? rbiM- i '■- fc&CL {oL i (f' ) •WMiUMMfr'^^1 AN ADDRESS, DELIVERED BEFORE THE MEDICAL SOCIETY OP TENNESSEE, EIGHTH ANNUAL MEETING AT NASHVILLE, On the 7th of Hay, 1838- 1 ty/0 BY LUNSFORD P. YANDELL, M. D. [Published at the request of the Society.] Eottufotlle, &g. PRENTICE & WEISSINGER. 1838. AN ADDRESS, &c. Mr. President: The organization of the Medical Society or Tennessee constitutes an era in the history of the State. It was the - first combined movement of its Faculty in behalf of the Medical profession. One of its original members, I have not ceased, during my long absence from the State, and amid all the engrossing and sometimes exciting objects by which I have since been occupied, to entertain a lively concern for the interests of the Society. It was the first organized effort in Tennessee to advance the character of the profession for which I was educated, to which from all my early associa- tions I have felt more than an ordinary devotion, and which was the most valuable part of my paternal inheritance. It was instituted to reflect a lustre and confer solid benefits upon the State of my nativity, to which I am attached by the dearest social connexions, in which were spent the years of my professional probation, and which has received the ashes of my father and my ancestors. To the Society I owe, moreover, a debt of personal obligation. An active partici- pant in its organization, and first deliberations, I was early honored by one of its highest offices, and am free to ascribe to the impulse thus given to feelings, then youthful and buoyant, a large share of the professional success which has 4 since fallen to my lot. That under circumstances such as these, my sympathies for the Society should be dissevered by my removal from the immediate scene of its operations would be unnatural; nor, with these things all fresh in my memory, have I been able to find in the pressing engagements which for the last twelve months have occupied my time and thoughts, an apology for drawing back from the discharge of this duty, although fully conscious of the disadvantages with which it is undertaken. I have encountered the task pre- ferring that I should be considered to have performed it imperfectly, to declining it, that others hereafter may be stimulated by my example to execute it well. And having engaged in it with the simple purpose of doing what little I may for the interests of our profession, my discourse will be strictly professional. In looking back over the history of. Medicine, it is impossi- ble not to perceive that its infancy was marked by peculiar weakness, and that in its progress toward maturity it has been outstripped by most other sciences. Astronomy, Phys- ics, Chemistry, and even young Geology are hastening to a state of perfection, while medicine, growing out of man's physical infirmities, continues to partake largely of the weak- ness of his moral nature. Yet, in the earliest ages of which history affords us any knowledge, it was esteemed a noble and divine science, insomuch that the founders of it were accounted Gods in after times—merito pro Diis hahiti—for the excellence of their invention. And, as beautifully ex- pressed by an old writer, "whereas Apollo was worshipped only at Delos, Venus at Cyprus, Diana at Ephesus, and the other gods were adored alone in some peculiar places, iEsculapius had his temples and altars in every land, attd received homage from every people." But while thus honored for its high aim—the relief of suffering humanity—we find 5 iittle in early medicine but wild fancies, gross superstitions, and remedies either disgusting and dangerous, or feeble, inert and useless. And hence it has passed through every vicissitude of fortune among different nations, and in the hands of different writers—now extolled as divine, and again denounced as the craft of impostors. Among the Greeks, where medicine first assumed the form of science, it was taught by the priests of the temple of Apollo, and the most powerful remedies were used on no better authority than the voice of oracles. The cures per- formed by iEsculapius were professedly made by magic; and charms, spells, and the agency of spirits were the powers upon which his successors relied in the treatment of the sick. The writings of Hippocrates, venerable for their anti- quity, and valuable for the evidences they afford of a powerful, philosophical mind, as well as of the advances which medical science made under his culture, are, neverthe- less, generally obscure, and the remedies of which they treat obsolete or unknown. His cures, Paracelsus affirmed, are to be ascribed rather to the faith of his patients than to any virtue in his remedies, nor does there appear to be much cause to quarrel with the injustice of the charge. Among the Babylonians we are told there were no professed physi- cians; it was their custom to bring their sick people to the market places, and to trust them to the precarious counsels of such as were bold enough to hazard advice. Herodotus relates that the same practice was pursued by the ancient Egyptians; and the same is related by Strabo as the usage of many of the early nations. The banishment of physicians from Rome was a thing of frequent occurrence, and both Pliny and Celsus relate that for the long period of six hun- dred years they were not allowed to pursue their professions in that city. Plato held it a sign of an intemperate and cor- 6 rupt commonwealth