g. o; ?i PROFESSOR LEE'S VALEDICTORY ADDRESS TO THE GRADUATING CLASS OF GENEVA MEDICAL COLLEGE. I Jewett, ThomM & Co., Printers. ;@ NATIONAL LIBRARY OF MEDICINE Bethesda, Maryland / -/ VALEDICTORY ADDRESS GRADUATING CLASS (@eneoa Jtte&ual College PUBLIC COMMENCEMENT, JANUARY 23, 1849. BY CHARLES A. LEE, M. D. Professor of General Pathology and Materia Medica. PUBLISHED BY REQUEST OF THE CLASS. '-itAIiJ ££?£' BUFFALO: STEAM PRESS OF JEWETT, THOMAS & CO. Commercial Advertiser Buildings. 1849. I (nlm) CORRESPONDENCE. Prof. Lee, Geneva, Jan. 23d, 1849. Dear Sir:—The class graduated this day respectfully requests of you, through the undersigned their committee, a copy of your ad- dress for publication. GEORGE W. FIELD, E. DORCHESTER, Wm. H. WORTH, D. L. W. RUPERT, R. P. BROWN, M. D. J. B. PURCHASE, — Committee. Gentlemen:— Geneva, Jan. 23d, 1849. I have the pleasure of acknowledging the receipt of your note of this date — requesting a copy of my valedictory address for publica- tion. The uniform kindness and respect which have at all times been manifested towards me by yourselves and the entire classr prompt me to a cheerful compliance with your request, although I must regret that the address is not more worthy of the honor. With ray best wishes for your future happiness, prosperity, and welfare, I am Your sincere friend, And obedient servant, CHARLES A. LEE. Messrs. G. W. Field, " E. Dorchester, '♦ W. H. Worth, D. L. W. Rupert, It. P. Brown, " J. B. Purchase. ADDRESS. Gentlemen : In accordance with a custom observed in all our Medi- cal Colleges, it becomes the duty of some one of the faculty of this Institution to address you a few words of friendly counsel, ere you separate for your respective homes, pre- paratory to your engaging in the active duties of profes- sional life. To me, this responsible task has been assigned; would that I could discharge it in a manner more worthy of the occasion; of one thing be assured, I enter upon it with the sincere desire to say something that may be remembered by you with profit hereafter. Gentlemen, I will first call your attention to the duties which grow out of the new relation in which you now stand. They are of a fourfold nature — such as you owe to yourselves — to your patients — your professional brethren, and society at large. You have now been admitted to the honors of the Doc- torate, but you will not, therefore, infer that your education is completed; you have learned how to learn, and what to 6 learn—'how to observe, and what to observe. Your education, now begun, is to be the work of your lives — to be carried forward by yourselves. Although indoctrinated in the facts and principles of medicine, you can hardly be said to have begun to learn your profession, until you have entered upon practice. Then you will find that every day will make positive additions to your knowledge ; you will doubtless find many deficiencies to supply — many errors to cor- rect. You will then appreciate the importance of acquisi- tions already made ; you will be able to test the value of instruction received during your pupilage; you will be able to investigate with care, and derive profit from observation. Never rest satisfied, then, at any future period of your lives, with your attainments, for with all your diligence and industry, you will never see the time when you will know too much; or when you will not wish that you knew much more. As members of a liberal profession, which ranks in respectability and social position, with that of the law and divinity, the members of which are generally educated men, you owe it to yourselves and to your pro- fession, to cultivate your moral and intellectual powers, that you may occupy no inferior or equivocal rank in soci- ety, but stand among the foremost for intelligence and general knowledge. It is not expected of the mere em- piric, that he be a gentleman in manners or feehngs, or a scholar by education ; but it is expected of you. Though a greater share of your time will be devoted to studies connected with the practical duties of your profession, yet general literature is not to be wholly neglected; moral and physical science must also receive a share of your attention; for they tend to expand the intellect, enlarge the views, and strengthen and disciphne the mind. You will probably have considerable time, during the first few years of practice, for study and mental cultivation; you may then perhaps supply any deficiencies of education under which you may now labor, even to the acquisition of the French and German languages, and make extensive attain- ments in moral and intellectual philosophy, and the collate- ral sciences. I regret that so many young men in our coun- try on entering upon the practice of medicine, throw by their books, and waste so much of then time in idleness, desul- tory and trivial occupations, amusements or listless despon- dency ; instead of applying themselves to a systematic course of study, which, in the end, would not fail to reward them a thousand fold for their labor. While one turns his attention to sporting, and cultivates an acquaintance with dogs, the rod and the gun; another enters the field of politics — that maelstrom, which swallows up time, money, and character, and makes no return; another engages in the occupation of a horse-jockey, and spends half his time in looking up, buying or selling horses, or in prosecuting or defending law-suits, growing out of his dealings. How can such men expect to attain an elevated professional standing, or any standing at all, except as drones in society, who live by expedients, and flourish^ if at all, by acci- dent ? Improvement in your profession must be