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  PURSUANT TO APPOINTMENT.




       BY HUGH L. HODGE, M. D.
     HONORARY MEMBER OF THE SOCIETY.
        February 15, 1823.


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PUBLISHED BY ORDER OF THE SOCIETY.
    •»   JESPER HARDING, PRINTER,
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   THE author of the following address yields
to the request of his friends and of the Medical
Society, for its publication, from a hope that the
views and principles maintained may be useful
to the profession.  As it was prepared  for an
audience composed chiefly of young men, can-
didates for the honours of medicine, and with
no idea of its  meeting the public eye,  it  is
hoped that due allowance will be made  for its
^tyle and manner. 
H> IB A VI® EN
Gentlemen of the Philadelphia Medical Society :
   Called by an unexpected and partial vote,  to
deliver  your annual address, I appear before you,
fully sensible of my incapacity to fulfil your reason-
able wishes.   The  appointment  has generally been
conferred on  my seniors in the profession;  men,
whose talents, whose observation, and whose expe-
rience, have usually qualified them to seize upon the
most  interesting and important occurrences of the
past year, and so to investigate,  illustrate,  and en-
force them, that truth has been elicited, science bene-
fited, and  our knowledge rendered  more accurate
and more extensive.
  The season which has elapsed, since we last as-
sembled for this purpose, has presented nothing very
new,  or very striking.  Our profession has advan-
ced steadily in the road of improvement;  much has
been achieved in overcoming error, and in elucida-
ting the principles of medicine:  but this has rather 
4
been the combined effect of many minor agents, than
the signal result of any great  undertaking to which
your attention might now be directed.
  Viewing, however, the state of the medical profes-
sion in the United States; beholding a very large pro-
portion of its members practising it merely as a trade;
as some art which requires no intellectual and no mo-
ral endowments and acquirements for its attainment
and its practice; perceiving, that th« high character,
the importance and the dignity .of medicine are sa-
crificed  at the shriues of ignorance and avarice; and
that candidates for its honours and its emoluments,
are multiplying in every direction, without any de-
finite ideas of the great intrinsic, as well as extrinsic
difficulties which they have to encounter; and espe-
cially, ignorant of the immense responsibility  which
they assume, as practitioners of our art; it appeared,
that I could not better occupy your time, or improve
my own,  than by attempting  to  pourtray,  however
feebly it may be, the importance and dignity of the sci-
ence of medicine; at the same time noticing some of
its difficulties and duties.
   Such an investigation will have a tendency to ex-
alt the  views of the medical student; to encourage in
the young practitioner a love  of his profession, and
an ardent ,desire to improve it; to the established phy-
sician,  it may afford fresh incitement to duty, and a
 delightful satisfaction, that his time, his talents, and
 his exertions have been devoted to an employment
 so exalted,  so truly ennobling; and in all, it may 
possibly serve to repress every selfish, every exclu-
sive feeling, to destroy every action, every thought,
derogatory to our  characters,  as men and as physi-
cians.
   To an audience, constituted like the present, it is
unnecessary to prove  the necessity of our science;
no one  here will be disposed to deny, that it is as
natural to demand relief from  pain, as it is to suffer:
that we are powerfully prompted to seek for, and to
employ remedies,  so  that  no individual, however
sceptical he may affect to be, while flourishing in un-
diminished health and  strength, can resist giving
practical evidence of his belief in our art, when dis-
ease has called him from the  pursuit of pleaspre,  of
business, or of knowledge, to  the bed of sickness,  or
to the couch of pain.  Were it demanded, additional
proofs  might be brought from  the instinct of animals,
from the customs of  uncivilized nations, from*the
 adaptation of the  productions of the field  and the fo-
 rest to the diseases of man;  independent of the va-
 rious instinctive propensities, by which he avoids all
 uncomfortable sensations and sedulously  labours for
 what will relieve.  While in health, men have, and
 will exclaim  against the unnatural methods, as they
 are termed, of  curing disease; forgetting, or rather
 ignorant, that each class of remedial agents has been
 indicated  and employed by nature.   It is the busi
 ness of the physician to know this; and while  he
 endeavours to improve, and even to perfect the means
 thus placed  in his power, let  him always remem 
u
 her, that the best lessons may be derived from study-
 ing the spontaneous indications of disease, and that
 the highest  and most difficult attainment of his art,
 is to know when he should abstain from doing.
   Believing, then,  that all will be prepared to ac-
 knowledge,  that the science of medicine is founded y
 in nature, and of course, that whether cultivated or
 not,  it  will be  practised,  it  becomes necessary to
 show the importance of improving it with attention,
 to exemplify  its dignified character, and the respect
 which should  be afforded to it, not only by its im-
 mediate votaries, but by the world at large.  Here,
 I could wish that the speaker should be forgotten ;
 for, while noticing what  is required of a great  pro-
fessional character,  much must be detailed to which
 be has no pretensions, and much with  which he is
 but very moderately endowed.
