THE TRIALS AND REWARDS O F T H E MEDICAL PROFESSION: AN INTRODUCTORY LECTURE DELIVERED AT THE ©petting of ttje JFirst Session OF THE MIAMI MEDICAL COLLEGE, AT CINCINNATI, October 3d, 1852. BY R. D. MUSSEY, M. D., PROFESSOR OF OPERATIVE SUROERY IN SAID COLLEGE. CINC INNATI: T. WRIGHTSON, PRINTER, 12 W. SECOND STREET. 1853. At a meeting of the Students of the Miami Medical College, convened November 8th, 1852, Mr. P. M. Williams was chosen President, and Mr. C. A. Logan Secretary. The object being stated, the following was prepared and adopted : Resolved, That we request from Prof. Musset, for publication, a copy of his highly interesting and valuable Lecture, delivered as introductory to the course of lectures in this institution. Q ^Accordingly, Messrs. Chase, Bentley and Neal, were appointed a com- mittee to obtain the address. C. A. LOGAN, Secretary. P. M. WILLIAMS, President. Prof. Musset, Dear Sir—We take great pleasure in presenting you with a copy of the above proceedings of the class, with the sincere hope that the request therein expressed will be complied with. ELMORE Y. CHASE, THOS. S. BENTLEY, !> Committee. THOS. L. NEAL, E, ) Gentlemen—In compliance with the request of the class, I submit the Lecture for publication. Respectfullv yours, R. D. MUSSEY. To Messrs. E. Y. Chase, T. S. Bentlet, and T. L. Neal, Committee. ADDRESS. The profession of medicine is full of interest to the philan- thropist and the philosopher. Its path lies among the sciences, as well as among the sufferings and the sympathies, of an erring and unfortunate race. If no honorable pursuit in life is destitute of its pleasures and solicitudes, those incident to medicine are in some respects peculiar; and the deserved rank and importance of this profession will, it is hoped, justify an attempt, on this occasion, to give a sketch of the trials and rewards of the enlightened and conscientious physician. The young man who has toiled hard and long in preparing himself to assume the labors and responsibilities of the pro- fession, often finds himself, month after month, and some- times year after year, with little or no employment; public confidence has not yet reached him j the passers by rarely call at his office, unless to inquire for the residence of Dr. Bloat or Dr. Puff. He has the mortification to be frowned upon by professional men much older than himself, who stand tolerably well with the multitude, and who, jealous of his superior education, have set afloat among the people, rumors, the object of which is to dishearten and drive him away, or to put at a distance the period when his talents shall place him among them as a competitor or a rival, or give him a career in which he will^leave them far behind. 6 It was a remark of Dr. Wm. Hunter, that " success in the medical profession always attends the diligent." This posi- tion cannot be admitted as strictly correct. So many circum- stances have an influence in shaping public opinion on the merits of the physician, that success cannot always be confi- dently predicted, even of one whose fidelity and diligence, in the pursuit of medical skill, are well known and acknow- ledged. Multitudes believe that a knowledge of physic comes by intuition, rather than by study; hence the low estimate put upon a thorough education. Some acquire the reputation of being skilful by a grave, thoughtful demeanor, and dropping a few words now and then, in an under tone, which fall like the decisions of an oracle upon shallow minds. Others, by an opposite course, inspire confidence—talking upon all occa- sions of the extraordinary cures they have wrought, and ridi- culing the mistakes and ill success of their neighbors. Others again, by using an unintelligible jargon, confound the percep- tions of listeners, who have a higher regard for the names of things than for the things themselves, and in this way secure their good opinion and support. The doctor who can apply hard names to diseases, in a prompt and confident reply to questions always put upon these points, is set down as one who has his wits about him, and may be trusted. He draws after him a large class of followers. A lady patient asked a physician how long she should be sick. He instantly re- plied, " Madam, that will depend altogether upon the duration of the morbific influences which, in their combined operation, have given rise to the several groups of morbid phenomena, which have been developed since you were taken." The good lady thanked him for his ready and satisfactory answer. There are others who never fail, when occasion offers, to flatter the vanity of those who conceive they have skill in deciphering diseases, and suggesting appropriate remedies. Several years ago I knew a physician who was indebted, pro- bably more than to any other qualification for a full practice, to the habit of saying "yes 'm, yes 'm." " Doctor, I believe 7 my disease is the liver complaint; don 't you think it is the liver complaint?" " Yes'm, yes'm." " Well, I suppose I know how it came upon me." " How? madam." " Why, I took cold. The girl raised the window one day, and the damp air came in upon my left side. You know the liver is on the left side, Doctor." "Yes'm, yes'm." "Well, Doctor, I'll tell you what I think will be best for me; that is, a catnip poultice." "Yes'm, yes'm; that is the very thing I was just thinking of." " He is a dear doctor," says the lady to her