The Eulogium of Medical Science. AN ANNIVERSARY DISCOURSE, DELIVERED BEFORE THE NEWYORK ACADEMY OF MEDICINE, NOVEMBER 2d, 1859. BY ¥M. M.D., FELLOW OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF NEW TORE. [published by order of the academy.] W56 NEWYORK : PRINTED FOR THE ACADEMY BY W. H. TINSON, 43 & 45 Centre Street. 1860. RG48« Ifw 3 ANNIVERSARY DISCOURSE. Mr. President, Officers, and Fellow-Members of the New York Academy of Medicine : The ceaseless march of Time brings us once more to the period at which we are directed by the by-laws, to celebrate the anniversary of the institution of this Academy by a Public Discourse. I should be culpably insensible to the high compliment which has been paid me, in my unsolicited selection to perform the duty of orator on this interesting occasion, did I not thus publicly express my deep sense of gratitude for the honor conferred upon me ; and I should lack modesty, did I not wish myself more worthy of it. The New York Academy of Medicine celebrates today its 12th anniversary. Beginning, in 1847, with the comparatively small number of 132 members, they now, by steady annual increase, amount to 370, composed of the elite of the medical profession in this city and its vicinity. A few members Note.—This discourse was compiled from various sources, which I could not now enumerate if I would. But, lest I should be justly accused of extensive plagiary, I desire to say that I have been greatly indebted, both for thought and language, to the philosophical and eloquent little work, by the late Prof. Elisha Bartlett, M.D., of this city, entitled, " On the Degree of Certainty in Medicine," etc. And for any such appropriations which may be detected, not specially accredited, I make this general acknowledgment of my obligation, and commend the work to the attentive perusal of my readers. 4 ANNIVERSARY DISCOURSE. are annually taken from us by death ; but, as fast as a gap has been made in the ranks, fresh volunteers have stepped bravely in to fill them, and present a serried and unbroken front to the common enemy. The objects for which the Academy was instituted, have, I am pleased to say, been fully attained. The social harmony of the profession has been preserved and increased ; its tone of ethics elevated ; the advancement of medical science hastened ; and, above all, the "moral necessity," which demanded an Academy of Medicine in this city —the want of the profession, and of the community itself, has been supplied ; a shield has been held up to protect the public from the poisoned arrows of charlatanism —a standard has been raised beneath which the loyal disciples of medicine can rally. A wide and impregnable barrier has been erected and maintained against the approach, or invasion of empiricism or irregularity. Membership of the Academy is a sure guarantee to the public, of the respectability of the practitioner, and of the legitimacy of his practice. The scientific character of the Institution is materially enhanced of late. A larger attendance of members is apparent at the meetings. Many very elaborate and highly valuable papers and reports have been read, and communications made : and during the past year, several very interesting scientific discussions have been sustained, upon important subjects connected with Hygiene, Diagnosis, Pathology and Practice, exhibiting, on the part of all concerned, high attainments, a readiness in debate, and an ex- 5 THE EULOGIUM OF MEDICAL SCIENCE. tensive knowledge of the subject, which would have conferred honor even on the oldest and most learned associations of Europe. The hand of death (I say it with a devout feeling of gratitude to the Supreme Disposer of events) has touched but very lightly upon the Academy during the past year. But for the decease of three of our number, Drs. Power, Ferguson and Churchill, we should, by the Divine mercy, have enjoyed the privilege of thankfully answering to the roll call, that we are all here. The Academy of Medicine bids fair, I think, to remain a permanent institution in city, state and country ; to be an oracle for the enlightenment of our fellow citizens upon all subjects connected with the improvement and preservation of the public health ; and to contribute powerfully to the advancement of medical science and professional respectability. To the furtherance of these desirable objects, let every member devote himself, his time and his talents, and let us hope that ere long, it will possess, besides an honorable name, a suitable local habitation. I have always thought, that upon these anniversary occasions, when we are favored with the presence of so many persons of both sexes, unconnected with the profession, invited, too, by ourselves, the subject of the discourse should be one calculated to amuse, interest, and, if possible, instruct a mixed audience. And, as many of those before me probably adhere to the old and legitimate practice of medicine, and it may be well for them to be able to assign a good reason for the faith that is in them, and to have their 6 ANNIVERSARY DISCOURSE. confidence in it strengthened and increased ; and as that confidence should be shared alike by those who practice, and those upon whom it is practiced—as no nobler duty can devolve upon the votary of medicine, than to speak 