k? m ® (5) I ft ft ft 0) ft (5) $ 0 a xs§; rP-^-e VALEDICTJO/Y ADDRESS sirS & © B £ IF Q £1 s S[!aA33 THE MEDICAL DEPARTMENT GEORGETOWN COLLEGE, DELIVr.UEI) AT THE '■'-■; '^ P 0 c t 4< 0 0 (ft 2 SMITHSONIAN INSTITUTION, MARCHOS^J^S XT? ,-e^ ^rOOOO-C' ^ NOBLE YOUNG, M . D . , I'ROFESSOR OF TUE PRINCIPLES AND PRACTICE OP MEDICINE. WASHINGTON: THOMAS McdILL, V It I N T E R 1857. VALEDICTORY ADDRESS TO THE ® IE & £D 0 A. ¥ 0 S3 8 ®IL&3§ OF THE MEDICAL DEPARTMENT OF GEORGETOWN COLLEGE, DELIVERED AT THE SMITHSONIAN INSTITUTION, MARCH 12, 1857. PR0F18S0R OF THB PRINCIPLES AND PRACTICK OP MEDICINE. WASHINGTON: THOMAS McGILL, PRINTER 1857. Washington City, D. C, March 16, 1857. Dear Sir: We, the undersigned, in the name of the graduates of the Medical Department of Georgetown College, respectfully request a copy, for publication, of the Address delivered by you at the Annual Commencement on the 12th inst. Very respectfully, J. C. W. KENNON, JOHN A. WILCOX, DAN. B. CLARKE, THOS. A. WOODLEY. Noble Young, M. D., Professor of the Principles and Practice of Medicine, Washington, D. C. Washington Citt, D. C, March 17, 1857. Gentlemen : Your favor of the 16th, requesting a copy of my Address, deliv- ered to the graduates of the Medical Department of Georgetown College on the 12th inst., for publication, has been duly received. If you consider it worthy of such notice, I place it at your disposal cheerfully. With many thanks for the high compliment, I am, gentlemen, your obedient servant, N. YOUNG. J. C. W. Kennon, M. D., John A. Wilcox, M. D., Dan. B. Clarke, M. D., Thos. A. Woodley, M. D. ADDRESS. Gentlemen : I am commissioned by my colleagues to offer you, this evening, the valedictory salutations usual upon separating as pupils and instructors. I perform this duty with mixed feelings—of regret, in parting with you, with whom we have so long enjoyed the most pleasant intercourse, aad pride, in the confidence that you are going forth into the world to be" come ornaments to the profession of your choice, and to reflect honor upon your instructors. You are entering the profession, gentlemen, at a most interesting period—a period of unexampled progress in medicine. The age is past when medical men, relying only on observation, without the means of investigating the nature and true origin of phenomena presented to them, indulged in the wildest speculation, and advanced hypotheses to become the doctrines of the schools and dogmas as creeds for the medical world. You are in the midst of that in which the laws of na- ture must be studied, and the most abundant means are presented to acquire that knowledge which lies at the foundation of all real med- ical education. The advanced condition of chemistry stands most prominently amongst these means ; whilst anatomy, aided by the improvements of art, has been enabled to accomplish the most wonderful results. The microscope, whose early history is still obscure, has been advancing to perfection in the hands of scientific men since before the Christian era until, in this day, it constitutes one of the chief resources of the anat- omist. What the telescope has done for astronomy, this instrument has achieved for anatomy : it enables you to explore the whole field of nature; what was dark has become light; your horizon is extended : like the fabulous ointment of the eastern tale, which enabled the eyes upon which it was applied to see the treasures in the bowels of the earth, it enables yours to inspect nature while yet employed in her pri- mary formations; to examine the constituents of her most wonderful organisms; whilst chemistry ,advancing a step further, reveals to you their elemental nature. The improved resources of this latter science makes you intimately acquainted with the composition of every tissue, 6 of every solid and fluid of the human body, in health and in disease. It has extended our knowledge of hygienic laws, by bringing to light the true nature of morbific agents, hitherto hidden, thus increasing our capacity to prevent disease by regulating and controlling their influ- ences. We have been enabled to make such general rules as con- tribute to the preservation of the health of individuals and whole com- munities. It is a knowledge of these laws which enables us to protect the largest cities from the deadly effects of their own over-crowded population, moderate the baneful effects of prevailing epidemics, and render camps, jails, ships, and hospitals comparatively free from dis- ease, the natural result of unrestrained causes. By the same means, we are enabled to throw around each individual a panoply of protection, as he moves amidst pestilence, and save him from dangers unseen and unknown to himself. With such means of obtaining knowledge, we may safely say that, in our day, we are too busy in the collection of facts, of material, to indulge in speculation. We are occupied in the study of the phenomena of nature, and in deducing from them the real laws governing our econ- omy—the only means by which we can arrive at a correct knowledge of our being. These laws, gentlemen, are perfect; they have been so from the beginning of time, and they will remain so to its end. It is from our imperfect knowledge of