UNITED STATES OF AMERICA
VIE B/
*  *
FOUNDED 1836
WAS  HINGTON,  DC. 
 
 
   DR. COGSWELL'S ADDRESS




             TO THE





         CANDIDATES




              FOR






  DEGREES AND LICENSES,




             IN THE





MEDICAL INSTITUTION OF YALE COLLEGE,




        JANUARY, 2 1-, 18 46. 
 
             THE

     ANNUAL ADDRESS

             TO THE

        CANDIDATES
              FOR

  DEGREES AND LICENSES,

             IN TUE

MEDICAL  INSTITUTION  OF YALE COLLEGE,

        JANUARY 21 , 1846,
BY WILLIAM H. COGSWELL, M. D.
  MEMBER OF THE BOARD OF EXAMINERS.
     NEW HAVEN:
PRINTED BY W. H. STANLEY.
       1846. 
 
ADDRESS.
  From an early age of the world to the present time, there has
ever been set apart  a class of men, whose appropriate business
and duty it was to watch over and guard the public health ; and
although in the earlier days of man's existence, they were with-
out education, they nevertheless occupied a commanding posi-
tion in society, possessed a powerful influence, and did much in
forming the character of the community in which they lived.  It
was believed that whatever skill they possessed was by virtue of
a peculiar gift, and that by this gift, a few charmed drugs, and cer-
tain  incantations, they wielded a  superhuman power over life
and death, and hence they were regarded as public benefactors.
The  untutored savage of North America, even at this day, has
his " medicine man," who is  believed to possess  this peculiar
gift, is regarded, with a kind of superstitious veneration, as a being
superior to those around him, is consulted on all occasions, and
exerts  a mighty  influence on the  tribe to which he belongs.
Long since, however, in all civilized nations, has  the  power  to
heal  diseases ceased  to be considered as a gift, but is acknowl-
edged to be an acquirement—an acquirement of the highest or-
der—one  that has engaged  the best energies of some  of the
noblest minds the world has ever produced.  As civilization and
the refinement of society  advance, more and  more by way of
acquirement is demanded of him who offers himself to the pub-
-4&'U63^ 
4
 lie as a physician.   He"must have a full stock of general learn-
 ing, and  his professional education must be complete ; he  must
 have spent long years in arduous study and patient investigation,
 with private and  public  teachers of acknowledged merit, and
 pass the ordeal of a rigid examination, before he will be received
 bv the public as one duly qualified to discharge the manifold du-
 ties of his profession.
   Now,  gentlemen, as you offer yourselves as candidates for
 the honors of this  time honored  Institution, it is  to be inferred
 that you  are thus prepared, that you have complied with all the
 forms of  study, and will be found duly qualified for  admission
 into the medical family.   This is an era in your lives of intense
 interest.  Your relations to society are now about to be chang-
 ed.  You have thus far been the recipients only,  of favors and
 benefits ;  all that anxious parents, kind friends and faithful teach-
 ers could  do to qualify you to enter, honorably, one of the learn-
 ed professions,  has been done ; the vast store of medical learning
 has been  thrown open for your  improvement; and if you on
 your part have been zealous, industrious and faithful students, we
 are bound to believe that you are fully prepared for this change
 in your relations to  those around you.  Thus far in your life all
 has been sun shine ; you have had the approving smile of friends,
 and the companionship of your fellow students, with a generous
 emulation among yourselves, to cheer  you on in the pursuit
 of your studies, and make your  task easy  and your  burden
 light.  But the halcyon days of your pilgrimage are now past,
 and you are about to enter  upon the sober realities  of profes-
 sional life.   You are about to take upon yourselves new duties,
 new and weighty responsibilities,  to which you have hitherto
 been strangers.  You are now to  become dispensers of good,
guardians  of the public health, and are to  render your  services
to a society, of whose real character you must, in a great meas-
ure at least, be ignorant.   You have yet seen little of man, save
his fair exterior, and are ill  qualified to judge of the  heart by
what appears on the outside.   A few years in the practice of 
5
 your profession will enable you to see man as he is, and to judge
 of his true character.   The profession  you have chosen is one
 full of perplexity, toil and anxiety; it has too, its bright  spots;
 it may and will at times afford you a higher  degree of satisfac-
 tion, than any other profession or calling  in which the physical
 and mental energies of man can be enlisted.
   You are not to suppose that you will  be exempt from disap-
 pointments and discouragements ; they  are the common  lot of
 man, and to no class of men  are  they  so common, as  to  the
 young men in our profession.   You will serve a capricious and
 ungrateful public,  who know little  how to appreciate  your
 worth, your  labors, your anxieties and  your responsibilities.
 You will often find your best  efforts and  your severest  labors
 repaid with coldness, neglect,  and ingratitude.
   You  commence your professional labors  at an age  of the
 world when quackery overspreads the land, and pervades every
