AN INTRODUCTORY LECTURE, OPENING OF THE THIRTIETH SESSION MEDICAL COLLEGE OF OHIO. DELIVERED AT THE REQUEST OF THE FACULTY, NOVEMBER 5, 1849. 15 V DANIEL DRAKE, M. 1>., PROFESSOR OF SPECIAL PA HOLOGV, PRACTICE, AND CLINICAL MEDICINE. H PUBLISHED BY THE CLASS. 0 1 N 0 I N N A T 1 : MORGAN AND OVEREND. PRINTER: 1 S4<>. AN INTRODUCTORY LECTURE OPENING OF THE THIRTIETH SESSION MEDICAL COLLEGE OF OHIO. DELIVERED AT THE REQUEST OF THE FACULTY, NOVEMBER 5, 1849. BY DANIEL DRAKE, M. D., PROFESSOR OF SPECIAL PATHOLOGY, PRACTICE, AND CLINICAL MEDICINE. PUBLISHED BY THE CLASS. CINCINNATI: MORGAN AND OVEREND, PRINTERS. 1849. CORRESPONDENCE. Medical College of Ohio, ) Cincinnati, Nov. 8, 1849.$ Sir: — The introductory lecture, delivered by you, on Monday evening last, was listened to by the members of the class with interest and profit ; and, desirous of pre- serving something besides a mere remembrance of it, the undersigned have been appointed a committee, on behalf of the class, to request a copy for publication. Yours, very respectfully, Foster Carroll, , Samuel W. Lindsay, John Ocheltree, W. W. Highlands, K. W. Reynolds, Committee. Professor Dan. Drake. Cincinnati, November 9, 1849. Gentlemen : — 1 have the honor to acknowledge your note of yesterday, requesting, on behalf of the class of the Medical College of Ohio, a copy of my opening lecture, for publi- cation. 1 cannot but feel much gratification, that those to whom it was addressed should desire to see it published, and will, with pleasure, furnish the manuscript. In making this known to your brethren, please to assure them of the consideration with which I remain your and their very obedient servant, Dan. Drake, Messrs. Carroll, Lindsay, Ocheltree, Highlands, and Reynolds, committee. INTRODUCTORY LECTURE, Youxa Gentlemen — It is at the request of the Faculty, as well as of a respectable portion of your own number, who attended our preliminary lectures in October, that I appear before you, this evening. I do not come to begin a course of instruction on special pathology and the practice of medicine; nor yet to greet you as students of my own class room. My mission is, to salute you as pupils of the College; and, on behalf of its Trustees and Professors, to welcome you within its walls, and give you the assurance, that whatever may be practicable will be done for your instruction and comfort. Of the prospective and probable value of our labors to these ends, it is not my intention to speak; but I may remark, that whether it be much or little, a willing and earnest cooperation on your part, will be indispensa- ble to your improvement. It will, therefore, be expected of you to be punc- tual in your attendance in the College and Hospital, orderly in your deportment, courteous to each other, respectful to your teachers, temperate in your habits, and unwearied in your devotion to study. Some of you, young gentlemen, have already attended a course of lec- tures, in this or some other medical school; others have not, although they may have been for some time engaged in medical studies; while others have read but little, and attended no lectures. Now, no truth could be more obvious, than that students so differently advanced, should be placed in dif- ferent classes. In every stage of our studios, from the infant school to the university, this is done. Medical institutions, alone, constitute an excep- tion — an exception which establishes the necessity of the rule; for the instruction afforded by our medical schools, under the present system, is far less profitable to the student, than it would be if the pupils were properly classed. I hope that some of you may live to be the honored au- thors of this great improvement. Meanwhile, let me advise those who have as yet made but little progress, to direct their attention chiefly to the first or elementary branches. These are anatomy, physiology, chemistry, pharmacy, and the natural history and clas- sification of medicines. Until they are well understood, the more complex and practical branches cannot be mastered, any more than we can compre- hend the circulation of the blood, without knowing the structure of the heart; or the movements and powers of the magnetic clock, without a knowl- edge of its mechanism. By neglecting this obvious truth, the student | involves himself in the most discouraging perplexities; and not unfrequently 4 Introductory Lecture. finishes his first course of lectures, without having acquired an accurate or well-defined knowledge, of any of the subjects to which his attention has been called; has a superficial knowledge of many things, and a deep and exact knowledo'e of nothing, except the absurdity of having neglected what I am here recommending. To protect you the more certainly from the error into which so many students fall, I must 'present the subject in another aspect. The phrase, " Science of Medicine," is by no means an accurate and logical expression. Strictly speaking, there is no such thing as the science of medicine, but there is a profession of medicine, to which you are aspiring; but how are you to reach it ? I answer, by studying, not one, but several sciences. If medi- cine were a science, the advice I have just given you, would be superfluous, for you could make no progress whatever without beginning with its rudi- ments—its definitions and axioms—its primary and fundamental propositions ; and proceeding from the known to the unknown, in the invariable order of its relations. As it is, you may study one of the sciences, which make up the profession and neglect another; you may study first that which should be studied last; or, neglecting the first, attempt to build without a founda- tion. A just view of the relations and dependencies of the different sciences with which the physician must be acquainted, as constituting his profession, is of the utmost importance; and should be attained by all who conduct medical