  The first circumstance which indicates the disni-
ty of  our profession, is  the talents required for its
pursuit.  It  no doubt has been  observed by every
one, that in  public estimation no mind is too feeble,
and no  talents too  contemptible for the student  of
medicine; and when a  young man can pursue no
other  liberal profession  with advantage or credit,
he is devoted to physic with the brightest hopes and
the fullest confidence.   But,  I am safe in declaring
that there is  no employment  which  requires more
strength of mind, a more enlarged understanding,
and more diversified talents, than the scieuce of me-
 licine. Here we are called upou to investigate every 
7
source of knowledge, to separate truth from ali the
false  theories, the partial statements, the distorted
facts which have been sanctioned by time and author-
ity, to pursue her amidst the rage of controversy, the
superstitions of the ignorant, and the subtilities of the
learned ; laying aside with the greatest self-denial,
all the influences of a warm imagination, all the sug-
gestions of a feeling heart, and all the prejudices
of an  ill-conducted education:  here we must often
decide, while the comfort, the happiness and the lives
of individuals hang  on  our decision, and await our
answer ; at the same time, doubts  and difficulties  of
the most distracting character are congregated around
us, while one moment of hesitation seals the ruin of
our reputation, the destiny of the patient and the hap-
piness of his friends.  What mind is sufficient for
these things ?  Do they not demand one, of the most
retentive memory, of the  nicest discrimination, and
of the quickest apprehension ?  one capable of em-
bracing, comprehending, and  of  acting  upon the
most abstruse, and the most  complicated  subjects ;
and above  all, a mind in which every feeling and
every  faculty are under the dominion of the most
unerring judgment.9 This last talent may be consi-
dered  essential  to a physician—by it I  mean the
power of  deciding  correctly  between  truth  and
error, and of  discriminating between circumstances
and facts,  which, to a  common  mind, present no
shades of difference.   To this should be added great
strength of mind, by which a physician can rely 
8
confidently on the dictates of his judgment, and can
commit all, with  a  safe, although an  anxious con-
science to the decisions of futurity.
  But, perhaps, I have not mentioned a talent more
important to  the  practitioner of medicine, than to a
member of any other profession, without which, he is
incapable of improving his art.   I allude to  what
is properly termed genius, or the  faculty of invent-
ing or discovering.
  In the pulpit and at the bar, there is comparatively
little demand for  what is new in itself  or new in its
application.  The divine and the barrister have their
respective standards, from which they must not wan-
der, and to which their arguments and their judgments
musti equally bend.—To  the law and to  the bible,
must be their ultimate appeal.  In illustrating  and
enforcing their dictates, various powers of  the  mind
are demanded, while learning,  eloquence, and  all
their graceful attendants afford a powerful and com-
manding assistance.
  But to become  merely a learned physician is, and
must be, of secondary importance.  All the learning
and all the knowledge which have been treasured
by  the observation, and the experience of  centuries,
cannot make a good practitioner.   As  a celebrated
divine has affirmed, a man must be born a physician;
that is, unless he is furnished by nature with an ori-
ginal inventive genius—with  a certain faculty  of
discovering the characteristic traits  of  disease,'and
of  adapting remedies to its cure,  he cannot practise 
9
medicine without dishonour to himself, and  without
detriment, perhaps destruction, to those  committed
to his care.
   This is not an exaggerated statement.   In our sci-
ence there is no standard;  our principles, although
many of them  good,  are not certain—we  have no
perfect theory to serve as a faithful guide—while on
every  side  there are difficulties  and dangers:  we
have to handle a machine of the most  delicate  and
complicated construction;  governed by  laws,  and
subject to derangements, with whose nature we have
a very slight acquaintance ;  derangements,  not uni-
form in different individuals, and similar under ap-
parently similar circumstances, but which are  al-
most universally complicated with each  other, and
are diversified  in  every constitution, and in every
climate.  We must employ medicines without know-
ing their  nature,  and whose effects are  constantly
modified by a thousand unknown causes, and at the
same time, we are  called upon to  act without study,
and without preparation.  To what can the medical
practitioner  resort  amidst the dangers of  his  sta-
tion ?  Where  will he discover the ariadne thread to
guide him from this labyrinth, more perplexing and
more dreadful than that of the Cretian tyrant? Where,
gentlemen, but in the resources of his  own genius,
improved by knowledge and directed by judgment?
   Perhaps 1 have  dwelt too long on this point, but
the subject is  important; for it  is the low opinion
entertained of medical talent, which  has  inundated
                       B 
10
our profession with the refuse of schools and colle-
ges ; which has degraded it in the eyes of the world ;
which has given character  to every ignorant preten-
der, to every undaunted,  impudent empyric,  and
brought even the utility of the  science into  serious
question and disrepute.
  For a moment,  however, glance over the history
of medicine; notice those  individuals whose names
are recorded with honour and reputation—dwell par-
ticularly on those who have  shone  as great  lumina-
ries in the  medical hemisphere.  Examine  the cha-
racters of Hippocrates, of Aristotle, of Celsus, of Ga-
len, of Vau Helmont, of Harvey,  of Sydenham, of
Boerhaave, of Cullen, of  Brown,  and of our own
pride, the never to be  forgotten Rush.   Were they
perfect ? Were they never blinded by prejudice, ne-
ver led away by imagination, nor their discrimina-
ting, and their powerful judgments turned aside by
all  powerful error ?   They have left records of the
weakness  of the human mind, and of its incapacity
to cope fully with  the difficulties of our exalted sci-
ence.  They have failed :  and shall therefore every
puny mind, every sickly soul be thrown on our pro-
fession and have the lives and happiness  of thou-
sands committed to his care ?—Truly, with the cele-
brated philosopher Vogel, we may affirm " that there
" is no science which requires so penetrating an intel-
" lect, so much talent and  genius,  so much force of
" mind, so much acuteness of memory as the science
{i of medicine." 