them that we have been so long in error, and from the habit, common to the human mind, of generalizing without sufficient data. You are entering at a time when this is being corrected; when facts alone are received and legitimate conclusions alone accepted. You have before you the acquired information of the whole medical world. The improved facility in the art of printing gives you speedily all results of medical inquiry. Facts ascertained in any part of the world come at once to you through this medium; and thoroughly informed as to what is known, you are prepared to explore further, and add to the sum of medical knowledge. The education which you have received from us is only primary elementary. You have been taught how to learn : it is for you to ad- vance from this point, to complete your own education. You are not to rest content with what you have; you are to acquire more and more, to become laborers in the field of progress—a progress to continue to the end of time. Medicine, as well as all sciences which depend for their advancement upon a knowledge of the laws of nature and their application, must continue to progress: it is their nature; this may be retarded for a time—they may again experience the blight of an age of darkness, as has been the case with medicine particularly; but the t onward path will be resumed, and so long as man, the most perfect work of the Almighty Creator, is to be the subject of study, so long will there be found at every step new and wondrous truths to be investigated and learned. We have acquired much knowledge of these laws, yet it is but small when compared with that which is unlearned. We are, for example, scarcely upon the threshold of knowledge of the nervous system. We are familiar with its phenomena, and we are acquiring facts in regard to its laws every day; but though the most important of all connected with the human machine, the supposed seat of the life-giving power, the controlling influence of the whole economy, we must confess our com- parative ignorance. This is and should be an incentive to greater ex- ertion in this field. We must expect to meet with difficulties seemingly insurmountable before we can acquire a knowledge of the essential nature of this connecting link between mind and matter—of that which is, perhaps, a constituent of the semblance of man to his Creator. It is cheering to be conscious that the knowledge which we have gained has been of vast service to our fellow-men. An examination of vital statistics will demonstrate a progressive improvement. For ex- ample, in 1805, one in every seven admitted to the Paris hospitals died; now, only one in twelve, an increase of 71 per cent, in 51 years. In the 80,000 persons annually passing through these hospitals, there is a saving of 500 persons as compared with former years. Formerly the time of treatment was an average of 39 days, now 24 days. In syphilitic diseases, one formerly died in every 56 cases, now only one in 294. The average of mortality has changed during the last 71 years from one in 20 dying to one in 40 in this day. In surgical practice, more than 35 per cent, has been gained since the beginning of the present century. The average duration of life has been increased, during the past 66 years, nine and a half years. In obstetrical practice, 150 years since one in 40 died, now not one in 250. From the best returns therr appears to be a gain of 25 per cent, of cure in the past 75 years, and the average time of treatment lessened more than one-third. Disease, too, is greatly shorn of its terrors to the people by the improvements in medical science. The discovery of ether and chloroform has caused the knife of the surgeon to be no longer dreaded by the patient; but, under the Lethean influence of these anesthetics, he calmly slumbers on his passage from the brink of the grave to the commencement of a new career of health and vigor. The plagues of the earth, formerly deci- mating the population, are no longer legitimate objects of terror. Small pox is changed from a desolating disease to one comparatively H mild and manageable. Cholera, too, when taken in what is now known to be its only curable stage, need no longer be considered fatal. Marsh miasm, which formerly robbed the fairest portions of God's created land of its beauties and its comforts, and shrouded its inhabit- ants with the gloom of death, or enfeebled them with wasting decay, uo longer holds supremacy—no longer dooms to death the victim who enters its dominions in the pursuit of pleasure or of business—no longer, "With its suffocating breath, •' Loads the dank pinion of the gale with death;" but, stripped of its power by the resources of modern chemistry, in the discovery of an alkaloid of cinchona it moves abroad as harmless as the air with which it is commingled. These results, gentlemen—and they are but examples—have been at- tained by a knowledge of the laws of nature as applicable to disease, :md of remedies for their removal. You are entering at a period when the means of acquiring this are in abundance before you, and in pro- portion to the facilities, more will be required of you. Much more is re- quired now to constitute an accomplished physician than even 