INTEODTJCTOEY LECTTJEE, delivered m THE MEDICAL COLLEGE OF GEORGIA, AT THE OPENING OP THE ANNUAL SESSION, NOVEMBER 6th, 1848. BY JOSEPH A. EVE, M. D., Professor of Obstetncs and Diseases of Women and Infants. n [PUBLISHED BY THE CLASS.] ,,o> $ * X°i / "V % 4 c»- •t » • * 'V ' MEDICAL COLLEGE, \ Nov. 7th, 1848. J Dr. J. A. Eve:— Dear Sir: At a recent meeting of the Medical Class, the undersigned were appointed a committee to tender you their sincere thanks, for the very instruc- tive and appropriate Lecture delivered before them on yesterday, and to request a copy for publication. An early compliance with the above request, will greatly oblige the committee. With sentiments of the highest respect and esteem, We remain, yours, &c. B. F. HALL, ) W. C. WARE, } Committee. H. R. PIERCE.) AUGUSTA, Nov. 9th, 1848. Messrs. B. F. Hall, W. C. Wire, and H. R. Pierce:— Gentlemen: Although conscious of the many imperfections of'my introduc- tory lecture, I do not feel at liberty to withhold it from the request of the Class, and therefore place it in your hands, with many thanks for the complimentary terms in which you have expressed their wish. With highest respect and kindest regard, I am your obedient servant, JOSEPH A. EVE. INTRODUCTORY ADDRESS. Allow me, Gentlemen, in the name of the Faculty of the Medical College of Georgia, whom I have the honor and plea- sure to represent on this occasion, to bid you a most cordial and affectionate welcome. Welcome, you whom former ac- quaintance and association have endeared to us, whose return, after months o- years of absence, affords the most satisfactory proof of friendship, and the cheering assurance that our labors have received your approbation. Welcome you, whom though hitherto unknown to us, we now receive as friends and younger brethren. And you, our alumni, who have kindly come to enliven us by your presence, ever welcome. Your alma mater regards you with parental affection; on you she proudly looks as her richest treasure, her present strength and her future hope! Whilst welcoming you within these walls, long consecrated to that profession to which you are about to devote your lives and energies, we cannot forbear to congratulate you upon enter- ing it, at this auspicious period, when the spirit of reformation pervades the land—when a new and brighter era has dawned on Medicine—when she is triumphantly vindicating herself from the reproaches that her enemies and false friends would heap upon her, and proving her high claim to rank among the noblest and best of all professions that have ever engaged the attention of man. Whilst we lament and have long lamented the defectiveness of medical education in our country, and the apathy in the profession on this subject, wre do not concur with those who calumniate the profession, deplore the modern degeneracy of our colleges, and sigh for the palmy days of old—the days of Shippen, Rush and Wistar. Far be it from us to join in such lamentations, or sanction such unjust reproaches; the profession is far in advance of what it was in those days, and the instruc- tion in the colleges far superior. But, though we do not admit 6 any retrogression or degeneration, it is to be lamented that far greater advancement, much more extensive improvements, have not been made. We do esteem it a proper subject of congratulation to the Class now assembling, that they are the first to realize the ben- efits of the prolonged and improved course of instruction—to reap the advantages of a reformation which the Medical College of Georgia, at its very organization, labored most arduously to achieve. When this College was organized, its Faculty and Trustees, especially the illustrious founder, deplored the defectiveness of the system of medical education in the Colleges in the United States, and earnestly endeavored to correct it. They recogniz- ed the shortness of the collegiate term as the principal and radical defect, and in fact the foundation of all or nearly all the rest. So zealous were our Trustees and Faculty for reformation— so determined at all hazards to effect it—so confident were they of the approbation and support of the liberal and enlightened members of a liberal and learned profession, that they ex- tended their regular collegiate course from the usual term of four, to six full months; no portion being taken up by prelimi- nary lectures not included in the regular course. Trusting that the advantages of the prolonged term would be appreciated and acknowledged by physicians and students, they persevered, but with little encouragement or patronage, to lecture six months, for five successive years. Although all professed to approve their plan, very few were found willing to remain here six months, when they could accomplish the same object, the acquisition of a degree in other schools, in four: for, unfor- tunately, with too many, a diploma appears to be the loftiest object of aspiration—the determining motive in attending lec- tures—when it should be regarded as a trivial circumstance, only a secondary and unimportant consequent thereon, as the mere shadow to the substance. They had the mortification to lecture to seats almost vacant, and to behold medical students hastening in crowds to fill the halls of four months colleges. Convinced