AN ADDRESS 
DELIVERED TO THE MEDICAL CLASSES OF THE 
UNIVERSITY OF PENNSYLVANIA, 
ON WITHDRAWING FROM HIS CHAIR, APRIL io, 1884, 
BY 
PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE. 
ALFRED STILLE, M.D., LL.D., 
FROM 
THE MEDICAL NEWS, 
April 19, 1884. AN ADDRESS 
DELIVERED TO THE MEDICAL CLASSES OF THE 
UNIVERSITY OF PENNSYLVANIA, 
ON WITHDRAWING FROM HIS CHAIR, APRIL IO, 1884, 
By ALFRED STILLE, M.D., LL.D., 
PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE. 
Gentlemen : The lectures which, twenty years ago, 
I began in the University, I have now concluded. I 
have contributed, according to my ability, to the store 
of useful knowledge from which your predecessors, 
for more than a century, imbibed professional instruc- 
tion. Everyone who, in his turn, comes to occupy a 
position such as I have had the honor to hold, is ambi- 
tious of deepening, and widening, and purifying the 
stream of knowledge, and, for such little time as the 
rush of events permits, of being held in remembrance 
as one who did not labor altogether in vain. 
In entering upon the duties of this Chair, I was not 
altogether in my novitiate as a teacher; yet I felt that 
my task was one of exceptional responsibility, and to 
the very last this impression, instead of becoming 
lighter by familiarity, has grown more serious and pro- 
found. I have never for a moment been able to put 
away from me the impression that according as I dis- 
charged or failed to discharge my duties conscientiously 
would be my responsibility for the lives and health of 
those who were to become the patients of my pupils. 
But no man lives up to his ideal. The further he 
advances in learning and experience, the higher will his ideal rise, and at the end of his career it will appear 
to him, more than ever, unattainable; and it must be 
so, for knowledge is infinite. 
The one principle that has shaped and governed my 
instruction was to oppose fact to theory ; to build up the 
walls of your education securely with the one hand, and 
with the other to defend you against the intrusion- of 
hypothesis and unsubstantial theories, the most danger- 
ous of all your enemies, because the most seductive to 
the young and ardent mind. I have often thought that 
the progress of knowledge would be more rapid, as well 
as more steady, if it were only possible to divide the 
speculative men from the practical, leaving a free field 
to the former wherein to manoeuvre their phantom 
squadrons, and to the latter an equal opportunity of 
cultivating in peace the fruitful furrows ploughed by 
observation and experience. But such an expedient 
would be opposed to the practice of mankind, which 
also has the sanction of divine wisdom, to let the wheat 
and the tares grow together until each has brought forth 
its proper fruit, when the one can be garnered, and the 
other destroyed. 
Well convinced that time never fails to do justice 
upon the false and fanciful, I have forborne to make 
that vivisection of them without anaesthetics, which 
reason and instinct suggested, and have devoted what- 
ever knowledge and skill I possessed to the simple, if 
difficult, task of knowing and curing diseases. I have 
striven, in season, and perhaps out of season, to impress 
upon you that medicine is, first of all, an art, but an art 
that can only be successfully practised when the physi- 
cian is able to recognize the individual diseases he must 
meet with in practice, and distinguish from one another 
those which are similar in appearance, but unlike in 
nature. This subject I would fain have had time and 
opportunity to illustrate by a detailed study of the his- 
tory of medicine, and by showing you what no medical 
2 3 
historian has yet elaborated, the pregnant truth that the 
real links of the historical chain are, above all, the 
practical men, the foundation of whose teaching was 
clinical; and that theorists in every age have been 
stumbling-blocks in the road of progress, or else the 
chains, the fetters, and the gags of those who, under 
proper guidance, would have worked for nature and 
for truth. 