30 years ago. Real knowledge must be possessed. Even the community, who have so little means of appreciating the merits of the physician, understand this. The medical man of this day, possessed, as he should be, of all that is known of his art, feels conscious that, with the aid of the Al- mighty, he is the only safe and proper guardian of the health of his fellow-beings. It is not that quackery does not exist that it does not succeed—that even the most enlightened are not deceived by it. It is too true that the public pay so little attention to this subject, have such limited means of acquiring correct information in regard to it, and are so completely governed in their opinions by results which to them seem legitimate, as to place the charlatan in rivalry with the man of true science; yet it is but for a short season; these errors pass away, one after another, like the mists of the morning, before the rays of ad- vancing truth. Let real merit be the object of your ambition. Possess yourselves of all the information existing in your day upon every branch of your pro- fession. Be ready for every demand upon you—be equal to all that your art ought to afford in every instance. As you advance, step by step, in the confidence of the community, command their respect by being always competent to discharge your duty. The personal regard of con- nections, the partiality of influential friends, are not to be disregarded; they may turn the balance in your favor, give you preference amongst 3 your compeers, in the commencement of your career; but real merit alone can enable you to retain such advantage. I know nothing so pitiable, so contemptible, as a medical man relying upon the partiality of friends, upon personal regard alone—having no hold upon the respect of his patients—or of one who lives alone upon the reputation of another; his borrowed plumes may not be recognized as such by the community, but to his medical brethren he will be a proper subject of contempt and ridicule. A. great object of interest to you should be your standing with your brother practitioners—not a popularity purchased by any im- proper sacrifice, but respect exacted by real merit as physicians and propriety of conduct as gentlemen. There will always be rivalry amongst men pursuing the same calling; it is well there should be; it is best for themselves and for the community; but in our profession it must be an honorable rivalry—not a scramble for advantage; no gain made by dishonorable practices or petty arts, but the success of an open, manly competition. It should be your aim to acquire, early in your career, a strictly correct estimate of your relations to your brother practitioners and to the public. To assist you in this, I would call your attention to one car- dinal rule. Every man has a right to select for himself and family his medical adviser. Let this simple rule be the guide of your professional life—the non-observance of it will invariably lead to mischief. The community, understanding this right, are apt to indulge capriciously in its exercise : it is for the medical man to protect himself and his breth- ren from the effects of this. If you find yourself possessed apparently of an equal claim with others to the charge of a patient in need of med- ical assistance, as frequently happens in emergencies, satisfy yourself of his preference or that of his family; let it be clearly understood; do not be forced upon any one by the officious interference of friends, with- out the cheerful acquiescence of your patient in their recommendation : to attend a patient preferring another is to occupy an inferior position, and would be abandoned by an honorable man as soon as such preference came to his knowledge. The observance of this simple rule will be of great service to you, particularly in the discharge of vicarious duties, the most delicate which you will have to perform. Never permit the accidental connection consequent upon these duties to be the means of supplanting the orriginally preferred practitioner; rather endeavor to confirm the confidence of the patient in his usual medical adviser. To your brother practitioners be at all times courteous, prompt to defend their reputations when idly assailed. Regard ehem as members of the same family, old and young, having a common interest, engaged in 10 the same great work, and entitled, when honorable, to your respect and regard. I need not tell you that your mission is one of benevolence, of charity to mankind. A heavenly character has been given to the office by the participation of the Saviour in its duties, and his commands to his Apostles to follow his example. To restore a fellow-being to health from the helplessness of disease is a duty worthy of a Christian. At the same time, these services are worthy of reward from those who receive them ; and from those who are able to compensate you, the full price should be exacted, always in proportion to the responsibility incurred and their importance to the individual. Reserve for the poor your gra- tuitous services. I cannot believe that any of you would ever descend to the contemptible art of purchasing the good offices of influential per- sons amply able to reward you, by