AN 
INTRODUCTORY LECTURE 
DELIVERED BKFORE THE 
MEDICAL AND DENTAL SCHOOLS 
OP 
Parlmb (ttmbcvsitn, 
NOVEMBER 2, 1870. 
BY 
JAMES C. WHITE, M.D. 
ADJCSCT PROFESSOR OF CHEMISTRY. 
BOSTON: 
DAVID CLAPP & SON 334 WASHINGTON STREET. 
1870. AN 
INTRODUCTORY LECTURE 
DELIVERED BEFORE THE 
MEDICAL AND DENTAL SCHOOLS 
OF 
Y) urban) Murbcrsitj), 
NOVEMBER 2, 1870. 
BY 
JAMES C. WHITE, M.D. 
vnirr«w»,. 
ADJUNCT PROFESSOR OP CHEMISTRY. 
BOSTON: 
DAVID CLAPP & SON 334 WASHINGTON STREET. 
1810. INTRODUCTORY LECTURE. 
Gentlemen oe the Medical and Dental Schools :— 
Within the last few weeks many of the great cities of the 
civilized world have seen assembling within themselves many 
thousands of young men, drawn together by one common 
purpose, the same which brings you here to-day ; some from 
the adjoining recitation room only ; some back again after a 
period of quiet reading and resting in country homes, eager 
to renew old acquaintanceship and curious to study the faces 
of those who are to be your fellow students during the com- 
ing winter ; some fresh from college or other preparatory 
school, it may be the field or work shop, to hear for the 
first time a lecture upon the profession you have chosen for 
the study and work of your lives. The pleasant task of first 
addressing you, of bidding you heartily welcome to these halls 
and to your teachers, has fallen to the lot of one of the young- 
est of them, who has not had time to forget his own first im- 
pressions of student life, its expectations and dissatisfac- 
tions ; who hopes to be able still to speak to you simply as a 
fellow-student, only a little farther advanced along the path 
you are just entering. 
I will not question the motives which have led you to 
choose medicine as your profession ; it would be perhaps im- 
possible for most of you so to analyze them as to give a rea- 
son for your choice satisfactory even to yourselves. During 
the sophomore and junior years there seems to spring up 
among undergraduates across the river a wide-spread passion 
to study medicine. It obtrudes itself in the form of half-dis- 
sected cats and their distorted skeletons, of unpleasant ema- 4 
INTRODUCTORY LECTURE. 
nations and unexpected explosions within the Rumford rooms 
(or did in my day), in half-whispered accounts of visits to 
the operating theatre on Saturdays and entire silence with 
regard to the illustrations of syncope furnished the class 
while there. But these are exhibitions of a merely passing 
fancy, and the men who show the strongest manifestations of 
it seldom come here as students after graduating. It is not 
to be expected that you have chosen ; you 
may have been drawn to it instinctively, or because a love of 
botany or partially developed taste for chemistry or zoology 
has guided you, but it is impossible that you should, even 
in a faint degree, comprehend all the difficulties and delights, 
the grandeur and the gravity of the study of medicine, until 
you are fully engaged in it, until it has completely possessed 
you. It is for this reason that counsel from those older than 
yourselves is valuable at this important period of your lives, 
that you may know in what spirit you are to begin, and 
after what method you should pursue, the study of this un- 
known object of your immediate future. 
Fortunately we can go but a little way in the study of any 
of the branches of natural science, before that spontaneous 
and inevitable enthusiasm for the subject is developed, which 
attends the true student through life. Nature rewards those, 
who thus love and woo her with this spirit abundantly. It 
is the most prominent characteristic of all eminence in sci- 
ence ; it permeates the whole existence of the real masters 
and teachers of our art, and radiates upon all who come with- 
in their influence a kindred glow and devotion. Recognize 
and cherish its first impulses in each other and yourselves 
therefore. It will strengthen by encouragement, it may be 
killed in the bud by a laugh or a sneer. It is the fashion in 
some places to deride it and its manifestations, if they seem 
a little above or outside the ordinary worldly or practical mo- 
tives of action, and fashion is often mighty in such matters. 
It may crush out all the lofty and generous impulses in a 
generation, or in a community, or in a school of young men. 
But do you not be ashamed of enthusiasm. It has sometimes 
led men without a proper balance of intellect to do a foolish INTRODUCTORY LECTURE. 
5 
thing, but never an ignoble one. It is impossible to achieve 
real greatness in our art without it. Cultivate a spirit of 
enthusiasm for it therefore, and thus honor your manhood and 
the choice you have made. 
But I need not tell you that something more than this is 
necessary, and more necessary in our profession than in the 
study of any other ; that is hard and honest work. Work 
which, beginning with this hour for some of you, is to con- 
tinue for you all as long as you claim the title of student 
or doctor of medicine. There can be no end, no interruption. 
You have come here to learn medicine, but in the three years 
nominally assigned to that object we can teach you almost 
nothing of its past history, but a part of what you should 
know of what is at present known, so much only as will 
enable you to go on with ourselves with the study of that 
of the future. You will learn that in those branches in which 
science is making the greatest advances the least is posi- 
tively known, that the results of recent investigations in pa- 
thology, physiology, and chemistry are as startling as was 
the discovery of the circulation in its day, and that each new 
revelation shows only more clearly how ill-founded is much of 
what we have hitherto treasured as fixed knowledge, and 
how much remains to be known. 
You have entered, then, upon the study of a science always 
changing, to be ever new. Our posterity will never exhaust, 
never complete it. Your work, therefore, is of two kinds— 
to study the labors of other men in their relation to those of 
the past, and to learn to observe and investigate for your- 
selves. Now you will never advance far in either course 
without this work in its strictest and hardest sense. Call it 
“digging/7 labor, or what you will, you cannot shirk it or 
avoid it in any way. It is before every one of you, whose 
humblest ambition it is to make himself a thorough, self- 
respected physician, in its naked and unpleasing reality, as 
your inevitable lot, as long as your mental and physical 
powers hold out. As long as the science of medicine pro- 
gresses you must advance with it; the moment you drop 
the oars, you are far back in dead water. 6 
INTRODUCTORY LECTURE. 
This is not an inviting picture, I know, of your life to- 
morrow and everyday to come. Work is not an easy thing, 
at least to most men. It often means turning from the sweet 
and pleasant things of life, which are close at hand, to do 
much which is dry and difficult, apparently needless perhaps, 
for an object far off and doubtfully attainable. Such is the 
path, however, along which we must go, and happy are they 
who can follow it, surrounded by that golden atmosphere of 
enthusiasm, which makes one’s footsteps swift and light. 