I have endeavored to keep before myself and before 
you, the great truths that in medicine whatever is not 
subsidiary to diagnosis and therapeutics is unessential 
if not superfluous; that it is quite as necessary for the 
physician to know when to abstain from the use of 
medicine as it is for him to prescribe when medication 
is necessary ; that he must, as far as possible, see the end 
of a disease from its beginning; that he must never for- 
get that medical art has a far higher range and aim than 
the prescription of drugs or even of food and hygienic 
means, and that when neither of these avails to ward off 
the fatal ending, it is still no small portion of his art to 
rid his patient’s path of thorns if he cannot make it 
bloom with roses. Such knowledge not only quickens 
the patient’s faith but confirms the physician’s also, be- 
cause he knows the limits of his power, and is neither 
deceived himself nor deceives others. The issues of 
life and death are not, indeed, in human hands, yet the 
physician, with his finite means, can sometimes render 
harmless the thunderbolt that threatens destruction. 
The power that permits death and the manifold causes 
that produce it has also given to man his love of knowl- 
edge and the intelligence to apply it for overcoming 
evil, and he has likewise implanted in us a conscience 
that will approve or condemn us as we use those gifts 
for the welfare or the hurt of our fellow-men. Sooner 
or later every one of us must sit in judgment on the 
conduct of his life. We cannot escape self-questioning. 
We must ask ourselves whether the talents we have re- 4 
ceived as natural gifts or developed by labor, have 
grown and multiplied as they should have done, or 
whether, at the end of our career, we have nothing 
more to show than the original handful of seed, grown 
hard and dry, and perhaps mouldy in our unprofitable 
possession. 
To produce a harvest of knowledge that shall be worth 
gathering, demands at least as much labor and vigilance 
as the crops that minister to our material wants. In 
the earliest springtime of life the soil must be thoroughly 
prepared for the seed, and the seed itself must be of 
the best quality. Education should begin from the very 
cradle, and in early life the habit of observation ac- 
quired which is of inestimable value in every pursuit. 
Then, if the child be destined for a professional life he 
should be systematically trained, and more and more 
strictly as he grows older, towards the field of knowl- 
edge he is destined to occupy. Thenceforth he must 
begin to fill his own treasure-house with the fruits of 
study and observation, not trusting wholly to his 
memory, which is unfaithful, but recording from time 
to time, if not day by day, all that is worth preserving. 
He should never forget that medicine, like all knowl- 
edge, has a past as well as a present and a future, and 
that in that past is the indispensable soil out of which 
improvement must grow. He should remember, too, 
that however closely related the several branches of 
medicine are to one another, each one in its turn is best 
learned by an almost exclusive devotion to it for a time, 
and when his barns are filled to bursting with his har- 
vest, let him not forget that the grain has still to be 
winnowed. His fan must be in his hand to purge the 
threshing-floor of the dead, the unessential, the hypo- 
thetical, the fanciful, and, above all, the false. In all 
things truth must be his object, his inspiration, and his 
guide. 
You have fallen upon a time in which medical knowl- 5 
edge far exceeds in amount and variety that of any 
previous era. The measure of it is most readily appre- 
hended when we consider the extent of the medical 
literature of the day, and, in some respects, its superi- 
ority over that of any previous era. It is perhaps as 
distinctly indicated by the improvement of medical 
periodical literature as by any other sign. That it still 
leaves much to be desired is very true ; but in every di- 
rection indications may be found that it is gaining in 
seriousness, dignity, solidity, and energy. Hardly less 
noticeable is the tendency, at least, of most of our 
medical colleges to recognize the need of a higher stan- 
dard of education, while in a few, including the Univer- 
sity, actual progress has been made by lengthening the 
period of professional training, and enlarging and perfect- 
ing its laboratories and clinical work. All of this is well, 
is praiseworthy, is hopeful. But it is not all that is neces- 
sary. One thing, at least, is lacking in nearly all of our 
colleges, and in the few where it exists it is in a formal 
and merely embryonic state, a promise rather than an 
achievement. I allude to the preliminary or entrance 
examination. This was one of the watch-words of the 
American Medical Association at its organization in 
1848. In that body, and in the local medical societies 
that have concerned themselves with medical education, 
it has yearly been echoed and reechoed until in the ears 
of many it has become a mere phrase without practical 
meaning. And yet, in truth, it lies at the foundation of 
all radical improvement in our educational system, for 
it needs no argument to prove that the merely medical 
education of otherwise uneducated young men will 
never elevate or dignify the medical profession. 
