f
y £U^
ORATION
DELIVERED BEFORE THE
HUfotcal  anb Cjrintrgkai  Jfatnltjj
OF
            JUNE 3,  1858,

                     BY

      SAMUEL  CHEW, M. D.,

Professor of the Principles and Practice of Medicine, and of Clinical Medicine,

         IX THE UNIVERSITY OF MARYLAND.
  Omnibus bonis in rebus conatus in laude, effectus in casu est: et sicut ad pcenam
sufficit meditari punienda, sic et ad laudem satis est eonari prasdicanda.—Apci.eius.
Florida, 20.
        BALTIMORE:
PRINTED BY HEDIAN & PIET,
       No. 82 W. Baltimore Street.
              1858. 
\ 
                ORATION

                    DELIVERED BEFORE THE

Jjjefoical  airir  (ftjjtntrgicai  Jfacdtg
                            OF
              MARYLAND,


                  JUNE  3, 1858,
                            BY   {J
           SAMUEL  CHEW, M. D.,
    Professor of the Principles and Practice of Medicine, and of Clinical Medicine,
              IN THE UNIVERSITY OF MARYLAND.
  Omnibus bonis in rebus conatus in laude, effectus in casu est: et sicut ad poenam
sufficit meditari punienda, sic et ad laudem satis est eonari proedicanda.—Apuleios.
Florida, 20.
         BALTIMORE:
PRINTED  BY HEDIAN  & PIET,
       No. 82 W. Baltimore Street.
               1858. 
                                                  Baltimore, June 5, 1858.
Dear Sir:
  The undersigned have been appointed a Committee by the Medical and Chirurgi-
cal Faculty of Maryland, to tender to you the thanks of the Faculty for the very
eloquent and able address delivered before them on the occasion of their late anni-
versary session, and to request a copy of the same for publication.
                  Very truly, yours, &c.,
                            J. GILMAN,  M. D.,
                            H. M.  WILSON,  M.  D.,            Committee.
                            W. H. DIFFENDERFFER, M. D.,.
  Prof. Samuel  Chew, M. D.
                                                 Baltimore, June 6, 1858.
 Gentlemen:
  I have just received your obliging communication of June the 5th.  The address
to which you so kindly refer, was prepared hastily and with no view to publication.
Such, however,  as it is, I submit it, of course,  to the disposal of the Medical and
Chirurgical Faculty.
  With great respect for the Society which you represent, and for yourselves per-
sonally, I am, gentlemen,
                          Very truly, your obedient servant,