11
  But the dignity of medicine is also evinced by the
knowledge which its cultivation demands.  Here we
enter truly upon a boundless theme.   The  accom-
plished physician renders all nature and all  art, tri-
butary to his science ; he wanders through animate
and inanimate being; he examines the  productions
of the earth; he explores its deepest  recesses; he
consults the heavenly bodies, and from all,  collects
important  assistance, and is furnished with  new
ideas which redound to the improvement of his art.
  We must, however, descend to particulars ; and
in doing this, I would wish it to be distinctly under-
stood, that nothing will be mentioned, a knowledge
of which,  in some degree at least, is  not requisite
for a physician.  This statement is made on the au-
thority  of  some of the best writers,  and is sanction-
ed by the  character and attainments of those great
men, who in every age have  ornamented our pro-
fession  and vindicated  its  reputation  from the ob-
loquy of an envious world.
  An enlightened  medical  practitioner should then
be furnished with all  that diversified  information,
which is comprehended  under the  title of a liberal
education.  This supposes a knowledge of the lan-
guages, in which the works  of literature and science
have been written, especially the Greek,  Latin,
French, German, Italian,  all  of  which  are  too
little cultivated by the  modern  student.   It in-
cludes  an  acquaintance  with history, ancient and
modern, with  politics,  with  poetry,  and  all the 
12
branches of  the belles  lettres.  It embraces the se-
verer, but also the more important studies of mathe-
matics, and of natural philosophy in all its branches;
including botany, chemistry, mineralogy, and astron-
omy.   It  comprises a  knowledge of  the faculties
and operations  of the human mind,  the  connexion
of  mind  and matter with  their mutual  influence,
forming the  science of phrenology; of logic, or rules
for reasoning correctly ; and of moral philosophy, or
the methods by which the mental and moral powers
may be directed to their  proper and  laudable ob-
jects.  To complete the character of a well educa-
ted gentleman, some knowledge of law is necessary,
not only in a general sense as applied to nations and
the rules of  their intercourse, but as affecting the
transactions  of  corporate bodies and  of individ-
uals.   To this  should be  added au acquaintance
with the  natural  history of animals,  especially of
the human species; all which should be  accompa-
nied, adorned and rendered useful by a thorough
acquaintance with men and  manners,  which can
only be obtained by frequent and social intercourse
with the cultivated and polished circles of society.
  Important  and  extensive  as  these studies may
appear, they form only a proper introduction to our
inexhaustible science.  They are, comparatively, of
little value,  as merely a general  knowledge of them
can be obtained ;  for most of the time and labour of
the medical student must be devoted to the accurate
study of subjects,  equally extensive in their  nature. 
13
and more difficult in attainment. This general know-
ledge is, however, essential to his further progress,
destitute of which he cannot  comprehend  the sim-
plest  proposition;  the structure of the body, its
functions, and the theories of disease will, to him,
be unintelligible;  and, after much fruitless research,
he will find himself  involved  in the darkest laby-
rinth,  with no  glimmering light to illuminate his
path, and with no guide to direct his wandering and
bewildered steps.
  Professor Gregory, (in his  admirable lectures on
the duties and qualifications of a physician,)  defines
medicine to be " the art of preserving health, of pro-
longing life, and of curing diseases."  This three-
fold design of the profession  should  constantly be
kept  in view  by the student and practitioner of me-
dicine ; and a very little attention will prove, that
these objects  cannot  be obtained without laborious
study and  accurate observation.  They will impe-
riously demand a knowledge of the structure of the
human body, acquired not from descriptions or plates,
however well executed,  but by practical and per-
sonal investigation, and it  should  be illustrated by
comparative anatomy.  The  functions of the body,
and the laws by which they are governed, forming
the science of physiology,  claim much study; and
here no progress can be  made without considerable
acquaintance  with chemistry and  natural philoso-
phy.   Who can understand the functions of  the eye
and ear, while  ignorant  of the  laws  which govern 
14
the transmission of light and of sound?  Who can
explain the mechanism of respiration, the  effect of
muscular action,  while unacquainted with the pres-
sure of the atmosphere, and  with the mechanical
powers ?  How can the theories of respiration, di-
gestion, secretion and absorption be comprehended
by him who has paid no attention to chemistry and
its kindred sciences ?  Next to the healthy functions
of the system, pathology, or the diseased condition
of these functions, demands a very laborious investi-
gation.  For under this term are comprehended, the
nature of  disease in the abstract, which of course
brings under review the various theories which have
been promulgated in different ages, and have form-
ed epochs in medical history; the division of diseases,
or nosology;  their causes, symptoms, prognosis,
and the general principles of cure, or therapeutics.