by fair experiment that they could not effect a reformation, without a concurrence of other medical institutions, 7 in 1835, they addressed a circular to all the Colleges in the United States, suggesting to them the propriety of a conven- tion to consider the subject of reform and to adopt some plan for the accomplishment of that great and desirable object. In this circular it was proposed in compliment to the University of Pennsylvania, the oldest college in the United States, to leave the time of meeting, the number of delegates from each college, &c, to be determined by them. From some colleges replies Were received favorable to the proposed object, when a general concert of action should be obtained. Some expressed them- selves disinclined to make any innovation—whilst others, un- willing to commit themselves, remained silent. Great hope was entertained that the University of Pennsylvania would be found ready to second the enterprize; but this expectation was not realized; the reply received from that University is as follows : Philadelphia, Nov. 15th, 1845. Dear Sir,—Shortly after the reception of yours of May 19th, I informed you of the fact, and of my intention to lay your communication, on the subject of modifying the terms of ad- mission into the Profession of Medicine, before the medical faculty at their first business meeting. Having lately executed this promise, I have now to state that the medical faculty, after giving it full consideration, have thought it better for each school to adopt such regulations as might suit its particular views, than to enter into any general obligations on the subject, when there exists no competent power to prevent their violation. I am, very respectfullv, your ob't serv't. *W. E. HORNER, Dean, &c. Dr. Lewis D. Ford. Last year, the University of Pennsylvania extended their regular course of lectures to five months, with an additional month of preliminary lectures unconnected with the former, since which they have claimed priority of movement in estab- lishing a six months' course, and called on the Profession to sustain them in this effort. Can they do this with justice ? Disappointed in their endeavors to induce other schools to come up to a higher standard, the Faculty of this college were at last compelled to come down themselves and adopt the four months' term, and content themselves with remodelling and im- 8 proving their course of lectures,—making their examinations more rigid, and requiring higher qualifications in their graduates. After the adoption of the four months' term, their classes increased rapidly, far beyond the expectations of their most sanguine friends. But the Medical College of Georgia have never been satisfied wfth success, based upon the abandon- ment of the principal and distinctive advantage in their own, and the adoption of what they condemn as a radical defect in the system of instruction in other Colleges. They have been reluctantly constrained to submit, by the force of circumstances which they could not control; but they have ever anxiously awaited opportunity to return to their original plan. With joy they heard in 1846 a call made, by a physician in New York, to assemble a convention of professors and physi- cians, and with deep regret an illiberal endeavor to frustrate it, by a professor in the same city. They have been ever ready to co-operate in any enterprize for the improvement of medical education, and to adopt any practicable measures that might be proposed by the Convention. Opposed to reformation, as our Northern brethren appeared to be, when the call came from the South, we rejoice to find they have awakened to its importance and become convinced of its necessity. The whole profession, as by a consentaneous impulse, is aroused throughout the length and breadth of the land. From North, East, South and West, the cry is heard importunate for reform. The profession and the people will not be satisfied without it—the age in which we live requires- it—the rapid improvements in the arts, the glorious discoveries in thekindred sciences,demand it: opposition is vain—no power on earth can longer retard its progress—the triumphal car is rolling on—some may lag back and endeavor to clog its wheels; but their attempts will prove unavailing—they will be unwill- ingly dragged along, or sink in the estimation of an enlightened public. The meeting of the National Association at Baltimore, in May, afforded an excellent opportunity to ascertain the views of the profession on this subject. Among physicians uncon- nected with colleges there was but one sentiment, among pro- 9 fessors, too, there was great unanimity with respect to the necessity for reform, but some difference as to the means by which it should be accomplished. You have all doubtless been looking with interest to the ac- tion of the National Association, arid juany of you have become acquainted with their proceedings; but on the present occasion, it will be proper to state the resolutions passed that relate to medical education and collegiate instruction, that we may com- ment upon them and inform you how far they have been adopted by our College. The American Medical Association, at this meeting, confirm- ed the following resolutions, which had been adopted by the