friends; " he understands things, and has re- gard to the opinions and feelings of his patients." The young, upright and high-minded physician, when he sees quacks around him riding into favor on popular credulity, now puffing themselves in the newspapers, now flattering the vain, now playing off tricks of handicraft upon the simple and the lovers of the marvelous, is apt to turn away with dis- gust, being unwilling or too poor to await the slow progress of honest but unaided merit, or to rely upon those fortuitous occurrences, which sometimes give a sudden and unexpected impulse to the despairing aspirant, and place him, at once, before the public, in a respectable or commanding attitude. Having spent years in the dissecting room, in the lecture room, in the wards of a hospital, and in his study, to furnish his mind with the literature of medicine, as well as to trea- sure up the revelations of modern science, in their numerous bearings upon his profession, and seeing no prospect of an adequate reward for his efforts to link himself strongly with society in the practice of a learned, scientific and philanthro- pic profession, he seriously meditates turning his back upon the long-loved objects of his pursuit, and entering upon a new career, far less congenial to an enlightened and philosophic mind, and to a benevolent heart. I had a friend who was a more perfect medical scholar than any man I then knew, and than most of the distinguished physicians I have since known, whose intellect belonged to the very first class of minds; who loved truth as he did his own life, and hated imposture as he would hate a fiend from the pit of darkness—who came deli- 8 berately to the determination to abandon medicine, and to turn his thoughts in another direction. Indeed, he had al- ready begun to move in a new path, when he was brought back, and saved to the pursuit of his early choice through the influence of friends chiefly professional; and although he has passed from his earthly labors, his memory is embalmed in many a heart, and his rich and matchless teachings, listened to by medical classes year after year with breathless interest, have now become widely operative, through their ministra- tions for the relief of human suffering, scattered, as they are, upon the length and breadth of our land. His eloquent and classically written work on physiology has assigned to Daniel Oliver a niche in the temple of our profession, which he will continue to occupy so long as medicine shall endure. The celebrated Dr. Cullen was an obscure practitioner in a country village in Scotland, and so unsatisfactory was his progress, that he thought seriously of leaving the profession for the church; but before he had taken the decisive step, chance brought him acquainted with the Duke of Argyle, when on a visit to his neighborhood. The Duke was fond of chemistry, and during this visit, not having apparatus for some experiments he wished to make at that time, had the suggestion from his friend, that Mr. Cullen could probably furnish him with what he needed. Cullen was accordingly introduced to the Duke, who was so well pleased with him, that he introduced him to influential friends. In this way he was brought before the public, and afterwards became an eminent teacher and practitioner of medicine. Dr. Baillie is an example of an individual rising to emi- nence by dint of application and perseverence. It was not until he was forty years old, that his reputation was fully established. " From that period he became completely en- gaged in practice," and in a very few years rose to great emi- nence in his profession, in the metropolis of England. It is not, however, the lot of the physician, who has strug- gled through early discouragements, and to whom the public 9 has accorded a good share of confidence, to find himself free from solicitude and trial. He sometimes meets with a cold-hesrted selfishness which nearly chills his aspirations for usefulness. There are those in the community who estimate a physician's services as they do a drayman's—by the number of hours he is employed. In the family of one of this class, the medical man has la- bored professionally by night and by day—has watched the varying phases of disease on one or more of the inmates with an oppressive solicitude, at length has the relief of finding his patient convalescent, and ultimately restored to health. When his bill for professional services is rendered, it is met by fault- finding and ill temper, and, although his charges may have been moderate, he is abused as an extortioner. The trials from false brethren are sometimes by no means slight. Unsuspecting, open and high-minded himself, he has yielded his confidence to a professional brother, who to ac- complish sinister ends, has come to him with a smooth tongue. Too late to meet the evil, he finds his reputation has been assailed under the guise of friendship and respect, while thrust after thrust has been made at points the most sensitive, and, as he had himself thought, the most secure. There is honor in open hostility, but the secret enemy can- not be met on equal terms by the honest and upright man. Joab took the unsuspecting captain aside in the gate, and while speaking "quietly" to him, smote him under the fifth rib. A patient laboring under a painful and incurable disease, is attended by a physician whose assiduities, and sympathies