                                                        SAMUEL CHEW.
  J. Gilman, M. D., H. M. Wilson, M. D., W. H. Diffenderffer, M. D.,
                                                               Committee. 
ORATION.
   Mr. President and Gentlemen :—The present  annual meeting of our
 Society is an occasion of more  than ordinary interest.   The building in which
 we assemble to-day for the first time, is one which has recently become the
 property of our Association.   We have  heretofore had  no fixed and regular
 place of convocation.  To-day  we inaugurate a wiser and better arrangement
 of our polity.  From to-day we are  prepared, as a body, to experience the
 happiness ascribed by the wandering hero of the Roman Epic to those who
 possess a local habitation, "Forlunati quorum jam mcenia surgunt."  The hall
 in which we are now gathered  together will probably be the usual, or perhaps
 the constant, place  of all  our  future meetings.  May its use be auspicious to
 the best interests of our fraternity !  Happy for us  all  if its name be heiace-
 forward associated in our minds with recollections of the knowledge, the good
 sense, the urbanity of deportment, and the friendly and cordial feelings which
 should subsist among the members of a scientific, liberal,  and honorable pro-
 fession.
   Of our common possessions, this building, with our library and its other con-
 tents, is the least important—the one which we  might lose with least regret.
 And, indeed, if, instead of this plain and humble hall, we possessed a lyceum
 equal to the most beautiful and stately of those palaces erected by the  genius
 of Vitruvius or Palladio;  if,  instead of  our  useful but  limited collection of
 books, we owned a library of Alexandrian or  Bodleian amplitude; even such
 possessions would be of but trivial value  in comparison with  others which we
 hold in common as members of the medical profession.   We hold in common
 other possessions of higher account than any material property.   We hold  in
 common the reputation of our profession, and the reputation, the well-being, and
the future prospects  of our professional science.  These things have come down
 to us as an inheritance from our  predecessors,—as a sacred trust consigned to
our keeping, to be transmitted, unimpaired and unsullied, to those who shall
succeed us.  The nature of such an  inheritance, of such a trust, it behooves
every physician to understand ; and it may therefore, on an occasion like the
present when we are met to consult for the welfare and honor of our Faculty,
be not inappropriate or unseasonable to turn our attention to this subject.   To 
4
 those who are engaged with proper feelings in the study and practice of medi-
 cine, the reputation of the medical profession and  the  condition of medical
 science can never be an argument destitute of interest.
   By the reputation of our profession, I mean  that character and credit which
 physicians havelield among  their contemporaries, not for professional ability
 alone, but also for general learning, for integrity, probity, benevolence, benefi-
 cence, or for any other qualities, good or bad, by which they are distinguished
 as a class from other classes of men, or from men engaged in other pursuits.
   The members of our profession possess,  and must always have possessed, a
 certain common or general character.  Those who  are  long engaged  in  the
 same occupation become necessarily, after a time, more or less assimilated to
 each other in both physical and  mental habits.  Abeunt studia in mores.   We
 witness this effect  in many of the other walks of life.  We  observe it in  the
 case of divines, of lawyers, of soldiers, of artists, of merchants.   Each of these
 classes is found to be  more or  less distinguished from all others by peculiar
 traits of character ;—traits which, whether good or evil, are evidently produced
 by the influence of their professional pursuits.  Of each class it is true that their
 turn of mind and modes of thinking and acting are  affected and modified by
 the nature of their habitual occupation.
   The professional character of physicians has long been distinctly marked  and
 generally recognized.  It is one  for which we have no cause to blush.  It is
 one which, in its predominant features, may- be contemplated with just  and
 rational satisfaction.  It is not my business or purpose to extol that character.
 What we have been made by our speculative studies  and practical pursuits, is
 a subject which may be more appropriately treated by any other speaker than
 a physician.  When Matthew Prior, the English poet, was viewing the apart-
 ments  at Versailles, with the victories of Louis the 14th painted on the walls,
 he was asked if the palace of the King of England, the heroic William the  3d,
had any such decorations.   " The monuments of my  master's actions," he re-
 plied,  "are  to  be seen every where except in his own hou<e."  In the same
 spirit, we may prefer to have the praises of our professional  character proclaimed
 any where rather than among ourselves, and by any tongue rather than by our
own.   And we  may the more readily forego this subject when we recollect that
some of the  wisest and most  illustrious members of  the other learned profes-
 sions,—some of those best qualified to judge what physicians ought to be  and
 what they are,—have been the most emphatic of our eulogists.  We mav safely
be silent  when we have such advocates as Johnson, Temple, and Parr to speak
in our  behalf and celebrate our merits.
   Waving therefore  the consideration  of this topic, we may find in  the char-
acter of that department of philosophy which we study and practice, a subject
of a less exceptionable nature, one which we  may speak  of with less reserve
and one which equally comes home to our business and bosoms.  Let me then
solicit your attention to a few desultory remarks on the present condition  and
future  prospects of medical science. 
5
  On the very threshold of this inquiry we are met by a statement which has
of late been so often repeated, that it begins by some to be considered as fully
proved and established,—as a truth which can be  called in question  only by
those who are either heedless observers or deficient  in candor.   We are gravely
told,  that the general confidence once reposed by mankind in the science of
medicine,  as professed and  practiced by physicians, has,  within  the last  few
years, been disturbed and shaken, and is now  greatly impaired ; that  there is
at present a very general distrust of the efficacy  and  utility of that  science;
that there are many who consider it dangerous and injurious ; and that there
is a large  and increasing number of persons who believe that  there are other
methods of  treating  diseases, differing essentially from  those employed by
physicians,  which are more  safe, more rational, and more successful.
  These assertions are so contrary to my own observations, and to the experi-
ence and judgment of the  ablest  of those with  whom I  have conversed, that I
should be inclined  to regard  them with indifference and  contempt.   Yet, as
they are frequently heard, and as their truth  has been recently admitted by
one of the most  distinguished American writers on medicine, it would, perhaps,
be scarcely proper to pass them  by  without notice. An examination  of them
would appear also to belong properly to our present inquiry, since the condi-
tion of our science must be judged of by reference  not  only to what it is, but
also to what it is supposed to be.
  Is it true, then, that the community have less faith at present than they had
formerly in the  utility and value of medical science?
  If such be the case, the change appears to be not so considerable as to be
plain and manifest to common  observation.   Some assert it.  Some deny it.
The facts alleged by some as proving it, are considered by others to prove no
such thing, but to be such facts as have existed in former times, and perhaps
in all times.  It would appear difficult to decide  the question by reference  to
observation and experience.   The only other means of solving it, is to inquire
whether any cause can be assigned for the supposed revolution in  the judgment
of the public.   If no sufficient cause  can  be discovered, we may infer  with
probability that no change has in reality taken place.
  The reasons  commonly stated for the alleged decline in the reputation  of
medical science, are either that the science has not been making  progress pro-
portionably to the other departments of knowledge, but has remained station-
ary, or has  been moving in  a retrograde direction; or  that the physicians  of
the present day  are, from defective education  or inferior natural  endowments*,
less  qualified than their predecessors to inspire the  community with respect and
confidence; or that better methods have been  devised for the treatment of dis-
eases than those employed by the regular physicians; or,  finally, that the  more
general diffusion of knowledge among the people has enabled  them to form a
more correct and less favorable estimate of our claims, and to detect  and un-
derstand the imperfections of our science, and the inefficiency or mischievous
and fatal errors  of our art. 
6
   Now, do these causes, all or any of them, exist in such a degree as to  ac-
 count sufficiently for the effect which they are said to have produced ?
   In the first place, is it to be admitted that medical science has not of late
 been advancing?  Is it true, that  while in other branches of knowledge im-
 provements have been taking place either rapidly and brilliantly, or slowly
 and surely, medicine alone has remained inactive, torpid and hibernating?  Is
 it true that while other speculative and practical pursuits  have been  more or
 less constantly increasing their contributions to the service of mankind, medi-
 cine alone, effete and incapable of useful exertion, has wrapped  her talent in a
 napkin, and hid it in the earth ?
   It can hardly be necessary before an audience  of well-informed men, and
 least of all before an audience of medical  men, to  bestow much  attention  on
 this inquiry.
   The relative conditions of a science at different periods of its history, can be
 ascertained only by collating  and  comparing together the books in which the
 existing condition of  the science in those several periods is recorded and em-
 bodied.  In the present question, what  do we  learn  by such  a  comparison?
 How doe's the condition of medical science in our age, compare with its condi-
 tion in former ages ?
   The reply is obvious.  The superiority of the science of the present day is
 unquestionable.  It is unquestionable,  whether our retrospect extend all the
 way across the vast abyss of  more than twenty-two hundred years which sep-
 arates us from the Coan Sage, or whether we revert to a period  of but  little
 more than half a century from our own.
   It would be difficult, 1 suppose,  to find in the present day any one so blinded
 by the dust of antiquity, as to avow the opinion that all that is  now known in
 medicine is contained in the tomes of Hippocrates and Galen, or of Sydenham
 and Boerhaave.  It is proper to speak with respect and reverence of those illus-
 trious philosophers.  But we must not forget respect and reverence for truth.
 Some of the early writers on medicine, some, indeed, of the earliest of those
 whose works have descended to the present time, were men of extraordinary
 sagacity and vigor of intellect.   Their contributions to science constitute noble
 and imperishable  monuments of the power  of the  human mind to struggle
 against difficulties, and to make honorable  progress in knowledge under the
 most unfavorable circumstances.   But nature cannot  be conquered in a single
 campaign.   There are difficulties and obstacles in the pursuit of science harder
 to be surmounted than those which beset the retreat from Moscow or the storm-
 ing of the Malakoff.   It is no impeachment of the merits of the  ancient physi-
 cians, to assert that their  modern successors have far surpassed them in knowl-
edge, and in the most glorious attribute of knowledge, the  power to do good ;
 surpassed them, however, less perhaps by superior abilities than  by superior
advantages of time and position.  "The dwarf,"—to use the  apposite illustration
of Didacus Stella,—" The dwarf standing on the shoulders of a giant  may see
farther than the giant himself."  The progress of medical science, more perhaps
than that of any other kind of knowledge, evinces the justice of Bacon's aphor- 
1
ism, that "Aniiquitas seculi est juvenilis mundi;  and that these present times
are the ancient times when the world is ancient, and not  those which we ac-
count ancient, ordine retrogrado, by a computation backward from ourselves."0
Knowledge, like wealth, is accumulated more easily and more rapidly in pro-
portion  to  the amount already acquired.   The genius and  industry of the
ancients have aided the moderns to excel them in science.
  All who  are acquainted with  the history of  medicine  know how zealously
and ably its recent cultivators have availed themselves of the advantages af-
forded by  the enlarged experience of the profession, and by the improve-
ments of the cognate and collateral branches of knowledge.  It is remarked by
Bacon, that " Medicine is a science which  hath been more professed  than
labored, and yet more labored than  advanced ; the labor having been rather
in circle than  in progression, and with much iteration but small  addition."f
But  this censure, harsh even when first uttered,  was pronounced by the great
Chancellor  more  than two hundred years ago;  and two  hundred years  have
not passed over our profession, as  over the head of  the wandering Hebrew,
without bringing changes and improvements.   The  single discovery of the
circulation  of  the blood, announced  by Harvey in the reign of Charles the 1st,
is of more importance and value—of more  scientific interest and more practical
utility—than any thing, or than every thing, that had ever before been known
in Anatomy or Physiology.
  Upon the whole, there seems no ground  for doubting that medicine, with all
the imperfections and short-comings that it still  presents, has, since the days
of Bacon,  made advances fully equal to the best that have occurred in any
other department of knowledge.   It can be easily proved that in no other field
of research, in no  other science,  in no other useful art,  have the discoveries
made in recent times been more important, or the improvements more benefi-
cial to mankind.   And it  is equally certain that at no other period have these
discoveries  and improvements been more numerous, more  conspicuous, or more
valuable than  during the last half century.
  If, then, the reputation  of medical science has been waning during this pe-
riod, its decline must be referred to some other cause than any impairment of
its ability to be useful.  We  must seek elsewhere for a cause sufficiently potent
to produce the change in question, and to  produce it notwithstanding the most
conspicuous and unquestionable increase in the beneficent power of the science.
  Such  a cause, it  is sometimes said, may be found in the character and qualifi-
cations of the  physicians of the present day,—their inferior natural abilities and
deficient education.
  This agreeable and flattering explanation is commonly propounded by per-
sons who have but small claim to be considered judges of  mental capacity and
culture.   It is probably not  very often  credited  even by those who suggest it,
and it is certainly wholly unsupported by evidence.
  In  a  profession  so crowded as ours, there must always have existed much