National Medical Convention, in Philadelphia, May, 1847: Resolved, 1st. That it be recommended to all the colleges to extend the period employed in lecturing, from four, to six months. The Medical College of Georgia have prolonged their lec- tures to five months, the longest period to which any College have extended their term, exclusive of preliminary lectures not essential to or connected with the regular course. They would have gladly complied with the recommendation of the conven- tion from the very first and to the fullest extent; but it is not surprising that they should be cautious in resuming a position from which they had been compelled to retreat, after a self- sacrificing struggle of five years, until it could be ascertained Whether there would be a concurrence of any other schools in the South and West; they determined, however, after the meeting of the Association they would adopt the five months' course. Six months would have been preferable, but prudence had been taught by experience—they were content to take one step at a time, There are two great objections to the four months course. It does not admit a sufficient number of lectures, and requires so many to be crowded into each day, that sufficient time is not allowed for reading, or reflection on them, or for practical anatomy and clinical instruction. The necessity of having the student's attention, distracted and confused by listening to dis- courses on five or six different subjects in the same day, has 2 10 ever been deplored as a .great evil; as such it was especially regarded by the Convention and Association. But, recently, it has been discovered by a college that has refused to adopt the recommendations of the Association, that it is particularly ad- vantageous to have many lectures in a day, as it keeps students more constantly employed, and consequently less exposed to the temptations of a large and dissipated city; "that attending lectures is being read to"—" that to lecture is synonymous with to read"—and that it is no harder on them to be read to, than to read six hours in a day. It is not so long since we attended lectures, but that we retain a distinct recollection of the irksomeness and distraction of attention consequent on attending five or six lectures daily—besides we have always regarded lectures as something more than reading, or being read to—to consider the demonstrations, accompanying the lectures on most of the branches, of the very highest import- ance, and to look on oral instruction, even when the subject does not admit of ocular demonstration, far more impressive and profitable than reading ; but we have always thought read- ing necessary to confirm and fix the impressions thus made. For the student's time to be most advantageously employed, it should be properly apportioned between attendance on lectures-, reading after and reflection on them, practical anatomy and the observation of cases in hospital and private practice, beside the portion due to rest and recreation. It is contended that the vacation between the two sessions of lectures, an abridgement of which they seem to regard as an infraction of the rights of students, will suffice for reading and independent study. To medical journalists be the task of exposing the fallacy of such views, and the sophistry of the arguments adduced for their support: to their tender mercies we commend them. The five months course is merely an approximation to the proper term. Lectures should be continued through the greater part of the year, at least as long in medical as in literary col- leges. The elementary branches should occupy the first, and the practical the latter half of the collegiate course—this would allow the pupil an opportunity to attend hospital practice to some profit. If the student can spend his time more profitably 11 in college than in a private office, of which there can be no doubt, the longer the collegiate course the better; if on the contrary, he can employ his time even with equal advantage in private reading, then not only should the vacation comprise more time, but medical colleges, worse than useless impositions on the public, should be abolished. In extending the term from four to five months, the Faculty of this College have endeavored as far as practicable to remedy both the evils of the four months' course, by increasing the aggregate and lessening the daily number of lectures. Had they continued the same number of lectures each day, they would have delivered a fuller course; but the attention of stu- dents would have been so much more fatigued and more thoroughly exhausted, that it is doubtful whether they would not have lost rather than gained by the change. Were only the same lectures delivered, in five as formerly in four months, the Class would doubtless profit much more by them, but there would have been no additional instruction. A happy medium is adopted—the most advantageous arrangement that could be made. On motion of our Professor of Surgery, a meeting of the professors present at the Association was called, at which a large majority, perhaps nine-tenths, voted in favor of extending the term of lectures to five months—this was, we believe, the best method of arriving at the general opinion of the profes- sors throughout the