If the nature of medical science and art is considered, 
it becomes plain that to embrace them a greater variety 
of knowledge, and a greater skill in the exercise of the 
mental faculties, are required than is demanded by any 
other professional pursuit whatever. Hence it is that in 6 
older countries than our own, where education is better 
understood and more easily managed, because managed 
by more competent men than with us, the laws prevent 
all unqualified persons from becoming members of the 
medical and, indeed, of every liberal profession. It is 
there universally understood that no one can be qualified 
even to enter upon the study of medicine, unless he has 
been trained in the classics, in mathematics, and in 
natural science. There it is taken for granted that no 
one destitute of classical education can appreciate either 
the spirit of modern medical literature, in the best of 
which the wisdom of the ancient world survives, or the 
value of doctrines, descriptions, precepts, and practices 
which, though apparently of modern origin, take their 
rise in the remotest periods of medicine; or the signifi- 
cance of words now in daily use which reveal only to 
the etymologist their essential and recondite meaning. 
In a word, it is taken for granted that no man can 
become a physician in the best sense of the word unless 
he is also a scholar, that the training of the mind which 
makes him one, also best enables him to form clear 
notions of things as well as thoughts, and to arrange 
his ideas in so orderly a manner that, whether for his 
own use or for the instruction of others, he will always 
find his knowledge ready and efficient. But that is a 
part only of the value of a liberal education to a physi- 
cian. Hardly less valuable—and if estimated not by its 
material results, but by the mental and moral satisfac- 
tion it ensures—not less, but much more, valuable is it to 
physician, as it is to every other man whose pursuits 
are as absorbing, as exacting, and as exhausting—is the 
culture of some extra-professional field of knowledge. 
In the hours of resFIremay snatch during his busiest 
life, and in the years of repose that he looks forward to 
in the waning of his life’s evening, he will then never be 
without the recreation of reading that refreshes his 
weariness more than idleness, and quickens his faculties by varying their exercise. Every young physician 
must, indeed, begin his career chiefly among the vulgar 
and illiterate, but in due time, and all the sooner the 
better he is prepared for it, he will enter the circle of the 
intelligent, the educated, and the refined, and then, if 
he is a mere dispenser of drugs or brandisher of instru- 
ments, he will fail to gain their esteem as a man, even 
while he commands their employment of him as a 
helper in their emergencies. But if he is a man of 
liberal education, of cultivated intelligence and taste, 
and has that large humanity which makes him feel in- 
stinctively that his patients are not diseases or injuries, 
but suffering human beings who may be influenced by 
psychical as well as by physical agencies, he will learn 
that mental medicine is often more potent than drpgs, 
and that if in his therapeutics'he has not included this 
agency, he lacks one-half of the power he ought to 
possess. 
Some one may object, perhaps, that the picture I have 
drawn is an ideal one, and that young men who are 
educated in medicine cannot often be expected to reach 
it. Nevertheless, a true ambition would be degraded if 
it did not set before itself the highest possible attain- 
ment, if it duTnoTfeel dissatisfied with any system that 
fenced in its strivings and dwarfed its ideals. But true 
ambition is rational and not quixotic. It feels that its 
discontent with the present and its striving towards a 
better time to come must be subordinated to the laws 
that govern development in all living things. 