education, and by every student who aims at distinction in his calling. Some of these sciences, as I have already said, must be acquired before others; I may now say, that some must be studied more carefully than others, because they are more intrinsic—essential—indispensable. The essential are anatomy, physiology, pathology, therapeutics, and operative surgery. You may study several of these, and yet be unqualified for the duties of the profession at large. You may be good anatomists and adroit operative surgeons, without being physiologists. You may know physiology and remain ignorant of pathology. You may be profoundly skilled in pathology and pathological anatomy, without making the slightest acquaintance with therapeutics or clinical practice. All this is abundantly obvious to every well-educated physician, and yet nothing is more common, than to see young men graduated on the basis of full attainment in some of these branches, while their knowledge of others remains deplorably superficial and imperfect. But while the sciences I have named are essential, there are others which, to a certain extent, must be known. The most important of these is chemistry, with its applications to materia medica, physiology, and pathology. Next comes natural philosophy, especially that important and delightful branch called meteorology—then comparative anatomy, and the general physiology of organized nature—then botany and mineralogy—lastly, the philosophy of the human mind. The whole of these in varying degrees, and on various sides, connect themselves with medicine—make portions, more Introductory Lecture. 5 or less considerable, of that coalition of sciences, which constitute what is called the profession of medicine. I would not advise you to prosecute the study of the whole, nor even any single one, to its limits; but I would impress you deeply with the momentous truth, that if these auxiliary sciences had never been cultivated, those which are essential would have remained fatally imperfect and uncertain. Such is " the Science of Medicine," to employ an expression which I have condemned; but which, from the want of a better, I must still employ, to indi- cate the branches of human knowledge, with which the accomplished and Bkillful physician must be more or less acquainted. You will perceive, young gentlemen, that the whole are sciences of observation and experiment. Their very existence depends on the induction of facts. With the progress of obser- vation they began and have advanced—by the aid of future observation and experiment, they must reach a degree of perfection, of which, at present, we have but an imperfect glimpse. The earliest record of these facts is found in the writings of Hippocrates. For nearly twenty centuries those writings were the text book of all the schools of medicine in the world—the chief treasure of every medical library, public and private. All discoveries and inven- tions—all recorded experience—all speculative efforts of the human mind on the subject of health and disease, arranged themselves around the writings of this Father of Medicine. From him there was a lineal deriva- tion—a legitimate descent—an unbroken succession. The fountain which he opened, although at first, of necessity, feeble and impure, but still a fountain before which there was no other, has continued to flow on, and will roll on, widening, and deepening, and becoming purer and purer, to the end of time. In every age the banks of this stream have been perforated, and a portion of its waters made the head spring of a rival current; but, like the waters which overflow the banks of our great Mississippi, they have returned to the channel, after having deposited the errors which ignorance and presumption had mingled with them. There is, then, but one profession of medicine—one medical literature—one legacy of medical knowledge; and, however scattered over the civilized world, but one class of laborers. All the truths which have been discovered—all that may ever be discovered— will, by an irresistible attraction, associate themselves with those already known. It is vain and idle to talk of two kinds of medical science. AYe might as well speak of two sciences of anatomy, chemistry, botany, or natural philosophy. All the truths bearing on the production, effects, and cure of diseases, which have been developed, belong to the same original, ancient, and honorable profession — enrich its archives, and nobly swell the list of its cultivators. You have assembled, young gentlemen, in one of its schools, to prepare yourselves for discharging the duties which it imposes, and for handing it down to the generation that wiU foUow you, augmented in the number of its truths, and purified from many of its errors. I hope and trust, that you 6 Introductory Lecture. will fulfill the mission, with which you will be charged, by your graduation ; but, to do so, you must take expanded views, and compass, if possible, the wide range of scientific knowledge, embraced within the limits of the pro- fession, as indicated by the sciences which have been enumerated. The reason that so many branches of human knowledge unite in the medical profession, is to be found in the varied and intimate relations of man with all the objects and operations of nature, all the works of art, and all the events of society and the world. It is these extended connections, that make him, under God, its governor; that constitute him the greatest, not less than the latest, of its organized beings. In his perfect development he lives, and feels, and thinks, and acts, amid things and movements as count- less in number, as the leaves of our summer woods — as diversified in aspect, as their forms and autumnal tints. The oak, on the summit of the hill, has a relation only to the soil, the winds, the rain, and the thunderbolt, which may at last rive it asunder. The flower, which blooms beneath its wide- spreading branches, is