your main absorbing pursuit, to which every thing else, except the duties of religion, and the cultivation of the moral feelings 8 must yield; turning neither to the right hand nor to the left; persevering against all obstacles; patient under all diffi- culties ; spurning what are called pleasures, but which are too often follies, with a resolute will; fixing your standard high, and relaxing not your efforts, till it is attained. At times you may be tempted to doubt whether such exertions and sacrifices are worth the object in view; whether any rewards, sufficient to compensate for such a fife of toil and labor, can be reasonably expected; whether, in short, it would not be better to fall into the common current of careless, hap-hazard, routine practitioners — making up in bluster, pretension and boasting, what you lack in merit; striving to bring your superiors down to your own level by open detraction or insinuating inuendo, rather than raising yourselves up to theirs. Yield not to thoughts like these; for they are unworthy of those who mean to act as men, among men, and leave their mark in the world when they have left it behind. There is no calling in life, in which the attainment of success, does not require as great exer- tions and sacrifices as that of medicine; nor is there any which furnishes more certain prospect of reward. The divine may occupy a loftier position, but his responsibilities are even more weighty, than those of the physician, while he is by no means as liberally rewarded here for his anxious, unrequited labours. In the discharge of your duties to your patients, it is obvious that you cannot withhold your services, when demanded, either by individuals or the community, except under rare and peculiar circumstances. If you reside in 9 places where medical attendance is supplied to the sick, through the medium of Aims-Houses and Dispensaries, your obligations will only extend to seeing that, if the patient is a proper object, relief is furnished from these sources. A previous stipulation of pay, in any case, is contrary to the spirit of beneficence, which should actuate the medical man, and should never be practised. In your intercourse with the sick, be careful to blend kindness and gentleness of manner, for nothing is more annoying and distressing, than a cold, haughty, rough or unfeeling deportment. Let condescension be combined with authority; gentleness with humanity; humoring, as far as possible, the mental imbecilities and caprices of your patients; treating their feelings, and even their preju- dices, with indulgence; sacredly keeping all their personal, domestic and family secrets; never abusing the confidence reposed in you, but observing the strictest rules of deli- cacy, fidelity and honor. Let your visits be frequent enough to make you fully acquainted with the disease; but never multiply them unnecessarily, or merely for the purpose of running up a bill. It may be difficult always to regulate your attendance, so as to satisfy the patient and his friends, that you are simply intent on discharging your duty, without exciting a suspicion of interested motives. But your general character for probity, honesty and honor, should always be sufficient to shield you against any such imputations. Remember that the lives of those committed to your care, will often depend on your assiduity, attention and skill; if they are lost from any 10 neglect or deficiency on your part, that might have been supplied, you will not stand acquitted, either by your own consciences, or at a higher tribunal. Some physicians are in the habit of magnifying the danger of their patients, perhaps for the purpose of gaining greater credit, in case they recover. There are some, who even seem to delight in dark and gloomy prognosti- cations, doubtless thinking, that in any result, their repu- tation will not suffer, and may be enhanced. Gentlemen, you will carefully shun these practices. Resort to no artifices to acquire or bolster up a medical reputation. It is the highest cruelty, to both patient and friends, to prognosticate an unfavorable result, as long as there is a reasonable probability of recovery. Your mission is, to carry hope and comfort wrhereever you go; to revive the drooping hopes of the sick; to diffuse an air of cheerful- ness in the sick-room; and especially to avoid every thing which may tend to dishearten and discourage. " We are not ourselves, When nature, being opprest, commands the mind, To suffer with the body." * The timorous are to be\'heered; the desponding encour- aged ; the doubting confirmed; the despairing comforted. As hope is a more valuable cordial, a more diffusive, and yet permanent stimulant, than is furnished by the materia medica, cherish it with the greatest care — fan its fading embers, when ready to expire; kindle it into a bright and enduring flame; add not the depressing influence of des- * Shakespeare. 