But work can be made easier by cultivating habits of indus- 
try, by forming plans of study and disposition of time, the 
routine of which must be held inviolate. Custom makes 
everything endurable at last. Before this week has closed 
make your choice of studies, what lectures you will attend, 
what time you will pass in the dissecting-room and hospital, 
how you will spend the intervening hours, and how much of 
the evening you will give up to the requisite reading. These 
plans must vary for each of you of course, according to what 
you have already accomplished in your studies ; but having 
wisely fixed them and in proportion to your strength, make 
it a matter of honor with yourselves not to deviate from 
them a single day to the end of the course. Let even Feb- 
ruary, when lectures become a burden to student and teacher, 
and when lengthening days foretell the relief at hand, find you 
constant to this pledge. If you succeed, you will have gain- 
ed a victory which will well nigh of itself ensure your emi- 
nent success in after years, for the next trial will be easier 
to bear, and repetition of such training fixes the habit for life. 
Remember that there are no short cuts in medicine, that you 
are to take, what seems perhaps as utterly useless as it is un- 
interesting to you, at the value your teacher sets upon it, 
trusting him as the better guide to choose what you should 
be taught. With the confident expectation of the dawning 
of this spirit of enthusiasm, and with such self-promises of 
earnest and steadfast devotion to your purpose, I would have 
you to-day begin and continue your medical life. 
But which of all the many branches taught here am I to 
select, and how shall they be best studied, are questions INTRODUCTORY LECTURE. 
7 
which will naturally arise in the minds of those just entering 
upon these duties. To those who have received no advice 
upon these matters, and have never attended a course of lec- 
tures, 1 would say, devote the largest part of your time to 
anatomy, physiology, and chemistry. These will teach you 
the structure of the human body and the phenomena of its 
functions, which constitute healthy life. Many life-times 
have been spent in acquiring our present knowledge of them 
you can well spend a year upon the same. Until you have 
done so, you cannot comprehend the later studies relating 
to the abnormal manifestations of the same vital actions we 
call pathology. Disease can never be properly recognized, 
interpreted, or treated, until the composition and function of 
every tissue and organ in the body are so intimately known 
that the nature and extent of any deviation from their nor- 
mal laws are clearly understood. The autopsy room and 
lessons in pathology taught there are of no use to you, until 
you have familiarized yourselves with the dissecting-table 
and the histology learned in the microscope room. The bed- 
side and the medical lecture-room are no places for you, until 
you have learned all that physiology will teach, and have 
made yourselves familiar with chemical reagents and their 
action upon the normal tissues and fluids of the body; you 
cannot understand therapeutics or venture to produce the 
physiological action of drugs, until you have studied their 
toxicological laws and relations of incompatibility. Two 
years are given to these studies in better schools than ours ; 
so much you cannot give in our short and insufficient courses, 
but do not be tempted to give less than half as much. These 
branches are the groundwork of the art of medicine, and it 
is in these that students generally fail in thoroughness, and 
therefore as physicians fail to know their art through life. 
You are to study them in the months which immediately 
succeed in several ways. Sitting through a lecture or a 
course of lectures is not necessarily study at all, and even 
faithful and comprehensive listening is but a small part of it. 
What you hear is to be received into your mind, not to be 
shut up within the covers of a note-book. It is to be digested 8 
INTRODUCTORY LECTURE. 
while the impression is fresh upon the memory, and to be 
fixed there by the evening’s collateral reading. A note-book 
is useful for such immediate assistance to the memory; if 
kept as a substitute for it, it is worse than useless. But in 
addition to the lecture and the faithful reading at night, your 
days should be largely given to the dissecting-room and the 
microscope, and to such chemical and physiological labora- 
tory work as opportunity affords. A few dollars will give 
you all the apparatus you require to work out some of the 
most important investigations in these branches for your- 
selves, and to learn the processes of manipulation, which 
you will never acquire later, if you neglect them now. By 
such beginnings you will gain the taste and courage for that 
independent work in later years which will distinguish you 
from the ordinary practitioner. I do not mean to say that 
you should take absolutely no share in any of the other exer- 
cises of the school, that you should not attend operations and 
occasionally visit the hospital, and see an autopsy, and per- 
haps study surgery and materia medica ; but the less of 
these and the more of the others the better. A single year’s 
attendance upon the advanced branches after such a pre- 
liminary training will give you a far deeper knowledge of 
them than one gets by a three years’ course pursued without 
system or given wholly to the so-called practical or special 
branches. 
There is no such contemptible spirit among students as 
this exclusive or preferred attention to such parts of their 
studies as seem to have a practical value. It exhibits itself 
in attendance upon the lectures relating to the practice of 
medicine or the hospital visit only, and in the production of 
the note-book only when the word treatment is mentioned or 
the formula of a recipe is given, and in the neglect of all 
that raises medicine to the rank of a science and its followers 
to be learned men. It degrades the art to the level of a mere 
trade. Such would be the spirit of one of a band of natu- 
ralists who, in regions unexplored by science, should spend 
his time in stuffing his pockets with grains of gold for future 
barter, while his companions were collecting the new and INTRODUCTORY LECTURE. 
9 
beautiful productions of nature's present work or the ves- 
tiges of the past lying about him, the possible and long- 
sought solutions of the grand mysteries of creation. I trust 
there is no one here who will entertain for a moment the 
unworthy thought of what is the money value of any in- 
formation he may gain this winter. The truths we teach 
are worth knowing for their own sake, or they are not worth 
hearing. With us must rest the responsibility of the selec- 
tion of what is best to teach. Have confidence enough in 
our judgment to receive as alike important whatever we offer. 
There is another error with regard to choice of studies 
among students, of recent origin and of increasing impor- 
tance. It has arisen from the modern custom of specialties 
in practice, and the desire on the student’s part to devote 
his time wholly to those branches which seem to him most in- 
timately connected with the particular specialty he may have 
thus prematurely elected for his future career. It is an error 
fatal to your life both as student and practitioner, for it is im- 
possible properly to study the diseases of any one organ of 
the body without that preliminary knowledge of pathology, 
which is only to be gained by a study of the whole. The 
most renowned teachers in special departments have been 
most thoroughly accomplished in others. What would oph* 
thalmology, for instance, be to-day, had its special students 
not been eminent physiologists and physicists ? Make no 
plans for your future life of practice of this kind, while you 
are students; the physician only can study a specialty. 