      * Advancement of Learning, B.  1.    f Advancement of Learning, B. 2. 
8
variety and  diversity in the character of its members.  Among them there
have doubtless been at all  times, as there  are at present, persons eminent for
virtue, learning, wisdom and skill.   Associated with these there have also per-
haps at all times been others of a  different and opposite character.   But that
the proportion of the  worthy to the unworthy members  is smaller  at present
than it was in former  periods,  cannot be proved.  There is no reason  for be-
lieving that such is the case.  There is no reason for believing that among  the
physicians of the present day, there is less of moral  and intellectual  excellence
than existed among their predecessors.  On the contrary, it is probable from
various considerations, that the standard  of morals  and intellect was never at
any time higher in our profession than it is at present.
  With regard to the  power of newly-devised empirical methods of treating
diseases to eclipse and degrade the reputation of scientific medicine, it is an old
story which physicians have heard  so often and so long  that it can scarcely at
present be expected to make any very violent and painful impressions on their
sensibilities.
  The only true and rational system of medicine must  be founded on knowl-
edge of Anatomy, Physiology and Pathology, and on  extensive and accurate ob-
servation of the effects of remedial agents.   A system resting  upon this basis,
however imperfect and defective it  may be, is yet founded on a rock, and must
possess over all systems destitute of such support, infinite and  unquestionable
advantages.   Such a system can have but little to  apprehend from the com-
petition of the  Natural Bonesetters, the Thomsonians,  the  Homoeopaths, the
Hydropaths,  the Spiritualists, or the shallow advocates of the other  ephem-
eral follies that are successively springing up to amuse and delude for a time
the adult infants of the community, and then  pass away and be forgotten.

                '' The earth hath bubbles,  as the water has,
                  And these are of them."

Of  each form of  charlatanry that  in  its  turn has fluttered above the medical
horizon, its  prophetic admirers and followers have proclaimed that it would
inevitably overthrow and destroy the  regular school of medicine.   Such pre-
dictions have not yet been fulfilled;

                    ----" non usque adeo permiscuit imis
                Longus sumrua dies."----

  Our science has  experienced the fortune  of Drydeu's hind,—" Oft  doom'd
to death, but fated not to die."  It has encountered, without fear and without
detriment, stronger and more perilous opponents than any whom it now be-
holds ; and, in spite of all that its present adversaries can do, it will doubtless
long continue its onward course, conquering and to  conquer, wise with the ac-
cumulated experience of many  centuries, ardent   with the  aspirations and
energies of perpetual youth, still  increasing its power  to do  good, and still
adding to its claims upon the gratitude of mankind. 
9
      When I think of the systems of ignorance, empiricism and chicanery that
    attempt to raise themselves into rivalry with Medical Science, I am reminded
    of Jotham's aspiring bramble that was willing  to be king over the trees, but
    which will never again be invited to such illustrious eminence.  When I contem-
    plate medical science,—what it has so long been, and what it is,—I sometimes
    liken it to the oak of Marius, celebrated in the lost poem and in the imperisha-
    ble prose  of Tully, as growing stronger as well  as  more venerable under the
    weight of years,  canescens sceclis innumerabilibus; or, sometimes,—if the
    thought may be allowed,—I image it as presenting some faint but perceptible
    resemblance to  that more  sacred  tree which grows by the pure  river of life,
    and whose leaves are for the healing of the nations.
      In every community there will  persons be found who harbor unreasonable
    and absurd opinions respecting medicine, as respecting,  other  important sub-
^   jects.   This is what a very moderate acquaintance with human nature might
    prepare us to expect.  But such  erroneous judgments  appear to be  neither
    more common, nor more injurious  to the interest and reputation of our profes-
    sion, at present than in former  days.  The  silly aud'crotchety notions of igno-
    rance and presumption are dangerous principally to those who entertain them.
    There was lately a gentleman residing in this city who  through  the whole of
    a long life obstinately refused to be vaccinated/alleging as h:s reason that vac-
    cination is  an artifice of fraud and  knavery, wholly destitute of protective
    power, and  contrived by physicians  merely for  their own emolument.  This
    poor gentleman died  some two or  three months ago  of confluent smallpox.
    The sad effect upon himself of  the cardinal article of his creed was sufficiently
    manifest, but I have not heard that it has as yet  destroyed the credit of Jen-
    ner's discovery, or put an end  to its use.
      The stud}r of  Jurisprudence  is not abandoned  because persons are occasion-
    ally met with who take advice in matters of law from  pretenders and interlopers
    whose names are unknown to the learned faculty of the Bar.  The study of The-
    ology is still cultivated,  though there are some who  choose to seek counsel in
    cases of ethics and religion from Muggletonian prophets and  Mormon elders.
    And so, likewise, the science of Medicine is not to be considered in a  hopeless con-
    dition because there are certain wise people who doubt the abilities of regularly
    educated physicians, but have full faith in the leechcraft of men whose whole
    literary and scientific traiuing  has been  in the art and mystery of coachmen,
    coblers and tailors.
      We  shall augur favorably of the  prospects of  our profession when we con-
    sider who  are its advocates and  who its  opponents.   It has been  remarked
    of Tillotson, that whoever  reads over the  names  of  his friends and of his en-
    emies,  will be inclined to  rank among the best  and most fortunate of man-
    kind the  person who was  loved by such friends and hated  by such enemies.
    A similar two-fold  felicity has fallen to  the lot of Medical Science.   If we
    think highly of  that  science when we reflect on the illustrious men  by whom
    it was founded and advanced,  and on the good and  wise men  in  other walks
    of life  who have given it  their esteem  and confidence, our  respect  for it will 
10
be  still further exalted, when we recollect  the  character and  endowments of
those by whom it has been condemned and reviled.
  That the general diffusion of knowledge by which the present age  holds it-
self to be so honorably distinguished from all others, has  diminished the pres-
tige and reputation of medical science, is an  opiniou often expressed,  and one
which we hear sometimes  from  those who are hostile, sometimes  from these
who are friendly to our profession.
  We are told by some that the  public have at length become  sufficiently en-
lightened to detect the vanity of our science, and the  dangerous nature of our
art; that claims and assumptions, which were generally  admitted in times of
ignorance, are now scrutinized with  philosophic skepticism, and rejected with
contempt; and that physicians are consequently beginning to experience the
fate of their predecessors in deception, the astrologers and alchymists.
  Others who regard our profession  with more friendly eyes, assure us that the
present low estimate of our science is not from  the increased intelligence  of the
age, but rather from the presumption and  arrogance that  always attend super-
ficial and imperfect knowledge—not because there are more philosophers, but
because there are more sciolists in the community.
  This latter explanation is the  one which we  should be most willing  to ac-
cept.   If the credit of medical  science have  really declined, every physician
would prefer to ascribe the change to the unwisdom  rather than  to the wisdom
of the age.   We should all think it better  to be condemned  by folly and  ig-
norance than by good sense and  sagacity.  The meaner the tribunal, the less
should we regard the sentence.
  In the present case,  the supposed  unfavorable verdict appears to have been
rendered by judges not wholly  above  exception.  This is made probable by
the fact that the persons  most hostile to the claims of medical science are in
general the most strenuous and  noisy supporters of empirics and charlatans.
The sages, who are  too acute, wary and philosophic  to trust the wisdom, skill
and honesty of men like Andral, Louis, Watson and Latham, are yet found to
listen with credulity  to illiterate and ignorant imposters; to consult  table-
rappers with awe and reverence; to swallow infinitesimal  globules of charcoal
and sugar of milk, and to send locks of their hair to  be examined by Mademoi-
selle Julie,  to  enable that ingenious  young lady, by such exploration of phys-
ical signs, to discover  that her male  patients are suffering from cancer of the
uterus, and her female  from enlargement of the prostate gland.
  It requires but small experience in life to discover  that skepticism in rela-
tion to medicine, as in  relation to other subjects of even higher importance, is
not at all more apt to spring from  knowledge, sagacity and  reflection than
from ignorance and imbecility.   The fool is fully as prone to be a skeptic as
the  philosopher—and infinitely more prone in cases where skepticism is erro-
neous and irrational.*