11 a clear and earnest word for the science which we study and teach, and the art which we practice and inculcate 19 (B art let t), and no fitter occasion than the present can offer for so doing, I have selected for my subject this evening, and proceed to deliver, as well as the vastness of the theme, the brevity of the time allowed me, and my own very limited capability will permit: THE EULOGIUM OF MEDICAL SCIENCE. Medicine, the healing art, as it is often called, is, according to strict etymology, rather the art of remedying than of curing. Its object is the preservation of health, and the knowledge and treatment of disease. It embraces many departments of knowledge, all intimately dependent on each other. If not a perfect one, the combination of these various branches, relating and tending to a well-defined object, constitutes it, and has from its very origin constituted it, what some have denied its claim to be, a true science. Next to theology, it is the noblest study which can engage the attention of man, for it is the study of man, in health and in disease. Its utility is incontestable, for it teaches man to preserve the dearest of his possessions, his health. "All that a man hath" says the good book, "will he give for his life." And now, 7 THE EULOGIUM OF MEDICAL SCIENCE. more than ever, is it indispensable, since man, by the progress of civilization, and the increase of luxury and refinement, has become an easier prey to disease than during the simpler periods of his existence. Its origin is Divine. " Of the Most High cometh healing." It is the practical carrying out of our blessed Saviour's injunction, to " do good to all men." Never did His power show more gloriously, and never was the mercifulness of His mission more gratefully and awfully recognized and acknowledged, than when His miraculous gifts of healing were exerted. It was then that " the multitude marvelled, and glorified God who had given such power unto men." We, also, go about doing good, and, in this respect, may reverentially be said to follow in His footsteps. It is an outward manifestation of God's love and sympathy for his suffering creatures. All remedies come from Him, and man only applies them, with the hope of His blessing. "If" says the pious Rush, "every other argument failed to prove the administration of a Providence in human affairs, so great are the blessings which mankind derive from the healing art, that the profession of medicine would be fully sufficient for the purpose." It springs from that instinctive humanity which causes us to pity the sufferings of our fellow-men, and to desire and attempt to relieve them. It is the offspring of our necessary infirmities : not the product of a fictitious want, resulting from either effeminacy of habit, or other evil results of civilization. Suffering is the inevitable condition of man's existence, let him live how and where he may ; and as naturally 8 ANNIVERSARY DISCOURSE. he seeks for relief from his ailments. " It would indeed be a blot and anomaly in the beneficent adjustments of the creation, that human beings under the extremity of suffering, should cry aloud for relief without any means being provided for furnishing it." — Blane. Hence the necessity of medicine to the welfare and happiness of man ; medicine, which cures many, and palliates all of his physical ills. Tradition teaches us that there exists not, and never has existed a people, barbarous or civilized, without some sort of medical art, however superstitious, absurd, or inefficient. Commencing as a mere domestic application of remedies to disease, and primitively exercised by heads of families, tribes, or nations, generals and legislators, and next, for a long period, almost exclusively an appendage of the priesthood, it has come at length to constitute a distinct science or profession, which has been extensively subdivided. Those who deny its progress, can never have seriously studied its history. Requiring from its cultivators, the possession of every quality of the head and heart which can ennoble human nature : a high order of intellect; extensive learning ; manners at once dignified and gracious ; a pleasing exterior ; an abnegation of self and a repudiation of society, that time may be given exclusively to the sedulous and indefatigable study and practice of the art; inculcating the virtues of chastity, sobriety, piety, courage, integrity, charity, patience, magnanimity, disinterestedness and discretion ; demanding for its successful exercise, the utmost tact in the 9 THE EULOGIUM OF MEDICAL SCIENCE. management both of the sick and the well, there is no profession nobler than that of the physician. Cicero has truly said, that "in nothing does man approach nearer to the .gods, than in giving health to his fellow-men." A physician of genius is the noblest gift which nature can bestow upon humanity. He is the equal everywhere of the highest in society. " I know," says Rousseau, "no profession that requires more study than his, and in all countries, none are more truly learned and useful than physicians." " Is there anything in the world more estimable," asks Voltaire, " than a physician ; who, having in his youth studied nature, and known the springs of the human body, the ills which torment it, the remedies which may relieve