United States, on this important subject. Resolved, 2nd. That no student shall become a candidate for the degree of M. D., unless he shall have devoted three entire years to the study of medicine, including the time allotted to attendance upon lectures. In accordance with the custom of other colleges, that requi- sition has not been rigidly enforced : we are ready to enforce it when others will. Resolved, 3d. That the candidate shall have attended two full courses of lectures, that he shall be twenty-one years of age, and in all cases shall produce the certificate of his preceptor, to prove when he commenced his studies. Attendance on two full courses of lectures has always been 12 required ; but we have not been very particular in reference to age, nor have required a certificate to prove when the pupil commenced his studies—these are comparatively unimportant points—we have been much more scrupulous in determining his proficiency, than his age—the amount of knowledge acquired, than the time he commenced its acquisition; but we are ready to comply with this recommendation, when there shall be a con- currence of other schools. Resolved, 4th. That the certificate of no preceptor shall be received who is avowedly and notoriously an irregular practi- tioner, whether he shall possess the degree of M. D., or not. We would certainly never receive a certificate, but from a regular and respectable physician. Resolved 5th. That the several branches of medical educa- tion already named in the body of this report, be taught in all the colleges: and that the number of professors be increased to seven. Our college has for many years had seven professors—and instruction imparted in all the branches referred to, save that of Medical Jurisprudence, which will be taught during the present session. Resolved, 6th, That it be required of candidates that they shall have steadily devoted three months to dissection. The ticket of practical Anatomy is required to be taken once at least by every candidate for graduation. Resolved, 7th. That it is incumbent upon preceptors to avail themselves of every opportunity to impart clinical instruction to their pupils; and upon Medical Colleges to require candidates for graduation to show that they have attended upon Hospital practice for one session, whenever it can be accomplished, for the advancement of the same end. With the spirit of this resolution the Faculty have fully com- plied. They have charge of the City Hospital, which is acces- sible to the students every day, and clinical lectures are delivered there twice a week or oftener during the course. The infirmary of the Professor of Surgery is also open to the Class, in which they have an opportunity to witness many interesting opera- tions. The Faculty have made every arrangement in their power to bring interesting cases before the Class. 13 Resolved, 8th. That it be suggested to the Faculties of the various Medical Institutions of the country to adopt some effi- cient means for ascertaining that their students are actually in attendance upon their lectures. The Faculty will endeavor as far as practicable to fulfil the requirements made in this resolution. The object of the Uth resolution is to impress on colleges, that it is incumbent on them to enforce the above recommenda- tions; and of the 10th, to make it the duty of preceptors to patromze only such as do comply. In addition to the foregoing recommendations of the Conven- tion of Philadelphia, the American Medical Association in May last, advised weekly or daily examinations, recapitulatory of previous lectures, to allow candidates for graduation to present clinical reports of cases, in place of theses, and to adopt some method by which to secure the faithful attendance of students to the end of the term. It has always been the custom of our Faculty to make such examinations as the Association have advised. We have pre- fered clinical reports to theses and encouraged the preparation of them, by publishing those deemed suitable. We have always been willing, and are ready to adopt any practicable method that may be proposed, to secure the faithful attendance of the Class to th3 end of the term. The Convention also passed some resolutions recommending preceptors to require a certain amount of education* of students, before receiving them into their offices, and professors to require a certificate of their acquirements, before admitting them to attend lectures. The adoption of this advice, if practicable, would doubtless tend much to elevate the profession. The requirement they propose is indeed moderate, far less than it is desirable that ♦ Resolved, That this Convention earnestly recommends to members of the medical profession throughout the United States, to satisfy themselves,either by personal inquiry or written certificate of competent persons, before receiving young men into their offices as students, thai they are of good moral character, andthatlhey have acquired a good English education, a knowledge of Natural Philosophy and the Elementary Mathematical Sciences, including Geometry and Algebra; and such ari acquaintance, at least, with the L;.tin and Greek languages, as will enable them to appreciate the technical language of medicine, and read and write prescriptions.