Fortunately it is a self-limited error, for the present fashion 
which leads almost every young medical man on going abroad 
to study a specialty, tempted by the easy success of many 
who led the van, will soon glut the real demand for such 
practitioners and convert general practice into the specialty, 
thus restoring the equilibrium. 
I do not propose to discuss the subject of specialties, how- 
ever ; only to warn you, that you as students have nothing 
to do with it. What it has done for medical science in cer- 
tain departments, you have opportunities of learning from 
the courses of University lectures, hitherto so-called, deliver- 10 
INTRODUCTORY LECTURE. 
ed in the school during the year. I am sorry to say that 
these opportunities have not been improved, as they should 
be. The Faculty has endeavored during the past few years to 
have presented to you by gentlemen outside their body and 
most eminently fitted for such duty, a summary of the most 
recent advances in these new and special fields of research. 
These courses have been prepared with great outlay of time 
and painstaking, and such labor has been wholly gratuitous 
on their part your benefit alone. They have fur- 
nished just such advanced knowledge, as many of you will 
go abroad to seek after graduating, and you have it offered 
you here by, I do not hesitate to say it, some of the very 
best students of the best masters. Let me advise you to 
show your appreciation of such teaching and of the personal 
efforts of these gentlemen in your behalf by a more universal 
attendance upon such courses. 
There is one thing else I advise you to study during your 
whole pupilage, that is the German language ; because the 
most of you have no doubt already more or less knowledge 
of the French, and secondly, because it is so much more im- 
portant. Indispensable is the term I should use, for the sci- 
ence of modern medicine cannot be pursued without it. Why 
this is so, I shall try to explain later, but the fact is to be 
accepted that nine-tenths of all that is new and important in 
physiology, pathology, and medical chemistry is the work of 
German hands and brains, and is given to the world in their 
tongue. Sooner or later the cream of this is translated into 
English no doubt, but before it is converted into this medium 
of circulation much of it is no longer new, and for workers 
in the same fields nearly valueless. If you desire to keep 
up with the progress of your art, you must learn German. 
It is far more essential to you as students than any knowledge 
of Greek, or Latin and French you may have or have for- 
gotten ; it wilbbe to you almost a sixth sense of acquisition. 
Begin the study of it at once. Those of you who purpose to 
continue your studies in Europe, will find yourselves thus 
enabled to enter upon them without a six months' loss of 
time after reaching your field of operations, and most of you INTRODUCTORY LECTURE. 
11 
may not find elsewhere the favorable opportunity of learning 
which a large city affords. You all could use it to your im- 
mediate advantage in the reading to be done in connection 
with the lectures in some departments. 
Thus I have tried to show you in what spirit you should 
take up the work before you, how you should do it with 
your might, and in what order and method you should pursue 
the studies, and all the studies, prescribed for you, I have 
said that with us rests the whole responsibility of the 
choice of those studies and the character of the teaching. 
If you fail therefore after faithful improvement of the oppor- 
tunities here offered to become physicians of the first order, 
the fault is ours, and you and the community may call us to 
account. Is the standard of education in the medical depart- 
ment as high as in the others of the University of which we 
are a part, as in the other medical schools of the country, as 
in the schools of Europe, or as it should and can be ? These 
are questions about which a very wide difference of opinion 
exists, and in which the profession, and you, as future mem- 
bers of it, have the same interest as ourselves. It would be 
difficult perhaps to determine whether the system of medical 
education, so long adhered to in American schools, is due to 
the views concerning its efficiency held by the profession gen- 
erally, or whether it is the schools which are accountable for 
the tone which prevails in the profession at large with regard 
to the subject, because each creates the other; the schools 
fill up the ranks of the profession with their handiwork, and 
the profession in turn furnishes the teachers and governments 
of the schools. But it is perfectly fair to judge the latter 
by their fruits, and a comparison of the character of the medi- 
cal profession with that of the production of the other depart- 
ments of the University warrants the conclusion that in its re- 
lations to the scientific aspects of medicine we cannot claim 
for ourselves our proper share in the credit which attaches 
to the other learned professions. That our cities are not 
known and honored in other lands as much for distinguished 
physicians as for their well-known men in literature and sci- 
ence, is our own fault alone, and the reason is that we do not 12 
INTRODUCTORY LECTURE. 
sufficiently honor our own calling. We labor mainly to ac- 
quire position and comforts, but how few of us are really stu- 
dents and care more for the advancement of science than for 
our own “ getting-on ” in the world. How seldom has an 
American physician made independent and systematic inves- 
tigations in any of the sciences connected with medicine I 
How different is a medical reputation in some other countries! 
In Germany the celebrated physician first makes for himself 
a name by incessant toil and self-sacrifice. He cares neither 
for society, for appearances, for comfort, only for science, 
and then in after years come riches and honors, as well- 
deserved rewards. I would not have my meaning misinter- 
preted. I believe that those amongst us, who are so deserv- 
edly popular as practitioners, are in every way worthy of 
their success. It is the resting satisfied with success in 
practice and making this our only aim, which is so fatal to 
the progress of medicine with us. 
This opinion is less deserved of some parts of our coun- 
try than others; it has been too true I fear of all, I take 
my own share fully in any odium which may attach to any 
single member of the profession ; but I believe that such 
will be the inevitable future of medicine in America, until 
change is wrought, where I consider the source of the trou- 
ble lies, viz., in our medical schools. So long as it is held 
that there is a demand for cheap doctors in this country, and 
that an American can get as good a medical education in 
three years without any necessary preliminary mental train- 
ing, as a Prussian or Austrian youth thoroughly drilled to 
methods of work and habits of industry can get in six years, 
or one at any rate good enough, so long we shall make 
poorly educated doctors and nothing else; or we should do 
so, if students themselves did not know better and act ac- 
cordingly in exceptional cases. A student who spends one 
or more years in foreign schools, after being made a doctor 
here, cannot be pointed at as a specimen of American handi- 
work in answer to this view of the case. Do we ever reflect 
that the multitudes of American students in the medical 
schools of Vienna and Berlin are a reproach to our country ? INTRODUCTORY LECTURE. 
13 
Why do we not find an equal number in the seats of Law 
and Theology, of natural and mechanical science there ? The 
high and well-deserved reputation, which our students bear 
among foreign classes for quick perception and interest in 
their studies, shows the quality of the native material waiting 
the proper training at home ; though I fear that our student 
abroad clings too closely to the spirit of his American educa- 
tion, and is found still following too exclusively the practical 
branches of his art. This is the evil genius of our system, 
its radical defect. It is here and within our schools that we 
must meet it. Until we renounce the theory that medicine in 
America is to be taught not as a science as elsewhere, that 
only so much of it is to be served up to the student as will 
make him a good practising doctor, and that he has no share 
in its future progress as an independent worker in its deep 
places, we need not hope for better things. Plans for eleva- 
ting the standard of education by longer courses or forced 
attendance throughout the year, are of little importance, until 
we are prepared to make the spirit of our schools what it 
should be. Then every desired reform will follow without 
forcing. 