  *L'ignorance a deux filles,  l'incredulite et  la foi aveugle.—Gibbon, Easai sur
Vetude de la literature. 
11
   In all ages there have been among mankind enough of wisdom and enough
of folly to afford a copious theme to those who, according  to  their respective
dispositions, are inclined to admire their contemporaries, or to  deride and stig-
matize them.   How much wiser is the present age than the  ages that have
gone before it ?  Who can decide ?  Our own opinion that we  are  superior to
all former generations, is no absolute proof of that superiority.   The same im-
partial and amiable verdict  in its own favor has been  rendered by each one of
all preceding ages.  iEschines, the eloquent  rival of Demosthenes, declares that
human life in his time had risen  above  the common lot of mortality, and that
he and his contemporaries were born to one end alone,—that posterity, through
all the coming centuries, might discourse of their wonderful exploits.  Posterity
have found other  subjects for their admiration and applause.
   The generation of the present day certainly understand steamships, railroads,
electric telegraphs, the physical arts in general, very much better than their fore-
fathers.   But such  knowledge is compatible with a very abundant measure of
ignorance and absurdity in relation to more important matters.  Wisdom  is not
the only attribute of our time.   There are errors still prevalent respecting sub-
jects of  the highest  moment, that are fully as gross  and pernicious  as any that
obtained in the darkest years of that period, which, as contrasted with the
present  enlightened era of Mesmerism, of table-moving,  of spirit-rapping, of
Mormonism,  and  of Homoeopathy, we are accustomed to call the Dark Ages.
  In regard  to medicine and physicians, the  mistakes of mankind appear to
have been very much the same in all ages, as in all ages they have  arisen from
similar weaknesses, prejudices, and  perversions of intellect.  It  has  been justly
remarked, that "  He who wadeth thoroughly in learning or contemplation will
find  the conviction printed in his heart, that there is nothing new upon the earth
—Nil novi super terram."0  It is now as difficult perhaps to be original in
blunders and follies as in wisdom and wit.  Most of the errors of judgment and
of conduct in relation to our profession that prevail at present, are " clean past
their youth," and have not only  " some  smack of age in  them, some relish of
the saltness of time," but are indeed of venerable antiquity.   Of this truth,
familiar to every one who is conversant with the history of popular opinions,
it would be easy to  adduce numerous illustrations.
  One of the most common complaints made by physicians of the present day
against their  contemporaries is in relation to the countenance and patronage
given to ignorant and dishonest pretenders to medical  knowledge, and  the
neglect of just discrimination between those who have devoted  time and labor
to  the study of  medicine and others who have  made no such preparation, and
whose medical  ability, such as  it  is,  has come, like Dogberry's reading and
writing, by nature alone.  But  this is no new grievance.  It  was  familiarly
known,  lamented and denounced,  by  our  predecessors before the days of
steamers and railroads.  It has always been the fashion with a part of mankind,
—sometimes  with persons from whom better judgment might be expected,—to