sustained by the evening and morning dew, the shower, and the sun; and, having these, it sends forth its fragrance for a season, and dies a natural death. The wild deer, of our forest, crop the natural herbage, escape from the wolf, and lie down in their grassy lair, until age puts an end to an existence, more simple than that of any human being. The passenger pigeon leaves the south, as the heat of summer arises, spends a season in the north, rears its young, and returns to the place of departure. Its relations are with food, and water, and temperature, and the air by which it performs its migrations. The dwellers in the deep, from the whale to the coral insect, have relations to the water in which they live, and to each other, on which, in part, they feed, and to these they are confined. Far different from all these limited connections and dependencies, are those which man sustains with other portions of the creation. His instincts and his wants, corporeal, intellectual, and moral, lead him into all climates. In the south he lodges under the boughs of trees; in the north in huts built of compacted snow, and on the swampy banks of lakes and rivers he drives down piles, on which to support his dwellings. Go into the sandy desert, and there you find his tents; turn your eye to the bleak mountain-top, and there you see his cabin embosomed in the cloud; look upon the ocean, and you behold it white with the canvas of his floating habi- tations, driven to and fro by the tempest. On the broad continents he cuts down, and burns or applies to his own use, the mightiest forests; his plowshare annihilates the natural herbage, and his sagacity and toil replace it with productions more to his taste, or better suited to his wants; in one region he lives solitary, and gives full play to all his desires and fancies; in another he struggles through the conflicting masses of a city population where he invents new modes of industry; dooms himself to a confined and unventilated room, or a dark and damp cellar; passes much of every day in some constrained posture; breathes an atmosphere impregnated with irri- Introductory Lecture. 7 tating dust, or poisonous gases; watches his rivals, and seeks to wrap him- self up from their scrutiny; labors to outstrip them in the career of mingled ambition and avarice; concocts schemes for their defeat, or his own advancement; delivers himself over to midnight studies, or gluts his pam- pered appetite with meats and drinks, drawn from the abounding store- houses of every land: He founds and conducts institutions of benevolence, literature, and science; devises enterprises which demand concert of action; adventures on gigantic projects the most visionary; and grasps riches, with the power and luxury which they bestow, or involves himself and others in hopeless ruin. When we look into man's organization, organism, and internal functions —his capacities of body—his faculties of mind—and the emotions and desires of his heart—we find a fullness, variety, and perfection—a complexity—a quickness of irritability and a delicacy of feeling, no where else to be found in the world of organized nature ; fitting him admirably for the position he occupies in that world; but, at the same time rendering him vulner- able to its thousand influences. If he act on all around, everything around reacts on him. If he shape and fashion them to his liking, they, in turn, modify his organization, impress on him peculiarities of constitution—deve- lop one organ into excessive dimensions, and arrest the growth of another— exalt this sensibility, and depress that—break up the equilibrium of his vital functions, and derange his system with a greater variety of diseases, than are found in the whole kingdom of organized nature, of which he is at once the monarch and the victim. Such, young gentlemen, is the being, whose diseases you will be called upon to prevent or heal. To accomplish the former, you must inquire into the action of all the influences, material and mental, to which he may be subjected, and either withdraw him from them, or fortify his constitution against their deleterious impress. But how can you do this, without that power which knowledge bestows ? How can you detect the sinister agency of the water that he drinks — or the food which he eats — or the soil which he tills — or the shop in which he labors—or the climate which he breathes — or the passion by which he is consuming away — unless you have studied their nature, and know the relations which they bear to his constitution of body and mind ? But, you will be called upon, still oftener, to cure, than prevent his diseases; and how can you perform that part of your mission, without a thorough and diversified knowledge, of the effects of the multitude of agents, which exert their influence on his constitution? In proportion to this knowledge, will be the richness of your resources — according to your sagacity and sound judgment, will be your success in their application. And, now, have I not shown, that you have undertaken no ordinary task ? You may feel discouraged at its magnitude, and disposed to seek some simpler and humbler pursuit; but do not falter too soon. To a chill suc- ceeds a fever; on a momentary revulsion of feeling, from the sudden appearance 8 Introductory Lecture. of danger, there follows a reaction, which nerves the arm and achieves a victory. The morning sun may not be able to send his beams through the mists, and fogs, and clouds, which hang over us in autumn; but he rises higher, and shines with fiercer and warmer rays, until they gradually melt away. To the little child, the knowledge you now possess, seems vast and various. At the same age, you might have thought it beyond your reach ; yet it has been reached, and how? By intuition? By gift? By infusion, while you slept, or lolled at ease, or reveled in luxurious pleasures? All experience answers, no. I say to