How is it with the other departments of learning ? Is there 
not the same demand for poorly educated men in the other 
professions as in medicine ? Yet what would we say of the 
character of a law-school which should content itself with 
a plan of instruction adapted to make its students merely 
good practising attorneys, and not attempt to stir a higher 
ambition in them for the graver matters of statesmanship and 
international law ; or what of a polytechnic that should turn 
out chemists and mining engineers with so little self-respect, 
so low a conception of the dignity of their calling as to sell 
their name to be attached to every nostrum in the market, 
or to furnish from an ounce of ore a certificate that a moun- 
tain of equal value awaits the investment of too credulous 
capitalists ? Should we not demand a reformation in their 
management; would not a University to which they were 
attached enforce it? Fortunately this is not the character 
of these professional departments of Harvard ; as high a tone 14 
INTRODUCTORY LECTURE. 
prevails throughout them as in any of the oldest and most 
renowned schools of Europe, and their graduates are recog- 
nized as the peers of their co-laborers all the world over. 
Can we say this of those whose education has been acquired 
solely in any of our schools of medicine ? Is there any rea- 
son why we should not be able to say it, or at least should 
not want to say it ? Has public opinion not a right to de- 
mand that medicine like all the other learned professions shall 
be of equal excellence with that of any country ? For if 
there is any question of education in which the public should 
feel an interest, and act on it, it is that which determines 
the character of those to whom it must confide the care of 
its physical well-being. 
To those who may say that I am taking an unpatriotic view 
of the matter, that my estimate of medical education and our 
profession in America is too low and unfounded in fact, I 
will only reply : when I find the young men of Europe flock- 
ing to our shores and crowding our native students from 
their seats and from the bedside, when the fees of our best 
lecturers are mostly paid in foreign coin, and when thousands 
of wealthy invalids from across the sea fill the waiting-rooms 
of our physicians, then I will confess that I am wrong, and 
that of the two systems of education ours is the best. Until 
then I shall seek in the spirit and working of their schools the 
secret of their success, the cause of our failings. 
Turning a little way back into the past will perhaps bring 
out in still stronger lights the truth of the lesson we may 
read there There was a time when the French capital 
was looked upon by the medical profession throughout the 
world as the one and only seat of science, where alone the 
grand truths of our art could be discovered and taught. 
Students from every country went thither to complete their 
studies, and to see the men whose names had been upon 
the lips of their teachers all through their early instruction at 
home as derai-gods in science, and whose opinions they had 
been taught to receive unchallenged, as fixed principles. 
Even the hospitals associated with their teachings became 
famous, and Hotel Dieu LaPitie, La Charite, du Midi, San INTRODUCTORY LECTURE. 
15 
Louis, were as familiar and classic names to the student of 
medicine, as the Parthenon and Forum had been during school 
and college days. The distinguished men who composed 
the Faculty were then at the height of their fame, and form- 
ed a body whose brilliant reputation was fully deserved and 
has never been equalled. Paris had then no rival as a school 
of medicine ; she was the acknowledged front and centre of 
science. This was only a quarter of a century or less ago ; 
but what position does she hold now ? The earnest students 
of other countries no longer visit her exclusively, or even 
first or second, to complete their general studies, or to per- 
fect themselves in any special branch of our art; nor is French 
now the universal or most important language of science, 
as it once was. The very names which then commanded 
such world-wide respect are now almost memories associated 
with the past, and are no more the representatives of the 
medicine of to-day. 
What is the cause of this decadence ? Why is it that 
the Wiener Schule holds at this moment the place then occu- 
pied by the Ecole de Medecine ? The great masters in Paris 
have not died out and left their places to be filled by smaller 
men in Vienna, for with one or two exceptions the roll of 
French professors bears the same distinguished names that 
it did twenty-five years ago. Other causes have wrought 
the change. Gradually the philosophic German mind, so 
sceptical and irreverent as to accept no dogmas unchallenged, 
and so patient and industrious in following the suggestions 
of nature to their very source, began to make itself heard. 
This influence, at first felt in small things and expressed in 
special directions, soon became an acknowledged power, as 
the careful observations of devoted students, men who cared 
for little else in life than their studies, who had no higher am- 
bition than their scientific reputation, who knew no other 
pleasure than was to be found in the laboratory or hospital, 
and who never aspired to become rich, became known. Such 
men as these were called together, as their names and works 
attracted attention, and formed the Vienna School, a body 
of special students, in no way men of brilliant genius, but 16 
INTRODUCTORY LECTURE. 
keen observers and accomplished teachers. It is this devotion 
to study in special directions, as the prime object of their 
lives, science before wealth, that has made German medicine 
what it is. It has given ns Rokitansky, Virchow and Forster 
in pathology; Wunderlich, Oppolzer, Skoda and Frerichs in 
general medicine ; Hyrtl in anatomy ; Briicke and Ludwig in 
physiology ; Jager, Grsefe, Bonders and Arlt, Ilebra, Sig- 
mund and Scanzoni in their special departments; Liebig, Leh- 
mann and Scherer in chemistry, and many other distinguished 
instructors who might be mentioned. In the meanwhile 
Paris has been living chiefly on the reputation of her past 
greatness, and the slight progress she has made has seemed 
complete stagnation by the side of the vast advance of her 
indefatigable German neighbors 
This is a sketch I made only four years ago. See how 
closely the words then written resemble the language of Prof. 
Helmholtz, perhaps the purest scientist living, at the meet- 
ing of the German Association for the Advance of Science, 
at Innsbruck two years ago, in speaking of the secret of the 
success of science in Germany—the Siltenstrenge und uneig- 
ennutzige Begeisterung of its students. Words which Prof. 