11 pair to the sedative influence of the disease, for it will often suffice to turn the scale. If the case should become hopeless, cease not your visits or your attentions; relax not one iota of your care; for, where you cannot cure, it is your duty to alleviate the pains of sickness; to smooth the passage to the grave; to calm, if possible, the troubled spirit; comfort the anxious relations, and pour the balm of sympathy into the bosoms of an afflicted family. It is cruel to abandon a patient to his fate, under any circum- stances, while " the lamp of life holds out to burn." In all dangerous cases, the friends should be apprized of the extent of danger; but you should be the first to suggest a consultation, because it may result in benefit to the patient, will not lessen the confidence reposed in you, and sometimes, it may save your reputation, by sharing the responsibility of an unfortunate case, with others of more enlarged experience, and established character. Where you can do so with profit, fail not to drop a word of friendly advice and caution, especially where the disease has been incurred by the vicious conduct of the patient. Strengthen his good resolutions; encourage his return to a virtuous course of living, by spreading before him the inevitable consequences of a life of vice; and thus use whatever influence you may, in winning him back to virtue. We are never to refuse our good offices, because the disease is the consequence of improper conduct, or dissipated habits; the Good Physician healed all manner of infirmities, and never stopped to upbraid or rebuke the sufferer. 12 Gentlemen, the new relation which you now sustain, imposes upon you very weighty responsibilities; responsi- bilities which you may not slight, without culpable dere- liction of duty. You are now entitled to all the privileges and immunities of the profession; its honor and its dignity are, in part, committed to j^our trust; should you do aught to lessen its respectability— to lower its standing — to diminish its influence in the community, you will have proved recreant to the confidence reposed in you, and proved yourselves unworthy of the honor now conferred. But, you are not to rest satisfied with a negative position; you are bound to advance its usefulness — to contribute your share towards its improvement. Every medical man, however humble his attainments, can do something towards adding to the common stock of knowledge, from his own personal experience and observation. For this purpose, let me recommend you to keep an accurate history of every case of disease you may treat; you will find it a source of constant improvement, and you will be surprised, in a short time, to observe what a rich accumulation of clinical facts you have gathered, which will always be valuable in the treatment of disease; far more so, than any which you gather from books. Begin, then, with your first patient, and let nothing prevent you from pur- suing the practice, even when fully occupied with business. As you are now regularly initiated into the profession, you are not only to conform to all the conventional rules and regulations which have been established for the gov- ernment of its members, but yon are to cherish and culti- 13 vate a spirit of brotherhood; encouraging associations for mutual improvement and good fellowship; frowning upon all attempts at discord and ill-will; indulging in no oppro- bious or contumehous remarks respecting the profession, or any of its members; defending its reputation as your own; regarding its interests as your interests; its honor as your honor. Treat your seniors with marked respect; your equals with courtesy and attention; your inferiors with kindness and civility. I need not dwell upon the importance of a pure and ele- vated moral character to the physician; so essential, indeed, is this to success, that no medical man, at the present day, who lacks correct moral principles, can hope for an elevated standing in his profession, or in society. The confidence which the community reposes in him, is not founded solely on his scientific attainments, but on these combined with strict integrity and pure morals. No one is willing to invite into the bosom of his family, a man of dissolute habits and vicious conduct. He can never feel safe, while a physician of such a stamp is allowed to cross his threshhold. To sustain the dignity and usefulness of the profession, you should conform, in your habits, to the strictest rules of temperance. It has been said that the surgeon should have an eagle's eye, a Hon's heart and a lady's hand; but none of these can he have, who habitually indulges in the intoxicating cup. The physician certainly needs a clear and vigorous understanding, an unclouded head, and 14 steady nerves; and no one can have these, in their high- est degree, but a strictly temperate man. You are aware that it is in direct conflict with the rules of the profession, to issue public advertisements, or private cards, or handbills, publicly offering advice and medicine to the poor, gratis, or promising radical cures; or to pub- lish • cases and operations in the public prints, or suffer such publications to be made; to invite laymen to be present at operations; to boast of cures and remedies; to adduce certificates of skill and success, or to perform any other similar acts. These are the ordinary practices of empirics, and are highly reprehensible in a regular physician.* It is also derogatory to professional character, to patent any medicine or surgical instrument; to dispense any secret nostrum of your own or others invention, or to give certificates, testifying to the value of any secret or patent medicine. The benevolent character of our calling, makes it the duty of every one, to publish to the world any use- ful discovery he may make; should he fail to do so, he forfeits caste, and takes his rank among the ignoble herd of nostrum-mongers and quacks. These are no new regu- lations or precepts, just introduced for the government of the profession; many of them are as old as the age of Hippocrates, whose appreciation of the medical character is so just and exalted, that I shall read you the oath which he required all his students to take, and which, I * Code of Ethics of American Medical Association. 