them, modestly practices his art; takes equal care of rich and poor ; receives his fees reluctantly, and employs them in succoring the indigent?" "Men," he elsewhere says, "who should employ themselves in restoring health to others from solely benevolent principles, woul'd be far above the greatest of the earth. They would partake of the Divinity." The stern moralist, Johnson, too, has left this compliment on record to the Profession : "I believe every man has found in physicians great liberality and dignity of sentiment, very prompt effusion of beneficence, and willingness to exert a lucrative art when there is no hope of lucre." — Life of Garth. Properly to appreciate the progress of Medical Science, it would be necessary to take a brief retrospect of its history, and compare its past condition with the present. But this would here be quite impossible. I will therefore ask my hearers, passing 10 ANNIVERSARY DISCOURSE. over the historical periods of iEsculapius and the Asclepiades, of Hippocrates, Galen and Arabism, to pause with me a very few moments and consider the condition of Medical Science at and. from the commencement of the 15th century, when its history begins to assume a brighter aspect. It is no longer shrouded in mystery and obscurity, or disgraced by ignorance and empiricism. The scientific spirit of nations is aroused. Fewer intestine wars occur, and a better social organization exists. Institutions are formed calculated to elicit and extend the light of scientific research. The compass has opened to the hardy navigator a pathway across the trackless deep. The microscope has revealed a world of hitherto undreamed of natural phenomena. Copper-plate printing has enabled man to combine verbal description with graphic representations of its object, and treatises on anatomy have become more general and instructive. But above all, printing, " the art which derides the havoc of time' and barbarism," has assured the triumph of reason and intelligence in the world, and thought, like its principle, becomes henceforth imperishable. The cultivation of the Greek classics is resumed ; their best authors purified and multiplied by the art of printing. Dissection of dead human bodies again becomes prevalent, and treatises on human anatomy, embellished with engravings, first on wood and then on copper, are numerously issued. Monographs of particular diseases and of individual cases, with reports of hospitals and other institutions, begin to be publishe —a plan, whose continuance under improved THE EULOGIUM OE MEDICAL SCIENCE. 11 methods, has been a powerful means of the rapid advance of Medical Science in later times. Chemistry makes progress, universities are established in various great cities of southern Europe, as Montpelier, Bologna, Vienna, Paris, Padua, Pavia, Milan, Rome and Naples, and medical lectures are delivered. The other branches of Medical Science advanced with proportionate rapidity. Surgery, which had been in a very low and degraded state, being chiefly in the hands of barbers and bone-setters, emerged from its obscurity „ Thanks to the genius of Ambrose Pare, the ligating of arteries took the place of the dreaded and terrible applications of red hot iron and boiling oil, for the arresting of haemorrhage after wounds and surgical operations. Military Surgery, which had been a torture, became a beneficent art. The celebrated William Harvey, about this period, made the glorious discovery of the Circulation of the blood, and, bitterly as his theory was opposed during the subsequent quarter of a century, lived to see it universally adopted. The theory of Respiration, under the researches of Malpighi, Haller and Lavoisier, received an almost complete development. Aselli and Pecquet, in 1647, discovered and assigned the uses of the Lymphatic Vessels, a discovery scarcely inferior to that of the circulation itself. Physiology in general, and that of the nervous system in particular, was elucidated and brought to a high state of perfection. Thus, guided by the light of experiment and correct reasoning, based upon just observation, the nature of the various organs composing the wonderful structure of the human body, began to be 12 ANNIVERSARY DISCOURSE. developed ; their formation, functions and mechanism to be understood ; and a practically useful light was thrown upon the nature of their diseases, and the means of their cure. The Department of Hygiene, public and private, received its due share of attention, and progressed accordingly. It is only from the 17th century that we date the establishment of quarantines and lazarettos ; that of Marseilles, the first founded to prevent the introduction into Europe of the Plague from the East, and which has served as the model of every subsequent establishment of the kind on the shores of the Mediterranean, being of this epoch. The smallpox had raged periodically in both worlds, levying on the population of Europe an annual tribute of not less than 400,000 souls, blinding, disfiguring and mutilating as many as it spared. Lady M. W. Montague had indeed introduced from Constantinople the practice of inoculation ; which, however, exposes to a danger almost as great as that of spontaneous contagion. The discovery made by the celebrated Jenner, in 1798, is so generally known as