laying them under the obligation of professional services unpaid for, although this course, if followed, would contribute to your popularity with the public, who might attribute it to benevolence or indifference to money; yet it would merit and would receive in time the contempt of your brother practitioners, placed at disadvantage by their unwillingness or inability to compete with you in such a dishonorable career. Of your duties to your patients I need scarcely detain you to speak: your feelings as men, your principles as physicians, and your con- sciences as Christians, will, I am sure, direct you always correctly. You must combine the attributes of all these in your relations to the sick under your care. You are bound to be competent to discharge your professional duties to those who have placed their lives in your keeping. It is no light responsibility to guide disease, to avert the death of a fellow-being, to preserve to a family a head, to children a protector, to the community a valuable public servant. You are as the pilot of a vessel, who must know the chart by which he sails, or not undertake the duty. Your connection with families will be of the most confidential char- acter ; much will come to your knowledge which must be held sacred by you; the peace of families may be in your hands, and even im- prudence, without intention, may wreck it. In your management of females, cultivate the most refined delicacy. Remember that these lovely beings are of a more delicate mould than yourselves, and that this is increased by disease. Teach them to look to you as a gentle friend, as well as their kind and skilful physician • to expect your visits with pleasure, and to yield to a request instead of obeying a command. 11 You are entering upon an arduous profession, one which you must not look to as a source of wealth. With few exceptions its members are poor. It entails a life-long servitude. Not one hour will ever be your own. You can never lay down your load except with your life. In all weather and at all hours you must be the servitors of the public. Its trials, too, are hard, but they must be borne patiently. You must expect ingratitude. Many will refuse or neglect to compensate you, even with money ; and most of those who do pay for your services will consider all obligations as thus cancelled. You will become the phy- sicians of families; preserve for years, perhaps, the intimate relation of medical advisers and confidential friends, and in a moment of caprice, without any just cause, any want of competency or success, find your- self put aside, and another preferred, or your seeming friends bestow their confidence upon some popular quack, some pretender to the practice of a new system, as it is called, or their influence given to some nostrum vender—their names appended to his affidavits or certificates of won- derful cures. You must not expect a better fate than the illustrious Bichat, who had to trudge upon foot whilst giving to the public the benefit of his eminently scientific acquirements, whilst the quack salver rolled by in his coach, whose fortune, perhaps, had been acquired in a few years by some prescription given to him by a medical man, so far recreant to his prof«ssional duty. You must expect to have your merits discussed by persons wholly in- competent, and decisions made against you, and in favor of those who are known to you and your professional brethren to be greatly inferior; in many instances these decisions to be influenced by members of your own profession from selfish motives. You may raise your voice against quackery—your motives will be misconstrued ; your opposition ascribed to selfish reasons. You must expect to see individuals and families, whom you have attended during poverty gratuitously, desert you when they have become affluent. Every man of experience will recognize this as a common occurrence. One of your most severe trials will be to find the whole community indisposed to recognize the superior merits of regularly educated phy- sicians, and a philosophic practice based upon scientific acquirements. This is not so in regard to other professions and pursuits. A man will select an able lawyer to conduct his cause, an eminent divine to teach him, an accomplished mechanic to build for him; yet this same man will bestow his confidence upon a pretender when laboring under disease. When pestilence is abroad, your post will be that of danger; others may secure safety by flight—you must remain to battle with the foe; 12 subjected to anxiety, exhausted by fatigue of body and mind, your life may be sacrificed, yet the sacrifice must be made, if necessary: it has been made by many. The history of epidemics in our own country particularly will attest the fidelity of our profession to their trust. But, you will naturally ask, is there no other side to this gloomy pic- ture—no incentive to enter upon our career ? There is, gentlemen. It is a noble profession. The science of medicine is worthy of the best efforts of the human mind for its acquisition. Its object is sublime. The very instincts of our nature impel us to it. It is honored of God, and man is commanded to honor it. Where is there a sight more noble than a