                   * Bacon, Advancement of Learning, B. 1. 
12
conclude that the more ignorant and untrained the candidate for medical busi-
ness, the better necessarily must-be his fitness for the treatment of diseases.  It
was not reserved for the wisdom of the 19th century to be the first to exercise
in matters of medicine a faith akin to that of Tertullian  and Sir Thomas Browne,
and to believe in the skill of charlatans and imposters all  the more confidently
because it is manifestly impossible that it can exist.   It requires but slight ac-
quaintance with the records of the past  to show that  this  heroic creed is  no
dogma of recent discovery.
  In an act of Parliament passed in 1511, the third year  of IL-nry the 8th's reign,
we find it commemorated, that " The science and cunning of physic and surgery
(to the perfect knowledge whereof be requisite both great learning and ripe ex-
perience) are daily within this realm of England exercised by a great multitude
of ignorant persons, of whom  the greater part have no  manner of insight in the
same, nor in any other kind of learning ;  some also  ken no letter on the book;
so far forth that common artificers, as  smiths, weavers, coachmen, and women,
boldly and accustomabl'y take upon them great cures and  things  of great diffi-
culty, in which they partly use sorcery and witchcraft, partly apply such med-
icines unto the disease  as be very noious, and nothing meet  therefor; to the
high displeasure of God, great infamy  to the Faculty,  and  the grievous hurt,
damage, and destruction of many of the king's liege people, most especially of
those that cannot discern the  cunning  from the uncunning."''
   Let those who are indignant at the  follies of  the present age cast their eyes
on the picture here presented, and cease  to  applaud  the superior  wisdom of
antiquity.   Let them  observe how many absurdities  of our day had their exact
and  perlect types in the days of old.   We tee the  same artificers busy in
medicine then as now ; the same  smiths, weavers, and coachmen ; the same
women,  graduates perhaps,  or  not  graduates,  of  Female Medical Colleges ;
the  same illiteracy or unacquaintance with  letters on the book ;  the same
witchcraft, sorcery, and necromancy;  the  same reckless boldness to undertake
great and difficult cases; and  the same consequent hurt, damage, and destruc-
tion  of human life.  The only difference to be observed is,  that there is no men-
tion  of infinitesimal pills ; and that it is hardly possible, at the preseut time
and  in  our country,  to conceive of a legislative body that could venture to
speak of charlatans and their craft with such irreverent freedom.  How much
the world has gained  by such improvement in pills,  and such refinements and
amenities in legislation, is a question for the wise and  learned.
   If medical  science  is to be put down  and abolished only by the  universal
prevalence of light and knowledge, it certainly appears to be at this time in no
very extreme and immediate danger.  Yet while the present generation are not
perhaps so immeasurably superior as they may think themselves to all who
have gone  before them ; while there are many still, as there  were in the days
of the immaculate Defender of the Faith,  not exactly qualified to  form a cor-
rect judgment respecting the claims of the various  aspirants  after the honors
*Stat. 3, Hen. 8, c. 11. 
13
and profits of Medicine, and to " discern the cunning from  the uncunning;"
and while much of the vaunted  knowledge of our time  is of that innutritive
quality  which puffeth up without conferring wisdom and discretion; it must,
notwithstanding, be admitted, I think, by all candid observers, that of mental
activity, useful information, and real intelligence there  is perhaps among sev-
eral nations of  the present age a rather  more general diffusion than existed in
any former time.  And this characteristic of our day we can have no desire to
question or dispute, since it must  necessarily be propitious to the interests of
our profession.   It gives us the best reason  to believe that the claims of medical
science will be  justly and favorably estimated.  The appeal of that science is
not to the ignorant.   It is  addressed to  the cultivated, the  intelligent, the
thoughtful,—to those who are capable of understanding the inherent difficulties
that obstruct  the progress  of medical  knowledge,—to those who, while they
know how much remains  to  be done  by physicians, know also how much
physicians have already done for the benefit of mankind.  It is by this class of
men, not by ignorant  pretenders to knowledge, not by " the great vulgar or
the small," that the merits of our science are to be adjudicated, and its position
to be fixed and decided.  And by this class,—a class relatively larger and more
influential in our age than it ever was in any preceding period,—a decision ap-
pears to have been made of which we have no cause to complain.  At no other
time have the claims of the scientific physician been by the  intelligent class of
the community more promptly admitted,  or. his services more gratefully ac-
knowledged, or his science and art more valued  and respected.
   The judgment of the public in regard to the merits of medical science appears
to be in the main sufficiently favorable.  How far  is that judgment warranted
and sustained by the present condition of the science as respects its fitness and
power to  accomplish the great ends for which it is cultivated ?
   In considering this question, we shall find much cause  for  regret, much also
for satisfaction, and much for encouragement and hope.
   Medicine, both as a  science and as an art, is still imperfect and defective.  It
is a study which must have received attention from the earliest period of human
society.   It has long  been prosecuted with diligence and zeal.  It has at all
times numbered among its votaries men of distinguished learning and genius.
And, notwithstanding this, it must be confessed that its progress, through the
greater part of its long career, has been  slow and irregular ; that its condition
is still far inferior to what might be desired ; that  it is  still, as a science, in-
capable of explaining many things belonging to its province which philosophy
would desire to understand; and that  it is still, as an art, incapable of doing
many things belonging to  its province which  humanity would desire to see
accomplished.
   For such tardiness of progress, and such imperfection of result, it is not diffi-
cult to account.
   It must be remembered, in the first place, as a general consideration, that of
useful knowledge of every kind the little that mankind have ever acquired has
been acquired  slowly and  with difficulty.   The more valuable the object  at 
14
 which we aim, the slower and more difficult in general is its acquisition.  The
 sciences of jurisprudence and of government are scarcely less important to the
 world than the science of medicine.  Their importance has been  felt and ac-
 knowledged in all ages, in all countries, and by all mankind.   Yet they have
 advanced as slowly and irregularly  as medicine, and are still fully as remote as
 medicine from the ideal standard of perfection.
   It requires but little reflection to  discover that the science of medicine, from
 its nature and object, is uecessarily a study of great and especial difficulty :

                          ----"Pater ipse medendi
                      Haud facilem esse viam voluit."----