  The investigation of the causes of disease calls for
a very multifarious  knowledge.  They exist every
where, and to examine  them we  must have a pre-
vious acquaintance with the ordinary and extraordi-
nary condition of the several kingdoms of nature;
we must particularly study  the state of the atmo-
sphere, when pure and undisturbed, and then calcu-
late the effects  of temperature, of winds, of storms,
of the various and almost  endless contaminations
from marsh and  human effluvia, and  from unknown
emanations, even from the bosom of the earth. This
includes the difficult subject of epidemics, their na-
ture,  laws  and  history, and  the influence of the 
15
heavenly bodies. But the causes of disease arise not
only without,  but are generated within, from the in-
fluence of our dress,  manners, customs, our food and
drink; by  the indulgence of passion,  and even by
the gratification of our natural desires.
  Gentlemen,  the subject is endless; for, having made
these extensive acquisitions, we are still unfurnished
with  the materials  for curing disease.  Here, we
must resume  our researches;  again ransack every
department of inanimate,  yes, even many parts of
animated nature, that we  may form our long  cata-
logue of Materia  Medica.  In doing this, botany,
chemistry  and mineralogy are again put  in requisi-
tion,  and afford essential assistance.  The arrange-
ment and  classification of  medicines, the principles
\m which they should be administered, and the cir-
cumstances suited to each class, and to each indivi-
dual of the class, have already been alluded to un-
der the heads of pathology and therapeutics.
   Having  thus noticed the various departments  of
preparatory studies, the history of  medicine should
be attended to, that  the important eras of the science,
its theories, the causes which  have  retarded its pro-
gress, the mistakes and the errors of its cultivators,
the means by which  it has  advanced,  its present
state and its future prospects,  may be severally pre-
sented to the  mind, as beacons to indicate danger, or
as bright luminaries to enlighten, guide and direct in
the toilsome road  to usefulness and  eminence.
    After all this study, all this time and labour, the 
16
 important  and the essential  branches remain unno-
 ticed.   The knowledge, the principles, and the ma-
 terials thus accumulated  are to be reduced to  prac-
 tice.  By these,  and through these alone,  can any
 man be rendered competent  to undertake an art for
 preserving health, for prolonging life, and for curing
 disease.  It is the practical application of medical
 attainments which  forms  the continual study of the
 physician, and which demands  so imperiously the
 enlarged medical genius, without which learning and
 science  are of no  avail.   In our country, the want of
 this information in  the young physician  is a subject
 of just  and severe  animadversion.   Furnished with
 theoretical knowledge, and it may be, with the best
 practical rules, he undertakes  the  exercise of  his
 profession  without having  seriously and careful if
 attended to their  clinical application. Dr. Rush has
 observed, that just  principles are, in a great degree,
 a substitute for experience.   This I most willingly
 and cheerfully subscribe to,  and believe that it con-
 stitutes  one of the best practical proofs of the claims
 of medicine to a science.   But this does not do away
 the great necessity of clinical observation; for how-
 ever forcibly and  eloquently these principles may be
 detailed, and however appositely they may be illus-
 trated by a lengthened catalogue of cases, yet, un-
 less these illustrations are not only heard, but seen;
unless they have  fallen under the actual personal
 observation of the student, the principles are not his
own, they  belong only to  his teacher.  He will not 
17
know how, when, or where to apply them ; but will
grope in darkness, and  be forced  to feel his way
amidst doubts and anxieties.  I speak, gentlemen,
from some experience; for notwithstanding my edu-
cation was  directed by a revered preceptor, whose
emphatic  and  unceasing directions were,  that 1
should attend to practice,  yet, when called  to  the
duties of the profession, I found myself bewildered
and harassed, and in a great measure ignorant how
to apply the principles with which my  mind was
stored.  To a feeling heart, this will be a source of
continual  uneasiness, and  to the latest hour of life
will form a subject of constant self-reproach; for, as
my amiable teacher exclaimed, "What can be more
dreadful, than to gain experience at the  expense of
your  patitfhts?"
  This is a very brief and imperfect sketch of  the
knowledge with which a medical practitioner should
be  furnished,  and but  moderately vindicates  the
claim of his science to superior dignity and eminence.
Lest, however, any should imagine that the speaker
has pourtrayed  his subject in too dazzling colours,
permit him to state the opinions of some eminent men.
  Professor Gregory, in a  work already alluded to,
observes,  " that to  excel  in medicine  requires a
greater compass of learning than is necessary in any
other profession."
  Dr. Young, in his Medical Literature, has affirm-
ed  "  that it exceeds, as a science, the comprehension
tfthe human mind."  Testimony perhaps more dis-
                        c 
18
interested is furnished by the celebrated translator of
the II ad, Mr. Pope, who, speaking of physicians in
one of his letters, says, " They are  in general the
most amiable  companions and the best friends,  as
well as the most learned men  I know."
   The rev.  Dr. Samuel Parr observes, "that after
a long and attentive survey of literary characters, I
hold them to be the most  enlightened professional
persons in the whole circle of human arts and sci-
ences."  Blackstone in the introduction to his cele-
brated commentaries, speaking of physicians read-
ing law, says, it is necessary  "to complete the cha-
racter of general and extensive knowledge which this
profession, beyond all  others, has remarkably de-
served."  Higher authority cannot be adduced.
  Behold then the elevated station to which our pro-
fession is raised by the talents and knowledge of its
followers, and consider for one moment how much
will be required from us, their successors, to maintain
and support  her in this commanding situation.