that physicians and lawyers abounded in it. An early historian of Great Britain boasts that the people of that island without the aid of physic or physicians lived, not unfrequently, to the age two hundred and fifty years. "There was of old," remarks this credulous and quaint annalist, "no use of physic amongst us, and but little at this day except it be for a few nice idle citizens, surfeiting cour- tiers, and stall-fed gentlemen lubbers. The country people use kitchen physic; and common experience tells us, that they live freest from all manner of infirmities who make least use of apothecaries' physic" Juvenal, in one of his satires, enquires how many sick people had Themison killed in a single autumn? The emperor Adrian according to the adage died from the multitude of his medical counsellors—multitudo medicorum principem inter- fecit. A Roman satirist asks in a quaint epigram "what the difference is between the surgeon and the physician? Only this, that one kills with his juices, the other with his hand; and both only differ from the executioner in doing slowly, what he does at once." And Paracelsus was behind none of the satirists in his censures of the practice of the rival sect. Hippocrates, Galen and their followers he denounced as infants, idiots, and sophists, unworthy of the name of physi- cians, being ignorant of the qualities and uses of chemical preparations. The remedies of the first physicians were directed to the most fanciful and preposterous ends, and such as we have any distinct knowledge of were for the most part of an inert character. Homer, in the Odyssey, speaks of a plant, the nepenthe, sent as a present from the wife of Thonis, king of Thebes, to Helen, which possessed such virtue that taken, steeped in wine, it would enable her to witness the cruel slaughter of her best friends without the loss of a tear. This 7 plant Dioscorides and his commentators suppose to be the simple and harmless bugloss, or ox-tongue, of modern times. Many remedies were prescribed for the purpose of cleansing the brain, of expelling all careful thoughts, and all anxious imaginations. Others were supposed capable of purging away melancholy vapors from the spirits, expelling devils, and easing afflicted souls. The loadstone—the mild oxide of iron—taken by parcels inwardly, it was held, was capable of effecting rejuvenescence. Pliny assures us that the beryl much avails a good understanding, represses vain conceits, and evil thoughts, and excites the mind to mirth. The same writer makes mention of a stone found in the abdomen of the swallow, called chelidonius, which, being folded in fine cloth, and fastened to the right arm, will restore lunatics and melancholy men, and make them amiable and joyous. The heart of a wolf, the lungs of a fox, and various parts of different animals, have a place among the materia medica of Dioscorides and other ancient authors, and were prescribed for the fulfilment of indications as absurd as the remedies themselves. A ring made of the hoof of an ass's right foot was supposed to contain a powerful charm. The teeth of the sick were anointed with the ear wax of dogs and hares, which was deemed highly efficacious, as the blood of a black cat is fancied by the unlearned of our own day to possess rare curative and prophylactic virtues. Great virtue was ascribed to the thigh bone of a criminal, and to the lungs of a man who had died a violent death. The spiritus cranii humani stands in the list of remedies prescribed for Charles the 2d when he was sinking. Astrology mingled in the philosophy of primitive medicine. The stars were consulted, and cabalistic signs were among the chief resources of the art—superstitions which have descended to within a few years of the present period, and, indeed, have still a foothold 8 amongvthe ignorant of most countries. Armatory unguents were the resort of the surgeon at one time, and appeared to possess singular efficacy. The sword of the warrior was carefully dressed with these healing ointments, while his wounds were simply bound up to exclude the action of the air, and then committed to the safe guardianship of the vis medicatrix natures. For many centuries Medicine seemed to have an elective affinity for all that was absurd in the other departments of science. It embraced alchymy, by which was to be extracted from the mineral kingdom a catholicon for all diseases, and which should render the race immortal. Divination and astrology were impressed into its service, and aided to swell the catalogue of its absurdities. The mechanical philosophy lent its light to physicians only to bewilder them, and thence- forward, so long as the delusion lasted, the animal functions were resolved into a system of pulleys, hinges, strainers, levers and wedges. Chemistry, at a later day, volunteered its aid to render the hypotheses of medical men more grotesque and preposterous. The human body, no longer a system of mechanical powers, became a living laboratory where all changes were evolved by the action of acids and alkalies, diluents and solvents, putrefaction and fer- mentaion. Such, for a long series of ages, was the condition of Medi- cine. What it is now—the countless discoveries with which it has been enriched—how old errors and gross superstitions have been rooted out—how its efficiency and safety, certainty and promptitude have been increased in every department, in every class of disorders and almost every individual