—[See Proceedings of Convention, page 81. 14 every student should possess, before he commences the study of medicine. Nothing less than a thorough collegiate educa- tion could be regarded as an adequate preparation. But it is doubtful whether in the present state of our country, especially the Southern and Western States, even the very moderate re- quisition of the Convention ispiacticable, without bearing hard on some of the most worthy of those who devote themselves to medicine,who would be most useful to society and eventually become bright ornaments to the profession. We are not of those who would undervalue classic learning; if not absolutely essential, it is certainly very important to a physician. It is contended by some, that French and German are much more valuable to the physician than Latin and Greek: without con- troverting this position, and without detracting from the value of the former, it must be admitted that the latter are highly useful to him, not only enabling him to comprehend properly the technicalities of medicine and all the sciences, but rendering him more thoroughly master of the English and facilitating the acquisition of many other languages. But the educational pro- visions in some parts of our country are so defective, and the circumstances of some students so straitened, that to require of them much preparatory education, would be to exclude them from our colleges and compel them to practice medicine with- out the benefits afforded by them. Education, scholastic and professional, should be the business of government, equally free and attainable to the children of every citizen, however poor. Public schools should be established throughout the land, ex- tending the blessings of education to all classes—then might the standard be elevated without injustice to any. These views are not Utopian—they are now realized in some of the North- ern States, especially in large cities: in Philadelphia and New York, the public schools are the best in those cities, and the sons of the day laborer and of the wealthy contend side by side for the highest prize, and find the path to distinction equally accessible. It would certainly be bad policy to place any obstacle in the way of those who would attend lectures—the more generally they are attended the better, the more general the diffusion of 15 medical knowledge among the people the better for the profes- sion, as nothing would so effectually suppress empiricism. If any preparatory education be required, let it be demanded of the candidate when he applies for a degree, let him undergo an examination to test his qualifications ; for little dependence can be placed on certificates, especially when the certifiers are re- mote and unknown. It is well known with what facility certi- ficates can be obtained, by any person and for almost any pur- pose. The system of certificates would favor the unprincipled and bear hard on the more conscientious ;—let all be subjected to the same ordeal. Instead of requiring certificates to prove extrinsic and unimportant points, as age, time of reading, &c, let the colleges adopt every method by which to improve their courses of instruction, to afford the pupil greater facilities, more extended opportunities of acquiring knowledge, and then raise the standard of qualifications proportionally higher. We be- lieve these the true principles of reform, the only method by which a reformation can be accomplished. Instead of requiring a certificate of a certain amount of pri- vate reading, which could often be obtained on very slender merits, it would be far better to require the candidate for grad- uation to have attended three or four courses of lectures, for which he might pay no more than for two, or that he should not be considered eligible, until the third or fourth commencement after his first course. Though this might not ensure the close application of the student to his studies, during the whole time intervening between the first and third and fourth course; yet it would be more likely to effect that object, than the mere re- quirement of a certificate that he had been reading such a length of time, especially when he knew he would have to un- dergo a more rigid examination. In Great Britain, Ireland, Germany, and almost every where on the continent of Europe, a much longer period of attendance on lectures is required, be- fore the candidate is admitted to an examination for a degree. The best introduction to the study of medicine is attendance on a course of lectures and demonstrations, after which it will be acknowledged, a student can read to much greater profit than before ; therefore we think it would be better to require at- id tendance upon three or more courses oflectureS; or that one or two years should intervene between the first and last course, than a certain amount of previous reading. But we would not by this be understood to undervalue private reading or private instruction—far from it, we believe it is only in the office and practice of private preceptors, that a thorough knowledge of the prescription and administration of medicines, and all the minutiae and details of practice, Can be obtained, knowledge essentially necessary to a physician's usefulness and success. Teachers and professors