Rolleston quotes in his recent address before the biological 
section of the British Association, and which, that they might 
be the guiding principle of all other students of science, he 
translates—“ Severe simplicity of manners and absence of a 
spirit of self-seeking.” What might not be said of the lesson 
brought down to these memorable days in the history of the 
two nations. How have splendor and self-glorification, wor- 
ship of pleasure and shallowness of life gone down before 
earnest devotion to duty, trained habits of industry, and the 
highest and most universal education of the individual 1 
When I went to Vienna, fourteen years ago, I found but 
one American student there; but few had been there before 
me at long intervals, and hardly one, I believe, to remain any 
length of time. In contrast, a picture may be seen hanging 
in the office of many of our youngest physicians apparently 
of the recitation-room of our professor of clinical medicine 
during the summer session. The somewhat unstudent-like 17 
INTRODUCTORY LECTURE. 
grouping will reveal to closer observation, however, that it is 
a Vienna photograph, but recently taken, in which that in- 
structor is surrrounded by the multitudes of our former stu- 
dents, who were continuing their studies there at that time. 
The change from then to now is not greater perhaps than 
what may follow a few years hence, when the graduates from 
our progressive collegiate department shall omit the interme- 
diate step here, and begin, as well as end, their medical stu- 
dies in foreign schools. Such must inevitably follow as the 
sequence of a more general acquaintance with the superior 
advantages offered by them, and with that requisite knowledge 
of the German language which enlarged freedom of election 
will afford, unless American schools shall make such a course 
unnecessary, by making themselves what those are and they 
should be. 
This is to be a work, however, of slow and gradual pro- 
gression. It cannot be enforced by any enactment of associ- 
ations or change of statute alone. Their future success de- 
pends upon the teachers, and teachers, such as have made 
those schools what they are, must be created by our schools, 
and that is possible only by adopting the spirit and system 
which have led them up to their greatness. An ardent enthu- 
siasm, earnest devotion to work, and a search for truth for 
truth’s sake alone ; and a system which recognizes a thorough 
scientific training as the only groundwork for a medical educa- 
tion, which teaches to the utmost limit the science of medi- 
cine in all its branches, and which believes, and proves, 
that the most practical man and best practising physician is 
he who has the widest and deepest knowledge of these sci- 
entific truths. 
Follow with me the first clinical teacher in the world at 
the bedside. See how largely, in all he teaches, he draws 
upon the sciences connected with medicine, how thorough a 
knowledge of them he reveals, how constantly he applies it 
in the illustrations of his marvellous powers of diagnosis, how 
it makes him the renowned practitioner, as well as teacher, 
that he is. His knowledge of them is not picked up second 
hand, nor is it a patchwork of fragments selected with sole 18 
INTRODUCTORY LECTURE. 
reference to its practical application. None more eager than 
he in attendance at the laboratories of his co-laborers in 
chemistry and physiology, at the microscope, by the cadaver ; 
none so constant through years, always searching, but as 
ready to follow as able to lead, knowing that there can be 
no halt in such labors and duties. Can we wonder at the 
success of a school where the most practical branches are 
thus taught? Yet there are those who hold and express 
honest convictions that such studies are not a part of a prac- 
tising doctor’s business, and that their patients are even the 
worse for it. In other words, that a man cannot make per- 
sonal investigations in the sciences connected with medicine 
and do his whole duty by his patients. See how the vast ad- 
vances in modern ophthalmology, which have elevated this 
branch of surgery to the rank of a true science, have been 
the result of the labors of a few such men as Bonders, per- 
formed in the midst of the busy life of the popular practi- 
tioner. Do we not prize the professional advice of such 
as of the highest value, and seek it at any price ? Scientific 
truths of the most important practical bearing in medicine 
must in fact be mainly the result of the study, if not the 
prime discovery, of medical men, and I believe that no man 
can be a fit teacher to a medical school in any of the collateral 
branches of science, who has not received that special train- 
ing which a medical education alone affords. 
Who of us can say that he gives his whole time to his 
patients, that he takes no interest or active part in concerns 
outside the immediate care of patients, which might not, 
with the same devotion to them, be spent as well in the culti- 
vation of scientific studies ? Do not some of our best and 
busiest physicians find time and inclination for such side 
studies? May I not be allowed the liberty of naming one 
formerly and so long connected with this School, who though 
now retiring from an active part in the labors of his life, 
has been for so many years the acknowledged and revered 
head of our profession in New England, the physician to so 
large a portion of our most refined citizens, and the councillor 
sought above all by physicians far and near; is it believed INTRODUCTORY LECTURE. 
19 
that he was any the less skilled or attentive in his personal 
care of the sick, any the less sagacious in consultation, for 
the labors of his earlier life as explorer and writer in the un- 
roamed fields of American botany, in whose path no gleaner 
has since been needed ; or for those later studies in the arts 
and sciences, which made him so long conspicuous as the fit 
president of the most ancient and learned body of men of 
science and letters in the country ? Would any of us change 
the memory which will attach to the name of Bigelow in 
American medicine ? Would we rob our models of the orna. 
ments which have given them this distinction ? I fear we 
should thus degrade the greatest of them, if we are consist- 
ent with such teaching. Let us rather believe that great 
physicians have become great not in spite of, but in conse- 
quence of this cultivation of the sciences and liberal studies, 
which so characterize their lives. 
Let me use the branch of medical instruction with which 
I am connected as an illustration of the relations of what is 
called science to medical education. There is no study which 
is considered less practical by the student, therefore there is 
none in which he takes so little interest, none in which he 
betrays such extreme ignorance in many cases at examina- 
tion for degrees, as chemistry. How shall such a branch be 
taught ? Chemistry has become of itself a circle of sciences, 
which no one man can now master, even by exclusive devo- 
tion to its study. It is applied chemistry then alone which 
can be taught in a medical school, and the question is, how 
widely or how narrowly shall we interpret its application. 
Take, for instance, its relation to the study of one of the most 
important excretions of the body, the urine. Every student 
knows the importance of a chemical examination of this solu- 
tion as a means indispensable in the diagnosis of certain dis- 
eases, and that it is necessary to be able to recognize the 
presence or absence of certain substances in it by simple tests. 
But is it enough for him to know, or for us to teach, the 
crystalline form and chemical reaction alone of uric acid and 
urea, for instance, and the semeiology of their fluctuations ? 
Is he not rather to be led also to comprehend how inti- 20 
INTRODUCTORY LECTURE. 
rnately the study of these bodies is connected with that of 
the metamorphosis of our tissues and the dynamic value of 
the intermediate products of tissue change ; how from the 
former an almost endless series of new compounds may be 
created, some of which are important way-stations between 
health and disease, and which can only be understood 
through the formulae which express so much while seem- 
ingly so meaningless? How the latter, the last expression 
of a long series of intermediate chemical changes, passes 
out into the world again reduced to the simplest form of 
matter, ammonia and carbonic acid, to form in turn the life 
of the vegetable upon which the animal directly depends 
for support. How the quantity of urea is the index in part 
of the amount of heat and motion manifested by our tissues ; 
how its spontaneous change into ammonia and carbonic acid 
leads to the lesson to be learned by the study of its artificial 
production in turn form cyanate of ammonia, which was the 
first blow to the theory of vital action as a necessity in the 
conversion of inorganic into organic matter. 