When an institution, be it political, social, or educa- 
tional, is discovered to be no longer adapted to the 
actual condition of a people, it can be safely modified 
only in accordance with the peculiarities of the people 
for which it was established. All history teaches the 
folly of supplanting it by another institution which was 
not made for the place or time, but was constructed ac- 
cording to some abstract notion of its usefulness and fit- 
7 8 
ness. It is like ready-made clothing, which is suitable 
for the average man only, and can never perfectly fit 
any individual man. The mental qualities of young 
men are as various and unequal as their complexion, 
their stature, or their weight; and it can as little be ex- 
pected that the same system of education will be adapted 
equally well to all, as that the uniforms from an army 
sutler’s stock will fit becomingly or comfortably every 
soldier who is to wear them. And yet, practically, such 
uniforms must be worn, and as we very well know their 
defects do not prevent their wearers from bravely fight- 
ing and winning battles. In like manner the systematic 
education of professional men is no less necessary, and 
although it suits no one perfectly, it suits all well enough 
in the battle of life. The individual’s education in 
common can never be the best; but it can always be 
improved, always made to suit a progressively increas- 
ing number. In proportion as the students who come to 
be clothed intellectually attain to a greater elevation 
and quality of mental development, the methods of 
education should be expanded to fit their intellectual 
height and breadth. So shall they no longer present 
the sad spectacle of manhood in the jacket and pinafore 
of childhood, or the ludicrous one of childhood tottering 
and stumbling in the garments of maturity. 
Meanwhile, let us not expect nor attempt abrupt 
changes. The defect of all reformers is impatience. 
They insist that, because a principle is intrinsically true, 
it should forthwith be put into practice ; that because a 
practice is right it should be enforced upon every one. 
It is not in this manner that good ends are reached, 
either by nature or by mankind. To take the most 
familiar illustration: religious doctrines and precepts 
have never yet leavened the whole of humanity, and 
crime and its punishments abound in nations that claim 
to be governed by the highest moral principles. The 
perfect law of right is opposed by passive ignorance, and moral progress by the tendency to wrong. Only 
inexperienced and impractical dreamers expect good to 
flow spontaneously and immediately from evil, or to see 
a defective system that has the vantage-ground of age 
swept away as soon as one that is esteemed better is 
ready to take its place. Such are apt to be the mistakes 
of those who take a microscopic view of things, whose 
vision is bounded by the narrow circle of personal rela- 
tions and interests, and who forget that the questions to 
be solved are as wide as the whole profession of medi- 
cine, and to the end of time will involve dissident if not 
antagonistic opinions. But if it is impossible, upon a 
very close view of a subject, to see all of its parts and 
their relations to each other, it is equally impossible to 
do so if we take a standpoint above the clouds, where, 
if we have a wider field of vision, it is a very indistinct 
one, and where, if the atmosphere is clear, it is also so 
cold as to freeze humanity out of medicine. It behooves 
us to remember that medicine is, above all else, humane 
as well as human ; that its beginning, middle, and end 
is to relieve suffering, and that whatever is outside of 
this may indeed be science of some sort, but certainly is 
not medicine. 
In one form or another, the doctrine has come down 
to us from a remote period, Ars tnedica tota est in 
observationibus—the art of medicine is founded on 
experience alone. It is the business of science to ex- 
plain what experience has established; but it is not the 
primary business of science to observe and connote 
facts. That is the function of rational empiricism. The 
application of the results of observation to definite ends 
constitutes an art. The explanation of those results, 
i. e., the act of bringing them under some general law 
or principle, is a function of science. But whether 
science explains or fails to explain the art, the art is 
neither more nor less perfect as an art, any more than 
the eye was less perfect than now in its power of seeing 
9 before the structure of the organ or the laws of optics 
were discovered. Art is inherent in the nature of things 
and in man’s mental constitution. Science is an artificial 
method designed to generalize the results of observation 
and experience. There was an art of painting and of 
sculpture before the laws of proportion and color were 
understood; and it need hardly be added that if Michael 
Angelo and Titian rivalled Phidias and Appelles, it was 
not because the former were better acquainted with the 
laws of proportion and harmony in form and color. 
There was an art of rhetoric before the laws of language 
were discovered; an art, and a science too, of chemistry 
before the atomic theory was invented; and there was 
a culinary art, and is at this day, which in its perfection 
makes ridiculous the laws that chemistry and physi- 
ology have promulgated for its government. There is 
also an art of medicine which no less completely eludes, 
or as flatly contradicts science, by means of empirical 
facts, and gives the palm to sagacity and common sense 
over laws formulated by experiment, and proclaimed 
with the conviction and imposing solemnity of a new 
delivery of the decalogue. 