should be paid by government. The fountains of all useful knowledge should flow free and un- restrained to all who would receive instruction from them. As medical colleges in the United States are at present com- pelled to support themselves, it is necessary and proper they should chftfge for the benefits they affbfd ; but they should cer- tainly be open to all who will pay for them ; and liberal provi- sion should be made for those who are unable to pay, but who are likely, from their talents and acquirements, to become Valua- ble members of the profession. There should be no impediment in the way of any who would receive instruction; but testimo- nials of qualification should be conferred on those only who are thoroughly qualified. Besides the want of preliminary education's a prerequisite to graduation, which we believe not practicable in the present state of the South and West; the three radical defects in Amer- ican Colleges, are the shortness of the course of lectures, the shortness of the whole term between the time of entering col- lege and of graduation, comprising only two courses of lectures, and the paucity of branches taught. The first has been to Borne extent corrected by the extension from four to five months. The second, which we consider equally important, has attracted the attention of the Convention and Association—but they have passed no resolution on the subject—it is to be hoped some ac- tion will be taken at a subsequent meeting. It would do more toward accomplishing the desired reformation, than any other measure that could be adopted. The paucity of branches taught was regarded by the Convention as a serious defect—they have recommended that in all colleges, in addition to the subjects al- 17 ready embraced in their course, there should be lectures deliv- ered on Medical Jurisprudence, with which recommendation our college has complied, the prolongation of the term allowing time for the Professor of Therapeutics to deliver lectures on that important subject. Several other branches are included in the course in European Colleges ; but we must be content to advance step by step ; the work of reformation has only com- menced—it must necessarily be gradual and slow, but it will be progressive and certain. The American Medical Associa- tion will do much toward its accomplishment; but as they have no power to enforce obedience to their recommendations, their resolutions being only advisory, the good they achieve must be by influencing professional and public opinion, which we trust Will eventually prove more effectual, than legal enactments pos- sibly could, even if they could be brought to bear upon it. The proceedings of the American Medical Association and the reports of the various committees, constitute a most inter- esting volume, which should be in the hands of every physician and medical student in the United States. It is the duly of every physician, who wishes to elevate his profession, to uphold the Association, by forming societies, sending delegates, and by complying with their recommendations, as far as practicable. It is only in this way their power can be felt, and their influence extended. Do hot despondingly regard this as too slow a pro- cess for accomplishing a reformation. It may be silent in its operation; it may work unobserved and for a time apparently without effect; but if properly sustained, the Association can- not fail to move public sentiment, an agency competent to the accomplishment of the grandest results, and the achievement of the most wonderful revolutions. Let the profession gener- ally point to Colleges that comply with the recommendations of the Association as worthy of patronage, and their diploma entitled to respect and confidence—and very soon others will be compelled to adopt the same course or see their halls deserted. Nothing can be expected from legal enactments. The Na- tional government has no power over State institutions, nor have State legislatures power to annul or modify existing char- ters. And what power they have, they are generally disposed 3 18 to exercise more in opposition to, than in favor of reform, by legalizing empiricism and granting charters upon no other than political considerations; thus multiplying colleges to an injuri- ous extent. This evil has prevailed to a greater degree in Penn- sylvania and New England than any where else. In Philadelphia there are five medical colleges, which causes a competition and contention for pupils derogatory to the pro- fession. In vain do other colleges reject unqualified candidates, when they have only to hasten to Philadelphia, certain of a diploma in a few months, however limited their qualifications*. These facts are too notorious to require scruple or delicacy in adverting to them. While in Philadelphia, we were informed, that a student who had been rejected) in the University obtained a diploma, a fortnight after in that city. In no other city does the same corruption, do the same enormous abuses exist. It is certainly more incumbent on the physicians of Philadelphia than all others to be active and energetic in the work of re- formation. We are confident that the reformation, now happily com- menced in our country, and previously undertaken hi E«- rope, will progress—-that the