   The object of the science is to prevent, to cure, or to mitigate diseases.   To
 accomplish these ends in the best possible  manner, requires the possession of
 varied and extensive  knowledge,  and the exercise of great  and uncommon
 powers of intellect.  The physician must understand the structure and func-
 tions of the human body, the most complex as  it is the most admirable of all
 the visible works of the Divine  Creator.  He must  recognize the diversity of
 constitution and temperament imparted to individuals by nature, or impressed
 on them by accident or habit.   He  must be acquainted with all the multitu-
 dinous causes, mental and physical, that are capable of  throwing the system
 into disease  by changing the  texture or deranging the action of its organs.
 He must be familiar with  the  nature  of those  morbid changes and derange-
 ments, and be able to detect their existence, and to note their progress and va-
 riations.   He must know the virtuous powers and uses  of that vast  array of
 agents which  experience has shown to be capable  of exerting remedial influ-
 ences on the suffering organism.  And he must have a mind capacious, acute,
 provident, logical, not to be agitated by passion, not to be misled by prejudice,
 not to be deceived by appearances.
   Such is the knowledge, such the capacity, requisite for the  thorough com-
 prehension and  effectual advancement  of medical science.  Where are such
 knowledge and such capacity to be found?  When we consider the extent and
 difficulty of the subject of inquiry, and the limited faculties of the human mind,
 we cease to wonder that medicine has advanced so slowly and  is  still  so im-
 perfect.  We are tempted, on the contrary, to forget its deficiencies and fail-
 ures in admiration of its glorious achievements.
   It has been alleged  that the modern improvements in our science  consist
 rather in an increased knowledge of the nature and character of diseases than of
the art of treating them; and that Therapeutics, if it have advanced at  all, has
certainly not advanced in proportion to Pathology.
   This opinion is often expressed in the spirit either of reproach or of  regret;
 and its truth has been sometimes admitted,  without sufficient thought, by phy-
sicians themselves.  Yet a little  consideration  will show that  it is not only
erroneous but absurd.
   To the proposition that the advance of Therapeutics has not been proportionate
to that of Pathology, we might reply by inquiring, what is the due proportion 
15
that should subsist between those two departments of knowledge.  Who can de-
fine to us the exact measure of improvement in the method of treating a dis-
ease that ought to result from a given amount of  increase in our knowledge of
its  nature?  Before we are condemned for not improving  our therapeutic
skill as successfully as  our  pathological knowledge, let it  be decided how the
disparity between the two is to be measured, and how and where the desired
point of equality is to be fixed.
  But if the statement be made in a looser sense, as expressing the opinion
that while Pathology has been much improved by recent researches, Therapeu-
tics has  been improved but little, or not at all,  or far less than might have
been reasonably expected,—and this, I suppose, is what is commonly meant,—
the proposition  assumes a more intelligible form, but is  still erroneous,  and
must be met by a denial of its correctness and truth.
  Therapeutics is the art not merely of curing diseases.  It is the art of treating
diseases.  In cases where it cannot arrest and remove a disease, it can yet al-
most  always, by proper application of its resources, allay and diminish the
pain and distress which the disease is occasioning, and defer the fatal termina-
tion to which it  is tending.  With this  correct understanding of its objects,
we may justly assert that  Therapeutics  has been improved—necessarily and
signally improved—by the improvements made in Pathology.   In almost every
instance increased knowledge of the character of a disease  has led to some im-
provement, more or less important, in the  method of treating it.  Such must
of necessity be the case.  The pilot is better fitted for his post at the helm by
knowing the  situation of  the rocks and shoals  that lie in the course of his
ship.  The leader of an  army is better prepared to hold  the  truncheon
of  command  by  being  properly  informed respecting the  position, arrange-
ment, and strength of his enemies' forces.  And,  in like manner, the physician
cannot be acquainted with the disease which he  is called to treat,—its causes,
its  seat, its nature, its symptoms, its ordinary course and tendencies,—without
being, by consequence, the better qualified to treat it properly and skillfully. As
we learn more accurately the natural history of diseases, we necessarily un-
derstand better what we should do for their relief, and,—what is often fully as
important,—what we should forbear to do.
   The physician whose science enables him to discover that his patient has a
tuberculous cavity in the lungs, or an obstruction at the mouth of the aorta,
or  a morbid patency of the mitral or tricuspid orifice of the heart, is as unable
to  accomplish the removal of these lesions and effect the restoration of health,
as the ignorant blunderer who finds in the pulmonary disease mere nervousness,
and in the cardiac affection mere catarrh.  The cure may be equally impossible
to both.  But how different will be the treatment!  How much relief may be
 afforded by knowledge!   How much  misery may  be inflicted by ignorance!
 Knowledge may soothe the patient's sufferings, prolong his life, and render life
 tolerable and  even  comfortable.   Ignorance may condemn him unnecessarily
 to  painful, dangerous and  destructive methods of treatment;  may expose him
 unnecessarily to the  brunt of lancets, cups, leeches, blisters,  and cauteries; 
16
may subject him unnecessarily to the penalties of mercurial salivation;  or may
bind him to the muzzle of some other of the heavy artillery of the Materia Medica,
—a  situation  sometimes scarcely less terrible than that to which British hu-
manity has consigned her Hindoo captives,—and may thus cause him to suffer
more severely and perish  more speedily by the pretended  remedy than he
would have done by the disease.
  The recent  improvements in practical  Medicine have  resulted principally
from  increased knowledge of Physiology and of Morbid  Anatomy, and have
been manifested partly in the better treatment and partly in the more success
ful prevention of diseases.
  To recount these improvements in detail would be a long and tedious task,
and on this occasion, and before the present audience, it is wholly unnecessary.
The subject is familiar to all physicians, and  a  brief and  cursory glance at it
will be sufficient.—Only a few particulars need be enumerated.
  We all know that the frightful devastations of Small Pox have been in a
great measure arrested, and  that Scurvy, long the terror and  scourge of navi-
gation, has been so subjected to the control of art that its occurrence may now
be prevented with  almost absolute certainty.  These invaluable improvements
were made somewhat more than half a century ago.  If we descend to  a more
recent period, and  observe the progress of our science during the last fifty years,
we shall be struck  by other  important  changes.   We  shall find  that  during
this period the natural  history of  diseases has  been  studied  with a degree of
industry and success never before equaled, and that Diagnosis  has consequently
attained a precision and accuracy formerly unknown.   We shall find that the
process of inflammation is better understood, and inflammatory diseases more
successfully treated; that the nature and structural lesions of continued fever
have been more satisfactorily investigated, and its varieties  more accurately
determined; that the treatment of malarious fevers has been signally improved
by the early and active employmentof anti-periodic remedies, especially the Salts
of Quinia; that mental  insanity is treated more humanely, more judiciously, and
more successfully ;  that chemistry and the microscope have thrown new light
upon  the character and  treatment of several important diseases; that the  fre-
quent occurrence of granular disease of the  kidneys has been discovered,  the
nature of the disease to a considerable extent explained, and  the methods of
detecting its existence established; that new and valuable remedies  have been
added to the Materia Medica,  conspicuous among which are the anaesthetic
agents; that the properties of the really efficient  remedies  have  been more ex-
actly ascertained; that  the active principles of many of the vegetable remedies
have been isolated, and  employed with greater convenience and  advantage
in their pure state; and,—what is  perhaps the most  important of all—that
the  admirable invention of Medical Auscultation has  enabled the physicians
of the present day to  detect the existence and  character, and  to  mark  the
changes, of diseases of the  sanguiferous and respiratory organs,  which were
formerly often undiscovered, and indeed  often undiscoverable, until their fatal 
11
termination, or their advance to a stage in which medical treatment was neces-
sarily useless.
  Of the value of Auscultation in  clinical medicine, every one is aware.  Its
utility and importance  are  most conspicuously manifested by comparing our
present knowledge of thoracic diseases with that possessed by the most enlight-
ened physicians before the introduction of this mode of examination.
  Of Cardiac diseases, the medical writers and the medical profession before the
present century were almost wholly ignorant.   In relation  to these affections,
they appear  to have entertained the despondent sentiments of Cowley—

                 "The heart of man what art can e'er reveal ?
                         A wall impervious between,
                         Divides the very parts within,
                  And doth the heart of man e'en from itself conceal."*