I do not make this attempt to show you whereabouts 
lie the quicksands that may engulf your most cherished 
hopes, and the rocks upon which they may be dashed, 
without knowing how prone the youthful mind is to be 
led astray by false lights, and how confident it feels of 
passing safely across the dangerous period of life. Un- 
fortunately, the danger is either not seen at all, or is not 
regarded as danger, and the self-deceived physician, 
unconscious of his error, becomes an example, instead 
of a warning. But my object is not so much to con- 
vince your judgment, as to lead you to pursue studies 
that will lessen the risk of your falling into error. My 
plea for medical history is to induce you to examine it 
for yourself, being persuaded that you will learn from it 
that the unity and continuity of medical art have been 11 
maintained, not by theories of disease and of medicinal 
action, that have chased one another like jack-o’-lan- 
terns along the road of time, but by the facts of obser- 
vation honestly and laboriously accumulated from the 
beginning until now. This was the theme of a lecture 
that I delivered nearly forty years'ago, and all these 
years of experience and study have so confirmed me in 
its truth that now, in this, my last public utterance, I 
cannot refrain from handing it over to you as the sum 
and substance of my teaching and the best legacy I 
can bequeath to all my pupils. 
Nearly half a century ago, I was about to emerge, as 
some of you are now, from the chrysalis state of under- 
graduate. Surply, no butterfly sees the world brighter 
before it than this fledgling of medicine. How radiant 
and fearless is the spirit of youth when we stand upon 
the hill-top of hope, and seem to embrace the universe 
in our horizon. The freshness of the morning is in our 
limbs; the heart’s fountain gives out only pure waters; 
our eyes glow as we turn eagerly to the rising sun, and 
“From mount to mount through Cloudland, gorgeous 
land !” we behold the peaks that we feel predestined to 
surmount. Upon the mist that veils the sun from us 
(and we thrill as we behold it) is projected a living 
picture of ourselves, but of gigantic proportions; and as 
we salute in it the prophetic image of our future great- 
ness, it seems to return the salutation with the “ All 
hail! that shall be king hereafter !” .... But the sun 
has risen to high noon; it has long ago dispelled the 
mist and its delusive phantoms; we have been way- 
farers on the highway of life, foot-sore and weary, and 
perhaps soiled by its dust; possibly we may have been 
carried forwards in luxurious chariots ; but never, never, 
we may be sure, have we gained possession of that 
estate in Cloudland which to our youthful eyes seemed 
so sure an inheritance. Even if we seized the golden 
apples, and for their possession overcame as fearful 12 
foes as the dragons that watched the garden of the 
Hesperides, too often we have left behind us the appe- 
tite that made us covet them, and they seem to turn 
to ashes on our lips. 
Professional life, like every other, is a life of mingled 
joy and sorrow, of success and failure, of rewards and 
disappointments. The vastness and variety of the 
numerous departments of medicine, the nobleness and 
beneficence of its aims, fill the student who is worthy to 
pursue it, with perpetual admiration ; and, as he masters 
each new field of research, inspires him with an enthu- 
siasm which hardly any other study is so well fitted to 
excite. His confidence increases as he proceeds, and 
he is so sure of success that he can scarcely repress a 
feeling of pity not unmixed with contempt for the 
veterans who have grown gray in the practice of their 
art, and who have, perhaps, little reward to show for 
their long and faithful service but honorable scars and 
a premature old age, and who often lack even that re- 
tiring pension granted by their country to soldiers whose 
ambition and business it is to destroy life and not to 
save it. The proverb tells us that “the first step is 
always the most difficult,” but the young physician 
takes that step with braced sinews and a heart swelling 
with hope. It is the steps that follow which cost, when 
his disillusion has begun, and when he perceives that 
the theories which promised to form so sure a foundation 
for his practice have played him false. “ Like little 
wanton boys that swim on bladders—but far beyond 
his depth,” his “high-blown pride” at length breaks 
under him, and leaves him “ weary and old with service, 
to the mercy of a rude stream that must forever hide 
him.” Of all the splendid apparatus of science on 
which he staked his hopes, none does its work any 
longer, nor produces to good purpose, save only that 
which is moved by powers he had learned almost to despise, the authority of experience and the genius of 
common sense. 