 class of community.  Turn  which way you will, nostrums, pan-
 aceas and catholicons  will  stare you in the face, and  often you
 will find your best exertions thwarted by  the stealthy  introduc-
 tion of some  secret medicine; and if perchance  you shall be
 so fortunate as to rescue from impending death, in the  hands
 of some bold empiric, any quack-loving patient, and restore him
 again to health, be not disappointed if, when he shall no longer
 need your aid, he turns his  back upon you, pays  your reasona-
 ble bills grudgingly, or not all, and again goes forth to herald the
 praises of quackery.   It will  be the part of wisdom to bear all
 these things with  patience and an unruffled temper.  If you suf-
 fer your equanimity to be so far disturbed, as to betray you into
 a noisy  controversy with empiricism, you will find yourselves
 warring with an intangible and soulless foe, that has nothing to
 lose ; and if victory  perches upon your standard, it will be with-
out its laurels.  If this love of the marvelous, this belief  in the
existence of a universal remedy, was confined  to the  low and
the  vulgar, there  would be less cause to blush for the  inconsis-
tency and credulity of man; hut unhappily such is not the case. 
6
There may be  found  learned counsellors  and eloquent divines,
who would denounce all irregularity in every thing but in med-
icine, who are as ready to lend their names  and their influence
to give currency to the nostrums of the day, as any other class
of the community.  It is  but reasonable, when faithful  service
has been rendered, and the sick healed,  to expect  a reward, at
least of gratitude ; but in this you will often be disappointed, and
instead thereof, find yourselves repaid with  neglect, your mo-
tives called in question, and pecuniary compensation denied, or
paid only by  compulsion.  But be not alarmed or discouraged,
for you are only treading the path of those who  have gone  be-
fore you in the profession.
   I have presented some  of the  dark features in the life of a
physician, and  there are many others yet untold;  but  there is a
counterpoise  for them  all—there are brighter spots in  this dark
picture.  The  faithful and  skillful  practitioner  receives  daily
compensation,  of which the ingratitude or caprice of men can-
not deprive him,  in the proud consciousness of discharging his
duty to his fellow men, in the spirit of our Saviour's golden rule,
" to do unto others as  we would that others should do unto us.''
There are other modes by  which he receives a compensation as
he goes along.   To a  mind that has been disciplined by thorough
education and habits of industry,  there is no greater enjoyment
than may be  derived from close study, patient investigation and
critical  observation, and more especially when research has for
its object some great and practical good.
   To become rich by your profession you need not ordinarily ex-
pect.  Few  of our profession have ever accumulated great es-
tates ; and here let me say to you, if you are impelled to action
by no higher or better motives than the love of lucre,  you have
sadly mistaken your  calling, for  there is scarcely any trade or
business that will not, with equal exertion and capital, yield a bet-
ter pecuniary reward.  If the holy flame of charity  and pure
benevolence  is burning brightly  in your bosoms, pecuniary re-
ward will be a remote and contingent object.   You will derive 
7
 much greater satisfaction from your mental employment, and in
 doing good to those around you ;  the principle of " good will to
 men,"  will become a prominent feature in your character,  will
 sink deep in your  hearts, and take possession  of your inmost
 soul.   You will in your business be likely to find full scope for
 the exercise  of the principle of benevolence ; for  no class of
 men are called upon and expected to perform  so much service,
 without  the  hope  of pecuniary  reward,  as  physicians.  The
 poor we have with us always ; and from  their  destitute condi-
 tion, from the  want of the  many comforts and necessaries of
 life enjoyed by the more fortunate, and from their greater expo-
 sure to_the inclemencies of the seasons,  they become peculiarly
 a prey to disease.   In this condition they have strong and urgent
 claims upon  our sympathy and  charity,  and we are morally
 bound to render them that service, which they cannot ask or
 expect to receive at the hands of any other class of  their fellow
 men.  I do not mention this because I consider it a tax or a bur-
 den, but to warn you of what you may expect to meet in your
 profession, and to exhort you to discharge this part of your duty
 cheerfully, and with the strictest fidelity.  This service, viewed
 in its  proper light, instead of being  a burden, is a favor; for
 your reward, in gratitude and blessings, will  be greater than
 you are accustomed to derive  from  any other  service,  or
 to receive from  any  other  quarter.  You  will also  derive
 greater  satisfaction from  the reflection  that  you  have  dis-
 charged  your whole  duty toward this worthy but unfortunate
 class of your fellow men,  and that without the hope or  ex-
 pectation of  pecuniary reward.  You will too have your re-
 ward in that satisfaction that is sure to flow from an approving
 conscience, and you may  look with confidence  for the smiles