  But true dignity does  not consist simply  in genius
and learning.   However highly an individual may
be gifted by  nature, and however sedulously he may
have improved  himself by laborious study,  unless he
has rendered his powers and his attainments useful
to his species, and unless he is ornamented by a vir-
tuous  disposition and by virtuous  actions,  he may
claim an outward respect, he may receive a homage
paid to his talents  and  acquirements,  but  he never 
                        19

will or can have the homage of the heart;  he never
will be sincerely and truly respected.
  In this view of the subject, the dignity of  medicine
shines with renewed splendour.  The health, the
happiness, and the  life of man are its objects, it is
entirely devoted to doing good, and summons all its
varied powers and its multitudinous resources to pro-
mote the well-being of our race.   Its utility is evin-
ced more particularly, by the opportunities which it
continually affords for the improvement of the facul-
ties of the mind.   The study and the practice of the
profession cannot be pursued without engrossing the
whole attention,  and  of course,  augmenting the
strength  and  energy  of the  talents thus  enlisted
in its service.   And we have already seen that medi-
cine demands not  only the ordinary endowments of
miud, but all that superior range of intellectual facul-
ties  which designates  the man of  genius ; the culti-
vation of which, exalts him higher and higher in the
scale of existence, and closely allies him to those im-
mortal spirits who dwell  beyond his now limited
vision, and who enjoy greater powers and opportu-
nities  of investigating  the works  of  the all  wise
 Creator.
   The utility of medicine is again exemplified by its
leading to the  practice of virtue.  Here I enter upon
debatable ground,  for it is a common  remark, that
 the continual sight of misery renders the heart cal-
 lous to the sufferings of others, and gives to the phy-
 sician an unfeeling disposition.  At present, T would 
20
only answer, that this objection is almost universally
made by those who have enjoyed good  health, and
never known from personal experience, the kind and
tender sympathies of an enlightened physician ; they
who have once been confined to the bed of sickness,
will absolve  us from the charge.  But I only  wish
to maintain  at present, that our profession leads to
the practice of virtue;  the love of it is a distinct ques-
tion.   On this point, I may safely appeal to univer-
sal experience, to the records of the healing art, and
to  the daily  and  hourly conduct of every accom-
plished practitioner.  To pourtray  in their proper
colours, the numerous virtues which the healing art
brings into continual exercise, is far beyond my pow-
ers : it would require a mind peculiarly constituted,
a heart gifted with every generous,  every disinter-
ested, every noble feeling, and a character who had
tested, by a long and laborious life of professional
sacrifices, the  virtues he described. Think not,  gen-
tlemen, that this character exists only in the imagina-
tion, and is not to be found among the cultivators of
our divine art. Hippocrates, Sydenham, Boerhaave,
Fothergill, and a host of other honoured names have
exemplified the union of medical science, knowledge
and virtue.  The practitioners of our own country have
maintained this strong claim of medicine to dignity
and excellence.  Examples  must have  occurred to
every  individual.  Such a character,  it was the pride
and happiness of the speaker to  call his  friend and 
St
preceptor.* A man, endowed by nature with a strong
and discriminating  mind, enlarged by attentive ob-
servation,  industrious  research  and the  laborious
study of the productions of nature, of art, and of
science; whose heart was most sensibly alive to all
the sufferings of humanity,  was gifted  with every
generous and virtuous  feeling, and adorned by all
that is lovely and excellent in our nature.  These
qualities he brought to the profession of medicine, he
cultivated it with enthusiasm and improved it by his
practice.   In his manners, in his conversation,  and
in his character, were embodied all the requisites of
an accomplished physician.   Considering medicine
" as an art by  which an individual may be a bene-
factor to the universe, and confer blessings  on unborn
generations," he devoted his whole soul to its culti-
vation,  he forgot himself and his own interests, and
lived for others, sacrificing continually his personal
comfort  and feelings to the welfare of  his patients,
the happiness of their friends  and the good of man-
kind. Disinterested benevolence was the distinguish-
ing: trait of his character.  Not satisfied with fulfilling
the ordinary duties of his humane  profession, it was
his part to  " weep with those who wept;  to comfort
those who mourned," and to imitate  the example of his
divine master,  in "going about, doing good." Thus
science and virtue, uniting in his person, gave true

  * Dr. Caspar Wistar, late professor of Anatomy in the Uni-
versity of Pennsylvania. 
22
dignity to his character.   He was loved, he was re-
vered, and many still survive him to whom he has
extended the hand of kindness, and the consolations
of sympathy,  and  who  continue sincere mourners
over his departed worth:
     " He sleeps in dust, and all who knew him mourn,
     He, whom each virtue fired, each grace refined,
     Friend, teacher, pattern, darling of mankind."
  The science of medicine  not only  improves the
intellectual powers, and the benevolent and virtuous
dispositions  of  its cultivators, but it  lays  claim  to
still more exalted usefulness.   Its natural tendency
is to lead the heart of man to the worship,  the ado-
ration and love of the great Creator of the universe.
In common with all the pursuits of the true philoso-
pher, it  discovers the power of the  Deity in the
works of  creation; it beholds his omnipotence  and
omniscience manifested  not only  in the stupendous
and sublime arrangement  of the  planetary system,
and of the innumerable  worlds and systems which
roll amidst the immensity of space, but as demon-
strated in the wonderful  structure and  the admira-
ble contrivances  of  the human  body.  Our own
frames bear in  a peculiar manner the impress of a
divine hand, and the more laborious and minute the
examination, the more convincing and  overwhelming
will be the conviction that we are indeed " fearfully
and wonderfully made."