   On this subject scarcely any information can  be derived from their writings,
 —none that even the most  zealous admirers of medical antiquity can profess to
 consider valuable.  They had acquired by dissection some knowledge of the
 morbid changes in the  structure of the heart;, but they were unable to connect
 these changes with the symptoms  which occurred  during life; and they were
 consequently unprepared to detect with certainty the existence of disease dur-
 ing its  early stage, or to  ascertain  its  true character, or to propose any satis-
 factory or rational method  of treatment.
   The  only  diseases of the heart referred to by Boerhaave are aneurism and
 weakness, f  Cullen notices none but palpitation and syncope.^  Kiverius  de-
 clares that the diseases of this organ are so speedily fatal  that they allow no
 time for the application of  remedies, and that an acquaintance with them is of
 no clinical value, except in the case of syncope, palpitation, and debility.§
 And at a later period, Dr. Mason Good,—who, though a recent writer, may
 justly claim to be, in relation to this subject, a  competent representative of the
 ignorance of the ancients,—in his ponderous work  on the study of medicine,
 confines his account of cardiac maladies to a  very  brief chapter on carditis,
 of which  he knows nothing, and pronounces that  there are no signs by which
 inflammation of the pericardium can be distinguished from that of the substance
 of the  heart.|j
    On the subject of diseases of the respiratory  organs,  the state of knowledge,
 or rather of ignorance, was  almost equally unsatisfactory.   The existence of
 some of the most important and most common  of these affections was often
 doubtful, was often unsuspected, while they were making fatal changes in the
 affected organs;  and in regard to their diagnosis,  prognosis  and treatment,
 every thing was  involved in confusion and obscurity;
                  "Quale per incertam lunam, sub luce maligna,
                   Est iter  in silvis."

   • Ode upon Dr. Harvey.        t Aphorism,  1T6, 661.        t First Lines.
   § Praxeos Medica}, Lib. 8.  Geneva, 1*737.
    I Study of Medicine, edition of 1825, published during the author's life.
             2 
18
  The embarrassments and perplexities connected with these cases are admit-
ted and lamented by many of the ablest physicians of former ages.   " 0 how
difficult is it," says Baglivi,  " to treat diseases of the lungs r   0 how much
more difficult to detect their existence, and to prognosticate their results!  They
deceive the most experienced; they baffle the very princes of medicine.  Do
you, my pupils, be cautious and prudent in  treating them, and never promise
an easy cure, as the mountebanks do who have not read Hippocrates."*
  How widely different is the present condition of science in regard to diseases
of the chest,  is universally  known.   The  change has been from darkness,
doubt, and uncertainty, to a light comparatively clear and satisfactory ; and it
must be ascribed almost  exclusively to Laennec's invaluable invention, which
has supplied physicians  with  a new instrument,—literally a novum organum,
—for detecting and investigating so many of the most common  and most de-
structive diseases to which the human body is liable.
  In referring to the modern improvements in  Medicine, it would be improper
to omit mention of the tendency which has  been gradually increasing among
the members of our profession to abandon  the  use of what is known by the
name, at one time  too attractive, of heroic practice.   Physicians are disposed
at present to employ, in general, a mode of  treating diseases that is less osten-
tatious, less perturbating, less hazardous,—a mode that  is milder, more cau-
tious, more regardful of the patient's safety, more considerate of the curative
power of nature, and more ready to confide in  that power.  Not that the wis-
dom of this course  has been discovered only of late, or was ever wholly un-
known to our profession.  It has  in  all times  been  recognized and justly
appreciated by many able and eminent physicians.  Hippocrates cautions his
disciples to beware of injuring their patients while attempting to help them.
Sydenham warns us to remember that  we are merely the ministers and inter-
preters of nature, and that our function is to follow her guidance and assist her
efforts.  But it is only of late that this method  has been gaining ground among
the bulk of  the medical profession.   It is only of late that physicians,  as a
body, have been led by increased knowledge of Pathology and Physiology,—
by increased acquaintance with  the  natural history of diseases, and with the
marvellous recuperative  powers  of the human system,—to understand that it
is often safe, and often advisable, to dispense with active and violent remedies,
and to depend upon gentler means.  Happy the change that has taught us just
reverence for the wisdom* and humanity embodied in Chomel's aphorism : that
while to do good to our patients  is  oaly the second law of Therapeutics, the
first and great law is to do them  no  hurt.
  When we contemplate  the history of medicine, the present  condition of the
science, and its great and rapid advances in recent tiroes, what are we to expect
of its future caree* and its ultimate  destiny ?