scarcely to need mentioning. When we consider the zeal, the patience, the exquisite sagacity shown by him in his long course of experiment, and the immense benefits conferred upon mankind by his discovery, we no longer discuss his claims to priority, and have only words in which to praise and bless him! It is pleasant, in this connection, to reflect, that in our day the mortality from smallpox is reduced from 50 or 75 per cent., even to 9, 10 and 12 per cent.; and that its unhappy victims, instead of being abandoned, 13 THE EULOGIUM OF MEDICAL SCIENCE. isolated and neglected, now receive, in comfortable hospitals set apart for the purpose, every care and kindness, and such a coarse of treatment as has produced the above enviable diminution in the ratio of mortality. The other great discovery of the age, which with greater propriety, perhaps, might be introduced under another head, is that of the Cinchona Bark, in the cure of agues, which in earlier ages constituted one of the most prolific causes of mortality among European nations. The certainty of its action is one of the greatest triumphs of the medical art, and thanks to the skill and labors of the analytical chemists, the bulky and nauseous powder has given place to the smaller doses of its less unpleasant active principle, the well known Quinine. Pathology, which has for its object the investigation of the causes and effects of diseased action in and upon the human tissues, as discovered after death, and which, when combined with a sound physiology, furnishes the only true clue to diagnosis and the cure of diseases, rapidly advanced from the commencement of the 17th century. Obstetrics, and clinical teaching, first attempted at Padua, in 1578, shared largely in the general progress. The results of clinical observation, too, began to be collected and published, together with the influences of climate and medical topography, and thus have we brought down hastily the history of the healing art to a period not far remote from our own day, and shown that from the epoch of its awakening, its advancement toward the perfection it at present 14 ANNIVERSARY DISCOURSE. enjoys has been steady and satisfactory. I rejoice to say that the successors of the great men of former times, have not ceased to improve upon the labors of their predecessors, and that the last three-quarters of a century have been productive of results which even throw them wholly into the shade. The strides made in medical science may in truth be said to have kept pace with those of the practical sciences, numerous and marvellous as these have been. Morbid anatomy, under the auspices of Baillie, Cruveilhier, Carswell, Hope, Louis, Andral, and many others, has revealed the true nature of most diseases, discovered others hitherto almost unknown, and separated those which had been confounded. In so doing, the scalpel has found an efficient coadjutor in the microscope, only of late applied at all extensively in medical science, from the aid of which many very important and interesting discoveries have been made, and more may be fairly expected. Much too is to be expected from the continued and careful study of pathological chemistry, in reference to the morbid conditions of the blood and other fluids of the body, in which material advance has been made within the last half century. If a proof of the correctness of this opinion were needed, we should only have to advert to the celebrated discovery, by the late Dr. Bright, of albuminuria. It is quite possible that much light may hereafter be thrown upon all those diseases which appear to result from poisoning of the blood, and that such poisons may either be neutralized in, or ejected from the body. 15 THE EULOGIUM OP MEDICAL SCIENCE. In nothing, again, is the superiority of modem medical science more strikingly shown, than in the increased use and importance of physical diagnosis. The percussion and auscultation of the contents of the chest and other organs, as taught by Avenbrugger and Laennec, and improved upon by their successors, and the measurement of diseased organs by the combination of these means, as originally suggested by our able associate, Dr. Clark, and his friend Dr. Cammaun, of this city, has enabled us to acquire, with regard to the nature and extent of disease in various organs of the body, an exactitude wholly unknown to our predecessors, and a proportionate precision and success in their treatment. In the department of the materia medica a vast amount of useless rubbish has been expunged from, and many new and useful additions have been made to the lists of the Pharmacopeia. The active principles of many powerful and valuable remedies have been separated from the inert material in which they were concealed; the vegetable alkaloids and extracts, in smaller quantities, have been substituted for the bulky doses of disgusting powders and potions formerly exhibited. Simplicity in form has been made to coincide with increase of power. New modes of introducing remedies into the system are yet probably to be adopted, and the discovery of many new and potent therapeutic agents is yet destined, no doubt, to reward the persevering labors of the chemists. A more certain and direct knowledge of the manner in which medicines operate, will soon probably be arrived at, and remedies, in consequence, be applied with greater certainty and success. 