affection—it would be out of place for me to recount to this Society. In an assembly much less learned, it would be unnecessary. The most ignorant are at no loss to note the 9 change. Horce Musarum nutrices—the hours have still been the bountiful nurses of philosophy not less than of the Muses. We are naturally led to inquire what brought about this altered state of the healing art, at which science and hu- manity rejoice? What banished jargon, and wild, visionary hypothesis from the schools, and blind, empirical, hazardous experiment from the practice of physic? To these questions there can be but one answer—the change was the necessary result of the introduction of the Baconian philosophy, and especially of the growing interest with which human anatomy has been cultivated during the last half century. Anatomy achieved the revolution. It taught physicians at last what the human body is. Out of it the whole science of physiology has grown. It has exhibited the structure and arrangement of the parts composing the body in health, and as altered by disease. The whole structure of medical science has been remodeled and rebuilt, and now rests upon anatomy, owning no other foundation. Harvey's grand discovery was one of the first fruits of the patient study of this science. He had carefully noted the structure of the bloodvessels—had re- marked that the veins in most parts of the body were supplied with valves, while the arteries were destitute of these appen- dages—that these valves were so disposed that the blood could move in but one direction,—towards the heart—and hence, he concluded, that the blood was distributed to distant parts of the body along the arteries, and re- turned to the heart through the channel of the veins. To his knowledge of anatomy Cheselden was indebted for his brilliant success in surgery; and it was his surpassing zeal in the cultivation of the same science which has placed the name of John Hunter in the first class of medical philoso^ phers. 2 10 But I consume the time of the Society with stale truisms. Since they were recognized, and anatomy assumed the rank of paramount importance due to it as the basis of medicine, the profession has gone forward with a celerity unknown to any former age. The greatest improvements have beer made within the last thirty years, and are especially due to pathological anatomy. Hospitals and autopsies ushered in the new era, since which the science has advanced with a sure and vigorous step. A broader and clearer light has been beaming upon its philosophy, and greater certainty, safety and efficiency have been given to its practice. Human and comparative anatomy explaining the functions in a state of health, and the inspection of the dead body revealing the character of disease, while an extended and greatly improved chemistry has enriched its resources, medicine at the present day appears a new science, or an old one instinct with a more rational principle. It is among the curious facts with which history abounds, that this change was favored and accelerated by causes quite foreign to medicine, and which seemed at the time as hostile to science as to humanity. In the wars which for twenty years deluged Europe in blood, we find one of the chief impulses which led on to this revolution. The campaigns of Napoleon opened to his physicians schools of practical anatomy such as the world had not yet beheld, and his all-grasping mind embraced every interest which involved the fame of his country. The savans of the Republic made a part of the grand army, and traversed the earth with his resistless legions. The genius of science flew with his eagles from sea to sea, and collected treasures under every path of the sun. Medicine is enriched by the records of what his philosophers observed at the foot of the pyramids, and amid the Pontine marshes—under the burning sun of Syria, an' 11 the frosts of a polar winter—on the banks of the Nile and of the Beresina. They saw disease as it is modified by every climate, and race, by passion, vice, hardship, fatigue and hunger. They were called on to treat every wound which could be inflicted by the countless implements of refined warfare. They saw the human body lacerated and maimed in every member, and in every form that the imagination can picture. The march of the conqueror demanded the per- petual study of anatomy. The human system with all its curious mechanism, hewn down in full health, or wasted by slow disease, was ever exposed to his medical staff, and the ravages of every form of human malady from the plague of Egypt, to the diseases engendered by a Russian winter, were traced and recorded. But Napoleon contributed directly to science in the reform and improvements which he caused to be made in the French Institute, thus greatly augmenting its means of usefulness. He made it the richest of all existing institutions in anatomi- cal facilities, and in this way gave to it that pre-eminence among the medical schools of the world which he strove in vain to confer upon France among the nations. The triumphs of his civil wisdom have outlived the conquests of his sword. The allied armies resisted successfully the mili- tary domination of France, but no power has been able to prevent Paris from becoming the medical emporium of the world. Its schools are filled with pupils from every country where medicine forms an object of scientific human pursuit. The school of Leyden has dwindled to