in assuaging pain, and giving solace, are unremitted. The pa- tient professes a desire to know whether there is a prospect of his recovery, and seriously asks the doctor's undisguised opi- nion. The physician, too honest to deceive, and regardful of the spiritual interests of the sick man, informs him that the ten- dency of his malady is to a fatal termination. This intelli- gence is so unwelcome, that the physician is discarded, and 10 another called in to take his place. The new doctor comes with words of encouragement and flattery; and when it is but too evident to all that dissolution is at hand, he professes much sympathy with the afflicted friends, assuring them that had he been called in season, he could have accomplished a cure. The conscientious practitioner of the healing art, has a case of deep interest, his skill is exerted to the utmost, and when he finds his patient out of danger, nearly cured, he is suddenly superseded by an ignoramus or pretender who car- ries off the credit of the cure; although there was nothing left to be done in the way of remedial interference. If the physician remonstrates at the injustice of such treatment on the part of the patient or his friends, he gets nothing but abuse, and a settled hostility, got up at first perhaps and sus- tained by the insinuations and misrepresentations of him who has surreptitiously stepped in and taken his place. But this disappointment or trial falls short of that which is connected with a deep sense of responsibility on the part of the physician, when the life of his fellow man has been put into his hands. He knows, more than any one out of the pro- fession can know, the various influences that may have a bear- ing upon the case ; such as the poison which has predisposed to, or excited the disease, the predisposition to disease inheri- ted or interwoven with the fabric of the constitution, the state of air which the patient must breathe, whether pure or im- pure, its moisture or dryness, its temperature and electrical condition, light, sound, the quality and quantity of the food and drink administered, the state of the mind whether peace- ful or agitated. Then the various medicaments which may have been employed, or which now come under considera- tion as suitable, are to be taken into the account, along with the idiosyncrasies of particular constitutions which may se- riously vary their actions, and shape the character of the re- sult. How complicated and difficult the problem which comes before the physician's mind, every time he sits down by the 11 bedside of a very sick patient, and when he finds it almost or quite impossible to secure a faithful observance of his direc- tions on the part of the nurses, relatives or neighbors when they clandestinely or openly and perversely obtrude their pre- scriptions of food and medicine, is it a matter of wonder, that he is absorbed with his cases, that he is in a measure shut out from the pleasures and comforts of social intercourse ? that he dwells among his books and his patients, that his slumbers are disturbed by visions of the sick and suffering, calling imploringly for protection against the ignorance and officiousness of those around them ? When, day after day, under a close scrutiny of the changing phenomena of the case, he at length, finds one unfavorable symptom after another giving way, and is just ready to set down the case as one of durable convalescence, his hopes are suddenly crushed, an important change has taken place, the unfavorable symptoms return, are rapidly aggravated, and the patient sinks and dies. Who is disposed to envy the physician his feelings on such an occasion? He may not be able to discover the cause or causes of the change, and if he be not allowed a post mortem examination of the body, his doubts may never be cleared away; his mind being left to fluctuate among hypothetical views, which are numerous and complicated in proportion to the amount of knowledge he has acquired of the diversity of influences which give origin to, or shape the progress of disease. In some cases, the cause of the important change, and the termination is obvious. A strong and unsuitable medicine has been smuggled into the patient's stomach, or some article of food or drink given which has done the mischief. Several years ago, my advice was requested in a case in which a young woman had labored for ten or twelve days under catarrhal fever. She was convalescent. The night before I saw her, between twelve and one o'clock, she ate a quantity of fried veal. This was followed by severe pain and inflammation, which, thoughpartially relieved, turned the scale, and the patient died. I have known a little patient 12 under cholera infantum, subjected to regular medical practice, to homooepathy and hydropathy all in one day, with the re- sult of dying the next. One of the trials of a well educated physician is the self-de- nial he is obliged to practice in relinquishing the cultivation of a literary taste. Perhaps in youth he had a love for poetry and song, and ventured so far as to invoke the muses. But under the pressure of a full professional practice, he is compelled to abandon these cherished objects; and not for- getting that he is on a mission of mercy to suffering hu- manity, he pursues submissively the more substantial inquiry after medical truths, and assumes the arduous labor of carry- ing them out in