J^ v-vjr^-e ;^- INTRODUCTORY LECTURE, DELIVERED AT THE OPENING OF THE Cf)iito- '0 1 CINCINNATI : WRIGHTSON & CO., PRINTERS, 167 WALNUT ST. 1857. 1 . Ccrnspanhnce. Cincinnati, Oct. 19 Science, while it justly acknow- ledges a temporal relation, possesses also an essence which claims affinity with the pure benevolence of a higher sphere. It is a benevolence which, like the rays of light springing from a great center, illumine the darkness of distant spheres, while its own great fountain remains undimmed and inexhaus- tible. You must study medicine as a science, and not as a trade. In mere commerce, success is measured by the accu- mulation of money ; in science, by the absolute knowledge attained. "The end of literature," says Thomas Carlyle, " was not, in Schiller's judgment, to amuse the idle or recre- ate the busy, by showing spectacles for the imagination, or quaint paradoxes and epigramatic disquisitions for the under- standing ; least of all was it to gratify in any shape the self- ishness of its professors, to minister to their malignity, their love of money, or even of fame. * * * Genius, even in its faintest scintillations, is the inspired gift of God; a solemn mandate to its own to go forth and labor in his sphere, to keep alive the sacred fire among his brethren, which the heavy and polluted atmosphere of this world is forever threatening to extinguish. Woe to him if he neglect this mandate, if he hear not its small still voice! Woe to him if he turn the inspired gift into the servant of his evil or ignoble passions; 13 if he offer it on the altar of vanity, or if he sell it for a piece of money." Let me say to you, then, cultivate your profession as an ennobling and exalted benevolence. Look minutely and pro- foundly into the deep mvsteries which belong to the several departments of this science. Do not rest satisfied with a superficial and imperfect knowledge of anything which bears on the practical duties of your profession; but with untiring vigilance, and an unfaltering determination, pursue your stu- dies until you learn all that others know, and add new mate- rials from your own observations. But, gentlemen, while we admonish you as pupils to avoid the errors of indolence and cupidity, and to seek by exalted deeds an exalted position in our profession, the question for- cibly recurs, are none of the sins which degrade the profession attributable to professors and schools who assume to be moni- tors and guardians of our honor and prosperity ? It is greatly to be feared that the mantle of charity, with all its amplitude, is scarcely sufficient to cover the delinquencies of schools, or to shield their professors from merited condemnation. In this land of freedom, every half-dozen physicians who aspire to the title of professor, can readily obtain a charter and erect a medical school, whether it be for the purpose of promoting the improvement of the profession, the good of humanity, or a more sordid and selfish one of individual interest. The establishment of medical schools at points where they are not required, or in too great numbers in any location, give rise to precisely the same results which follow competition in trade, namely, cheapening of the article produced. But, unlike the same result in trade, the cheapening of medical education has a tendency, in more ways than one, to deteriorate the quality of the product, and thus to damage the whole profession. When schools are established at points not requiring them, an unusual effort becomes necessary in order to force them on the profession; they require the prestige of numbers ; and for this purpose every inducement will be held out in the reduc- 14 tion of fees, free schools, and conferring degrees on all who apply. The process of cheapening is a direct inducement to persons out of employment to enter the profession ; and thus hundreds of persons, wholly unfit for physicians, and who have failed in other pursuits, finding medical studies the cheap- est, and the most likely to yield a large interest on a small capital, at once enter a free or cheap school, and soon become competitors for the emoluments of practice. There can be no question that these facilities have the direct tendency to over- crowd the profession; and as a natural and inevitable conse- quence, to cause undue competition in practice, with all the evils which arise from such a condition. Those who obtain their education for nothing, can well afford to practice at cheap rates, and thus supplant abler and better men ; and the whole system has a direct tendency to withdraw the mind from the science, and fix it on the mere trade. In making these remarks, I do not intend to assert that a student's intellect is proportioned to his money ; on the con- trary, I speak of the system of cheapening in its general effects, and its certainly disastrous influence on the profes- sion. The whole tendency is necessarily and unconditionally evil; and it seems to me strange that the mental vision of any one can be so clouded as not to perceive the tendency, or his conscience so stultified as to permit him to engage in a traffic so criminal in its character and so pernicious in its results. And it becomes the duty of every student and physician to frown on all such paltry exhibitions of selfishness, cupidity, and criminal disregard of the exalted duties of the physician, and the dearest interests of humanity. Those persons, in the judgment of Schiller, who pervert science to minister to their own selfishness, malignity, love of money, or even of fame, betray the sacred trust reposed in them, and therefore richly