16 ANNIVERSARY DISCOURSE. Surgery, too, may proudly boast of its great names and continued advancement in modern times. • 1 It has progressed uninterruptedly," to use the ever felicitous language of Dr. J. W. Francis, in his first brilliant anniversary oration before this Academy, " amidst every mutation, and proved a succession of benefits to the descendants of Adam, from the day that a drop of water from the spring was first given to allay traumatic suffering, and the bruised leaf applied to staunch the wound, up to the present era of its brightness, when there is scarcely a fibre of the body beyond its research, or, by its power, insusceptible of remedy." Aneurisms are now often successfully treated by pressure, without the operation of the ligature. Hideous deformities, as clubfoot, squinting, wry neck, etc., are overcome by simple division of tendons underneath the skin, and the use of improved instruments. Dislocations, even of the larger limbs, are now readily reduced by manipulation, under the relaxing influence of anaesthetics, and by improved knowledge of muscular action, without recourse being had to the oldfashioned, cumbrous and painful machinery of bands and pulleys. The method of treating fractures is improved and simplified. The loss of parts, resulting in unpleasing disfigurements of the features, is now easily supplied, and comeliness restored, by a resort to the art of autoplasty. Hernias are radically cured by safe and simple processes. Nor must we omit, in an allusion to the advancement of modern Surgical Science, to include among its most striking achievements, the cure, by means of the silver suture, of a most deplorable casualty, peculiar to the softer 17 THE EULOGIUM OF MEDICAL SCIENCE. sex in whose welfare all feel so deep an interest, due to the skill and perseverance of one of our own number, Dr. J. Marion Sims. Great arteries are now tied, under the safe and skillful management of steady hands, directed by an intimate knowledge of relative anatomy: from the dread of encountering which, even if they had ever dared to dream of its possibility, the ablest professors of the art, centuries ago, would have shrunk in dismay. Immense tumors and masses of diseased structure, involving the most delicate and important parts, are boldly attacked and successfully removed. Lesser operations are substituted for graver and more dangerous ones, The lithontriptor has often superseded the knife, once the only resource in the removal of the stone. A strong conservative tendency is manifesting itself, in lieu of a reckless desire to obtain a great surgical reputation, at the expense of the suffering, and even the life of the patient. To cure, or to save, rather than to cut off, is now the rule and not the exception, and surgeons are willing to confess that it is only when they are unable to cure, that the knife becomes at once their reproach and only resource. Hundreds of limbs are now wholly saved, which formerly would have been amputated, and parts only are now removed, when previously the whole limb would have been sacrificed. Simplicity of dressing has replaced the clumsy layers of poultices, ointments, etc., once in constant use. The after consequences of operations are better understood and guarded against. And, lastly, the wonderful powers of anaesthetic agents, ether and chloroform, 2 18 ANNIVERSARY DISCOURSE. the merit of introducing and popularizing the former of which agents we may fairly claim for our own country, and whereby we have repaid a heavy installment of the debt which we owe the world for benefits derived from other countries, have disarmed Surgery of all its terrors. The patient now no longer looks forward with gloom and dread to the day of operation. He now no longer lies down before his surgeon in an agony of apprehension, anticipating torture and misery. His groans and writhings no longer distress the bystanders, nor rack the heart and unsteady the hand of the operator. But, wrapt in a blissful slumber — lapped in Elysium —dreaming, perhaps, of heaven and its angels —he lies tranquil and unconscious throughout the performance of the longest, most painful, difficult and dangerous operation, and awakes at length to the delightful conviction, that all is happily over, and he has known and suffered nothing I My hearers, if medical science had done nothing more to benefit suffering humanity, than to discover vaccination and anaesthesia, would it not have amply merited man's thanks, his praises and his blessing ? The actual practice of medicine has advanced, during the period I am now considering, pari passu with its sister branches. The art of Diagnosis is simplified, extended, and assured. The real nature of disease is better understood, and it is better treated. The difference between diseases of really inflammatory character, and those of debility and nervous irritation, is better known and appreciated. Blood poisoning receives its due share of attention. The restorative powers of nature are better under- 19 THE EULOGIUM OF MEDICAL SCIENCE. stood and more confidence felt in them —the extent to which- they may be trusted—the proper moment at which art is to step in to her aid, more clearly defined. Hence, while