  * 0 quantum difficile est curare morbos pulmonum !  0 quanto difficilius eosdem
cognoscere, et de iis certum dare prsesagium.  Fallunt vel peritissimos, ac ipsos med-
icinae principes.   Tyrones mei, eauti estote et prudentes in iis curandis, nee facilem
promittite curationem, ut nebulones faciunt qui Hippocratem non legunt.—G. Bagli-
vi,  Opera Medico-Praetica, p. 34, Lugduni, 1710. 
19
  If we attempt to look forward into the dark and boundless regions of futu-
rity, we should guard our minds against the opposite errors of distrust and de-
spondency on the one hand, and of ignorant and unreasonable enthusiasm on
the other.  We should not conclude with Lucretius that science and art  have
already attained the  utmost degree of perfection  of which they are capable;
nor yet believe with Bishop Wilkins that philosophers will some day succeed
in accomplishing, by means of flying chariots, a safe and easy communication
between  the earth and the moon.  Calm and rational reflection will teach us
to expect further improvements in medical science, greater, more useful, more
wonderful than any ever yet revealed to mankind; but at the same time it will
moderate and chasten our expectations by pointing out  the numerous difficulties
that must for ever retard and limit the progress of all human knowledge.
   The circumstances which favor the hope that medicine will continue to ad-
vance, and to  bestow new  benefits  and blessings  on mankind,  are  partly the
condition which  it has already attained, and partly the  judicious methods of
research now used by those who are endeavoring to further its improvement.
   The present condition of the science  is eminently favorable to progress.  Its
cultivators are no longer, as to their means of advancing it, in the position of
needy and destitute adventurers.  They possess what in mercantile  language
is called an abundant stock in trade.   The ample amount of knowledge now
in the hands of the profession, if used with proper skill,  must necessarily lead
to farther acquisitions.  It  is written, that  " To him that hath much  shall more
be given, and he shall have abundance.''''  Every new fact that is ascertained,
every new principle that is established, must tend, in a greater or less degree,
to facilitate farther discoveries.  " As we justly expect," says Bacon,  " a greater
knowledge of  things, and a juster judgment, from a man of  years than from a
youth, on account of  the greater experience, and the greater variety and num-
ber of things, seen, heard,  and though* of by the person in  years; so may
much greater matters be justly expected from the present age than from former
times; as  this is  the more advanced  age of the world, and  now enriched and
furnished with infinite experiments and observations."3
   A circumstance of  the present age strongly conducive to the advancement of
medical knowledge, and  of all kinds of knowledge,  is the increased intercourse
among all parts of the world by means of the recent marvellous improvements
in the facility and rapidity of locomotion.  The present is the fated period in
which " many run to and fro," and in which " knowledge is increased."  AU
the nations of the earth are now brought,  so to  speak, into the  immediate
neighborhood of each other.  All persons engaged in the prosecution of a com-
mon study, no matter how widely asunder their abodes, are now assembled, as
it were, in one great university, where all labor together, and where each one
receives  assistance from all the rest.  The scientific discovery made to-day in a
hospital of London or Paris will in a week or two be read of, discussed, criti-
cised, confirmed, or confuted by physicians  at the foot of the Himalayas  and
of the Andes; on the banks of the Euphrates, the Ganges,  the La Plata, and
• Causes of Errors in Philosophers, Part 1, Sec. 5, Aphorism 84. 
20
 the Columbia; at the cataracts of the Nile, and at the falls of  the Mississippi;
 in the ancient and holy cities of Jerusalem  and Benares,  and in the new and
 profane villages  of  Kansas  and Australia.  Never before did knowledge and
 genius appear in so noble a threatre, and address themselves so directly to so
 vast an audience.  " The world is all before them," to listen to their teaching,
 to adopt their  suggestions, to  applaud their  success, to excite them to new
 achievements, and more glorious triumphs.
   The other reason for expecting our science to improve is found in  the better
 and wiser method of investigation employed by its present cultivators.
   The progress of medicine was  for many ages retarded and interrupted by the
 habit, which long prevailed among eminent medical writers, of forming pre-
 mature theories or general doctrines, without sufficiently patient, exact, and ex-
 tensive investigation of facts. The attention of the whole profession was long
 fixed  upon such fabrics of  the imagination,  and diverted from  the study of
 nature.  The important and obvious truth was long overlooked, that medical
 knowledge must in all cases derive its origin  from one source alone, the accurate
 observation of facts,—facts that occur spontaneously,  or that  are called into
 existence by properly devised experiments.   This vital  and essential principle
 is at present recognized and admitted by all medical inquirers.  All are now
 aware that the only just mode of investigation is the one introduced by Hippoc-
 rates, whose admirable sagacity enabled him to anticipate the Baconian method,
 and, two thousand years before the time of Bacon,  to teach the inestimable
 lesson,—too soon and too long neglected and forgotten by his professed follow-
 ers,—that the only means to arrive at the  knowledge of general laws is by
 careful observation of particular facts.  The only theory that can now command
 the attention of physicians  is one that consists of a mere summary and exposi-
 tion of the known facts belonging to the science; a theory, in short,  which, to
 use the expression of Heraclitus, is  drawn from the great world of nature and
 not from the little world of man's brain.   It is observed by Sir John Pringle,
 that from the Greeks down to  his time  there  had  been in medicine a vast
 amount of reasoning  upon a very small number of facts; but that, on the con-
 trary, it would be better to have in  future very little reasoning or a large num-
 ber of facts.   This sentiment expresses the judgment of the physicians of the
 present day;  and from its general acceptance  among them we may justly
 infer that the interests of science are not likely ever again to suffer  from  the
 prevalence of hypothetical systems.   It is not probable that  theories, unsup-
 ported by facts and proofs, however plausible and ingenious they may be, will
 ever again exert  any extensive and lasting eontrol over the minds of physicians,
 or succeed in calling  off their attention from observation and experiment.
  To turn to the best account the advantages afforded by the present position
 of our science, and by the  present method of pursuing its study, so as to in-
crease as far as possible  the utility of the art of medicine, is an important and
manifest obligation incumbent upon every member of the medical profession.
It is the duty of every physician to exert himself, according  to his ability, to
improve his  profession, to adorn our common  Sparta—ornare illam Sparlam 
21
quam nactisumus,—and to do so by making his art as useful as possible to the
community in which he lives, and by laboring to transmit it to his successors
amplified and illustrated by his studies, and advanced to a condition of higher
and more  salutary  power  than that in  which he received it from those who
went before him.
  To accomplish these objects, requires long, diligent and earnest labor—labor
in clinical observation, labor in  reflection  and meditation, labor in studying
the recorded  experience of  other observers.  But there is nothing ungrateful,
irksome or repulsive in this labor to those who enter  on  the task under the
influence of the great cardinal principle by which all human actions should be
directed and governed—the love of God and of mankind.  To those who come
thus prepared, no other pursuit, as it appears to me, can be more delightful.
Our  profession holds out to us the most attractive of all sciences to engage our
attention at home, and the most useful and beneficent of all arts to exercise our
energies abroad.  Nothing, surely, in the whole range of natural science can
be more interesting  to  an  intelligent mind than the investigation of the won-
derful mechanism of the human body, in all its various conditions of health and
disease.  Nothing can  be better adapted than that study to exalt  our  concep-
tions of the Divine  Wisdom. Nor can it be a pursuit unattended with delight
to learn with what ingenuity the resources of art have been applied for the
removal or relief of diseases.  In all the vast extent of literature,—whether we
look to the writings of statesmen, philosophers, historians, orators or  poets.—
no where else shall  we  find more striking manifestations of the power, saga-
city  and wisdom of the human mind than are presented in the records of prac-
tical medicine.
  I cannot, gentlemen, conclude my remarks without congratulating you, and
all other true physicians, upon your happy selection of a walk in life.  There
are other paths which  lead more certainly to distincions, honors, and affluence.
There are other professions which may  be more exempt from cares and  disap-
pointments.   But where shall we find a pursuit more favorable than ours to the
development and improvement of the best faculties of our intellectual and moral
nature?  Where shall we find an  occupation for the few and fleeting  years of
life,  more conducive  to progress in wisdom and virtue ?  To grow old en-
gaged in the acquisition  of knowledge—ynpaoneiv  didacnouevoc—was  the wish
of the wisest of the ancients.  The sentiment is purified  and elevated  by re-
ferring it to a just and adequate motive.   To  grow old in the study of science
for the purpose of doing good to mankind, is a desire worthy not only of the
wisest but of the best  and holiest of men.   It is the daily business of  the phy-
sician " to seak  the bright countenance of truth in the  pure air of delightful
studies," and  to apply the knowledge thus acquired in affording relief  to hu-
man misery, in carrying  comfort to the afflicted, help to the  oppressed, de-
liverance and safety to those that are ready to perish.  I can  desire nothing
better for  you, gentlemen, for our professional brethren, and for myself, than
that we may feel and  appreciate the happiness of such a  life, and be thank-
ful to God for having  placed it within  our reach.