comparative obscu- rity—those of Pavia, Montpelier and Gottingen have receded visibly from their ancient standing—that of Edinburgh is in a state of decadence, while those even of London are com- pelled to do obeisance to the Institute of the French metro- polis. And what cause can be assigned for all this but the 12 ample provision made in the schools of Paris for the study of Anatomy? The value of hospitals and subjects to the student of medicine has only lately come to be justly appreciated by physicians. Names are not now, as once, every thing in the profession. Boerhaave, if alive and at the height of his renown, could not attract pupils by the thousand to listen to his dogmas. The ipse dixit of the most venerable and illustrious teacher has ceased to be law to his classes. Pupils are not required jurari in verba magistri, or to defend their doctrines with the zeal of the true knight the claims of his lady-love. Nature is the only authority recognized as infalli- ble. To interrogate her is the business of the student of medicine—to scrutinize for himself the symptoms, the ravages, and the treatment of disease. Systems and theories at one time prized above all things else, yield now in the estimation of physicians to facts, observations, and well directed experi- ments. The science is no longer cultivated by the student in his closet, but by the studious, observant practitioner at the bed side of the sick, or in the altered structure of their inanimate organs. It is no longer a tissue of hypotheses, but a body of systematized facts and sound generalizations. The truth is beginning to be felt, that it is the province of teachers not so much to communicate knowledge, as to indicate to their pupils the best method of study, and give to their feelings the proper impulse. Every man at last must educate himself. Schools furnish the means, opportunities and incen- tives, and their value is in exact proportion to the extent of their facilities—to the variety and richness of their apparatus and libraries—the abundance of their anatomical preparations and subjects—and the number of patients, in accessible hos- pitals, affording practical illustrations of disease in all the departments of the profession. These are the instruments L3 with which the learner operates in rearing the structure of his scientific education; and his attainments thus made are solid and available. They constitute true professional wis- dom—not knowledge merely, which may be extraneous and of little worth—but the right discipline of the faculties, by which the young physician is fitted for the exigencies and trials of professional life. In the absence of hospitals and means, adequate to the demands of the learner, for the practical study of anatomy, institutions professing to teach medicine are destitute of any solid foundation, and, with the enlightened views of the present generation of physicians, must decay, like the towns in false positions on our rivers and seaboard deserted by their commerce. The arts of those teachers who habitually decry the value of hospitals, and discountenance dissections by students of medicine, are to be reckoned with the tricks of the priesthood for keeping the people in ignorance, and in the end will cover the authors of them with shame and confusion. Of the graduates of the medical schools of this country what proportion, sir, do you suppose, compass during their pupilage such a knowledge of anatomy that they would undertake to tie the common carotid artery, or perform the operation for stone, or for strangulated hernia? What pro- portion are acquainted with the number and situation of the muscles about the hip or shoulder joint, involved in their various dislocations? And yet the full amount of this knowledge sudden emergencies may demand of all who exercise the functions of the healing art—emergencies which allow of no time for preparation, but which must be met by the young surgeon promptly and efficiently, or turned over to more skilful hands. And can such perfection of skill be attained by listening to lectures on anatomy, or by witnessing 14 from a remote point in the amphitheatre the display of parts by the most dextrous anatomist? As easily might we become familiar with the topography of a country by a simple geographical account unaided by maps, or of the color, form, odor and other properties of plants or minerals by the verbal descriptions of the botanist or mineralogist. It is only by actual, close, continued inspection, and by the analysis of parts for himself—only by practical research with the dissect- ing knife pursued through all the systems, tissues, and organs of the complicated human mechanism, that one can become a skilful, matured, confident anatomist and surgeon. It is not sufficient to accompany a demonstrator in his exhibition of parts, nor yet to trace out the origin and insertion of a few muscles, or perform a few operations upon the dead body. Such extent of preparation would not make a master-work- man in the humblest of the mechanic arts, and can much less be counted on in a high and responsible art involving human life, and putting the courage, firmness and science of the practitioner to the severest test. Is any one disposed to charge me with exaggerating the value of anatomy, or its agency in bringing about the revolu- tion in medicine referred to? If there be any such I beg that he will turn his eye to the condition of the science in those