medical profession; will assume a more elevated position—that medicine will be perfected in a degree commensurate with the improvement and perfection of other sciences. This may be considered the age of triumphs in scienee, an age in which it has wrought wonders, and almost performed miracles. Behold the wonder-working agency of Steam, by land and sea! the electro-magnetic telegraph, com- municating intelligence at the distance of hundreds of miles with nearly the rapidity of thought! or contemplate another glorious achievement of modem science, the triumph over pain by anesthetic agents! The spirit of the present age and of Medicine is-onward aad upward to improvement and perfection. The highly elevated and progressive state of the profession will require of physicians a far wider field of learning and higher qualifications henceforth than formerly. The most ex- tensive and varied knowledge will be necessary to constitute • f 19 the accomplished and competent physician, and no other will be tolerated in any enlightened and refined community. Now, whilst young, ere you become engaged in the arduous and engrossing labors of your profession, or immersed in the cares of life, lay a deep and broad foundation of learning, on which you may erect a lofty and noble superstructure ; now is the time to hoard up vast stores of knowledge, on which you may draw hereafter in days of need. As well might you, with- out foundation, attempt to build a magnificent edifice, as to acquire a competent knowledge of your profession, without a substantial groundwork in the sciences and literature on which medicine is based. To constitute an accomplished and tho- roughly qualified physician requires a wide range of knowledge, for nearly all the sciences and arts are more or less subservient to medicine. If you now recklessly waste your time, and trifle with the weighty and sacred, but fearful responsibilities, that the profes- sion of your adoption entails upon you, unless destitute of that sensibility which should characterize a man, you will ever after find them an insupportable burden from which desertion alone can a*elieve you. If you would forever free yourself from unavailing regrets over misspent time, with the spirit of that noble Roman who exclaimed "perdidi diem," because one day had passed unsig- nalized by some benevolent deed, determine to allow no day to pass, without making some valuable addition to your stock of knowledge. When, hereafter, as practitioners, you shall realize the extent and weight of your responsibility,—when you shall see the life and happiness of others in your hands; when you learn how much is required to be known, comparatively how little the most learned know, and that they who know most feel most their want of knowledge, then you will thirst after it—you will desire large draughts from the Pierian springs! then, if the op- portunity were allowed, you would, in the language of the accomplished Meigs,* "bathe your souls in knowledge as in an •Professor Meigs, of the Jefferson Medical College. 20 ocean, grow pale by the reflection of the midnight lamp, and be satisfied with nothing less than the fullness of knowledge." But too often the imperious requisitions of business forbid in- dulgence in the delights of study, and physicians are compelled to toil on without being able to profit by the learned labors and improvements of others, distressed by the painful appre- hension that their patients are not enjoying all the benefits that science might afford them. The task in which you have engaged is arduous; the field of your labors is illimitably wide; intense application and untir- ing energy will be required ; but let not the prospect discourage you—persevering industry, with even moderate abilities, will overcome every difficulty and ensure success. Be not disheart- ened, though you may contend with poverty, so far from pre- senting an insuperable barrier, most of those who have attained eminence in their profession have struggled with adversity in early life : this has indeed been so frequently remarked, that they who have resisted the temptations of wealth and the fasci- nations of pleasure, are considered to have evinced as sublime virtue, as those who have surmounted the impediments of pov- erty and triumphed over adverse fortune. Under the stimulus of necessity, talents are often called into action and energies aroused, that otherwise would have slumbered on unknown to their possessors and useless to the world. Medicine as a profession has advanced in importance and true dignity more, during the present than any preceding age, not only on account of its greatly increased power to do good, but from the higher tone of morality and piety which has cha- racterized its members, and from becoming connected very closely with the interests of religion at home, and its extension in heathen lands. In the character of a physician, the mission- ary can obtain access to nations and tribes whom he could not otherwise approach. " Behold Dr. Grant," says Dr. McGowan, " armed only with his needle for the extraction of cataract, forcing mountain passes, and, amidst ferocious warriors, win- ning his way to their homes and their hearts. On account of his professional skill he was enabled to traverse in safety