you, then, array against the future, your recollections of the past; compare yourselves with what you once were, and thence draw hope and expectation, as to what you may become hereafter. Call to mind your labors, and their slow but certain results—word after word, unfolding to you its meaning — fact upon fact, infixing itself in your memory — truth upon truth, rising before you in smiling beauty— and limited generalizations, imper- ceptibly expanding into great propositions — universal principles — perfect sciences. You owe these conquests to toil; labor is the parent of all knowl- edge ; constancy the secret of all success. Hold on, therefore, to the end. Every day's application will leave something behind you, conquered and brought into subjection to your will; while it lessens that which lies before you. When the engineer projects his railroad, a mountain, which cannot be turned, rises in its course; but he resolves to finish his enterprise. The pickax and the powder-blast are soon heard resounding in its bowels; the hardest rocks, by blow upon blow, at length lie in fragments at his feet; and he finally drives through the mountain in triumph. Imitate his labors, and you will be crowned with his success. Young Gentlemen — I have spoken a few imperfect words of counsel, and might say many more, but will leave them to my colleagues, who will advise you on all things which belong to their respective departments. For the remainder of my hour, I ask your attention, and that of the Trustees of the College and the Hospital, who have honored us with their presence, to a different subject; but one, I hope, in which both you and they will take an interest. If, in pre- senting it, I am led to speak of labors and events in which it was my destiny to bear a part, you will not, I trust, feel disposed to judge me with severity. The young man lives in the future — the old man in the past. One dwells with fond anticipation on that in which he hopes to bear a part—the other in fond recollection, of that in which he has borne a part; and each is true to the principles of his nature. My object is to say something on the origin of medical schools and hos- pitals, in this, our own peculiar and cherished portion of the great land of liberty; and, especially to speak of your own Alma Mater. To the state of Kentucky, the oldest of the Western sisterhood, belongs Introductory Lecture. 9 the distinction of having chartered the first University in the wilderness. Its franchises permitted the organization of every faculty, usual in the higher seminaries of learning; but a medical school was not in the contemplation of those who asked, or those who gave the charter. The town of Lexington, in early times the metropolis of the West, may justly claim the preeminence of being the first to cherish such a school. About forty years ago, Doctor Samuel Brown, and several other respectable physicians of that town, sug- gested the founding of a medical department in Transylvania University, but the suggestion was not then acted on; and it was reserved for Doctor Benja- min W. Dudley, in the year 1815, soon after his return from Europe, to revive the project. It was favorably received by the Trustees of the Uni- versity, and four professors were appointed. In the winter of 18L3-1G, some of them, without concert, delivered short courses of lectures, to a small num- ber of pupils. In the summer of the latter year, I was invited to join them; but did not do it, until the autumn of 1817 ; when, for the first time, the Faculty was organized. The professors of that, the pioneer medical Faculty of the interior of the continent, were Doctors Dudley, Overton, Richardson, Blythe, and myself. Our class consisted of twenty pupils, drawn chiefly from the neighboring counties. In the following spring, a public commence- mont was held, and the degree, to which you are aspiring, was conferred upon a single candidate — Doctor John McCullough—the first ever graduated in the West. Such was the implantation of medical institutions in the Valley of the Mississippi. Soon after the session ended, believing Cincinnati superior to Lexington as a site for a medical school, I resigned my chair — Materia Medica — and determined on proposing the establishment of a school in this city. As promotive of the enterprise, a course of lectures on Botany was de- livered, in the following summer, to a class of ladies and gentlemen, inclu- ding several students of medicine ; and in the winter, ten or twelve students of medicine, were collected for instruction of a strictly professional charac- ter. On the 19th of the following January, 181!.), in consequence of a per- sonal application to our legislature, the Medical College op Ohio, in which you have enrolled your names, was chartered; but it did not become organ- ized until the autumn of 1820; when its first session began with a class of twenty-five pupils. Thus came into existence the second medical school of the West, and the first on the northern side of the Ohio river. I had the honor, on the 11th of November, of that year, to deliver the opening discourse. It was printed; and, as thirty years have since elapsed, I propose now to make some extracts from it. The first passage which I shall quote, is an argument to show the possibility of establishing a second medical school in the West. "Till lately, like the otherfruits of advanced civilization, medical schoolshave beencul- tivated exclusively in the parent states. Whether they can be made to flourish in the new states of the West, can only be determined by trial. The Medical College of Ohio 10 Introductory Lecture. which we are now assembled to institute, is an experiment of this kind. At the open- ing of its first session, the question whether it will ultimately succeed, forms a problem of many conditions. I shall briefly state the principal data from which a favorable pre- diction has been drawn. " The mountains