merit the severest condemnation. But fortunately, such schemes are ephemeral as the passing cloud; and like the shadowy spectre of the mountain, flee away before the light of the rising sun. 15 We may profitably turn, however, to another view, in which you have a right to demand of professors the most scrupulous fidelity. It becomes the duty of every teacher of medicine to present to his class a full, comprehensive, and complete view of his department, according to the accredited doctrines of the best informed of the profession. Partial views, or hasty and crude generalizations, should not be tolerated in the lec- ture-room ; nor are we justifiable in discarding the opinions of those whose opportunities and candor entitle them to res- pect and confidence. It is the duty of a teacher to be familiar with all the important facts which have been established in his department; he should weigh well the opinions of others, and so far as he can, correct the errors of his predecessors; but a blind and obstinate adhesion to speculative views contrary to the leading doctrines of the great body of the profession, is an arrogant presumption, unworthy a philosophical mind and a true science. Superficial, partial, and dogmatic teaching is the bane of our profession. Those who are too idle to keep pace with the rapid advance of our science, or too egotistical to learn of their compeers, endeavor to hide their deficiency beneath a storm of words and a dogmatical manner, wholly at variance with a calm and deliberative judgment, and an accu- rate knowledge of the subject attempted to be taught. In attempting to follow our prelections during the ensuing session, you will at once perceive the natural distinctions which exist among the several branches taught;—a portion are styled elementary, embracing chemistry, anatomy, physiology, pathology, and therapeutics, while others are made up of the practical application of those several elementary departments. You will likewise perceive the importance of studying with due care these elements, for it is those branches which consti- tute medicine a science ; and if you neglect this great basis, it must necessarily follow that you will sink to the level of mere empirical practitioners. Allow me to warn you, then, in the beginning, that you have a broad and deep science to study, which will require all of your physical energies and 16 mental discipline to master. No sluggard can successfully pass the ordeal of medical study ;—it demands mental disci- pline, untiring energy, and ceaseless devotion to the great object before you. It is an acknowledged fact that the most rapid and success- ful method of imparting knowledge is by lectures, accompa- nied by suitable demonstrations. Hence you resort to medi- cal schools, wherein the various demonstrative departments can be successfully taught, and clinical medicine can be illus- trated in connection with hospitals. But as the great object of all medical study is the practical application of principles in the cure of disease, it is abundantly evident that hospitals are indispensable aids to the acquisttion of knowledge, and that without them medical schools utterly fail to fulfill the objects of their creation. But, gentlemen, you will speedily discover that a course of lectures embodies a vast amount of teaching, and that many different subjects will be presented for your comprehension and remembrance. This is the great difficulty which you will encounter—the necessity for comprehending, remembering, and fully digesting all of the departments which are taught. There is but one method by which you can successfully pass through the term, and that is by systematizing your labors. For the purpose of accomplishing this object, you should take notes of lectures during the day, which you carefully re-write and review in the evening. I am satisfied that it is a great mistake to attempt an extensive course of reading during attendance upon lectures; on the contrary, an occasional reference to text-books, and a careful review of manuscript notes, in clubs formed for that purpose, constitutes the best and most successful course. The teacher will present you a faithful out-line of all that is requisite—quite as much as you can retain, and this foundation becomes the basis of future reading and study ; which, with the improvements in clinical observations and practical tact enable the diligent and faithful students, ultimately, to become accurate, able and distinguished practitioners. 17 Ladies and Gentlemen :— A due respect for the non-professional part'of the audience who have honored us with their presence this evening, requires of me a passing remark in regard to the interest which they evidently feel and actually possess in this our cherished science of medicine. All mankind, civilized and barbarous, repose a high degree of confidence in the curative power of medicines; and all recognize in certain persons, skill in the application of these agents in the treatment of disease. True, Pliny asserts that Rome was without physicians for a period of six hundred years ; and Petrarch warns Clement the VI, against physicians, as a troop of enemies. But these events convey no idea of public conviction of the utility of medicine. The incantations and superstitious devices of the barbarous and ignorant; the ready faith and unreasonable expectations of the thoughtless and credulous; no less than the hopes and confidence of the refined and scientific, proclaim the universal belief in the necessity and existence of a healing art. But medicine is viewed very differently by different