it is shorn of none of its power, the present practice of Physic lacks much of that perturbatory character which it once possessed. There is less blood-shedding : less severity of diet is enjoined: no profuse, painful, disgusting and deleterious salivations are encouraged: less medicine is given, and what is, is directed, with greater judgment and certainty, to the nature and cure of the disease. In this enumeration of the steps of progress, discoverable in the various branches of the healing art, in modern times, I may not omit to allude to the present advanced state of Medical Jurisprudence, which, combining the two great topics of law and physic, is indispensably connected with the due administration of justice, and with the protection of the public life, and health, property and morals ; with the legal rights of communities, and the personal rights of individuals. By an enlightened combination of scientific knowledge and experiment, it elicits truth and exposes error ; it establishes irrecusably the proofs of guilt, or dissipates the unfounded aspersions which may affect reputation, liberty, and even life. In her contributions to this branch of medical science, America stands preeminent. She has produced the excellent work of Dr. Ray, and above all, the celebrated treatise of the Brothers Beck, of this State. This stupendous monument of the learning and research of this par ndbile fratrum — both, alas! prematurely lost to the science which so 20 ANNIVERSARY DISCOURSE. freshly deplores their inestimable loss —has been translated into every language of Europe, 'and constitutes the standard work of reference for the civilized world. A new and improved edition of this celebrated work, posted to the highest present level of the science, has recently issued from the press in Philadelphia, under the able supervision of my accomplished and valued friend and relative, the Professor of Obstetrics in the College of Physicians and Surgeons in this city, Dr. Gilman, whose qualifications for the task are too well known to require any notice at my hands. Such is, without exaggeration, the gratifying retrospect of the last three quarters of a century —such the present hopeful condition of medical science— such its cheering anticipations for the future. Nor need we doubt of its continued progress. "Every passing month furnishes its contribution to the work. Some new discovery is made, or some old truth revived, strengthened, or illustrated ; some error correcte —some delusion dispelled ; a thousand microscopes are prying into the deepest and darkest recesses of the organism ; a thousand laboratories are busy with the chemistry of life ; myriads of patient scalpels are plying their careful and laborious dissections, and so these, like all other branches of human knowledge, are carried slowly but steadily onward in their interminable career."— Bartlett. Excellent works from able pens are constantly appearing. Excellent schools of medicine flourish in every great city of the civilized world, vying with each other in the perfection of the course of instruc- 21 THE EULOGIUM OF MEDICAL SCIENCE. tion they shall impart to their pupils. Dissecting rooms, with ample material and excellent instructors abound. Museums of human, comparative and pathological anatomy exist in every college and hospital, and often in the office of private teachers. Journals of medicine and the kindred sciences collect, as in a focus, and radiate throughout the world, the rich stores of fact and thought derivable from the concentrated energy and labor of medical votaries everywhere. Hospitals, admirably appointed and officered, embracing every requisite for the care and cure of the sick, offer to the eye of the industrious student, cases of every conceivable form of disease which afflicts humanity, and opportunities for learning its proper treatment and nature. Excellent clinical lectures are delivered in colleges and hospitals by competent teachers —operations performed before the class —plates, models, specimens and diagrams freely displayed. Pathological, surgical and medical societies and associations everywhere contribute their quota, few more than our own, toward the general harvest. Not a stone is left unturned, not an effort untried, to render medicine, in the persons of its present practitioners, and of those who are to succeed them, worthy of the respect, the admiration and the confidence of the world. Under such favorable auspices, it must advance toward limits, which only the God with whom it originated can define. It cannot, indeed, conquer Death: but it often successfully defies his power, baffles his malignant purpose, and cheats him of his destined prey. To what further mastery over 22 ANNIVERSARY DISCOURSE. the grim King of Terrors may it not yet be destined to attain ? Let us now inquire what medical science does for mankind in the department termed Hygiene, public and private, the object of which is to obviate or remove the causes of disease, and thus to prevent their occurrence. It teaches him to be cleanly in his person, active in his habits, moderate in the gratification of his appetites, and in exercise. To be careful in protecting himself against the vicissitudes of climate and temperature ; to guard against changes of weather ; against deleterious