 of Heaven—for,  " inasmuch as you have done it  unto  the
least of these,  you have done it unto me."  Then  let benev-
olence  be a  prominent  feature in your character as physicians
and as men. 
8
  To become extensively useful, it is all important to the physi-
cian, and to those with whom  his destinies are linked, that he
possess a character for influence, and that this influence be exer-
cised in a spirit of benevolent humanity, for the well being of all
who may come within its reach.  The forming of your charac-
ter is  peculiarly your own work, it cannot be done  by another.
Although the profession is stripped  of the mystery in which it
was formerly shrouded, and he  who practices it is not  supposed
to possess any super-human power, yet the position he occupies
in society is such as to give him a commanding influence, an in-
fluence that may and will be exerted for the weal or woe of that
people with whom providence  shall cast  his lot.   The good
man and the skillful physician cannot possess too much weight of
character, too much influence with his fellow men.  If he would
possess this quality of character in an  eminent degree, he must
acquire a perfect self-control, a stern and imperturbable  equanim-
ity of temper, never suffering himself to be thrown off his guard,
never losing his balance, let what will come.
  The maintenance of becoming dignity will also contribute
largely to this end.   Independence, properly tempered, discrete-
ly and judiciously exercised, together  with a firmness, rarely if
ever called to his aid  in matters  of little moment, and  never
yielding  in matters of importance, but to the voice of sound
reason and convincing argument, will also give him a desirable
consequence with his fellow men.  Added to the above conside-
rations, an  affable, easy, amiable and  gentlemanly  deportment,
together with the  advantages derived from his position in soci-
ety, and his daily intercourse  with all  classes   of community,
will be sure to clothe the physician with all the influence he can
desire to enjoy.
   Thus armed with a control over your own acts,  and over the
acts of others,  you will have  committed to your charge the
power to  do  much good  or evil; and let me remind you, my
young brethren,  that you will be held to a strict accountability
for the manner in which you use this power, or this talent, com- 
9
mitted to your keeping.   You must answer for it at the unerring
tribunal of public opinion, and there will rest on you a still more
fearful accountability to Him who has conferred on you the
power.
  It is an error very common to young men entering upon  our
profession, to believe that they have acquired knowledge enough
—enough for every  exigency; that they  have a plaster for
every sore, a remedy for every disease that flesh is heir to;  that
they are fully armed and equipped to combat  disease in all its
forms, and even to wage a  successful war with the king  of ter-
rors.   If this shall happen to be your case, you will soon find that
you have over-estimated your powers; that diseases will  not al-
ways as readily retire at your approach as you may anticipate,
or desire, but that they  will often resist the most skillful applica-
tion of any and all the remedies you may possess.   You  will
often find your best  efforts powerless, and death will irrevocably
fix  his  seal upon the  lips of your patient.  It is here, perhaps,
that you may first become sensible that your stock of profession-
al learning is yet imperfect, and first see the importance of ex-
tending your researches, and adding constantly to your resources.
If you would be respectable practitioners  through life, you will
find it indispensable that you devote a portion of your  time to
reading, not only medicine as it was, but medicine as  it  is—
possessing yourself of all the discoveries and improvements of
the age in which you live.   If you would be eminent  in your
profession, you must cultivate a love for it; the various duties
of study and practice  must be performed with a cheerful and
hearty good will; for if these duties are performed of necessity t
not from choice, it will  all be an up-hill business, and you  will
never  reach  the goal of your ambition.  If you would be  emi-
nent, you must  bear in  mind that you have  merely begun your
mental training, that you have only learned the first principles
of medicine,  that you  have  just  stepped upon the  threshold
of the science,  and  that to insure  success  in your undertaking,
you need a steady and untiring perseverance.
            •                 2 
id
  All may attain to a certain degree of eminence:  and this is of
the utmost importance to you; for the eminent physician has de-
cided advantao-es.   Business seeks and finds him ;  his  services
are acknowledged  to be valuable ;  and in rendering them he is
considered as conferring a favor, and from this circumstance he
is better remunerated.  The moderate man, on the contrary, has
to seek business, and is not always successful in finding it ;  while
the employer considers that  he confers a favor when  he gives
business to the man who stands at or below mediocrity, whether
he pays him or not.  Then  to acquire a  full  stock of medical
knowledge, and some degree of professional eminence, is a duty
you owe to  yourselves,  no less  than to  the community  over
whose health you may be called to preside.