their practical details for the benefit of the human family. The learned professions of Law,Physic and Divinity, ought to be regarded as three strong pillars of the social compact, and it would be natural to expect that they should mutually sustain each other. If an enlightened education is useful in one of these departments, why not in each of the others? Why should either of these turn traitor to the fraternal rela- tion naturally existing between them? Clergymen are the most efficient supporters of medical quackery to be found in the community, and lawyers are not exempt from this infir- mity. A nostrum is puffed in the newspapers with a certificate from one who is called a " Minister of the Gospel," or a " D. D." or an " Hon. Judge." One asserts that he had a bad cough which was generally thought to be carrying him rapidly into a consumption, and that he took Dr. Rogers' " Syrup of Liverwort and Tar," and in a few weeks he was a well man. Another, that he was afflicted with pain of the stomach, and after taking five of Brandreth's pills every other day for three months, the pain left him. A third certi- fies that he took some homoeopathic medicine at the thir- tieth dilution for nine days, and that a soreness he had in one of his toes disappeared ; at the same time mentioning that he wore loose boots and shoes, which, the doctor had assured 13 him, was a measure well suited to favor the legitimate opera- tion of the medicine. There is now in this city a colored man who can neither write nor read, who is regarded by many as a very skilful doctor, and who has a sign over his door labelled " Instruc- tions given by Dr. Bailey drift and science Practish." A young gentleman of the city wrote from his mouth the following epitome of his doctrines. " Every joint produces a different fever. There are different colors to the different fevers, from the different joints. Every man has a hundred and ten joints, and every woman a hundred and ninety-nine joints. The fever will go out of the joints, and go into the stomach by taking cold. Then separate the fevers, destroy- ing whatever needs to be destroyed. Seperate fevers from the cold. " The red fever raises from the marrow, and settles on the lights. One portion of the brain is dark and rules the liver. If it is affected, so is the liver ; and if the liver is affected, so is that part of the brain. Bad breath of the child is owing to the liver growing fast to the ribs. If it hangs in the sys- tem it is in order. Brown fever starts from the brain, and settles in the stomach. Some people call it thrash. If you dont cure it, it goes clean through the child as though it had been scalded. Every joint has a different wind or draft. Blue fever settles in the left knee as its home. When a person gets cold and it settles in a joint it miscon- strues and settles all over you, and turns the blood to water. When you have a bone fever, your head gets dry, you have the snuffers, but you cannot produce anything at all. There are 24 kinds of fever. Yaller fever is established already in the right knee, and blue fever in the left. Green fever settles in the water vessels, established by a tenical worm. A green worm about an inch long and about as large as a pin. This causes the fever. By taking an emetical medicine you bring the fevers away from you alive, and that aint good. " When a person has a grey fever, he is hoarse, and where the cold settled, it makes him hoarse. It has then settled on 14 the spleen. When you have clear chills, the cold settles on the lights. But the ager settles on the kidneys. For head- ache, give whiskey and vinegar. For pain all over, wash all over with whiskey and vinegar, and then grease with castor oil. If much pain, take one table spoonful of pulverised salt petre, and four of castor oil. Mix. All you want of salt petre is to catch the gas about it. It will not melt." The author of this gibberish is patronized not only by the ignobile vulgus, but by gentlemen of education. One of his patrons was bred to the law, and has been well compensated in the practice of it. A respectable Presbyterian clergyman, not of this city, consulted last summer this same "drift and science doctor" in a case of minor surgery. Homoeopathy is'one of the most prominent delusions of our time. What is Homoeopathy? An ignis fatuus. If it be suited to attract children with its sugar-plumb materia medica, or com- mand the faith of their mothers with its mysteries and para- doxes, yet as a system of remedial medication for disease, it must be regarded as one of the most adventurous attempts ever made to impose upon the common sense of mankind. It asks us to believe what is incredible—to give our assent to a set of dogmas, as heavenly truths, while they bid defiance to all the commonly observed phenomena of nature. In bringing forth his paradoxes, Hahnemann, the inventor of Ho- moeopathy professed to be charged with "the great gift of God to man." Instead of pursuing the inductive method in learning the nature of diseases and the effect of remedies, he set himself to imagining or dreaming them out, and then asserted the truth of his imaginings. He informs us that medicines, to act medicinally in the cure of diseases must be greatly subdivided, and that the more they are subdivided, the stronger is their medicinal virtue ; or, if expressed according to common parlance, the weaker they are, the stronger