minds. It is one of those departments of science with which supersti- tion has been, and still is, largely blended. This melancholy fact is abundantly attested by the records of the past, as well as observations of the present time. Among the ancients, the Magi of the Assyrians and Chaldeans, the Brachmans of the Indians, the Magi and Pastophori of Egypt, and the Druids of Gaul are well known repositories of blind faith and superstition ; while the specious devices of Mesmer, the fanciful theories of Hahnemann, and the demoniacal assump- tions of the spiritualists, are so many modern evidences that the ancient superstition has been duly transmitted to our own time and generation. In the application of this element of superstition to the realities of life, there is always, and necessarily, a motive of interest. The deception arises from the efforts of systematic charlatans to impose a false practice on the people for the 2 18 sole purpose of self-aggrandizement; and it will be remarked that in all those departments of natural and moral science, in which the imposition would not lead to pecuniary gain, no attempt is made to impose on the credulous or superstitious. Thus, in the departments of astronomy, geology, chemistry, natural history, and kindred sciences, the elaboration of false systems could not be made to yield a pecuniary gain, and therefore offer no temptation to those who live by falsehood and deception. And thus, certain sciences having remained exempt from the defilement of sacriligious hands, are regarded as true beyond the possibility of doubt. What would the public say if a mountebank should elevate a new order of telescope to the heavens, and declare that your astronomer on Mt. Adams, with all others, was entirely mistaken ; that the law of gravitation was a mere fable ; the centrifugal and centripetal forces nothing but the vagaries of a disordered fancy ; that the erratic comets were merely the fiery steeds from Mount Parnassus bearing messengers to some remote colony—and, in fact, that the moon was a huge Western Reserve cheese! Such a proclamation, I am quite sure, would be received with jeers and laughter, and the proclaimer declared a fit subject for the lunatic asylum. And why ? Not because the great public happen to possess any very accurate knowledge on these abstruse points, but for the more simple reason that astronomy has offered no inducements for the deceiver's genius, and has, therefore, remained an uncontra- dicted science. And yet, this science of astronomy rests on no more demonstrable basis, is made up of no more indubitable facts, than the science of medicine. If Grecian astronomy had her Hipparchus, Grecian medicine had her Hippocrates. While Copernicus, in the 16th century, discovers the true motion of the earth, Harvey in the 17th century, discovers the circulation of the blood. If Newton deduced the law of gravitation from the planetary motions discovered by Kepler, and the cental forces of Huygens ; so Bichat, by the powers 19 of his own great observations, assisted by the discoveries of his predecessors, classified the tissues, and laid the great and broad basis of pathology. Nor are the discoveries of Kepler, Napier, or Newton, in astronomy, more clearly demonstrable than those of Magendie, Flourens, Sir Charles Bell, Marshall Hall or Liebig, in medicine. The two sciences, indeed, although their objects and nature are so widely different, exhibit a remarkable parallel in many respects, and evidences, demonstrable and philo- sophical, are no more decided in favor of one than the other. Nor can a spurious system of medicine be invented with more propriety than a spurious system of astronomy. But the practical fact is different. Medicine offers a large and profitable field for imposture and deception; and the cunning charlatan does not fail to profit by the opportunity. In regard to medical doctrines and assumptions the public credulity is as unbounded as it is incomprehensible. If our pseudo-astronomer were to assert that the moon was green cheese, he would be rewarded with the jeers and derision of the multitude ; but when Hahnemann declares that the prin- cipal part of chronic diseases are produced by the itch, the remark is considered one of stupendous profundity, and entitles its illustrious author to the first rank in the great army of reformers. If the fanciful paleontologist should point to the myriads of fossils locked up in the bosom of the earth, and declare that they had been destroyed by the noxious exhalation from the minerals which surround them, the delusion would excite only a smile of derision. But when the medical reformer declares that physicians poison their patients by whole hecatombs, and that the electric bath will extract the metal from the system with more ease than gal- vanic gilding can be practised; the assertion is regarded as evidence of profound wisdom and of great moral honesty. In these errors of judgment the public seem to ignore the existence of a science of medicine, and that the conjuror or witch doctor, guided by the chances of probability, will be as 20 likely to stumble on an effective remedy as the most learned and skillful physician. Allow me to say on this point, and with all due deference to public taste and discrimination, that individual judgment is worthless on subjects of which they are of necessity igno- rant, and that they must reason, as in other matters, from certain data, from the nature and fitness of things, and from high authority. By these rules of logic the existence of our science is clearly and emphatically established. The nature