that separate the western from the eastern states, and the declivity which extends from their base to the Mississippi, present an obstacle to free communication from the former to the latter, which requires from us an unceasing effort at self-depend- ence, in whatever relates to the support, the comfort, and the preservation of life. On this broad and permanent foundation, we may confidently proceed to erect many im- portant establishments, which, without it, like the rolling stone of Sysiphus, would fall, whenever the immediate support of those who might sustain them, should be withdrawn. " More than half the states of the Union lie west of the great rampart, and are thus coerced into a union of interests, by an impediment to the east, while they are power- fully attracted into communion, by a common channel of foreign intercourse in the south. The population of these states, already one-fourth of the national aggregate, is increasing at a ratio which must make it equal, within the present age, to such portions of the original states, as lie beyond the eastern sources of the Mississippi. In the Uni- ted States, every teii thousand inhabitants, on an average, supply one medical student to our universities ; and we may hence conclude, that the period is not remote, wher. one or more respectable schools of medicine may be supported in the west." You may feel surprised that it should have been thought necessary to show by argument, that the period was not distant, when the West might support two respectable medical schools. But we must not disparage the limited foresight of the men of that day. They predicted the future from their knowledge of the past; and the past afforded no precedent for such a future as was then about to unfold before them. Never before, in any land or age, did a few fleeting years transform the broad face of half a continent, from the wild and savage scenery of nature", into a panorama of cultivated fields, with throngs of intelligent and busy men. At the time that appeal was made, there was in the West, as we have just seen, but one medical college. Now, there are twelve in operation, one temporarily suspended, and three in the forming stage. Thus, on an average, every three years has given birth to a new medical institution. Their distribution is as follows: Lexington, one; Louisville, one; New Orleans, one; St. Louis, two; Chicago, one; Laporte, one; Buffalo,one; Geneva,one; Cleveland, one; Columbus, one; Cincinnati, one. The one in a state of suspension, is at Memphis; and the three projected or not yet fully organized, are at Indianapolis, Evansville, and Nashville. In the twelve schools, there were, last winter, not less than fifteen hundred pupils; and yet large numbers left the West, for the institutions of Phila- delphia and New York. From this evidence of the growth of your native or adopted country, you will perceive, young gentlemen, how great it must become, while you are still actors on the stage of professional life. You will realize, I trust, that you are not doomed to spend your days among rude and ignorant backwoodsmen; but in the midst of intelligent and refined communities; and that you should, by deep and protracted study, prepare yourselves for such associations;— for building up a profession worthy of v^f Introductory Lecture. 11 such a state of society, and for performing an honorable part in a thousand ' works of learning, science, charity, and patriotism. I must recur to the discourse for a different purpose, but one of equal ; interest. " Literature and science are not the same; but a physician should acquire both, and I the cultivation of the former ought to precede that of the latter. It is, however, a i mortifying fact, that in the United States, and especially west of the mountains, the young men designed for the medical profession are in general destitute of this prepara- tion in literature, so essential to their future acquisitions in science. Commencing the | latter while ignorant of the former, their progicss is comparatively slew and imperfect; and they learn, when too late, that a magnificent edifice cannot be erected on a narrow j and badly-constructed foundation. No young man should commence the study of medical I science until he is at least sixteen years of age ; and unless the preceding time have been devoted to the acquisition of language and the rudiments of general knowledge, ] he will neither possess that learning, nor those disciplined habits of application, that are | essential to a successful prosecution of medical studies. While the standard of literary | and professional excellence necessarily participated in the general imperfection which I attended the institutions of our new country, this want of prepa'ation in those who > undertook the study of medicine was less striking, and had to be excused, from being I unavoidable. The opportunities for prosecuting a better course of preliminary studies have been created, even in the western states, and no young man should hereafter be encouraged to become a student of medicine, who has not prepared himself in a man- ner corresponding with the vast extent, and inherent dignity of that science. This pre- I paration should not consist merely in a detached knowledge of his own language. He should ascend to its ancient sources, and drink deeply at its pure and original fountains. If the principles of medical science, which are now taught, be not the same that pre- vailed in Greece and Rome, they are partly expressed in the language of those learned and polished nations ; and to be thoroughly understood, the words in which they are conveyed must themselves be made an object of study. "So deeply impressed are the Faculty of this institution with the neglect of these studies, and the importance of them to the advancement and elevation of the profession, that they have offered an annual prize medal for the best inaugural thesis in the Latin