they are ; and when subdivided or dilu- ted up to the thirtieth division, a single grain of one of them, if 15 mixed with sugary requires a lump of sugar far too large to fill the orbit of Saturn. Now the tenth of a grain taken from any part of this big lump, becomes fearfully potent, and some me- dicaments thus diluted are peculiarly dangerous, and liable, without very careful handling, to produce the most serious effects upon a person who dares to take more than " three snuffs " at a phial, in which it is contained. Another dogma of homoeopathy, which Hahnemann in- forms us he arrived at after eleven years meditation, is, that all chronic diseases originate in three primary forms, viz. syphilis, sycosis and the itch, and that this last foul disorder is far more prolific than the others; and he enumerates be- tween thirty and forty diseases which are caused by this same itch. Among these are dropsy, hysteria, convulsion fits, St. Vitus dance, etc. A third dogma is founded upon an old hackneyed Latin pro- verb, viz, " similia similibus curantur," like cures like, or as the common people have it in English, " a hair of the dog is good for the bite." By this it is meant that a medicament adapted to the cure of aparticulardisease will cause that disease or one similarto it, when given in certain quantities to a healthy individual. Thus sulphate of quinine which cures intermittent fever, may be given to a healthy subject, so as to produce inter- mittent fever—in common language, chills and fever. Now this has never been proved, and there is no r}sk in saying that it never will be. Sulphate of quinine may be given in such doses to a healthy subject as to cause a feverish action, but this fever- ish action does not exhibit its paroxysms recurring at regular periods, and is therefore essentially unlike intermittent fever. There are hundreds of medicaments which will cause a fe- verishness when given in the same way; does it thence follow that each of them in homoeopathic doses will cure intermit- tent fever ? By no means. The fever which they occasion is destitute of periodicity, and is therefore essentially unlike an intermittent; for this periodicity is its distinguishing feature. A leading remedy for a well known contagious disease, is mercury. But can mercury cause that disease or one like it? 16 An essential trait of that disease is contagiousness; but mer- cury has never yet caused a contagious disease. Alcohol, prussic acid, and opium may be given to a healthy person, so as to cause apoplexy, or a state like it; but will the millionth or decillionth tpart of a drop of either of these ar- ticles wake up a patient from apoplexy, or from the uncon- sciousness and stupor occasioned by a heavy dose of itself? The rule fails then in the most essential points—it is no guide—is worth nothing because it is untrue. Neither is the converse of this true as expressed in " con- traria contrariis medentur," or diseases are cured by oppo- sites. No enlightened physician acts upon this dogma, for if there be instances in which it seems to be correct, there are others to which it is by no means applicable. If, therefore, we would learn what is true as to the effects of medicaments, we must rely on close and persevering observation—not upon the dreams or conjectures of any man. Dr. Hahnemann's views of the nature of disease were as striking, as were his dogmas respecting the action of medi- cines. " Diseases" says he, " are the immaterial changes which take place within ourselves, the dynamic aberrations which our spiritual life feels." We have met with no pa- rallel to th:s except in Hegel's definition of an idea. It is as follows: " The idea is the event, that the conception, as the universality whith is unity, determines itself towards the same as objectivity and antithesis, and this extremity which has conception for its substance, leads itself back through its immanent dialectic into subjectivity." A homoeopathic physician once said to me, that he had witnessed the most wonderful effects, from a dose of common table salt at the thirtieth dilution. I suggested to him that one grain of salt thus diluted must be diffused through a mass of fluid so great that it would require for it to run out at the rate of a thousand hogshead per second, more than seventeen septillions of years. He admitted all this, allowed that it was marvellous, but not the less certain on that account. In- deed, the marvellousness and incredibility of these dogmas 17 are among their greatest charms. A lady requested a lady patient of mine to give up the regular practice and employ a homoeopathic doctor; at the same time, for her encourage- ment, remarking that the more severe her disease was, the weaker would be the medicines, she would be required to take. How is this, said my patient. I do not comprehend that. O said her friend, it seems as though it could not be, and yet it is just so, and the mystery is all the beauty of it. There has never been any like it, for curing disease ! A homoeopathic doctor in this city was called to a patient, who had valvular disease of the heart, and who had been assured by regular physicians that medication would probably be of no avail; he gave her the homoeopathic globules, under the use of which she gradually failed, till it was evident, even to him, that she could survive but a short time. He remarked to her family, that her