and fitness of things most indubitably declare that an omnipotent and omniscient ruler would not create a world of pain and suffering without adequate means of relief. In the whole economy of nature there is no example of an evil without its appropriate remedy. Every poison has its antidote. The rose has been planted amidst the thorn. Harmony reigns throughout the illimitable domain of material creation. The laws of attraction and repulsion, of heat and cold, of day and night—so accurately fulfill the objects of creation that all is harmony and beauty. Spring follows winter, and summer spring—the golden fruit follows the fragrant flower. The vast spheres which hang on the seem- ing verge of creation, equally with the atom which enters into each particle of matter, obeys the primal laws of crea- tion. And can it be presunfed that man—the highest of all created objects—would be left to the blind course of chance, or the irremediable results of fate ! On the contrary, the remedy has been placed within his own grasp, with a balm for each human ill. Nor is it within the limits of probability that the applica- tion of remedies for the cure of disease would be left by an all-wise Creator to the ignorance of empirics, or the caprice of mountebanks and jugglers. In conformity to the great and immutable laws of nature, every department is reduced to a certain harmonious relationship, developed with unvarying precision, which we denominate science. We have attempted, as the exponents of medical science, to carry on from age to 21 age those investigations which shall perfect our knowledge, and enable the enlightened physician to relieve pain and disease, and prolong life. For twenty-two hundred years this spirit of investigation has assumed a systematic and scientific form. Every nation of the earth has contributed its share. The ancient Egyptians, Assyrians, Arabians, Greeks and Romans—together with all modern civilized nations—have contributed to swell this great fountain of knowledge. No class of men have been so laborious, philo- sophical and disinterested as those engaged in this great science. And now, as the reward, we have the proud satis- faction of knowing that not only has human suffering been mitigated, but the duration of life has been greatly prolonged. And still our labors continue. The friendly voice of greeting comes from the banks of the Neva, the Seine and the Thames, and mingles with those of our own Ohio. The Academy of Medicine of Paris, and the Royal Medico-Chirurgical Society of England, labor as much for your good, as their own. There is a universal philanthropy, which, like the dew of heaven, spreads over the broad face of the earth. It is the same light which glimmered in the lamp of Hippocrates, but now, bright as the meridian sun, illumines every land. The lonely habitation of the widow, and the dreary hamlet of poverty, equally with the pomp and pride of the palace, bless the hand of the " good Samaritan" as it relieves their pain and suffering. This is the testimony of the great world of letters. Governments and individuals—philosophers, sages, divines— bear testimony to the truth of this great science. And yet, a frivolous or ignorant few turn away with supercilious cant, and declare that neither Hippocrates nor Galen—Bichat nor Louis—Sydenham nor Hunter—are worthy of confidence ; that this long wrought science, rich with ancient wisdom and modern research, with its golden links binding every age and nation—is but a specious assemblage of hypothetical fallacies and dangerous dogmas ! But that the crazy theories of 22 Hahnemann, or the impudent assumptions of pretended reformers, embody all that is known in medicine !! Strange infatuation ! We can almost behold the prophetic hand, tracing on the broad face of Heaven, in letters of fire, " Ye would be dupes and victims, and ye are." No, fellow citizens, the mind of man could not have labored two thousand years in a false science. A merciful Provi- dence would not permit the best interests of his creatures to suffer by such a protracted and fatal delusion. Every fact connected with human suffering proclaims that God designed to create a healing art; and not all the ingenious devices of bad men and demons, aided by the credulity of weak, infatu- ated and misguided minds can inaugurate a spurious system, or annul the great purposes of Deity in the creation of our science. For ourselves, gentlemen, let us persevere. Our duty is plain and obvious. The great field of nature and truth is spread out before us. Pure Castalian springs gush forth from every land, and imbue the true physician with an inspired love of science. And although false systems rise up like spectre giants, and mar the harmony of nature, the true science never falters in its course. It was the eternal will of God which created our science, and it became a part of the divine government. The dignity and success of our profession, no less than the demands of suffering humanity, require of each member the highest order of candor, of integrity and of truthfulness. We are pledged to an absolute disregard of all false lights and spurious systems. Our profession must be not only pure, but above the suspicion of false pretensions. This integrity is the aegian shield of our science. It will protect us through the journey of life. And when the toil is ending, and the lengthening shadows proclaim the declining sun of life, the good deeds will stand forth as the gilded mountain tops in the last rays of light, while the calm zephyr will bear on its balmy wings, " Well done, good and faithful servant." 12632645