I language ; and hope by this measure to excite among the students of the west an emu- lation for excellence in classical literature." Since those words were spoken, one generation has been buried and another has risen;—the age of the pioneers has passed away;—the ax has conquered the forest;—infant villages, overshadowed by native trees, have grown into towns, with shadetrees from distant lands:—towns have expanded into cities, which abound in the luxuries of every climate;—new institutions of elementary learning have, from year to year, come into existence, and abounding opportunities have been brought to the door of every young man who aspires to the study of medicine ; and yet, I am sorry to know, that the prepar- atory learning of the pupils of the West, is now scarcely superior to what it then was. All else has displayed progress — this alone shows no improve- ment. Young gentleman, a defect so degrading to our noble profession, should not be permitted to continue; and I most earnestly and affectionately, call upon you, now while you are in the springtime of life, to devote to the cultivation of letters, a portion of every day, from the time you leave the college. All that I propose — all that is necessary — lies entirely within 12 Introductory Lecture. your grasp. You have only to resolve, and it will be accomplished. In the year 1840, while making a tour through the central parts of this State, for the study of its diseases, I met with a young physician, who rode with me for a while, and desired to converse on the means of improving himself in the literature and science of his profession. He had entered on its study with but little preparatory learning, and after an attendance on a single course of medical lectures. The result of our conversation, was a determination, on his part, to assign a fixed portion of every day to the study of the elements of literature, and other portions to the cultivation of his profession. He left me, but was not forgotten, and the hopes he had inspired were soon realized. In three years I had the pleasure to see his name in one of our periodicals, to which he became a regular and respectable contributor. His writings brought him reputation; and, in less than seven years from our interview, without attending a second course of lectures, he received an honorary degree from one of the most distinguished schools of the West. I must return to the discourse which has suggested this narrative, but cannot do it until I have exhorted each and all, when you shall become mem- bers of the profession, to look faithfully into the literary acquirements of those who desire to become your pupils; rejecting all who are not qualified, and turning them to some other pursuit, or to the academy for further elementary instruction. The discourse from which I have quoted, after speaking of some other grounds of hope for future success, cherished by the Faculty, holds the following language: " To show more fully on what foundation their expectations rest, will occupy us but a few moments. The College to which they belong offers one advantage over all that have been hitherto established in the United States. Not one has a session exceeding four months — a period confessedly too short for the course of instruction which they are designed to impart. The lectures in this institution will continue five months, and there will be fewer of them daily. Thus the pupils will not be perplexed and oppressed by exuberance, nor hurried so rapidly on, as to be precluded from the necessary reading and reflection. To this single regulation, there is much reason to believe, our College will ultimately be indebted for no inconsiderable part of the support which is anticipated. The advantages of a protracted session may not however be perceived, until sufficient time has elapsed for the graduates of this school to be compared, in the extent, variety, and perfection of their attainments, with those in which the pupil is revolved through the great circle of medical science in the short period of three or four months." Thus it appears that, in its infancy, the Medical College of Ohio had a session of five months, and it must be gratifying to all who participated in the enactment of that regulation to find, that very lately, the physicians of the United States, in general convention, have repeatedly and earnestly recom- mended the same thing to all our schools. But few, however, have had the courage to prolong their sessions ; although professors, very generally, admit the advantages that would flow from such a change. Deeply and thoroughly convinced that its general adoption would confer great benefits on the pro- Introductory Lecture. lo fession, and through it on society at large, I beg, young gentlemen, that you will bear the subject in mind, and use your future influence in its favor. The discourse, after some general remarks on the comparative fitness of different towns in the West for medical schools, holds the following language : " Of the numerous towns which have been built in this region, not one seems to me so proper for such a school, as Cincinnati. Its better geographical position, and more intimate relations with the western country generally; its more numerous population, and, above all, its greater necessities and facilities for the establishment of a permanent hospital, designate it as a spot peculiarly fitted for the erection of a medical institution. On the last of these local advantages, I ^feel it my duty to expatiate for a moment. Without the aid of an infirmary, no school for the cultivation of practical medicine can possibly be made to flourish. The citizens of Cincinnati are, therefore, urged to the erection of a hospital by all the prospective advantages which a successful College of Medicine could bestow upon them. To enumerate these at large would be a work of supererogation. I shall state that only, which has an immediate