benevolent and skilful physician devoting a strong and highly culti- vated intellect to the study of the means, and his body to the fatigue inci- dent to their application, for the relief of his fellow-man palsied by disease ? The medical man possesses that knowledge which none but the in- itiated can justly pretend to. He alone possesses all the human means competent to remove or alleviate disease. The consciousness of this power is a legitimate source of pride. The feeling of having performed a duty in its application which is not possible for any other to discharge must awaken in a heart not dead to all benevolence the most grateful emotions. The study of medicine, too, is the most captivating of all pursuits. The employment of the mind is perpetual. New facts, new discoveries, arise at every step. The whole range of the natural science is traversed, and made to contribute to the store of the medical philosopher. The heavens, the air, the earth, the sea, bestow their wonders to be examined, their influences to be understood, whilst philosophy teaches the application of this knowledge for the benefit of his fellow-man. The phenomena of life, in health and in disease, present a never- ending subject for the most delightful study. The evidences of design in the adaptation of every organ, every tissue, every function, to the great end for which man was created, captivates the understanding of the student, elevates his thoughts, purifies him, brings him into closer com- munion with his Creator, and leads him from " nature, up to nature's God/' To the truly Christian physician there will be added, in a still higher degree, that feeling of gratification which follows the honest discharge of duty. His feelings of true benevolence are not to be influenced either by man's ingratitude or his commendation; he may be pained by the one, or gratified by the other; but his aim is beyond such ephemeral estimate. He is obeying an impulse from on high, which enables him to 18 pass unscathed by the shafts of malice, to bear with patience his many and severe trials, to forget his own sorrows, his sickness of heart and body, and feel ever ready to fly to the relief of others. I have spoken of ingratitude as one of the trials to which you will be exposed. I must in justice add that there are exceptions, rare, to be sure, but so much the more valuable. The honest physician will be rewarded with reputation by the public, but it will not be speedy, not so captivating as that bestowed upon meritorious men in other pursuits. The warrior, with the flush of vic- tory on his brow, is received at once with the acclamations of a delighted people. The orator enchains his audience by his burning eloquence, enshrines himself in their hearts, commands their respect and regard, and is rewarded at once with the highest positions. The sculptor or the painter by a single work achieves immortal fame. The physician must, through long and weary days, in the silence and solitude of night, in the humble cot as well as the mansion of the rich, pursue faithfully his vocation, until the confidence of the public renders the verdict of approval. You are this day, gentlemen, consecrated to the profession of Med- icine. You have received the certificates accrediting you as practition- ers of the healing art. You are endorsed by our venerable Mother Institution, which, during a period of sixty-five years, has advanced from a modest academy to the position of a world-renowned mstitution of learning, unaided by the hand of power or the influence of wealth, but simply by the energy and talents of its professors, devoted to the great objects of education. • We may be permitted to indulge a little feeling of exultation on the occasion of the recurrence of this annual ceremony. A new guaranty is given of the success of our Institution as a school of medicine. Not quite seven years since we entered the arena as contributors to the cause of medical education. Our banner was unfurled, our name in- scribed upon the list of medical institutions, and we* were introduced to the medical world by our first friend, the accomplished and venerable Dr. Ryder, then the President of Georgetown College. With earnest eloquence he offered us to public favor, as the child of the Parent Institu- tion over which he so ably presided. Within the walls of this Institu- tion, established for the "diffusion of knowledge amongst men," and presided over by one of America's most gifted sons, whose name is en- rolled in the brightest letters amongst the savans of the world, this in- teresting baptismal ceremony announced the commencement of our career. During these years we have struggled alone, unaided, against 14 difficulties, embarrassments, and opposition of foes, of such a character as is only known and only to be appreciated by ourselves. Our success so far stimulates us to renewed exertion to deserve the confidence, to prove worthy of the trust reposed in us by our venerable Alma Mater. The character you will acquire, the position you will maintain, gentlemen, must be such as to contribute to this end—to cause her to preserve her interest in and look with pride upon the progress of the Medical Department of Georgetown College. s