countries where anatomical studies are neglected, or pro- hibited by law. What is it in Turkey, among a people long enjoying a stable government and civil institutions, and in constant intercourse with polished nations, but where a false religion has fenced around the practice of human dissections with all its fearful pains and penalties? To the Turk, the remains of the dead are sacred. The opening of dead bodies is expressly forbid by the Koran, "even should the dead per- son have swallowed the most costly pearl which did not belong to him." According to the Islam faith it is a more 15 heinous offence to molest the bodies of the departed, than to injure, or even to assassinate the living. To poison an enemy they hold, is merely to anticipate him in what he only waits for an opportunity to do, and which, moreover, cannot succeed unless fate have decreed his death. Life among this degraded people is little valued, and man only becomes sacred when he ceases to be conscious of benefits conferred, or injuries inflicted. Lunatics and idiots are held in high veneration from the superstitious belief that they are "pos- sessed"—the objects of peculiar divine influence. Among the medical practitioners of Turkey, divination is one of the principal remedial agents; and the influence of the stars, necromancy, talismans, amulets and cabalistic figures continue to be objects of their most undoubting faith. Dis- ease is sometimes viewed as an evil spirit, to be exorcised by peculiar arts; while at others, it is esteemed a direct judgment from God, whose wrath long prayers and counting the rosary must appease. A passage from the Koran, at one time, is inscribed upon paper, pounded into a bolus, and thus swallowed; or the characters are traced on a board, washed off, and the liquid containing the sacred letters given as a draught. "Amulets," says Dr. Oppenheim, "both as pro- phylactics and means of cure, are held in the highest estima- tion, and indeed by all classes of Orientals, as well Christians and Jews, as Turks. They mostly consist of triangular pieces of paper, containing written passages from the Koran or Bible, sewed into some part of the dress. These are deemed also very important in protecting the wearers from the evil eye; a superstition of universal belief in Turkey. The doctors also religiously observe what they term their white and black, or lucky and unlucky days; on the last, no course of treatment is undertaken, no surgical operation performed." 16 In this state of profound ignorance and gross superstition, the physician not unfrequently answers with his own for the life of his patient; and one of the chief duties to which native practitioners are called, is to minister "by fancied restoratives to the palled appetites and jaded powers of an exhausted or superannuated sensuality." Poisons are not only in liberal use, among the Turks, as means of despatching a troublesome enemy—in aid of which the skill of their physicians is often invoked—but from the carelessness or ignorance of apothecaries fatal accidents are so common as scarcely to excite attention. "Sugar, salts, arsenic, &c. are heaped together in open chests and baskets. Arsenic is not only sold in the apothecaries' shops to any one who may apply for it, but the next article called for is weighed in the same scales, to which, perhaps, enough of the poison adheres to send the purchaser into the other world. When called in to one of these wretches, made patients by their criminal negligence, the doctors, instead of feeling horror at the dreadful cramps and convulsions, unconcernedly shrug their shoulders, and leave him to his fate—declaring that he must be possessed by some evil spirit."* They have no hospitals for the reception of the sick, except lunatic asylums, which, owing to the superstition referred to, are found in every part of the country, and regulated by principles creditable to humanity. The circulation of the blood is there as profound a mystery as it was to the philoso- pher of Cos. The most enlightened of their Faculty know so little of the structure of the most important parts, that the bowels are supposed "to float in a pool,"—that when in dis- ease patients suffer with thirst, dry skin and parched tongue, it is because this "pool is dried up, and the viscera are on * Oppenheim on the state of Medicine in Turkey. 17 fire." In such cases, inflammatory affections for example, they condemn the use of the lancet which abstracts the liquid blood, forbid dry medicines, and drench their patients with potations of herb teas. Such are the necessary fruits of that inveterate prejudice— the inviolability of the dead—and such roust be the state of the healing art wherever the anatomy of the human body is not understood. Here, as the profession is seen in the hands of Turkish physicans, we are carried back to the days of primitive medicine—to the period when prescriptions for the sick were sought of the priests and oracles of heathen Temples—to the dark ages, in which astrology and alchymy were the reigning systems of philosophy—to the days in which Paracelsus boasted his alexipharmics and catholicon. And we are presented in the state of medicine among this barbarous people, as well as in the no less degraded state of morals which prevails, with a forcible illustration of the truth of the philosophical remark of the Roman orator, that it is their religion more than any other cause which gives supremacy to a