  With  the general philosopher, the physician  is
also constantly called to notice the goodness and the 
23
benignity of the great Creator.   He observes, that
the laws of nature remain unchangeably the same;
that although one generation  succeeds another, and
nations appear and disappear on the surface of the
globe,  yet the earth,  moon, and stars move  with
unchanging steadiness in their appointed orbits ; and
that the same causes under  similar circumstances,
produce the same effects now as at the  beginning of
all things.   The medical philosopher  beholds the
same goodness, and (notwithstanding the  imperfec-
tion of his science) the same certainty  manifested in
the causes  of diseases, in the phenomena they dis-
play, and in the relation  which  the productions of
the earth bear to the sustenance of man  in health,
and to his cure when diseased.    Hence he can rely
with  unshaken and unsuspecting confidence on the
constancy  of natural  laws,  and beholds them all
harmonizing and tending  to  his  real happiness and
welfare.
   From these constant  aud reiterated  proofs of the
wisdom, the power, and the  goodness  of  the Deity,
(manifested  more impressively to  the learned than
the unlearned,) the  feelings  of  adoration,  grati-
tude, and submission, are almost irresistibly excited.
 But  the physician has further  inducements  pecu-
liarly his own.  It is his privilege to enter the abodes
of want, of disease, of misery;  to behold the rich,
the wise, and the great, confessing the emptiness of
the pursuits of the world, and  their insufficiency to
 afford comfort and consolation amidst the  trials of 
24
life and at the  approach of death ; while he ofteu
views  the divine power of religion,  clothing the
poor and the unfortunate with the  mantle of peace
and of comfort, extending its consolatory influences
to the aching heart, and  opening  to the dep arting
spirits of the just, visions of immortal and unmin-
gled happiness. Is there, gentlemen, any profession,
any pursuit among the whole circle  of human occu-
pations, which addresses itself more powerfully to
the understanding, and  to  the feelings of its disci-
ples, or which presents stronger incitements to reli-
gious duty ?
   [This is the natural  tendency of philosophical
studies, but more particularly of medicine.  I say
the natural tendency, as it  seems to have been the
intention of the great Author of our existence, that
his works  should lead us to a knowledge of him-
self.  But what is the fact?  Are men of science the
advocates of religion ?  Are physicians found lead-
ing the way to the temples of  God,  and in sincerity
worshipping their Creator ? Or is  it true,  that the
professors of the healing art,  have seldom been the
professors of religion ?—Here and there amidst the
almost universal darkness, will be seen a few names
shining with  a meteoric splendour, increased by

   The statement inclosed in brackets was omitted in the delivery
of the address, as being  a digression from the main design, and
rendering it too protracted.  It is now inserted from a convic-
tion of its truth, and from a wish that it may at least afford mat-
ter for reflection. 
25
 contrast with the surrounding gloom.  Harvey, Syd-
 enham, Boerhaave, Hoffman, and a few others have
 redeemed  our science from  universal reprobation :
 but it must be acknowledged, that the great mass of
 medical practitioners and of philosophers in  general
 have not risen from nature's works to nature's God.
 I well know that  this accusation has been repelled
 by the lovers of science with becoming pride and
 spirit; but is  it not  supported  by general opinion,
 by the history of medicine, and I suspect  by the
 observation of every disinterested  inquirer?  Let
 every one candidly examine and  judge for himself.
   But whence  is it, that the cultivators of  science,
 which  presents the most  powerful  incitements  to
 religion, should be distinguished for their  unbelief?
 How is this paradox to be reconciled with truth and
 fact ? I feel, gentlemen, that I am wandering beyond
 the limits of medicine, and encroaching on the terri-
 tories of the metaphysician and the divine.  Let us,
 however, borrow  their assistance on a subject of  so
 much importance, that we may, if possible, discover
 the shoals and rocks on which others  have founder-
 ed, and  glide safely in the narrow channel  to truth
 and happiness.
  The  study of medicine and philosophy presents
continually, as  has been shown,  inducements to the
cultivation  of religion.  But this  very circumstance,
in a great measure, has  a counteracting effect: for
from the constitution of  the  human  mind,  impres-
sions frequently made render the feelings iusensi-
                        D 
26
He; the heart is uo longer acted on by those circum-
stances,  which at first,  thrilled it  with horror, or
inspired it with love.  The  anatomist  and  the sol-
dier often  look  back with  wonder  and even with
some mortification  to  those sensations which  the
sight of death originally produced—now they glory
in their insensibility.  So, he  who  has long been
habituated to the study of nature, no longer perceives
those impressions of the Deity, which might at first
have rivetted his attention.   He finds  that he can
refer almost innumerable phenomena  to some assign-
able causes, these again to other  causes, and so in
succession, through a chain of greater or less extent.