  Another error to which young men are  particularly prone, in-
volving a greater  degree of moral obliquity than the last, is in
the comparative estimate which they put upon thdr own abilities
and  acquirements—often thinking and speaking diminutively of
others, for the purpose of giving to themselves  a higher compar-
ative standing, a greater relative consequence.  On this point I
would advise that you tread lightly upon the ashes of the illustri-
ous  dead of our profession, and that you compare yourselves
with all becoming modesty with the living; never arrogating to
yourselves a greater share of astuteness, skill, and medical sci-
ence, than you are willing to accord to others  equally  meritori-
ous.   I have often thought  that too little respect  was paid to
the  memory of the pioneers in the healing art; that  too light
an estimate  was put upon their professional labors  and charac-
ter.   Much  that has been taught to you was once their property,
and by them used in behalf of suffering humanity.  They took
medicine from a mere  juggling art, and erected out of iLa re-
spectable science.   They laid out the way, and cleared on  the
rubbish, by  which you now  enjoy  smooth roads to professional
eminence.   Although they  were destitute of the opportunities
and privileges which we enjoy;  although they had to contend
against popular prejudice, and labored under  manifold embar-
4 
11
 rassments; still their zeal  was  ardent, their industry untiring
 and their benevolence unbounded.   They had few facts in med-
 icine from  which  to  reason ;  but they made the most of the
 light they possessed, established  many new  facts,  and added
 them to the scanty list;  did much by way of exploring the vast,
 and till then unknown field of medical science;  made  manv
 and valuable discoveries, and erected many  landmarks to warn
 their successors of lurking dangers, and direct them in the path
 of safety.   But the chart is yet imperfect,  much of it is blank,
 and remains to be  filled  up.  This is  appropriately your work ;
 and if you shall, in your day and generation, do as much  to ele-
 vate the science, as much for the cause of benevolence and hu-
 manity, as they have done, you will  have  no -cause to  blush
 when your past life shall  come up in review before you.
   In respect to the living, I would  recommend that you take
 good care to secure to yourselves the good will, and thereby the
 good offices, of your senior brethren.   They have the power to
 do you good, and you will often stand in need  of their counte-
 nance and kind offices ;  you will often want to divide with them
 responsibilities  greater than  you can bear with safety to your
 own character.   Then seek a  frank,  free, generous  and manly
 intercourse  with  them, and court their friendship,  to secure
 which nothing is necessary but to extend xo them that courtesy
 and confidence to which  they are entitled at  your hands ; never
 harboring jealousies, and  never practicing any of those little pal-
 try arts and tricks, which have so often been practiced by un-
 worthy brethren,  to supplant  those whose characters and servi-
 ces  might seem to  stand in  their  way.   I will not  here
 attempt to enumerate all the little meannesses that may be, and
 often have been, practiced for mischievous and wicked purposes,
 for they are legion,  and will full readily enough suggest them-
 selves to your consideration as you go along.  I have adverted
 to them only to warn you against calling them to your aid; to
 warn you, that although they may at times seem to give you an
advantage, and exalt your reputation—as you live, an advantage 
12
thus gained will be temporary, and a reputation  thus  acquired
will  be evanescent as a dream, involving you in lasting disgrace,
and leaving you to reap a bitter harvest in the scorn  and con-
tempt of every honorable brother.  Then  let your intercourse
with your  brethren  be high minded and honorable, for " such
measure as you mete," will be sure one day to be " measured
to you again."
   Yet another besetting infirmity of young men is an inordinate
thirst for civil honors.  I would advise  that you plunge not too
deeply into the political strifes of the day.  By this, however, I
do not  mean  that you shall decline to exercise your political
rights;  for the man who would, through weakness of character,
pursue this groveling  course, or from avarice would barter his
invaluable  rights for lucre, and  thus  disfranchise himself, will
be sure to call down upon his head the well merited contempt of
all political parties, and of every independent and honorable man.
I would advise rather,  that you thoroughly and carefully exam-
ine all the great  questions that divide the great political parties of
the day—all the great questions of national and state policy and
government,  and then  go  forth to the discharge of your duties,
and the exercise of your political privileges, fearlessly, independ-
ently, and in  the spirit  and bearing of full  grown men.   Thus
you  will avoid the charge of extreme weakness and pusillanimity
on the one hand, and  all  acrimony and partizan bitterness on
the other—commanding the respect of all.   Be not active par-
tizans.  Seek not the honors that may flow from civil distinctions,
for they are inconsistent with a faithful discharge  of your duties