nation. "Much," says he, "as we may be inclined to exalt our advantages, it is nevertheless true, that in number we do not equal the Spaniards, in physical strength the Gauls, in policy the Carthagenians, in the fine arts the Greeks—nor yet many of the tribes of Italy in native under- standing; but in piety and respect for religion, and this one wisdom, that we see all things to be over-ruled and ordered by the immortal Gods, we excel every other nation; and it is by the favorable influence of this circumstance upon the character of the people, that I account for the success in acquiring the political and military ascendancy that we now enjoy throughout the world." Medicine has no claims to being a perfect art, even where best understood. Imperfection, we admit, is written all over 3 18 it, and is displayed at every step it takes—after all the human slaughter by which its facts have been multiplied and corrected—after long years of anatomical study—and when the light of hospitals and medical schools, and an enlightened press has been beaming upon it for ages—with all the aids and advantages of the Baconian philosophy, and all the fos- tering influences of a pure, and benign religion. But, as we look down from the height to which it has attained in Christendom to the deep degradation in which it lies amid the followers of Mahomet, we find abundant cause for exult- ing, in the progress it has made—at the follies, superstitions and errors which have been rooted out of it, and for gratitude also, that our lots were cast in a land refined and exalted by the mild spirit of Christianity. But what is to be said of a State within the borders of Christendom, and in this age of civilization and boasted mental culture, which enacts the laws of the Koran, and joins with the worshippers of the Prophet in warring upon science? It would be unbecoming me, as it is repugnant to my feelings, to indulge in any language of invective or rebuke towards the legislature of my native State; but if there be any truth in the course of argument which I have pursued in this address, it must be conceded, that to repress the spirit of improvement in the most benevolent of human professions, by legal enactments against anatomical dissec- tions, is unworthy of the genius of the nineteenth century, and of a people claiming to be civilized. This superstition is giving away among the Turks. Surely it will not long have an abiding place among the statutes of Tennessee.* Under the superintendance of that most courageous and enterprising * I have had the satisfaction to learn, but not until after this address was prepared, that the obnoxious act referred to has been modified, and that dissections may now be practised, under certain restrictions, with impunity. 19 surgeon, Clot Bey, dissections of the human body are now publicly practised in Egypt, and the aspect of medicine begins to improve. While Tennessee has been thus throwing the weight of her influence into the scale of empiricism, what has been the policy of surrounding States? We see the people of a neighboring city contributing largely of their means to the advancement of science, and of themselves endowing an institution for the promotion of human health, and the diffusion of knowledge. Louisville, through her Council, with an enlightened liberality over which I should feel myself criminal, if, on an occasion like the present, I were to pass without notice, has appropriated nearly a hundred thousand dollars to the erection and furnishing of a school of medicine. If the Institute does not accomplish the high ends for which it was founded, the fault will not rest with these public spirited people. If medicine is not there taught in a manner worthy of the age, it will not be because her teachers lacked the necessary means. Louisville has discharged her duty to herself, to humanity, and to science. Upon those in whose hands are the interests of the Institute will rest the shame in the event of a failure. The example of this noble stand made by Louisville in behalf of science, cannot be lost upon the country. I trust its influence will fall with all its just weight upon the State in whose fame I claim to be a sharer as one of her sons, and whose name awakens in my bosom all those feelings which wait upon the sound of home. I trust she will be enlightened to the sad error which she has committed, while pursuing the dictates of a misguided philanthropy, in throwing barriers across the path of knowledge. It is time that we had grown more attentive to our moral and intellectual wants—more of a reading and studious, and less of a commercial and trading 20 people. Amid the many projected works of internal improve- ment, that most valuable of improvements—the improvement of the mind—the improvement of our academies and col- leges— of our apparatus and public libraries, has been too much neglected. But I believe I perceive signs of a waking up on this subject. A geological survey of the State is now in progress by an act of the legislature. That venerable structure,* which has survived many popular storms and revolutions, and lived on through long years of neglect which would have been fatal to any ordinary spirit, yet proudly rears it head, and is hewing its way, as through a rock, to a high and enduring prosperity. By the aid chiefly of the city, of which it is one of the chief ornaments, it is adding to the extent and beauty of its buildings—to its means of