When he can no  longer advance, he feels that he is
restrained by an ignorance of attending circumstan-
ces, and from his past attainments, is induced to be-
lieve that more can be obtained, and that still another
and another link can be added to the chain of causa-
tion.  His  boundless spirit cannot be satisfied, and
its pride refuses to acknowledge any bounds to its ac-
quirements, and to bow in humility before the great
First Cause. Thus the whole attention of the philoso-
pher is occupied and engrossed by the consideration
of secondary, or as they  have been termed, " natu-
ral causes;" with these he  remains satisfied.  The
natural pride of his heart is thus gratified, and he
rejoices in the persuasion, that all his acquirements
have originated  in  himself  and  been perfected  by
his own exertions.—Thus reason becomes his God.
   But it is  contended by  no less authority, than  the 
27
amiable and pious Gregory, that" to a sound under-
" standing, extensive knowledge is the truest teacher
" of humility," which he supports by the illustrious
and  excellent examples  of lord Bacon,  Mr. Boyle,
and sir I. Newton.  These names stand as bright
exemplars for the imitation of every lover of science;
and willingly would I believe, that they were gene-
rally imitated, and that their piety and virtue still
lived in all their successors.
  In a certain sense, knowledge teaches humility.
The man of science as he  advances in the road of
improvement,  finds the prospect expanding to  his
view :  as difficulties are removed, and obstacles sur-
mounted, he discovers a wider and still  wider  field
stretching before him ; he finds that all the informa-
tion  he obtains, but serves to demonstrate the inex-
haustible nature  of the  object  of his researches.
His  mind is humbled before  the  magnitude of its
undertaking, and mourns over the  limitation of its
powers; but at the same moment he looks back with
pride and contempt on him ; who  has only entered
the road, which he has  so successfully penetrated ;
and  looks forward with no  little  confidence  and
hope, that by  his own exertions all  may yet be ac-
complished.   Is not this the natural,  and is it  not
the  general effect?  for  the appeal must be ulti-
mately made to the observation and experience of
each individual.
   Thus, minds wholly engrossed with the works of
 nature and with the examination of cause and effect, 
28
generally stop short of the great First Cause.  But in
many instances, they advance further; they willingly
and joyfully acknowledge that the goodness, the wis-
dom, and the power of a God, are clearly manifested
in every thing around  and within  them,  and they
love and adore him, as the governor of nature, but
here they again halt; they do  not avert to him as the
moral governor of the world : they perceive not, that
as creatures of his power, as dependants on  his good-
ness, they are obligated by every possible tie which
can bind a creature to its Creator, to devote to his ser-
vice and to his pleasure every faculty of their minds,
and every power of their bodies.  They never avert
to the  fact, that  the pleasure of  man is  at direct
variance with the pleasure of  God and are ignorant
that he is  also an  inexorably just  being,  refusing
every method of reconciliation which does  not make
a full satisfaction to his violated justice.
   The nature of true religion  and the importance of
a revelation of  the divine  will, being thus unknown
to the ardent lover of science, he lives, and he often
dies, disbelieving the truth of any other religion than
that, manifested even to the savage of the desert by
the works of nature.
   It is time to return from this digression, but I may
be permitted to observe, that whether this accusation
be just or not,  it  should be sufficient for us that it
has been seriously  and perseveringly urged against
the professors of medicine.  Hence, it becomes the
duty of every student and practitioner of the profes- 
29
eion, to listen to that voice which speaks within and
around him, and by his own example, to refute all
the charges of infidelity with which science has been
reproached.]
   The usefulness and the importance of medicine, to
its cultivators,  appear then in the facilities which it
affords for  the improvement  of the mental powers
and in the inducements which it presents to the love
and practice of virtue and religion.   Respecting the
benefits which it confers on the world, neither your
time nor my abilities will allow me to enlarge.  They
are rendered sensible to every one  whose mind  is
not blinded by metaphysical disquisitions, or preju-
diced by  some partial observations.   Behold them
in the returning health and strength of him, who has
long languished for  the  first of Heaven's earthly
blessings; behold them in the gratitude of that wife,
and of those children, whose husband and father has
been restored to their embrace and caresses; view
them in the public rejoicings, when a friend, a phi-
lanthropist or a patriot has been  shielded from  the
arrows of death,  and returned in triumph to all his
useful and benevolent occupations.   Notice our hu-
mane profession scattering health, comfort and hap-
piness,  where sickness, penury and despair chilled
all  the  sympathies of domestic and social life, and
pointed to death as the only relief  from  intolerable
misery.  Behold the enduring monuments of its in-
calculable usefulness, in the extensive and munificent
establishments of dispensaries, lazarettoes, hospital* 
80
and the innumerable societies formed by the virtuous
and the benevolent in  every clime for the sufferings
of man.  Observe  her,  proclaiming to the proud
waves of a  devastating  epidemic,  thus far shall
thou come, and no further; binding  syphilis, small
pox  and other devastating pestilences in chains at
her chariot wheels, and like the mistress of the world,
exhibiting her captives to a  grateful and admiring
people.  Forget not, that she enters the mansions of
insanity and restores reason to her deserted  throne;
that  she appears at the  bar  of  the judge to detect
guilt and to guard innocence;  and that she pours into
the wounded  and troubled spirit, all  the divine con-
solations which issue from the perennial fountains of
virtue and religion.  Where can  we find an employ-
ment which  opens a more extensive  field of useful-
ness for that man whose  mind and whose education
entitle him to the appellation of an accomplished
physiciau ?