15 believe, is still required to be taken in some of the Euro- pean universities:— " I swear by Apollo, the Physician, by iEsculapius by Hygiea, by Panicea, and all the Gods and Goddesses, calling them to witness that I will fulfill religiously, accord- ing to the best of my power and judgment, the solemn promise and the written bond which I now do make; I will honor as my parents, the master who has taught me this Art, and endeavor to minister to all his necessities. I will consider his children as my own brothers, and will teach them my profession, should they express a desire to follow it, without remuneration or written bond. I will admit to my lessons, my discourses, and all my other methods of teaching, my own sons, and those of my tutors, and those who have been inscribed as pupils and have taken the medical oath, and no one else. I will prescribe such a course of medicine as may be best suited to the condition of my patients, according to the best of my power and judgment, seeking to preserve them from any thing that might prove injurious. No inducement shall ever lead me to administer poison; nor will I ever be the author of such advice. I will maintain religiously the purity and integrity, both of my conduct and my art. I will not operate for the stone, but will leave that operation to those who cultivate it. Into whatever dwellings I may go, I will enter them with the sole view of succouring the sick, abstaining from all injurious views and corruptions, espe- cially from any immodest action, towards men or women, freemen or slaves. If, during my attendance, or even 16 unprofessionally, in common life, I happen to hear of any circumstances, which should not be revealed, I will con- sider them a profound secret, and observe on the subject a religious silence. May P, if I rehgiously observe this, my oath, and do not break it, enjoy good success in life, and in the practice of my art, and obtain general esteem forever; should I transgress and become a perjurer, may the reverse be my lot." With regard to consultations, you are not to refuse meet- ing any respectable practitioner, who has been regularly educated, and is of good standing, when requested by the patient or friends. You will not forget, however, that it has been decided by the American Medical Association, the highest medical authority in this country, that no one can be considered as a regular practitioner, or a fit associ- ate in consultation, whose practice is based on an exclusive dogma, to the rejection of the accumulated experience of the profession, and of the aids actually furnished by Anat- omy, Physiology, Pathology and organic Chemistry. This rule necessarily forbids all consultations with Hydropaths, Homoeopaths, Mesmerists and Thompsonians. Shun every kind of artifice and management in obtain- ing practice; for such means are altogether unworthy of honorable men, and disgraceful to members of a liberal profession. Avoid all quarrels, bickerings and disputes with your medical brethren; If you treat their mistakes and failings, and no one is free from them, with generosity and indulgence, you may generally expect the same treat- ment in return; if differences should, unfortunately, arise, 17 therefore, should be reasonably remunerated by all who have the ability to pa)-, and from none others should a fee ever be exacted. Let your charges be moderate; but should your circumstances be such, that you do not need any compensation, still you are not to offer advice gratis, where there is the ability to pay; as, by so doing, you do injus- tice to your medical brethren. In whatever region of country you may establish yourselves, you should endea- vor to bring about a uniform rate of charging among the leading physicians, to which all should be pledged to con- form, and a deviation from which should be deemed dis- honorable. Your duties to your professional brethren may all be embraced in this. Act in accordance with the spirit of the golden rule of " doing unto others, as you would they should do unto you." This rule so broad and comprehen- sive, will guide you unerringly in every possible case that may occur. GentlemeD, you are now about to become active mem- bers of society, and must bear your share in sustaining its institutions and its burdens; as you participate in its benefits, so must you not shrink from any of the duties and obligations of citizenship. You will be called upon to give advice relative to all matters of public hygiene, or the medical police of towns and villages; your opinions will be sought in courts of justice, where you should ever be disposed to lean towards the side of clemency and humanity; you will be consulted in reference to the best modes of constructing, ventilating and managing public C 18 institutions, such as hospitals, alms houses and lunatic asylums; in regard to the prevention of epidemic, endemic and contagious diseases; you will be asked to enlighten coroner's inquests, in all matters pertaining to medical jurisprudence; to make post-mortem examinations, for which you will be entitled to compensation. The only cases in which your gratuitous, professional services will be obligatory, are those of poverty, of professional brother- hood, and such members of the clergy as do not encourage empiricism, nor certify in favor of secret and patent medi- cines. But services rendered to public institutions, how- ever they may have been endowed, examinations for life insurance, certificates of inability to serve on juries, or perform military duty, or for obtaining pensions, are all entitled to fair remuneration, unless the applicant be in indigent circumstances. One duty you will not fail to perform, and that is, to warn the public against the wTiles and artifices of quack- ery ; to point out its enormities; to lay open its secrets, and expose the multiform evils consequent on its encour- agement, and prevalence in the community. You may not be able always to dispel the delusions which some- times prevail in relation to certain novel doctrines and modes of practice; and perhaps there is nothing gained, on the whole, by harsh and wholesale denunciation; but when your opinions are asked, and whenever you have a fair opportunity, it is not only proper, but your duty, to enlighten the public, and so guard them against the arts of knaves and impostors. 