But, you will object, although the young cannot ex- 
pect to possess the wisdom, the caution, the balanced 
judgment of the old, are their faith, hope, and en- 
thusiasm to count for nothing ? By no means. Wisdom 
is the fruit of a prudent man’s experience, but faith and 
its attendant sentiments spring up in the virgin soul of 
youth, and shame on the hand that would blight or 
crush them ! But it is none the less true that they who 
have learned life’s lesson are bound to save from self- 
deception those who have it still to learn, and as far as 
possible warn them of the errors and pitfalls in which 
so many have seen their hopes perish. Surely the 
voyage of life will be neither less secure nor less pleas- 
ant if made with a chart that marks the places where 
storms occur, or shoals lie in wait for the unwary, and 
which shows at the end no El Dorado of the imagina- 
tion but the homely haven where peace and honor 
dwell. Of all who hear me now, not one whose life is 
spared need fail of that attainment. Only two things 
are essential, to live uprightly and to be wisely indus- 
trious. Whoever does these things need not fear the 
future. If he become successful, eminent, famous, to 
them he must owe his success. If he remain poor, 
humble, and obscure, his clear conscience will stand 
him instead of much riches, and perhaps make his 
home all the sweeter for its homely virtues. These 
thoughts remind me that the physician belongs to a 
much larger family than is sheltered by the domestic 
roof, and to which he is bound by the strong, yet tender 
ties created not only by a common training, but by the 
constant and reciprocal interests of professional life. It 
is sometimes asked why the medical profession alone 
should require a code of ethics for the regulation of its 
conduct ? The question is not without the flavor of a 
sneer, and implies that there must be something pecu- 14 
liarly perverting in the science of medicine, or corrupt- 
ing in its practice which renders necessary so formal a 
statement of its moral duties. Let us consider the 
matter. 
The moral government of mankind has never been en- 
trusted to merely abstract propositions. The most ancient 
of moral codes, the Decalogue, maintains its authority 
unbroken by thousands of years. Their sum and sub- 
stance are embodied in the two simple precepts of the 
founder of Christianity, and yet the former was ex- 
pounded by Moses and his successors into an elaborate 
system of law, was adopted into Christianity, and thence 
by all the civilized nations of the world, until it has inter- 
fused the legislation under which we live at the present 
day, and not the legislation only but the usages of society 
in all ages. Wherever law reigned men who were simi- 
larly employed were drawn together into guilds and 
societies for the common benefit of their members, and 
in each statutes were enacted which enforced compli- 
ance with them by heavy penalties. Even among trades 
ethical rules existed, and when the learned professions 
were gathered into their respective colleges or faculties 
the privileges and rights of the members were counter- 
balanced by laws for the regulation of their conduct. 
The clergy alone were destitute of any specific ethical 
code, because they were held to be especially under the 
divine law from which all other codes emanated, and 
yet every religious community, of whatever denomina- 
tion, possessed, and still possesses, special rules of con- 
duct by which its members must be governed. The 
necessity of ethical codes arises from the fact every- 
where and always recognized, that either through 
lack of instruction, or through a defective or perverted 
moral sense, or through mere heedlessness, men do fail 
more or less to conform their conduct to justice and 
equity. 
If men were habitually virtuous and just, unselfish and generous, if they could always see themselves as 
others see them, and judge their own motives and ac- 
tions as strictly as they judge of other men’s, then, in- 
deed, there would be but little need for ethical or religious 
laws, for “they that are whole need not a physician.” 
But law is nature’s medicine for nature’s defects and 
errors. Whoever imagines that he needs it not, that he 
possesses an inner light that will prevent his feet from 
straying into the paths of error and enable him to de- 
cide justly in every conjuncture of life, is more to be 
wondered at for his boldness than admired for his 
modesty, for he lifts himself into a judgment seat where 
even Solomon did not dare to sit. 