  Such, gentlemen, is the profession of medicine.
Its importance  and its dignity  are  maintained by
every thing indicative of the superiority of our nature,
by every thing tending to the mental  and moral im-
provement of man, and by  all  those innumerable
blessings which it confers on  the world. This being
its character, and these its noble objects, is it not
deserving of  the love and respect of all, especially
of those  who undertake to wield  its mighty powers ?
And how mistaken, yes,  how guilty are they who
dare to engage in the practical parts of the profession 
31
without being properly educated, and  without being
directed by upright and virtuous principles? Those,
whom I now  have the honour  of addressing,  have
made their election, and it is to  be presumed that all
are anxious, that  the real dignity of  the profession
should be known and acknowledged by the public;
inasmuch as their own standing in society,  and the
respect and influence awarded to them,  will be in a
great degree proportionate to the esteem and venera-
tion in which their science is held.  How then shall
this desirable  object be obtained ?  how shall medi-
cine be enabled to castaway the tattered garments with
which public estimation has so long  and so shame-
fully clad her, and to appear in her own bright and
glorious costume, the object of just and universal ad-
miration ?  The answer is easy, let every one of its
disciples form a proper estimate of the exalted cha-
racter of our  science and  act  accordingly.  Let no
ignoble thought, no selfish feeling, no mean device,
 no vicious propensity stain the character of a physi-
 cian; let every sentiment be just, virtuous and exalt-
 ed, and let every word and action redound to the hon-
 our of the profession.   Above  all, love your profes-
 sion, and remember that the duties you owe  it, are pa-
 ramount to the  duties which  you owe yourself:  in
 other words,  that medicine  is so  exalted  in its na-
 ture aud objects,  and has the power of being so ex-
 tensively and so permanently useful,  that it becomes
 the duty of a physician to wave his own personal in-
 terest, that he might increase the character of  his art 
32
 in public estimation. Thus, more good will be achiev-
 ed.  This sentiment is coufirmed by the excellent au-
 thority of Dr. liush, who observes, " that it is only
 by preferring the life of a fellow creature to interest
 and reputation, that a physician can be in  a condi-
 tion to do his duty." In an accomplished practition-
 er, self should receive but secondary attention, the
 good of others should be his primary object.  This, it
 must be acknowledged, is an Herculean  labour, and
 cannot perhaps be fully accomplished.  But let it be
 always remembered, that in proportion as the views
 of any individual centre in himself, in the same de-
 gree the mind becomes contracted, the feelings de-
 based, and the respectability of the character impair-
 ed ;  and on  the contrary, that in proportion as any
 one lives for others, in the same ratio every talent of
 the mind, every  sentiment of the heart, and every
 laudable  propensity  is  elevated  and  enlarged.
 This observation is exemplified in every station of
 life and in every pursuit.   That man, whose mind
 and whose feelings  are occupied and engrossed with
 the dear objects of  domestic life, enjoys more  real
 happiness and better fulfils the true  ends of his being,
 than he who devotes his powers  merely to his own
 interests.  Carry your observations through all the
 connexions  which bind man to his fellow man, and
 notice how much the character both of miud and heart
is improved in that individual who, forgetting himself
 devotes his energies to his friends, to the members of
 his own profession, to his fellow citizens, to his coun- 
a3
trymen and finally to mankind at  large.  See, how
he rises in excellence, as his heart expands with love
to others, and ascends, through the various grades of
social feeling, from  domestic  affection  to universal
philanthropy.   In  proportion,  therefore,   as  the
practitioner of medicine cultivates an attachment to
his science, will his views and his actions become
more disinterested: the debasing love of money, (the
source of so much injury to the reputation of the heal-
ing art,) the various little devices and  manoeuvres
which characterize  men  of little minds and  little
merit,  all the mean  resorts of the hypocrite, the sy-
cophant and the slanderer will be  banished from his
soul; while all the benevolent and dignified propen-
sities of his nature will be cultivated; while true po-
liteness  of  manners—true dignity of soul—justice,
truth, candour, humanity  and religion will influence
every thought, every word and every action.  The
dignity  of  medicine will be practically declared  to
that public which has been so long blinded and de-
ceived by its unworthy professors, and  which has  so
ungenerously charged their ignorance and vice to the
profession itself.  These  will  be exposed  in their
true colours, and of course, will be hated and despised,
while modest  merit and  retiring virtue will attract
deserved attention and receive their just reward.
   Love then, this great, this dignified science; culti-
vate it with enthusiasm by careful observation, and
by rational experiments :  and remember, that he who
assumes the character of  a physician,  and takes  on
F 
34
himself the responsible  duties of medicine^ without
the proper requisites from nature,  from education,
and religion, will pass through this life despised by
the wise  and  the good, distributing  misery  and
death  around  him;  and  after death  his  memory
will be abhorred, while his soul will appear before
the bar of a just and avenging God,  covered with
the blood of his fellow men.  While he who is pro-
perly qualified for his labour,  and adorned  by a
virtuous and religious disposition, will live beloved
and respected as a benefactor  to his cotemporaries,
and a blessing to  posterity,  and will  die mourned
for by his survivors, but prepared for  his great  re-
ward  in the kingdom of Heaven.
Philadelphia, February, 1823.