consents to barter his self-respect 
for a fraudulent consultation fee, is properly declared by the 
Code, to be unworthy of membership in an honoroble pro- 
fession. 
No disrespect is meant to be shown, in these remarks, to- 
wards any honest dissenters from the orthodox faith. True, 
we believe their views to be erroneous, and their practice a 
fearful trifling with human life. True, we believe that the 
rigid scrutiny to which every tenet of our faith is being sub- 
jected, and that the thorough and extensive experiments which 
are being made to ascertain the effect of administering, and 
also the effect of withholding medicines, will ultimately leave, 
for the exclusive systems, no valid reason for their existence. 
But many of these irregular practitioners are intelligent and 
estimable men. Some of them are our neighbors and our per- 
sonal friends. Deceived they may be, and illogical, and too 
credulous ; but they are not necessarily quacks, and we should 
not stigmatize them as such. 
Varying the language of the Venetian Israelite, we say to 
them :—Gentlemen, we will eat with you, walk with you, trade 
with you, and so following ; but we will not fraternize with 
you, nor consult with you. 
The model physician stands fast in his integrity. 
He detests intensely the so-called tricks of the trade. 
He never misnames a disease, nor magnifies its danger, in 
order to gain plaudits for a skill which he does not possess. 
He does not pander to popular prejudice. He does not 
claim to practice two contradictory systems of medicine. He 
does not manifest an exaggerated zeal and sympathy that he 
may win a patient or retain him. 
Almost every patient regards his illness as one of extreme 
severity; and he has little respect for the judgment of the 
medical attendant who does not confirm this opinion. 
Some physicians, of sensitive temperament, have a sympathy 
which is almost morbid. They bear the burdens, they suffer the anguish of all their patients. They are knights of the rue- 
ful countenance. They go mourning all their days. 
Now, these may not be the best type of physicians ; but 
they are sure to be popular. Their weakness is so amiable, 
their tenderness so genuine, that, while we pity, we give them 
our hearty respect. 
But there are doctors who take advantage of the craving for 
sympathy which all sick people have. They disguise their in- 
tense selfishness ; they assume a benevolent look ; they put on 
gentleness as a cloak ; they “ aggravate ” their voice ; and, in 
tremulous accents, talk soft words of kindness and pity. This 
practice, besides being a fraud, is a downright injury to the 
patient. It hinders his recovery. 
people need encouragement; and the brightest side of 
their case should be exhibited. 
The physician, who, at the bedside of his patient, thinks of 
aught except how he, best and soonest, can cure the disease, 
is not fit to take human life into his mercenary hands. He 
may take no thought for his own reputation. If he cure his 
patients speedily, people will find it out and he will have em- 
ployment ; but if he seek, by plausible trick, to cover up his 
deficiences in intellect or 'education, and gain an undeserved 
notoriety, although he may have a temporary success, his 
patrons will come at length to rate him at his real value. 
Patients need the bracing stimulus of hope, and not the 
enervating influence of solemn sympathy. 
The model physician irradiates the sick chamber with the 
light of his cheerful presence. He may not be hilarious-—he 
is not indifferent—but he has an irrepressible good nature, 
which lifts the patient out of the Slough of Despond, and 
places his feet on the firm land of health. In desperate cases, 
even a little harmless levity may be beneficial. Myrrh is good, 
but sometimes mirth is better. A well-timed jest may break 
up a congestion. A pun may add pungency to the sharpest 
stimulant. 
His patient may never know the extent of the danger from 12 
which he has been rescued ; he may never half appreciate the 
skillful services ; but, he is cured: and that is all about which 
the model physician feels any concern. 
Had the doctor been gloomy and pathetic ; adroitly exciting 
fears, and magnifying danger, the invalid and his friends would 
have been lavish of praise ; but the depressing influence of the 
sombre sympathy would have endangered the life, or prolonged 
the disease. 
But the model physician preserves his individuality. 
He does not tamely copy the manners of any one, however 
celebrated. 
Saul’s armor, although admirable for Saul, was promptly re- 
jected by David, as cumbersome and useless. 
The ponderous physician may challenge our respect, for his 
profound candor ; but we smile at his awkward attempts to be 
sprightly and playful. 
The solemn doctor moves us to tears only when he tries to 
be facetious. 
The model physician treats his professional brethren accord- 
ing to the injunction of the Golden Rule. 
He does not seek to exalt himself by dragging others down. 
He does not publish the mistakes of his neighbor ; for he 
knows that the broadest mantle of charity is often required 
to hide his own failings. Detraction, the sole weapon of little 
minds, has no place in his armor. 
He puts on no airs of patronizing condescension towards 
junior members of the fraternity. He affects no contempt 
for his competitors ; he never stabs with an innuendo ; he 
never damns with faint praise. He generously defends, from 
unjust aspersion, even his most formidable rival, and he always 
discourages those petty squabbles which so disgrace the pro- 
fession. 
The model physician may not be unduly sensitive ; he is 
not easily astonished ; but he is filled with wonder that any 
physician can hesitate to beg admission to the alms-house, 
rather than intrude or continue his attentions when he knows 
they are not welcome or required. 13 
You will expect me to say, and so I do, that the model 
physician belongs to the regular school ; yet candor compels 
me to add that I know some excellent men and women who are 
not of our faith ; and I am not quite certain that all regulars 
are model physicians. 