sinking so rapidly was owing to the blood running out of the little end of the heart into the bowels ! Yet this same doctor who could utter such an opinion, is patronized by several intelligent families, and by more than one lawyer is regarded as an oracle in medicine. The book of revelation and the book of nature, are both from the same author, and the teachings of the one are in perfect harmony with those of the other. In order to be understood, they should be studied with fidelity and perseve- rance, with a disposition to learn what is And not with a spirit to decide what should be taught there. The conscientious physician sits rivetted and enchanted with the exhibition of religious truth, enforced and illustrated by a profound logic and a glowing eloquence from a talented and devout man, ministering at' the holy altar; and need I ask, what is his mortification on seeing that same reverend gen- tleman linked, arm in arm, with a medical imposter, sustaining with all his influence unscientific and untruthful dogmas, re- nouncing the book of nature, and putting in its place the ex- travagant imaginings of a bewildered brain, or the puerile and impious enunciations of a mesmeric dreamer. Gentleman of the other professions, abandoning their com- 2 18 mon sense as a guide in medicine, seem to be taken as easily with humbugs as any other class of men, for they cannot be said to be, in any tolerable degree, informed in our profession. Probably not one clergyman or lawyer in five hundred has ever read a standard work on anatomy, physiology, pathology, and therapeutics; they have other things to occupy their minds, and when they assume a knowledge of medicine, they must get it by intuition or inheritance, as much as an old woman or a seventh son. Mechanics as a class, knowing the value of discipline, and training in their own calling, naturally enough infer that they are unfit to be trusted in those branches of knowledge which they have never learned, and, instead of claiming to know what they have not studied or been -taught, very properly yield to those who have received the requisite instruction. Hence the fact, that a larger proportion of them employ regu- larly educated physicians, than do those whose vanity inspires the belief that they possess divers sorts of knowledge, merely because they have made respectable progress or dis- tinguished themselves in a single department, whether in di- vinity, in law, or in trade. The man who has not studied medicine is no better qualified to sit in judgment upon its merits, than the farmer, knowing nothing of astronomy, is fitted to pronounce upon the correctness of the laws of Kepler, or the analogjwof Kirkwood. It may be suggested, that a person unacquainted with me- dicine can tell when a sick patient recovers, under a particu- lar kind of treatment. This is true; but it is one thing to know when a sick man gets well, and quite another thing to determine what cured him. The truth is, there are many forms of disease which nature can cure without medicine ; there are others, again, which require medication. Again, the same disease that requires medication in one constitution, may, in another, be cured without it. And fur- ther, a particular disease in the same constitution may, at one time, be cured by the powers of nature, and at another 'time, under different circumstances, require the aid of medicine. 19 Nature alone can sometimes get the mastery of disease, if a long period of time is allowed for it; but the wear and tear of the constitutional powers may be far greater than are pro- duced by an early and suitable medication, which speedily arrests the disease. This remark is sufficiently exemplified in certain grades of malarious fever. A patient has had in- termittent fever for several months, and has at last got rid of it without medicine, but is so far reduced in flesh and strength that many months more, and perhaps years, are necessary to effect a full restoration; whereas, under the judicious use of suitable medicine, he might have been rid of his fever in two or three weeks, with but very little reduction of his constitu- tional powers. And who but a well trained physician is best qualified to decide what shall be done in cases of this sort?* In order duly to appreciate the powers of nature in throw- ing off disease, it is necessary to be acquainted with various agencies which may regulate or modify the vital movements. Among these, the state of the mind takes high rank. The influ- ence of the depressing passions in aggravating or even causing disease, has often been spoken of, and multitudes of examples could be adduced, in which buoyant hope, or a strong faith or expectation of a cure, has given such an impulse to the vital movements of the bodily organs, as to result in the ex- pected restoration. Nothing is more common than for men to commit the gross- est blunders in estimating the influences which have given them relief under disease. A celebrated clergyman in the interior of our country, having become enfeebled by hard labor and great solicitude during winter and spring, visited the seaboard early in * Dr. Ford, a regular and well educated physician, who, for nearly three years, has been a member of the Gaboon Mission in Western Africa, has tried medication to a considerable extent among the natives, in the treatment of the endemic fever of that climate ; and his success has far exceeded that of the native medicine men, or Fetish doctors. These men seldom administer any thing in the form of medicine, but treat their cases with mummeries, incantations and antics, performed over the sick. In this way, the" no- medicine " plan is fairly tested, as the minds of the patients are kept easy by the entire confidence they place in the skill of their doctors. 