These are but a few only of the questions of prime import- 
ance suggested by the mention of these well-known ingredi- 
ents of this excretion, but they form but a small page in its 
chemistry as a whole in relation to medicine, and this but 
a chapter in the grand volume of physiological chemistry. 
Even the little deviations from its ordinary operations, which 
we know as pathological chemistry, can never be fully un- 
derstood without a thorough knowledge of its normal laws in 
their widest application. 
But it is not only in its relation to disease that the study 
of chemistry is of interest to the student Recent inquiries, 
directed by a few master minds, into the laws and pheno- 
mena of nature, have shown that a marvellous correlation 
exists not only between her creations, both animate and in- 
animate, but between forces hitherto considered distinct, 
bringing so-called physical laws into close connection or 
identity with those we call chemical, and throwing grave 
doubts upon the existence of any such distinct power as 
that called vital force. The study of auimal chemistry has INTRODUCTORY LECTURE. 
21 
therefore come to occupy a position of great importance 
and interest in this connection, for it is through its aid that 
we can trace the mutual relationship existing between the 
phenomena of our vital existence and outside physical forces 
and their products, between our tissues and those manifesta- 
tions of our higher and inner nature we call mind or intellect. 
These questions have excited the active interest of the high- 
est intellects of our time. Their consideration has been im- 
patiently snatched from the field of scientific observation, and 
made the subject of passionate discussion in public arena. 
Such opinions as the following could indeed hardly pass 
unchallenged. 
Prof. Owen expresses his conviction that “vital forces are 
only ordinary physical forces, that inanimate matter is made 
into living beings by conversion of chemical into so-called 
vital action.” 
Odling says, “ But what the physiologist means by vital 
force I have never been able to understand. So far as I can 
make out, it seems to be a sort of internal, intransferable, im- 
measurable, self-originating power, which performs nutritive 
acts by its absolute will and pleasure, as if it were not abun- 
dantly manifest that the growth of a plant and incubation 
of an egg cannot be performed without a direct supply of ex- 
ternal force. * * * Seeing then that the enormous number 
and variety of animal and vegetable compounds are produced 
out of carbonic acid, water, and ammonia, not by any peculiar 
vital force, but merely by the light and heat force of the sun 
acting through organic machinery, the question naturally 
arises, whether the chemist may not effect in his laboratory- 
machinery a similar intercombination of deoxidized carbonic 
acid and water, either by a direct application of sun-force, 
or indirectly by the aid of those terrestrial transformations 
of sun-force, which are so abundantly at his disposal. This 
question, decided absolutely in the negative so long as the 
fiction of vital force tyrannized over men’s minds, has of late 
years received a rapid succession of brilliant affirmative re- 
plies. Already hundreds of vegetable compounds, heretofore 
produced only in living organisms, and, as was supposed. 22 
INTRODUCTORY LECTURE. 
put together and held together by vital force, have been form- 
ed by the chemist in his laboratory, * * We see no reason 
to question the chemist’s ultimate ability to reproduce all 
animal and vegetable principles whatsoever.” 
There are those, however, who do not stop here, content 
with thus referring our merely animal functions to the gene- 
ral chemical and physical laws which govern all matter, laws 
which make no distinction in their control over the growing 
crystal and the human foetus, but would apply the same ex- 
planation to those intangible manifestations of consciousness, 
will, and intellectual power, which we have so long looked 
upon as within us and not of us, far removed from any con- 
nection with material phenomena, and which we call mind. 
The theory is a fair one, and we should not be scared from 
its contemplation now or its acceptance hereafter, if pro- 
perly substantiated, by any cry of materialism or heresy it 
has stirred up. The same outcry has been resounding in 
ever narrowing circles from long before the days of Coper- 
nicus and Galileo. If it had been heeded our knowledge of 
geology would still be confined within the scriptural state- 
ment, and our acquaintance with man’s previous existence 
on the earth limited by the records of a restricted archaeology. 
It has been the never failing opponent of all progress in 
natural science, but its influence has perhaps been more bene- 
ficial than otherwise, as it has served as a healthy stimulus 
to observers. We should never let it deter us therefore in 
our investigations of the laws of nature, or hesitate to accept 
the path their proper interpretation points for us, over what- 
ever dogma it may lead. A search for truth in an honest 
spirit of inquiry will never lead us to wrong, as we follow 
only where the Creator has been before. 
Thus we shall be prepared to receive in the spirit in which 
they are written these words of Prof. Huxley in his lay ad- 
dress on Protoplasm or the physical basis of life. “ In physi- 
ological language all the multifarious and complicated activi- 
ties of man are comprehensible under three categories. * * * 
Even those manifestations of intellect, of feeling, and of will, 
which we rightly name the higher faculties, are not excluded INTRODUCTORY LECTURE. 
23 
from this classification, inasmuch as to every one but the sub- 
ject of them, they are known only as transitory changes in 
the relative positions of parts of the body. * * * Carbon, 
hydrogen, oxygen, and nitrogen are all lifeless bodies. Of 
these carbon and oxygen unite in certain proportions and 
under certain conditions, to give rise to carbonic acid ; hy- 
drogen and oxygen produce water; nitrogen and hydrogen 
give rise to ammonia. These new compounds, like the ele- 
mentary bodies of which they are composed, are lifeless. 
But when they are brought together under certain condi- 
tions they give rise to the still more complex body, proto- 
plasm, and this protoplasm exhibits the phenomena of life. 
I see no break in the series of steps in molecular complica- 
tion. * * * If the properties of water may be properly said 
to result from the nature and disposition of its component 
molecules, I can find no intelligible ground for refusing to say 
that the properties of protoplasm result from the nature and 
disposition of its molecules. But I bid you beware that, in 
accepting these conclusions, you are placing your feet on the 
first rung of a ladder which, in most people’s estimation, is 
the reverse of Jacob’s, and leads to the Antipodes of heaven. 