19 Such are some of the more important and obvious duties to which you are pledged, on entering the medical profession; but, as it has been truly said, every duty or obligation, implies both in equity, and for its successful discharge, a corresponding right. As it is the duty of a physician to advise, so has he a right to be attentively and respectfully listened to. Being required to expose his health and life for the benefit of the community, he has a just claim, in return, on all its members, collectively and individually, for aid to carry out his measures, and for all possible tenderness and regard, to prevent needlessly harassing calls on his services, and unnecessary exhaustion of his benevolent sympathies.* But, do the public generally recognize such rights on our part, or duties towards us, on theirs? I fear not. Among tracts adapted for gratuitous, general distribution, I know none that are more needed at the present day, than such as relate to the obligations of patients, and of the public, to physicians. The first might treat of the importance of well educated physicians to the happiness and welfare of the community, of the many and important duties we are called on to perform, and of our necessary sacrifices of health, ease and comfort; it should teach patients to entertain a just sense of their duties to their medical attendants; pointing out on what principles a physician should be selected, when he should be employed, how obeyed, how trusted, and how and when paid ; when a medical man should be sent for, and for what causes * Code of Ethics of American Medical Association. 20 dismissed; how empirics and quack medicines should be regarded and treated, and many other subjects of a similar kind. Another tract might be occupied with an account of the benefits accruing to the public, from the beneficence of the profession; it should aim to teach the public how to appreciate medical qualifications and skill; to discrimi- nate, in some measure, at least, between true science and the assumptions of ignorance and empiricism; to encourage and patronize medical schools and medical education; to persuade the community to drop some of their prejudices against the profession, and some of their skepticism against the benefits of regular practice; to regard physi- cians as the true, and greatest benefactors of society; to look upon quackery in medicine in the same light as Millerism, Mormonism, or any heresy in religion; that, to prefer an ignorant pretender to a man of science and education in managing the sick, is doing violence to reason, and an unpardonable sin against humanity and common sense. Such are some of the topics, which need to be discussed before the community, and facts presented in such a light, as to lead to a change of sentiment and action towards our profession. As you mingle with society, you will find that it is made up of three classes, viz : those who are skeptical as to the benefits of medical science; those who are over credulous and superstitious; and lastly, those who view the profession in its true light, as one of the main pillars, on which the welfare and happiness of society rests. It may, perhaps, be doubted, whether such a classifica- 21 tion is strictly proper, since we find that those who are most sceptical towards regular and philosophic medicine, have, very often, the strongest faith in the most absurd pretensions of quackery: auguring some mental obliquity, or perhaps abnormal cerebral organization, which no array of facts or reasoning can remedy. The sceptical, that is those who utterly deny all efficacy in scientific medical treatment, and in the modes of practice, generally pursued in the profession, do not, I believe, constitute a very numerous class; and, as medicine becomes more rational and enlightened, and partakes more largely of the charac- ter of a strictly inductive science, as it is, this class is destined to dwindle in numbers, until it finally disappears. The credulous and the superstitious constitute a very large portion of the human family. Hence the immense consumption of worthless quack medicines in the world; the prevalence of various popular delusions, which extend, at times, over whole countries and nations, like some epidemic disease, involving all classes in its progress; the enlightened and the ignorant; the learned and the un- learned ; hence the faith reposed in new systems of prac- tice, which is usually in the inverse ratio of the amount of common sense evidence in their favor; hence the numerous certificates in favor of empirics and their nos- trums, given by those, from whom we might expect better things; hence the popular attachment to Indian remedies- to Mesmeric practice; to the Homoepathic system; to Hydropathy, Isopathy, and a thousand other absurd and conjectural fashions of medication. The newspaper and 22 periodical press, always powerful in correcting and shaphig popular opinion, and remedying abuses, lends its almost united influence in spreading and eternizing the enormities of empiricism, and we can never expect society to be rid of its evils and ravages, until the press becomes more enlightened and conscientious, and the community