Four hundred and fifty years ago, Guy de Chauliac, tracing 
the character of a physician, recommended “that he be learned, 
expert, ingenious ; that he be bold where he is sure, and 
timid when in doubt ; that he avoid bad cures and practices ; 
be gracious to the sick, generous to his companions ; wise in 
predictions ; chaste, sober, pitiful and merciful ; not covetous, 
nor extortionate, but receive a moderate fee, according to his 
labor, the abilities of his patient, the character of the issue or 
event, and his own dignity.” 
Little need be added,—Ladies and Gentlemen—to this des- 
cription by the French physician. 
Your habits of study, your zeal, your respectful attention, 
your correct deportment, have furnished the Faculty of this 
College good ground for the belief that you will all strive to 
become model physicians. 
Obstacles may block up your path ; surmount them. 
Temptations will assail you,—temptations to indolence, to 
falsehood, to vice, to envy, to meanness, to impurity; resist 
them. 
Slander may becloud your reputation ; wait ; be concerned 
only to have your character invulnerable. 
Business may be dull ; you will have more time for study. 
Your cash receipts may be small ; the gratitude and love of 
your patients may be more precious than gold. 
To St. Luke, the practice may not have been lucrative ; but, 
for eighteen hundred years, he has been the “ Beloved Physi- 
cian.” 
We charge you to be true to principle and loyal to your 
profession. We invite you to reciprocate the love of your 
Alma Mater, and to labor for her welfare ; we counsel you to 
be sincere followers of the Great Physician, who ever went 
about doing good. THE MODEL PATIENT. 
Extract from an Address to the Alumni Association of Albany 
Medical College, Dec. 22, 1874, by H. D. Didama, President. 
In a limited sense, the model patient is one who trusts his 
physician implicitly, and takes, without murmur or grimace, 
the medicines set before him. He does not, as the manner of 
some is, ask prying questions concerning the name and nature 
of each ingredient in the potion ; and he never has the 
temerity to proscribe any remedy or appliance, however 
heroic, which the medical attendant prescribes. 
But in a wider sense the model patient is more than this. 
He exercises great care in choosing his family physician ; he 
bestows confidence without measure, and he stands firm and 
unwavering in his allegiance. He knows that human health 
and life are too valuable to be entrusted to the ignorant or 
rash or careless practitioner; that the relations subsisting 
between the family and the medical attendant are too intimate 
and sacred to be established with one who is immoral or 
vicious or indiscreet; and so the model patient selects as his 
physician a man of brain and conscience and heart; one who, 
by assiduous study, becomes possessed of the best thoughts of his eminent brothers in the profession ; one who is able 
and willing to make a practical and faithful application of his 
knowledge to the case demanding his care. . 
The model patient makes no experiments with quacks or 
quack medicines. Even the harmless herbs, which the good 
old nurse so kindly volunteers, and so highly recommends, are 
respectfully declined with thanks. He seeks not gratuitous 
aid from “ the retired clergyman, whose sands of life ” are 
still mercifully permitted to drizzle, although they had “ nearly 
run out ” years and years ago. The siren songs of the sarsa- 
parilla men have no seductions for him. He never consults 
the peripatetic mountebanks who periodically infest our cities 
and villages, no matter how loudly they may blow their clam- 
orous trumpets. He has learned, as a rule which has no ex- 
ception, that every boastful, advertising doctor is a quack, 
and that every quack is a swindler. 
The model patient treats his physician with consideration. 
If the illness be serious, or involved in obscurity, he may 
ask for a consultation ; but he allows his medical adviser a 
large liberty in the selection of counsel. He does not demand 
that a practitioner shall be called to whom there may be 
strong objections, personal or professional. If, after proper 
deliberation, the model patient, feeling a loss of confidence, 
decides to dismiss his physician, he communicates his decision 
with gentleness but entire frankness. He never first invites 
another doctor to make a clandestine visit, and then sends a 
sneaking dismissal to the regular attendant. And he is very 
careful not to indulge in the bad taste and unkindness ot 
parading before you, the new attendant, the faults and short- 
comings of your predecessor. 
The model patient cherishes a deep feeling of gratitude for 
the faithful services of his family physician. Of course, as an 
honest man he pays the doctor’s bills, and he pays them prompt- 
ly, and he manifests unfeigned surprise at what he calls their 
moderate amount. But this cheerful and ready discharge of 
the pecuniary obligation leaves unimpaired the grateful appre- 16 
ciation which isfelt for the doctor’s skillful and friendly offices. 
And instead of locking up this feeling in his own breast, the 
model patient seeks occasion to communicate it to his medical 
friend, and so brings refreshment to the care-worn spirit, and 
new strength to bear the sometimes weary load of professional 
life. 
The model patient stands fast in his loyalty to the physi- 
cian of his choice. Envy may detract, and gossip may cackle, 
and slander may hiss, but the intelligent and well-matured 
faith remains unshaken. The counsel of Polonius has been 
heard and heeded : 
“The friends thou hast and their adoption tried, 
Grapple them to thy soul with hooks of steel.” 
Gentlemen, I trust that you all have and all deserve many 
model patients. I trust that, when your birthdays come, you 
have, and will continue to have, many and many a souvenir 
of the warm friendship which your devoted skill has enkindled. 
And I trust that your pleasant dreams on the near at hand 
Christmas eve, of slippers and dressing-gowns, of neckties 
and warm, ribbed woolen stockings, of seal skin caps and gloves, 
and flowers, and pictures, and precious books, all from the 
dear ones at home, and from appreciative model patients, will 
be most abundantly realized.