connection with the pau- perism and sickness which prevail among the lower orders of our emigrants. It is an unquestionable fact, that these wretched people, who at present subject us to the heaviest con- tributions, would, if an infirmary were provided, become a source of profit and prosperity to the city. I make this declaration advisedly, and hope it will be remembered by all who participate in the weighty imposition of taxes which annually falls upon us, even if it should be thought doubtful or unworthy of notice by those who direct our municipal concerns. "It is in hcspitals, that the lectures on practical or clinical medicine must be delivered. To hear these and witness the cases to which they relate, would be an object with every student who might attend the Medical College. The fees of admission for these purposes would go into the treasury of the hospital; and, as the professional attendance on the sick would, under this regulation, cost but little, the revenues thus accruing would, after a few years, become adequate to all the expenses of disease among this unfortunate and degraded class of our population. We should then make them do in sickness, what they did not perform in health — support themselves. The price of their exhibition, moreover, would be paid by persons from a distance, whose other dis- busements during a residence here, would become a source of positive benefit to the city. " The Legislature of Louisiana, in the true spirit of benevolence, has proposed to the different Mississippi states the erections of hospitals for the sick boatmen on the various waters of that great river. On this subject the Governor of Ohio has received a communication from the Governor of Louisiana, which will be transmitted to the next legislature. I cannot for a moment doubt, that this honorable body will make an appropriation for an object involving so deeply the prosperity and reputation of our state; and Cincinnati, as its commercial metropolis, would, of course, be the spot where the establishment would be erected. It will not be necessary, however, that the state should maintain a distinct and independent hospital for this object. Their efforts might, with great propriety and advantage, be united with those of the guardians of our poor and the Faculty of our College — the state supplying the means of erecting a common edifice, the city maintaining its police and expenses, and the college supplying it gratu- itously with medical assistance. " A poorhouse with shops and gardens might be made a part of the same establish- ment, and the whole confided to the care of a single board of managers. It is suffi- ciently apparent, however, that such a work cannot be accomplished without a general union of means ; a hearty co-operation of efforts ; a liberal and considerate course of legislative policy ; and, above all, a deep and general conviction of its necessity aud benefits. If this happy communion of feeling and design could be effected, our city 14 Introductory Lecture. would soon be graced with a house of charity, in which the unfortunate, when diseased, would find refuge and relief; and the people of the whole state an asylum for the insane, that, would wipe away the disgrace of confining them in the cells of our common jails; while our students of medicine, enjoying more ample opportunities of improvement, would become the benefactors, instead of the scourges of society." By this extract we see the origin of our hospital. In the second month of the first session of the school, a bill was drawn up by one of the Faculty, and laid before the tiustees of the township of Cincinnati. It proposed a union of the college, the township, and the state, in the establishment of a public charity. The trustees wisely gave it their sanction, and united with the Faculty in a memorial to the General Assembly, which had already been informed, by Governor Brown, of the application from the Governor of Louisiana. When I carried the memorials and bill to the legislature, they met with opposition ; but, after a month of laborious explanation and personal effort, the bill became a law. The state, having in view the relief of her sick boatmen, gave a small sum of money to assist in the erection of a house, and pledged, forever, half the auction duties of the city, toward the support of the patients. The township was to supply the remainder, and the professors of the college were to be its medical and surgical attendants, with the privilege of introducing their pupils for clinical instruction ;— the fees of admission to constitute a fund for the purchase of chemical apparatus, ana- tomical preparations, and books for the college. Such was the second step taken by the State of Ohio for the promotion of medical education, the chartering of the college being the first. An acceptance of the hospital law, by the trustees of the township, was deferred, until after the annual election in the following spring; and, during the time of delay, the subject was canvassed before the people. An argu- ment against it was, that the plan which had been devised, however beneficial to the college, might throw the boatmen of Ohio on the city, beyond the revenues provided by the State, and thus increase the taxes for the sup- port of the poor. To counteract the force of this argument, some of the professors moved their friends to unite with them in a bond of indemnity to the township. The bond was executed and tendered; and at the annual election, the ticket in favor of an acceptance of the charter, was carried by a vote of seven hundred to five hundred. The new trustees of the township confirmed what their predecessors had undertaken, and the hospital was erected. Five years afterward the state manifested itself a third time in favor of the school, by a grant of money with which the edifice since occupied was built. Such, young gentlemen, was the origin of the school to which you have resorted, and the hospital in which you are to receive clinical instruction. With the increase of the city and of western population, the wards of the latter have been gradually multiplied or enlarged, and for sometime past, nearly two thousand five hundred patients have been admitted annually. Among so great a number, almost every form of disease that prevails in the country in Introductory Lecture. 