I have said that the relations of a physician to his 
brethren and to society differ widely from those of other 
professional men, and, indeed, of all other men what- 
ever. The emulation and rivalry of clergymen and 
lawyers are, for the most part, displayed before the eyes 
of the world, so that there is no special opportunity for 
an evil-minded man of either profession to back-bite or 
malign his brethren. Moreover, he knows that if he 
offends in this manner, the court may affix a stigma to 
his name, or the religious body, or the superior, upon 
whom he depends, may ruin him by an ecclesiastical 
condemnation. In the medical profession there is no 
tribunal which is under such imperative obligations to 
act, or enforce its decisions so rigidly. Hence, one 
necessity of a code of ethics. But another, already 
implied, is even more cogent. The physician is the 
only human being who is habitually admitted behind 
the scenes of life’s stage. He is the depository of 
secrets to which even a confessor’s ear is a stranger— 
secrets on which station, honor, and life itself may de- 
pend ; and, even when not so burdened, he is more 
than anyone else the confidant and friend of those 
whose diseases he has healed. He is often the guardian 
of families that put their trust in him. Is it any wonder, 16 
therefore, that he should be jealous of the intrusion of a 
rival, or even of a friend, upon his preserves, and that, 
the evil of human nature aiding, the rival should en- 
deavor to supplant him, and that thereout coldness, 
estrangement, animosity, evil speaking, and ill treat- 
ment should arise ? Or is it surprising that the very 
confidential relations of a physician to his patient 
should expose him to the temptation to do wrong, and 
that he should, therefore, be warned by written laws of 
the danger he incurs ? 
These are the grounds out of which the ethical prin- 
ciples of the British and the code of the American 
medical profession grew, and which inspired the works 
of French and German writers on the same subject. 
They are the principles of honor, morality, and what- 
ever is best in modern civilization, and, therefore, 
should be had in respect by all. It is a sign of deca- 
dence in the American social and medical systems that 
such laws are treated as obsolete or superfluous, and 
sneered at as fit only for children in leading-strings. 
Let me, as the parting counsel of one not without expe- 
rience of life, adjure you to hold fast to this rock of 
safety, and, far from aiding to abrogate it, to strengthen 
and perpetuate it by every means in your power. 
Impatience of authority and restraint has, perhaps, a 
deeper source than I have yet indicated. Its most con- 
spicuous and violent outbreak occurred in France a 
century ago, and for a time covered the country with 
ruins steeped in blood. In our own day, the rebellion 
against law, if less sanguinary and destructive, is not 
less vehement, and is far more extended. Its name is 
Nihilism, and its creed is the denial of whatever has 
been known as religion, a hatred of all the virtues that 
are the fruit of faith, and a contempt of the obligations 
imposed by law. It tends to rob man of trust in what- 
ever has been loved or respected in religion, in law, in 
the love and authority of parents, in the affection and 17 
obedience of children, in virtue, in duty, in honor, and 
in the established order of things that links the present 
to the past and to the future, making it the offspring of 
the one and the parent of the other. 
If it were possible for this egoistic materialism to en- 
dure and prevail, the winter of humanity would indeed 
be near at hand, in which all signs of life, all progress 
and development, all beauty and nobility would be 
frozen out of it, and mankind would be reduced to a 
lower moral level than the beasts of the field. A world 
without faith ! A world without love ! As easy were it 
to conceive of a world without light or heat. In such a 
chaos what would become of all those institutions that 
have been established, perfected, and reverenced by 
advancing civilization ? Conceive, for a moment, a 
community where no song of bell nor inward voice 
called to worship ; where justice had become deaf as 
well as blind, because every man claimed to be a law 
unto himself; where there was no balm to soothe, no 
physician to cure, no right of property, no sacredness of 
person, where, in a word, mankind had lost whatever 
has hitherto distinguished humanity. If you can im- 
agine such a herd of human beings — for it will no 
longer be a society or a community—you may behold 
in it a picture of the one that will assuredly arise if 
these nihilistic doctrines, this worship of self, this scorn 
of faith, this contempt of the past and exaltation of the 
present should prevail. 