instruction—the number of its pupils—to its reputation and its usefulness—sending a reviving and healthful stream of learning through the State, and training an annual corps of young scholars to raise the standard of the professions. Nor must I pass unnoticed the efforts of individuals in other parts of the State to diffuse science among the people, and which betoken the approach of a brighter era. A revolution in public taste is thus silently but surely working out. In the establishment of this improved order of things, it was the reasonable expectation of the founders of this Society, embracing as it does a large share of the science of the State, that it would act a distinguished part. Its great purpose has never appeared to me, as it seems to have done to its mem- bers generally, to be the regulation of the practice of physic in Tennessee. Assuredly this is a most important object. A most desirable state of things will be that, in which the public will demand some test of qualification in medical practi- *Tiie University of Nashville. 21 tioners. It will be a new era in the history of man, when he ceases to believe that to cure diseases, like Dogberry's reading and writing, comes by nature. And, in the distant future, the philanthropist has a glimpse of this perfection of human discernment. It will arrive with the completion of our high task—it will come when medical men are agreed touching all the great principles of health, disease, and cure—when they cease to impute to each other dishonest motives for their honest differences—when we shall have discovered the true key to the Temple of Health. There will be no contrariety of opinion then; but the multitude will wait assiduously upon our steps, and press eagerly to the doors of the Temple—and the voice of the empiric will be heard in our streets no more. Mean time, independently of the regulation of practice, there is ample room and verge enough for the exercise of all the energies of the Society. Innumerable topics, deeply interesting to medical men— vitally important to the community, invite their investigation. Mortuary records, meteorological registers, the statistics of our most prevalent diseases—these remain to be furnished by the practitioners of the State, and it is the province of this Society to bring them out. Tennessee remains without a retreat for its insane, but it is gratifying to perceive that this cannot be much longer said. Humanity, as well as State dignity, calls for the early completion of this charity. The want of it has been the cause of great and manifold suffering. In all parts of the State, unfortunate beings, too poor to gain admittance into the asylum of a neighboring State, are chained in dark rooms, and log cabins, and treated with kindness or cruelty, as their keepers or friends may chance to be intelligent and humane, or ignorant and unfeeling. Mr. President: In casting your eye over this body you 22 find vacant the seats of a number of those members who were of our first meeting, and who encountered disease among the early settlers of Tennessee; and as you extend your view over the State, you will find few of the pioneers of the profession. In reference to that body and period it may be said, "Star after star decays, Everjr bright name that shed Light o'er the land is fled." The first generation of physicians in Tennessee has passed away; and we stand here their successors and representatives. They spent their days in the discharge of labors "huge and hard"—labors which demanded great bodily strength, indus- try and courage—exposed to cold in their long, lonely rides—compelled to ford dangerous streams—pursuing their way along blind uncertain paths—encountering hardships and privations to which these luxurious days afford no paral- lel. Amid such lives of toil, there could be but little leisure for study. Few books were reprinted in America, and few could be commanded. Those men had small advantages of professional intercourse. Schools of medicine were remote, and the expense of visiting them beyond the ability of most practitioners—and above all, they were without the advan- tages of the periodical press. These difficulties have passed away with the generation of men who lived in the midst of them. And with all the augmented means and facilities which we enjoy—with Macadamised roads, and the power of steam to hasten our travel—pursuing our professions in crowded, cultivated cities, or in thickly settled neighborhoods, and with increased leisure thus for study—brought into con- tact with all parts of the country, and light from the farthest east flying to the remotest west with more than the speed of the revolving seasons—the discoveries at Paris or Vienna 23 transmitted to Philadelphia, and from Philadelphia to Louis- ville or St. Louis, as if by telegraphic agency—with these enlarged efficiencies, shall we be accounted to have dis- charged the whole amount of our duty to our professions, if we pursue them with no more than the ardor and success of our fore-fathers? Nay! with the multiplication of means, has come a heavier weight of responsibility. We are in- voked by the laborious example of our predecessors—by the clamorous wants and imperfections of the Healing art—by the complicated sufferings of our fellow men—by the efforts of the profession in other lands—by our pride of State, and pride of profession, to transmit the science of medicine to our successors enriched by our labors.