20 thesummer to recruit his strength. While there, he was prevail- ed upon by some of his lady friends, to take some homoeopathic globules. In the course of the season his health was restored. This he attributed to the homoeopathic pellets, not seeming to understand that freedom from labor and care, the joyous intercourse with old friends, and the bracing effects of sea air and of exercise, were sufficient to account for his restoration. He afterwards remarked to a friend, that the little medicine operated like a perfect charm. That great and good man, John Wesley, Dr. Paris informs us, was " more disposed to attribute his cure to a brown pa- per plaster of egg and brimstone, than to Dr. Fothergill's salutary prescription of country air, rest, asses' milk, and horse exercise. The same sort of error is often committed in accounting for the existence of disease, by coupling together circum- stances which have no natural relation as cause and effect. Some years ago a young woman consulted me for an obsti- nate eruption upon her face—a species of acne. On being asked what she thought could have caused the eruption, she replied, that it must have been the death of her sister Cynthia, for it broke out immediately after her death, and had continued ever since. The influence of the imagination in ascribing medicinal effects to articles wiich have no medicinal virtue, is illustrated in the case of a distinguished doctor of divinity in one of our western cities. That gentleman, having taken cold one day, and finding himself indisposed at evening, sent for a homoeo- pathic physician. The doctor left some medicine in the form of sugared powders, and directed them to be taken at certain intervals. His wife was the nurse. The patient was co- vered warm in bed, and took some herb tea with his medi- cine. He soon got into a perspiration, felt much better, and said that he had never experienced so manifest and prompt relief as from this new medicine. The next morning he rose recruited, and attended to his ordinary avocations. At a large evening party, a few days after, to a circle of friends gathered 21 around him, he gave a glowing account of the magic effects of the new medicine in his own case. At this moment, his wife stepped forward and remarked, that instead of the powders left by the doctor, she gave her husband some small powders of sugar and starch in his herb drink. Nothing more could be said ; the bubble had vanished. Until the influence of the mind over the bodily functions is better and more generally understood than at present, quackery and imposture will fatten on human credulity. The remark has often been made, and it is presumed its correctness will not be called in question, that the members of the medical profession perform more unrequited labor than any other class of men. There is no small self-denial exer- cised by the physician, when at night he rises from a deep sleep, into which, fatigued and exhausted, he has just fallen, with the hope of refreshing his weary frame, in obeying the call to visit the sick, where he must remain for hours in pain- ful solicitude for his patient, without the privilege of closing his eyes in a sound slumber. But he remembers that he has embarked on a mission of mercy; that he has voluntarily as- sumed the office of relieving human distress, and of giving solace to sympathising friends. The life of a human being is committed to him; and though, day after day and week after week, he watches the suffering object of his charge, he often does it without the prospect of the smallest pecuniary compensation. Very few members of the regular profession in our country, even in a long professional life, by the practice of medicine alone, are able to secure an independence for their families. In our large and old cities, a competency, or sometimes more than this, is acquired; but the cases are rare, when, shut up to the avails of professional labor, with no adventitious means of acquiring wealth, the most active and useful practitioner rises above a mediocrity or competency. The ignoramus and impostor, by his flatteries, misrepresentations and self- puffings, fattens on the gullibility of the public, and in a few years rolls in a coach-and-four, while the scientific, honest 22 and hard-working physician is confined to his buggy or riding chair, wears out his life in toil and solicitude, and sinks into a comparatively early grave. The statistics of professions and trades show the average length of life in our profession to be less than it is in most of the mechanical trades, or in Divinity or Law. In the state of Massachusetts, the statistics for 1846 give as the average life of deceased clergymen, 64 years; of lawyers, 59 years, and of physicians, 47 years. In England, the ave- rage longevity of clergymen is 59 years; of lawyers, 50, and of physicians, 45 years. The rewards of the profession do not lie chiefly in the stinted pecuniary allowance grudgingly given as an equivalent for the saving of life, but are often derived