It may seem a small thing to admit that the dull vital actions 
of a fungus, or a foraminifer, are the properties of their pro- 
toplasm, and are the direct results of the nature of the matter 
of which they are composed. But if, as I have endeavored 
to prove to you, their protoplasm is identical with, and most 
readily converted into, that of any animal, I can discover no 
logical halting-place between the admission that such is the 
case, and the further concession that all vital action may, with 
equal propriety, be said to be the result of the molecular 
forces of the protoplasm which displays it. And if so, it 
must be true, in the same sense and to the same extent, that 
the thoughts to which I am now giving utterance, and your 
thoughts regarding them, are the expression of molecular 
changes in that matter of life which is the source of our other 
vital phenomena. * * * Every word uttered by a speaker 
costs him some physical loss; and in the strictest sense 
he burns that others may have light. So much eloquence, so 24 
INTRODUCTORY LECTURE. 
much of his body resolved into carbonic acid, water, and 
urea. * * * * Two things are certain : the one that I hold 
these statements to be substantially true ; the other that I, 
individually, am no materialist, but on the contrary believe 
materialism to involve grave philosophical error.” 
I have thus quoted from some of the most daring and yet 
soundest thinkers and keenest observers, to show the tendency 
of modern belief in these directions, and to illustrate how 
intimately the study of animal chemistry is connected with 
some of the most profound problems of life. In fact, the 
conclusions they advance are founded in detail almost wholly 
upon the observations of the latest German workers in phy- 
siological chemistry, and none but those prepared by study 
to judge the accuracy of the latter, are competent to decide 
how far the deductions of the former are justified. They are 
questions, however, about which all the intellectual world 
is talking, and too large a portion of it writing. Protoplasm 
has succeeded Darwinism, and later the Correlation of Forces, 
as the pet theme, and a great deal of nonsense is said and 
written about it. The thought of vast beds of homogeneous 
Urschleim, the matrix of sub-embryonic life, the unshaped 
beginning of the fauna and flora of future epochs, lying be- 
neath the silent and solemn depths of ocean, is indeed calcu- 
lated to startle the reason of men of science from its accus- 
tomed channels, and excite the interest of the least thought- 
ful. You will find yourselves often called upon, no doubt, 
as professional men and students, to explain or offer an opin- 
ion upon this or that statement in the controversies which 
have arisen and are to follow, but you will be able to make 
but a poor response, unless you have made yourselves fami- 
liar with the details of the data upon which the whole ques- 
tion is based, and which concern you so deeply in other 
relations. 
I would have chemistry taught, then, in its widest applica- 
tion possibly consistent with the student’s period of study; 
in its fullest bearing upon and as the most important means 
in the study of physiology ; in its relation to materia me- 
dica, the incompatibility and physiological action of drugs ; INTRODUCTORY LECTURE. 
25 
as the basis of toxicology, and its important services to medi- 
cal jurisprudence; and, finally, for the superior and exact 
mental training it affords to a profession sadly needing it, and 
for its irresistible guidance of the student into the ever widen- 
ing paths of general science and a broader culture. I would 
have the student taught all this, not as if it were to be the 
end of its study, but as the beginning of independent work 
on his own part in one or the other of these directions, so 
that his life may have given something to science in return 
for the much he has received from the labor of others. 
And such is the spirit I would see carried into all your 
studies. I would have you dispossess your minds of the too 
common belief that everything can be learned at the bedside ; 
it is a fatal barrier to individual and national progress in 
medicine. Nothing can be gained there but the shallowest, 
routine acquirements, until the senses have been taught how 
to investigate, and the mind prepared, by long and diligent 
study of the normal laws of life, to comprehend the phenome- 
na of disease there presented. Even when thus trained, you 
will find that much of the first importance cannot be gained 
by bedside studies. Man has been looking at his sick brother 
now for centuries; he has learned the interpretation of many 
symptoms, and the pathological changes of structure and 
disorders of function thus indicated, but what has he learned 
there of their causes, and how little of means to cure! 
Medicine has accomplished but little yet of its possibilities 
for the benefit of mankind. I may venture the prophecy that 
its grandest discoveries are waiting outside the sick room ; 
that in his surroundings, the air he breathes and its unseen 
inhabitants, the foreign elements which make his food and 
drink, the soil upon which he dwells, lie hid the obscure 
causes of pestilence and contagion. They will not reveal 
themselves by watching their effects, nor will they cease to 
do their accustomed evil in the world, while the present narrow 
system of exclusive clinical investigation is adhered to. 
There is of course nothing new in this prediction ; we are all 
familiar with such views, and all believe there may be some- 
thing in them, as we say, and there stop. But where do we 26 
INTRODUCTORY LECTURE. 
see put in operation in any systematic and large way, and 
by competent observers, those investigations which would 
sooner or later test their truth ? Where are our students 
taught, as they should be, the laws of hygiene, and made 
acquainted with the lowest forms of organized existence, 
without which knowledge their explorations may result in 
such pretentious exhibitions as have lately been forced upon 
public attention to the discouragement of future intelligent 
observation in the same field! 
I cannot refrain from quoting in this connection the 
closing passages of Professor Huxley’s address delivered 
before the British Association for the Advancement of Science 
at Liverpool a few weeks ago, on the germ theory of life. “ I 
commenced this address,” he says, “ by asking you to follow 
me in an attempt to trace the path which has been followed 
by a scientific idea, in its long and slow progress from the 
position of a probable hypothesis to that of an established 
law of nature. Our survey has not taken us into very at- 
tractive regions ; it has lain chiefly in a land flowing with 
the abominable, and peopled with mere grubs and mouldi- 
ness, and it may be imagined with what smiles and shrugs, 
practical and serioiis contemporai’ies of Redi and Spallanzani 
may have commented on the waste of their high abilities in 
toiling at the solution of problems which, though curious 
enough in themselves, could be of no conceivable utility to 
mankind. Nevertheless you will have observed that before 
we had travelled very far upon our road there appeared, on 
the right hand and on the left, fields laden with a harvest of 
golden grain, immediately convertible into those things which 
the most sordidly practical of men will admit to have value, 
viz., money and life. * * * * Looking back no further than 
ten years, it is possible to select three in which the total 
number of deaths from scarlet fever alone amounted to ninety 
thousand. That is the return of killed, the maimed and 
disabled being left out of sight. Why, it is to be hoped that 
the list of killed in the present bloodiest of all wars will not 
amount to more than this ! But the facts which I have 
placed before you must leave the least sanguine without a INTRODUCTORY LECTURE. 
27 
doubt that the nature and the causes of this scourge will, one 
day, be as well understood as those of the Pebrine* are now ; 
and that the long suffered massacre of our innocents will 
come to an end. And thus mankind will have one more ad- 
monition that 'the people perish for lack of knowledge;7 
and that the alleviation of the miseries, and the promotion 
of the welfare, of men must be sought, by those who will not 
lose their pains, in that diligent, patient, loving study of all 
the multitudinous aspects of nature, the results of which con- 
stitute exact knowledge, or science.” 