better informed on the subject of Physiology and hygiene — the organic laws of our nature, as connected with the preser- vation and restoration of health. It would really seem that those who manifest such credulity, are not only ready to believe in whatever is possible, without the slightest particle of proof, but also in impossibilities and miracles with no greater amount of evidence. This age of ours is not peculiar in this respect. There never has been a period since "sin brought death into the world and all our woe," but what has been infested with imposters of every kind and grade; there has been no age, or nation, in which they have not enjoyed the patronage and coun- tenance of men of wTealth and influence! In Europe, the nobility and aristocracy are the great patrons and supporters of quacks; there, rank and affluence have always provided a sanctuary, in which ignorant pretenders might find shelter. Look at the tar-water of Bishop Berkley ; the metalic tractors of Perkins ; the animal magnetism of Deleuze and Dupotet ; the infinitesimals of Hahnemann ; the baths of Preisnitz ! It is there, that the higher and more influential classes of the community, who are the chief encouragers and patrons of medical char- latanry and imposture, and we can hope for no change 23 for the better until society becomes better instructed in matters pertaining to the Healing Art. Credulity has been thought to spring from mental indolence and inac- tivity ; people are unwilling to be at the pains of sifting evidence and weighing the preponderance of contrary proofs and testimonies; they are ready to believe almost every thing they hear, and all they see in print, however marvellous it may be ; they take everything upon trust; nothing is too strange for credence ; a statement, however monstrous, goes down, not only because it pleases the natu- ral love of the marvelous, but because the hearer is unwil- ling to be at the trouble of refuting it. It goes by default; and when creduhty is wrought upon by knavery, and cunning and artifice lend their support, a whole community becomes infected as it were, by a species of monomania; common sense is at a discount; and whoever does not bow down and worship the new idol, that is set up, is cast into the furnace of popular prejudice, and fortunate will he be if he comes out unscathed. Females, who would be better employed in their domestic duties, assume to sit in judgment on opposing systems of medicine ; they discuss with wonderful fluency, the abstruse theories and doctrines of contending sects ; they repudiate the whole science of medicine, as it has existed, from the days of Hyppocrates to the present hour; and then they assure us that they are decidedly in favor of the new system ! Self-commis- sioned, they enter upon the task of proselytism; confirm- ing what has always been observed, that " the creduhty of dupes, is as inexhaustible as the invention of knaves." 24 Gentlemen, there is no country, probably, on the face of the globe where medical imposture of every kind, obtains more of the sympathy and patronage of the public, than it does in ours; and that too, not withstanding our boasted intelligence and the general diffusion of knowledge. As ours is the only civilized country on earth, where all restrictions upon the practice of medicine are removed, and where it is held to be no part of legitimate legislation to protect the lives and health as well as the property of community against the designing artifices of knaves and imposters; so is it the only one where heavy penalties are imposed by courts of law, (not justice) upon unsuccessful, or unfortunate surgery, if the practitioner belong to the regular profession; while no notice is taken of the daily homicides committed by empirics of every grade and description. Could my humble voice reach every mem- ber of society, I would ask, why do you take so little interest in the subject of medical education. Is it a mat- ter of trifling moment, whether you and your family and friends, fall into the hands of ignorant pretenders, when sick, or into those of careful, skilful, educated men, who have thoroughly qualified themselves by long study and diligent application, for the safe and judicious manage- ment of disease. In his own case every individual, what- ever may be his practice, will acknowledge the import- ance in selecting his medical attendant, of paying some regard to his character and qualifications; and yet soci- ety as a whole, seems quite indifferent as to the charac- ter of its medical schools, and all provisions for the 25 proper education of those who are to sustain this rela- tion to them. I trust that the time is not remote when community will wake up upon this subject; when they will leam that medical education, and the formation of the medical character, are not merely an affair of the profession, but a subject in which they themselves have the deepest interest; when they will cherish and sus- tain our medical colleges by their wealth; their influence; then friendly cooperation; instead of seeking, with, or without cause, to throw obstacles in their path, by in- creasing the prejudices already existing against such insti- tutions. Gentlemen, when I look abroad upon the face of soci- ety, I think I see the dawn of a brighter day. Empi- ricism would seem to have rung nearly all its changes. Its disguises have become so film-like and gauzy, that the dullest vision can penetrate them; its pretensions have become so palpably absurd, that the "way-faring man, though a fool, need not err therein!" Its false chame- leon hues have all been again and again presented to the gaze of the novelty-seeking portion of the