from other sources. One of the richest of these is the poor man's blessing. The physician who practises in the country, especially in a part of the country but recently settled, is exposed to peculiar privations and hardships. At dead of night, in pitchy dark- ness and in storm, when the animal world around is fast locked in sleep, he must pursue his lonely way for miles into a deep forest, along a winding foot path, made visible only by the lightnings flash. The faithful animal which bears him, and has long been his companion in toil, picks his way over the scattered fragments of some proud tree just riven by a thunderbolt; and when he comes to a stream or creek raised by the present rain fall, he carefully measures his steps into the flood, and swims with his charge to the opposite side. On reaching his destination, the Doctor finds in a solitary cabin, the sick man he came to visit, lying in deep distress. He applies the means of relief, watches the remainder of the night at the bed-side, and by morning sees his patient easy and quiet, and on leaving receives his benediction. "Oh doctor, what can I bestow for your self-denial, your sympa- thy, and your skill ? Silver and gold have I none, but I pray for richer blessings than these, and I know that my master will not fail to reward you." A skilful and faithful physician is often looked upon as a 23 kind messenger from the spirit world. A physician in this city, in the summer of 1849, visited a woman, (a foreigner^ in cholera, so reduced that she could scarcely articulate audi- bly, although her consciousness still remained. Under the treatment instituted she improved, and in two days was rapidly advancing to a permanent restoration. At this time she said to her physician, in her imperfect English, " O doc- tor, when you did first come in to see me, you did look just like one angel come right down from the heaven. With the help of God you did save my life. Oh I shall never forget this. The good Lord bless you." Sometimes he is summoned in the greatest haste to the abode of the sick. As he hurries to the door, he is met by a mes- senger with terror and dismay marked upon the countenance. " Oh Doctor, come in, come in, she is dying." Immediately he is at the bed-side, the image of death is there ; the purple stream of life is fast ebbing away. The cold and bloodless lip, and the half open, glassy, and motionless eye, tell the story. Not a moment is to be lost. Those appliances sug- gested by regular scientific medicine are instantly employed, and by and by the patient wakes up to life and consciousness. "Life returns, life returns," is echoed from every tongue, and aspirations of thanksgiving ascend from those lips which but just now were chilling in death. It is on occasions of this sort, that the intelligent and faithful physician is permitted to measure arms, as it were, with the great destroyer of our race. When that arch fiend has conducted the patient into his own dark valley, and is about to pass him through his iron gate, the physician thrusts himself in his way, wrests the vic- tim from his grasp, and bears him up to life, light and joy. Deprived of many of the solaces of social life, and com- pelled to relinquish the cultivation of a taste for letters and the fine arts, the medical man finds no mean solace in the study of his profession as a science. New truths are ever being unfolded, and the fanciful dogmas of ignorance and imposture, are one after another refuted, and disappear. A keen pleasure attends the study of those agencies which 24 modify the phenomena of life, both in health and disease, whether derived from objects belonging to external nature, or from the sympathetic relations of the several organs which compose the mechanism of our bodies, or from the still less traceable influence of the mind upon the body, at one time operating suddenly, rushing like a tornado, and sweeping the whole fabric to ruin; at another, playing more lightly upon the machinery, marked in succession by sadness and exhila- ration, pensiveness and joy, like the ^alternations of sunshine and shadow, upon a green or flowery field, under the passing clouds of a summer's day. The steady progress marked in the several departments of the profession, a better acquaintance with diagnosis, a decided though gradual approximation towards a knowledge of those ailments which require medication, and those which may be confided to nature alone, great advances in the science of hygiene, improved methods of medication, new, ingenious and successful modes of operating in difficult cases of surgery, all inspire confidence that the course of the profession, which, since the introduction of the inductive philosophy has never been stationary or retrograde, will continue to be onward in an accelerated ratio. A never failing consolation to the benevolent physician, is the consciousness, that, although he may have committed errors in the practice of his profession, owing to obscurity in some of the elements of the cases brought before him, yet it has been his constant endeavor to learn the truth, and to act upon it; that his exertions have often been blessed to the relief of many a sufferer, and that the delightful field in which he has labored, will, under a more perfect culture, yield from period to period, richer and richer ingatherings of those fruits which shall be for the healing of the nations.