re- gions heretofore untrodden by civilized man, and in whose defiles an army would perish in effecting an entrance." i 21 Medical missionaries are now laboring in Africa, India, China, Syria, and the Pacific Islands, whose principal motive is the propagation of the Christian religion, their medical knowledge being employed only as a mean to assist them in accomplishing more effectually that glorious object. We esteem it an honor to include among these one of our own alumni, the pious and devoted Cumming, who has for years labored in China for the benighted heathen, ministering to his physical as well as spir- itual maladies, positively declining all pecuniary compensation for his services, content with souls for his hire and Heaven for his reward. Failure of health has compelled a temporary sojourn in his native land, but he is now anxiously waiting its restoration to return with his family to the field of his arduous labors. O, that others would follow this noble example! In barbarous nations physicians are regarded with the high- est respect and considered to possess powers almost divine, which commends them to their regard and confidence, and by attracting crowds around them for medical prescription, affords an opportunity to address them on the more important interests of their souls. But beside its important bearing on the cause of Christian missions, it is itself at home a high and holy mission, a dispen- sation of mercy, one of Heaven's choicest blessings to fallen man—it ministers not to his passions or appetites or follies ; its business is not in the house of feasting, it goes not "Where revel calls, and laughter vainly loud ! " False to the heart, distorts the hollow cheek." It is his friend in the hour of sickness, of suffering and of sor- row. It leaves him in mirth and merriment, but returns to comfort and bless when " Pain wrings forth the lowly moan ;" like woman, a ministering angel then. No human occupation approximates more closely that of our Divine Master while on earth ; and no vocation requires in those who exercise it a cha- racter more nearly assimilated to his, a life more in harmony with his precepts and principles: for surely the infidel and irre- ligious cannot be qualified for the highest degree of usefulness in a calling, with which the spiritual as well as temporal welfare of man is so closely involved. 22 Science has confirmed so many of the most important truths of divine revelation, and by her illuminations so removed every difficulty raised by scepticism, and dispelled every infidel doubtj that unbelief evinces not only the most determined perverse- ness, but weakness of intellect and defect of knowledge. " If (says an eloquent writer) an undevout astonomer be mad, how much more mad the educated and instructed but undevout practitioner, to whom God's handiwork is revealed, and the operations of Infinite wisdom laid open in the living creation and especially in man, the image of God.' You will find Religion no less essential to your happiness than your usefulness, however fortunate your lot in life may be, however your path be strown with flowers. You may bask in the sunshine of Fortune ; the adulation and loud plaudits of the crowd may intoxicate; the approbation of the good and wise may comfort you; "Fame's obstreperous trump" may charm your ear; the ever solvent "bank of Benevolence," in which you may have long garnered up abundant treasures, may yield large "dividends of happiness ;" Science and Literature may afford a continual feast; the best, the brightest, the dearest things that earth can give may all be yours : but all these cannot satisfy the demands of the immortal soul, its hunger nought can ap- pease save " the bread of life that came down from heaven;" its thirst nought can quench, but " the waters of the river of life." Now, in the glow of youth, rejoicing in your strength, full of life and spirit, you enter your profession. Hope paints the fu- ture in brilliant colors. Distance, in time as well as space, "lends enchantment to the view." Benevolence inspires, Mammon incites, and Ambition impels you on. But Time roll- ing on, "Steals fire from the mind and vigor from the limb," awakening you from youth's fond dreams to the stern realities of life. Disappointment saddens the heart and paralizes the en- ergies ; or success leaves nothing more to hope or wish for. He that has attained the upmost round can rise no higher—he that has reached the highest eminence in life, as well as "He who ascends to mountain tops, shall find The loftiest peaks most wrapt in clouds and snow." 23 Success brings increase of labor and care, when increasing years, the flagging spirit and failing body demand repose. All the incentives that acted so strongly in early life lose their force: even heaven-born Charity that once warmed the breast becomes chilled by the ingratitude of those she serves. What then can supply their place?—What can sustain declining age ? Religion alone can reanimate the exhausted mind, renerve the toil-worn frame, and furnish higher and holier motives to ac- tion, by which you will be enabled to labor on, and never faint nor weary in doing good, until honorably discharged from ser- vice, or called directly from your work on earth, to your re- ward in Heaven.