public, and been pronounced false and deceptive ; public credulity has been stretched until it has nearly snapped in twain : and there re- mains but a sandy foundation for future humbugs to stand upon. All this will be accomplished by the diffusion of knowledge, by the enlightenment of the public mind in rela- tion to hygiene, the laws of health, and the causes of dis- ease. Medical commissions are being instituted by the gov- ernments of the most civihzed nations, to enquire into the D 26 causes of sickness, and the best means of bringing about sanitary reforms. No expense is spared, to increase the comforts, diminish the ratio of mortality, and add to the value of human life. The study of Human Physiology is being introduced into our schools and seminaries of leam- mg; the rising generation are taught the structure of the human body, and the means of preserving its healthy functions; and since all these things are so, can we doubt that the reign of quackery is drawing to a close ; or, that the public will not hereafter confide in that class of practi- tioners, who show themselves most devoted to the study of their profession; who pursue it as a great subject, all the rela- tions and bearings of which, it is their duty to investigate; who regard it not merely in the light of a money-making business, but as a science, which they are to contribute towards building up and perfecting; and who do this, as diligent, earnest, and disinterested enquirers after truth. I may be deceived, but I believe " there is a good time coming," when superstition and credulity will no longer hold sway over the human mind; when, in the opinion of the masses, witches and impostors will no longer compete with the regular faculty; but reason, enlightened by knowledge, shall, alone, govern mankind. An event connected with the proceedings of this day deserves some notice on this occasion, calculated as it is to excite curiostity and comment, and to be held up as an example for other institutions to imitate or condemn. I mean the conferring of the degree of M. D. upon one of that sex which is generally supposed to be wanting in the 27 physical, if not moral qualifications necessary for the suc- cessful practice of the Healing Art. So far as I am informed, this is the first instance, in this country, or any other, where a female has graduated in medicine, after having gone through the regular prescribed course and term of study; and in the present instance, it is my duty to add, without the omission, or the slighting of any branch of study, and that too, in so thorough a manner, as to leave nothing unattempted, or unattained, which it is necessary for one to know, who expects to practice with honor and success in every department of the profession. Such an instance of self-sacrificing devotion to science ; of perseverance under difficulties, and obstacles next to insurmountable—of unremitting, unrelaxing toil, in pursuit of that knowledge, so important to, and yet so rarely pos- sessed by her sex—and all this for the purpose of miti- t gating human misery, relieving the sick, and extending her sphere of usefulness in the world—this, I say, deserves as it will receive, the heart-felt approbation of every gene- rous and humane mind. This event will stand forth here- after as a memorable example of what woman can undertake and accomplish, too, when stimulated by the love of science and a noble spirit of philanthropy. Why should medical science be monopolized by us alone ? Why should woman be prohibited from fulfilling her mission as a ministering angel to the sick, furnished not only with the softer and kindlier attributes of her sex, but with all the appliances and resources of science ? If she feels called to this life of toil and responsibility, and gives evidence of her quali- 28 fieations for such a calling, in humanity's name, let her take her rank among the disciples of Aesculapius, and be honored for her self-sacrificing choice. Such cases must ever be too few, to disturb the existing relations of soci- ety, or excite any other feeling on our part than admiration at the heroism displayed, and sympathy, for the sufferings voluntarily assumed ! God speed her, then, in her errand of mercy, and crown her efforts with abundant success !* Let it not be thought strange by any one, that so many who enter upon the practice of medicine, turn astray and run after strange gods, seeking rather to advance then worldly interests, than to do good to their fellow-men. The fault, after all, chiefly rests with the community, which estimates men by their outside show, and their pretensions, and not by what they are. It is so in every calling of life. The acquisition of wealth is the great absorbing pursuit which swallows up all else : the end to be attained at all hazards: the quo-modo is a secondary matter. But such, gentlemen, was not the aim, nor the character of those who have been most prominent and honored in * Since the above discourse was delivered an article has appeared in the Boston Medical and Surgical Journal, condemning in very severe terms, the conduct of the Faculty of Geneva College, in allowing Miss B. admission to their courses of lectures, arid of the Trustees in conferring upon her the degree of M. D. The writer, while he acknowledges the validity of the argument, so far as it is founded on the general physical disqualifications of the sex for the medical profes- sion, and the incompatibility of its duties, with those properly belonging to the female portion of society, believes, nevertheless, that instances occasionally hap- pen, where females display such a combination of moral, physical, and intellectual qualifications for discharging creditably and skilfully the duties belonging to our calling, that it would seem equally unwise and unjust, to withhold from them those advantages and those honors, which are open to nearly all others, whether deserv- ing of them or not. While he holds this opinion, he at the same time feels bound to say, that the inconveniences attending the admission of females to all the lec- tures in a medical school, are so great, that he will feel compelled on all future occasions, to oppose such a practice, although by so doing, he may be subjected to the charge of inconsistency. 