But what can be done to correct the failings of medical ed- 
ucation in America, to elevate its tone, to stimulate the culti- 
vation and teaching of science, to place our schools on an 
equality with those of Europe, with other departments of learn- 
ing at home? In the absence of any general central power 
such a change can be effected, I believe, by no concerted or 
enforced action on the part of the schools, for they are too 
numerous and are governed by too diverse and independent 
motives of interest to unite in any practical scheme of reform. 
Each must act for itself, and stand or fall as its policy proves 
to be wisest or not in the end. We are responsible therefore 
only for ourselves, and the question reduces itself to the rela- 
tion of Harvard University to medical education, to the du- 
ties of you its students, of us its representatives in the medi- 
cal department. Your own obligations to the future of the 
profession, to the school, and to yourselves, I have tried to 
place before you in what I have already said ; but how can we, 
who are answerable for its more immediate success, respond to 
that new vitality which, radiating from the collegiate centre, 
shall freshen all the other departments to unwonted activity ? 
How can we contribute our share to the common purpose of 
making our alma mater in all her schools the head of educa- 
tion in America, a true University of the first class ? 
First, we might insist that students should come better pre- 
pared by previous intellectual training and by the study of 
* Vine disease. 28 
INTRODUCTORY LECTURE. 
such preliminary branches as general chemistry, physics, 
botany, and the Latin, French, and German languages, to 
comprehend at once the higher lessons of applied science. 
Secondly, that they should remain connected with the school 
throughout their whole period of study ; that the lectures 
should not be crowded into four months' space of over-work, 
but blend with the present summer course of instruction in a 
harmonious and far more useful scheme; that the students 
should be divided into classes by years, and be required to 
follow the gradation of studies adapted to such classification ; 
and that the whole time of study be prolonged one or two 
years, as in foreign schools. Thirdly, that no student should 
receive a degree in medicine, until he has passed a satisfac- 
tory examination in every branch that is taught in the school. 
Such are the measures which in time would raise an Ame- 
rican Medical School to an equality with the best elsewhere ; 
they can be, and, I trust, will eventually all be carried out; 
but what would be the immediate result, if the government 
of the University should ordain such a revolution in the 
American system ? An analysis of the list of those who at- 
tended lectures last year shows that of 276 students but 62 
had received a previous collegiate education, so that proba- 
bly not more than a quarter of the whole could have met the 
required terras of admission ; next, that but 92 of the whole 
number were connected with the summer school during any 
part of their whole course of study, and this represents fairly 
enough the proportion of those whose circumstances would 
permit a constant connection with the school, even fora three 
years course ; were it prolonged, even this estimate might 
be too high. We may conclude then that such a reform would 
inevitably be followed by the immediate loss of two thirds 
of its present number of students, by an equivalent crippling 
of its material resources, and the sacrifice of the prestige of 
a large school. It is evident therefore that without other 
means of support than those now at command the school 
could not be carried on. 
But if on the other hand such means were provided, what 
would be gained to counterbalance that which would be lost INTRODUCTORY LECTURE. 
29 
by such a reformation ? In the first place we should be able 
to systematize our instruction, now wholly impossible when 
individuals may begin their studies at all times ; for when 
the third year student and the beginner without the slightest 
preliminary knowledge of chemistry, for instance, are to be 
found in the same recitation-room, it is evident that such 
instruction must be far above the understanding of the one or 
as far below the requirements of the other. We should 
equalize the value of our degrees, which are now most unfair 
in their significance, while no distinction is made between 
the student who only sits more or less of four months in our 
lecture-rooms and those who have been under our personal 
guidance for three entire years. Now Harvard University 
puts the same stamp of approval and warranty on both. 
And we should enhance the value of our degree a hundred 
fold. As it became known that this school had ceased to com- 
pete with others in a system so well adapted to make the 
most rather than the best physicians, that it required a certain 
preliminary training before it received students, and kept 
them long enough to educate them thoroughly before it let 
them go, and that its degree meant something quite apart 
from that of other schools, this certificate from the oldest 
university in the country would be sought by the best class 
of students from all its parts, as is that of its other depart- 
ments, and its graduates would at once assume a distinctive 
position in the profession. This would force the best exist- 
ing schools in turn up to a higher level, and thus the charac- 
ter of medical education would be gradually rescued from its 
present deplorable condition. Such, I believe, would be the 
happy results of such a reform. Such a reform, too, would 
best come from a school which was the first to establish the 
summer session, and has inaugurated within a few years other 
changes in the system of medical instruction, by which it 
has not only greatly improved itself, but the schools of other 
cities also which have followed its lead. 
But if we cannot with our present means immediately effect 
so great a change, we can at least and at once take some of 
the steps above alluded to. If we cannot make it obligatory, 30 
INTRODUCTORY LECTURE. 
we can make the summer course so instructive that students 
will be drawn to spend the whole year in the school. We can 
encourage a love of science and the habit of independent in- 
vestigation among them. We can insist that the student 
shall pass a satisfactory examination in every department, 
before he can obtain a degree. If these branches, each and 
all, are considered an essential part of medical education, of 
course no person is fitted for practice, until he has acquired 
the slight knowledge of them necessary to pass the exami- 
nation at any of our schools. Yet the university now pub- 
lishes, with other inducements to the student, the offer that 
he need prepare himself in but five out of the nine depart- 
ments taught. How, with so wide an opening for escape 
kept standing before his eyes, can we expect him to know 
anything of the branches not directly connected with prac- 
tice. Finally, we can encourage the beginning of any move- 
ment tending to the consummation of any or all of these 
changes. 
The last public ceremonial in the Annals of the University 
before this of to-day was the laying of the corner-stone of a 
memorial in commemoration of her sons who met heroic 
death in discharge of man’s noblest duty. It is a monument 
to the dead, but for the living. While it rises, and as long 
as it continues to stand, it should be to all, student, teacher, 
graduate, the same memento ; that the spirit which led them 
in the hour of their country’s peril to offer their lives to her, 
should be none the less ours in the safe and easier future 
they have left us ; a spirit of devotion, of self-sacrifice if 
need be, to the highest duties, towards the noblest ends—not 
reserved for public and exceptional display, but to be the 
ever constant motive in the doings of daily life. To show 
how we may best discharge our present obligations to human- 
ity and to the cause of medical education in America, has 
been the motive of this address.