Let me plead with you to shun these poisonous prin- 
ciples which tend to the destruction of all that has been 
held noblest and best by the wise and good of every 
age ; principles which put farther asunder the nations, 
communities, and individuals whom the physical im- 
provements of the age should bind together and at last 
fuse into one. Faith is the parent and preserver of all 
good works. Unbelief, like Saturn, devours its own 
children. Faith is to man’s nature what sunlight is to 18 
the world, clothing it with beauty and life; while un- 
belief is like the moon, in which the sun’s rays create 
neither motion nor color, but fall forever upon its lifeless 
orb. Without faith, man’s ambition is but narrow self- 
ishness, contemptuous of the historic past on which it is 
compelled to build, and careless of what evil germs it 
may plant to be developed in the future. The higher a 
man rises in his humanity, the more clearly does he feel 
himself to be a link between the past and the future ; 
the more fully recognize that what he has received that 
also must he transmit, increased, perfected, and conse- 
crated by that spirit of love for humanity without which 
“ good gifts wax poor.” 
It has again and again been said, of old and in our 
own day, that the physician’s office is a priesthood, a 
service of the divine for the sake of the human. It does 
not exist for the discussion of scientific problems, except 
in so far as they relate to the prevention and cure of 
disease. Whatever is contrary to this may be science, 
but it is not medicine, and he who practises medicine in 
an exclusively scientific spirit very soon divorces his 
affection from his life’s work, and leaves it barren, 
spiritless, and unsatisfying. No man can become a 
great physician whose heart is not in his work at least as 
much as his intellect. It is a work of charity and love, 
of self-denial and long suffering, and yet, like all work 
that crushes down the selfishness of the human heart, 
its rewards are beyond price, and can be understood 
only by him who receives them. Many of you have 
heard of the great anatomist Vesalius, and seen the 
print that illustrates the devout spirit with which he 
pursued his immortal investigations even under the ban 
of religious persecution. By such a spirit ought we all 
to be guided and controlled, never divorcing from 
science and art the divine sentiment of their brother- 
hood to one another and to every human being that 
needs the succor of our skill. 19 
Other subjects there are, besides those I have caused 
to pass so rapidly before you that I may well fear they 
will leave but an indistinct impression, subjects hardly 
less urgent for consideration—but I must hasten to bring 
this, our last public interview, to a close. Looking 
back over the score of years which divides the beginning 
from the end of my professorial career in the Univer- 
sity, and comparing the classes of the one period with 
those of the other, I cannot avoid recognizing the 
steadily improving culture of the students I have had 
the pleasure of addressing, and that during the later 
years of my experience the classes have been much 
more receptive of knowledge and far better able to ap- 
preciate it than their predecessors. In former times, 
after the examination of certain candidates for the 
degree, I have felt my spirit sink under the thought that 
they were to be entrusted with the care of health and 
life. I did not blame them, I pitied them ; but I did 
blame and utterly condemn the system which introduced 
such persons into the medical profession. You have 
lived under a different dispensation; and during the 
years that it has been established, I have been spared 
the pain and the shame which were once the heaviest 
burdens of my office. I have enjoyed the satisfaction of 
seeing reflected in your faces an intelligent and inter- 
ested appreciation of what it had become a pleasure to 
teach. This sympathy with my audience has been the 
sharpest spur to my endeavors to be worthy both of my 
subject and of them. I have felt that in emphasizing 
and reiterating certain views and precepts I was teach- 
ing a lesson not to be learned by rote, but that would 
sink deep and always remain in the retentive minds of 
my hearers. Never before did I feel so strongly 
impressed with the dignity as well as the responsibility 
of the teacher of medicine. And hence it is that, stand- 
ing now upon the further verge of my professorial 
career, I can bid it farewell with a cheerful and con- 20 
tented spirit, satisfied that in the future those who may- 
hold this Chair will be still more worthy teachers, and 
that your successors will be still more accomplished 
students. 
To those who have followed my lectures, I return my 
heartfelt thanks for their great courtesy and considera- 
tion, and, above all, for that interested attention which 
is the best evidence a teacher can receive that his labor 
is not in vain. To you, to all who hear me, I offer my 
most earnest wishes for your success in life, bidding you 
to love mankind, to love your profession, and, above all, 
to LOVE TRUTH.