29 the annals of our science. They have ever been distin- guished for their disinterestedness ; they have exhibited a nobler nature; pursued a higher object; been governed by worthier motives. Their aim has been to acquire that knowledge which will confer practical benefits upon society, without reference to the amount of reward, or to any fame, except that of doing good. They have sought to discover the laws of disease, in order to prevent it; they have inves- tigated the causes of human maladies, for the purpose of removing them; they have explained and disseminated the principles of Hygiene, in order to raise the standard of health in the community. And they have done all this, not for the purpose of acquiring wealth or reputation, but to benefit their fellow-men. Disinterested benefactors of the race, ye have your reward! Gentlemen, I have referred you to that noble class of our profession, who have always been its ornament and its pride, whose names shine forth, and ever will, on the records of humanity, for your imitation and example. They are its true representatives—its only legitimate exponents. Their lives and their labors are our glorious inheritance. Let us follow in their footsteps. Love knowledge for its own sake, as well as because it is the instrument of usefulness ; be faithful to the true cha- racter of our profession; go forward with honesty and fidelity in the path of our honored predecessors, and doubt not that you will meet with an abundant reward ! As medical men, gentlemen, you will not have done your duty, if you confine yourselves solely to the treat- ment of the sick, and look not beyond the mere restora- 30 tive results of your therapeutical prescriptions. If I mistake not, it is our mission to labor, in season and out of season, for the amelioration of the condition of soci- ety ; to contribute all in our power to the prevention of the physical evils which afflict mankind ; to diminish the amount of sickness in the community, by pointing out and striving to remove its causes; and thus prove ourselves benefactors to our country and to mankind. That physi- cian, who limits his beneficence to the care of the sick alone, has but poorly performed his duty ; society claims of him a higher and a nobler task, that of preserving the health of those among whom his lot is cast. Let it not be said, that this is impracticable. If the causes of disease are hidden from us, owing to their refined and subtle char- acter, as in epidemic cholera, at least we can study, and make ourselves acquainted with the conditions, external and internal, on which the efficiency of these causes de- pend. We see abundant evidence in our profession, both in our own and foreign countries, to convince us that there is a more enlightened spirit prevailing, and that, as a body, physicians are rapidly returning to the principles promul- gated by the early founders of medicine. The time is not distant, when the treatment of disease will not be regarded as the most useful part of professional duty, though it will always be the most difficult; but men will come to look upon the physician as the true guardian and conservator of the public health, Avhose province it is to arrest evils at their fountain head; to purify the stream at its source, and not to cleanse its waters when polluted by a thousand 31 impurities, or dam its rushing current, when swollen by innumerable tributaries. Gentlemen, this is an age of progress, in which the claims of humanity speak trumpet-tongued as they never spoke before. What mean those movements in favor of peace and universal freedom, and temperance, and educa tion, and prison disciphne, and sanitary reforms, and hos- pitals ? Do they not proclaim that a new era is breaking upon the world ; that the day star has arisen which is to illumine every dark corner of the globe, and shed its influ- ence on ever}' poor child of sorrow and of sin ? And will you stand idly by and bear no part in the work ? It is to members of our profession that the world is more indebted for these reforming movements than to all others united. Have they not gathered the rich harvests of experience from other soils, and other lands, and other ages, and brought them forth, and poured them into the lap of soci- ety to enrich the common stock ? You will do violence to the humane and reforming spirit of the age, and of the profession, if you do not become co-laborers in this glorious work; if your hearts are not animated by that electric spark of sympathy and brotherhood which binds us to each other, and to the sacred cause of humanity ! Let us, then, labor in our vocation and toil on — abating not our diligence, till He who sent us here shall call us home to receive our wages. Then can w<: quietly lie down to our long, last sleep, in the sweet con- sciousness of duty accomplished, and good perfonned, and look for a happy're-union in that better world—where 32 pain, sickness, and death, the physical evils we have here endeavored to alleviate or prevent, never—never enter! Farewell. Exhibited: p. 26 Elizabeth Blackwell, NLM, Jan-Sept, 1999