15 which you are to practice the profession, will, of course, be found; and we may, without boasting, or one invidious comparison, affirm, that no where else in the West, or in the world, can better opportunities for clinical obser- vation be enjoyed. And here allow me to say, that all the tendencies of the age are to the study of medicine and surgery in hospitals. In them it is, that a student learns pathological anatomy, diagnosis, the art of prescribing, and operative surgery. The laboratory is not more necessary for the study of chemistry, or a garden of plants for the study of botany, than a hospital for the study of practical medicine and surgery. The time has passed by, when students will flock to men of genius (as they once flocked to Bocrhaave) for the pur- pose of listening to expositions of theory, or to be amused with creations of imagination. The school which is not based on a hospital, may have learned and able professors; but the results of their teaching can never be satisfac- tory to the student, who seeks to make himself a good practical physician and surgeon. A mathematician might compose an admirable system of nav- igation, but you would prefer to trust yourselves, on a dangerous voyage, with one of more practical skill, though less learned. In the arrangement for the session now opening, the Faculty have made ample provision for clin- ical teachings, by assigning each alternate afternoon to the hospital; and I would earnestly advise all, except those who arc but entering on their studies, to be punctual in their attendance on those days. Young Gentlemen — In conclusion, permit me to say something more of myself. Experi- ence, down to the present hour, has shown, that every medical school, at- tempted in the West, has suffered more or less of revolution in its forming sta^e; the inevitable effect, perhaps, of a new and unsettled state of soci- ety. The school at Lexington had its early revolutions — that in Cincin- nati was overtaken with the same infantile convulsions. After its second session, I was separated from it; and, as you are aware, have, at different periods, labored in several other institutions. They flourished; and I was happy in the consciousness of an honest fidelity to their fame and interests; but my thoughts often went back to the city, where, in the twelfth year of its set- tlement, I had bcnm the study of medicine, and in which, twenty years after- ward, I had labored to found the College. My heart still fondly turned to my first love — your Alma Mater. Her image, glowing in the warm and radiant tints of earlier life, was ever in my view. Transylvania had been re-organized in 1819, and included in its Faculty, Professor Dudley, whose surgical fame had already spread throughout the West, and that paragon of labor and perseverance, Professor Caldwell, now a veteran octogenarian. In the year after my separation from this school, I was recalled to that; but 16 Introductory Lecture. neither the eloquence of colleagues, nor the greetings of the largest classes, which the University ever enjoyed, could drive that beautiful image from my mind. After four sessions, I resigned; and was subsequently called to Jef- ferson College, Philadelphia; but the image mingled with my shadow; and when we reached the summit of the mountain, it bade me stop, and gaze upon the silvefy cloud which hung over the place where you are now assembled. Afterward, in the medical department of Cincinnati College, I lectured with men of power, to young men thirsting for knowledge, but the image still hovered around me. I was then invited to Louisville, became a member of one of the ablest Faculties ever embodied in the West, and saw the halls of the University rapidly filled. But when I looked on the faces of four hundred students, behold, the image was in their midst. While there, I prosecuted an extensive course of personal inquiry into the causes and cure of the diseases of the interior of the continent; and in journeyings by day, and journeyings by night — on the water, and on the land — while struggling through the matted rushes where the Mississippi mingles with the Gulf__or campino- with Indians and Canadian boatmen, under the pines and birches of Lake Superior, the image was still my faithful companion, and whispered sweet words of encouragement and hope. I bided my time; and after twice doubling the period through which Jacob waited for his Rachel, the united voice of the Trustees and Professors, has recalled me to the chair which I held in the beginning. The first moments of reunion are always passionate, and wisdom places little confidence in what is then promised; nevertheless, I must declare to you, that I stand ready to pledge the remnant of my active life, and all the humble talents with which the Creator has endowed me, to her future eleva- tion; and were I to put up the prayer of Hezekiah, for length of days, it would be to devote them to her aggrandizement; and, for the pleasure of see- ing her halls overflowing with inquiring pupils, attentively listening to ardent, learned, and eloquent professors. With this pledge, those who watch over her welfare, and those who govern the Hospital which she caused to be erected, are now silently mingling theirs; while you, I trust, are resolving that your own lives shall spread abroad her fame. Thus will she rise, and gracefully move onward and upward, until she stands in beauty and honora- ble rank, among her distinguished sisters of the Union —the pride of her sons, and a blessing to society.