as physicians;  but seek rather those  honors  which flow from
professional and moral excellence.
   A mistake which young men sometimes make, and will always
make if they yield to  the  temptations which beset them, is in
seeking, courting, and preferring the  applause  of the  public,
rather than that of their  medical brethren.  If this should hap-
pen to be your case, you will find too late, that in so doing you
have committed an error, of which you will in later life bitterly 
13
repent.   The applause of the public may give you bread, but
without the esteem  and  respect of your brethren it will not be
likely to give you bread all the days of your life.   If you are
talented men and able physicians, your inclination and  interest
will lead you to a free and friendly intercourse with your profess-
ional brethren—will lead you to prefer the good opinions of the
medical family, to the applause of those out of it, for they only
are capable of duly  appreciating your merit, and of doing you
lasting honor.
  Again, be not over anxious to commence business with an ex-
tensive practice,  and a popular reputation.   It is better that you
begin with a small practice, and study, examine, compare,  and in-
vestigate thoroughly what  few cases you may have, and fix in
your minds sound principles of practice.   There is such a thing as
a young man's having more business than he can do justice  to, and
more reputation  than he can sustain.  When this happens, the
sick must necessarily suffer, while the physician must most inev-
itably fall.  Be satisfied then,  first to creep, then to walk, and
when with the superstructure of  a  substantial reputation, you
shall  have laid  your  road  to professional distinction, and ac-
cumulated enough of intellectual power, you may  put  on the
steam, if you please, with little danger of being thrown from the
track.
  I congratulate  you, gentlemen, that you enter  upon business
at a time when you will  be beset  by fewer temptations to the
vice of intemperance, than were your predecessors.   Formerly,
when the free use of intoxicating drinks was fashionable, even in
the best circles, the medical man in full practice was peculiarly
tempted to an excessive use of them, and I regret to say, he too
often yielded to the temptation, and became an inebriate.   I say
this not by way of reproach, for it is not surprising that so great
a proportion of the practitioners  of that  day became intempe-
rate ;  it is only strange that any escaped the foul embrace of the
merry god, for the  physician was a welcome  guest in  every
family, and must be treated to a little good cheer wherever busi- 
14
ness called him.   But thanks to the temperance reformation, the
tide of intemperance is  arrested  and rolled back.  A brighter
and a better day is dawning—this vice is now rendered unpopu-
lar, and physicians, as a body, are almost  uniformly consistent
temperance men, and are among  the most devoted, able and ef-
ficient advocates and supporters of the temperance cause.   The
time is past, I trust, never to return, when the moral sense of
the community will often be shocked by the sight of a tippling or
drunken doctor.   The time is past when a physician will be tol-
erated at the bed side, to puff into his patient's face the fumes
of alcoholic drink, or the still more disgusting garlic effluvia of
a drunkards breath.  None  are capable of  doing so much good
in this heaven born  cause—none  so potent  for evil, as the phy-
sician.  You will remember then, gentlemen,  that you will, in
some good degree, be responsible for the temperance character
of that, community with whom you shall take up your abode.  I
doubt not that you will esteem it no less a privilege than a duty
to enter the arena, and wage a war of extermination against this
fell destroyer and merciless foe of the human race.  The mon-
ster is scotched, but not yet killed.
  There are many other charitable, benevolent, and religious in-
stitutions, of a kindred character, that will claim your patronage
and your support.  In many of  them you will  be expected to
lead, rather  than  to follow.  If you have any  doubts as to the
extent of your  obligations,  daily  recourse to the  Scriptures of
truth will set you right, make your duties plain, and the discharge
of them a pleasure, rather than a burthen.   Make then the Bible
the man of  your council and the  meditation of you hearts—it
will guide you into  all truth, it will  never  mislead or  deceive
you.   A strict observance of its  holy precepts will fit and pre-
pare you for extensive and varied usefulness in this life, and se-
cure to you a blessed inheritance  in that which is to come.
  Go forth then, with cheerfulness and manly vigor, to the dis-
charge of your every professional, moral and  religious obliga-
tion, in the true spirit of philanthropy, in the spirit  of christians, 
15
and as good stewards who expect to render an account.   In con-
clusion, gentlemen, it is the earnest wish of him who addresses
you, that when you shall be compelled to surrender at discretion,
to the foe, against whom you shall have been long contending,
you may be able to look back upon a life devoted to the cause of
humanity, a life well  spent  in  the  cause of benevolence and
christian  charity, and  forward with full hope and confidence  to
a blessed immortality. 
 
 
 
 
NLM032035390