influences, either at the poles, or in the tropics. It enables him to convey the crews of his ships across long watery wastes in health, to the advantage of commerce. Scurvy, that former scourge of the mariner, has, thanks to medical science, disappeared. It is now' only a myth of the past. Hygiene indicates to man the food which is proper for him under various circumstances of his existence, and how best to prepare it for his use ; the things which are poisonous and unwholesome, and furnishes him with antidotes for the removal of their effects. It cautions him against the abuse of stimulants, and shows him when they may be employed to his advantage. It lays down rules for the healthy assimilation of his food ; tells him what to eat, and when, and how ; the uses and advantages of bathing; how long and how to sleep ; and what are the best localities to select for the restoration of his health when impaired, according to the circumstances of his case and the peculiarities THE EULOGIUM OF MEDICAL SCIENCE. 23 of his individual wants and constitution. It regulates his habits, travels, exercises, amusements, studies and occupations. It teaches him to moderate his enjoyments, to subdue his griefs, to control his passions and to regulate his intellect, stimulating its torpor, or repressing its exuberance, as the case may be. In short, there is no single subject connected with man's life, and health, and happiness, in this his mundane sphere of existence, in which medical science, as a guide, or a mentor, does not exert an allpowerfully controlling and beneficial influence. Public hygiene instructs man how to remove from his midst the prolific sources of disease ; to level the thick forests which intervene between his homestead and the free passage of the purifying breeze, and the access of the genial rays of the sun ; to drain or fill up reeking swamps and festering pools ; to cleanse foul and fetid sewers and cesspools, and the proper system of drainage and sewerage for large cities ; to build barracks and hospitals in salubrious localities ; to remove bodies of troops from those which are not so, to others that are, thus greatly diminishing the mortality of armies and the expenditures of governments ; to oppose the lazaretto and the quarantine to the introduction of pestiferous effluvia ; to purify the infected holds of ships ; to cleanse the interiors of foul and filthy dwellings, and to separate their overcrowded masses of disease-producing inhabitants, and so to build tenant-houses, as to secure alike the health and comfort of their inmates. It teaches him how to effect the ventilation of all buildings destined for the 24 ANNIVERSARY DISCOURSE. reception of large concourses of individuals —prisons, churches, theatres, public schools, lecture-rooms and halls of legislation. It secures for the interior of hospitals, that necessary supply of pure air, which assures their inmates against the prevalence of those terrible scourges, hospital typhus, dysentery, erysipelas, gangrene and puerperal fever, which have from time to time produced in those institutions such an amount of mortality, as has caused it to be gravely debated whether hospitals were not, upon the whole, a greater curse than blessing to the poor. It removes from wards and other places, into which they had obtained access, all malarious influences, by means of suitable ventilation, cleanliness and disinfecting agencies. Is a city threatened with the approach of pestilence, Hygiene points out how best to oppose it. Is it invaded, it informs the citizens of the best means of prevention and of cure. It sends its heroic servants into the midst, reckless of exposure to the contagion, of fatigue and of death, to aid in staying its ravages. It is to them, in these perilous times, that the public looks eagerly for hope, for consolation, and for safety. Nor will medical men then, as the history of all time shows, prove recreant to their sacred trust, nor faithless to their high vocation. When others flee, they are at their posts, by night and day, regardless of self, administering to the wants alike of rich and poor, in the palatial mansion, or in the garret or the cellar. Numbers sicken, and many die. '' These simple-minded men, who go about their duty for duty's and humanity's sake," says Dr. John Bell, of Philadelphia, "are only 'doctors'—members 25 THE EULOGIUM OF MEDICAL SCIENCE. of a class at whom every witling is privileged to fling a sarcasm, and whom every venal quack may accuse of selfishness, and greediness of gold." But it is not for money that such risks are run. That might, indeed, be a consolation, an encouragement and a compensation. "But it so happens that in all epidemic and pestilential diseases, the chief privations and dangers incurred by medical men, are in their attendance on the poor, the needy and the destitute, and not seldom the dissolute and stranger, who have no claim on them from prior acquaintance, or the most trivial service, and from whom they receive no fees, and often no thanks, or the slightest token of gratitude." It is in labors like these that health and life are endangered or lost, and the happiness and competence of families jeoparded or destroyed. "And can there," let me ask, with Dr. Griscom, in his admirable address before the Academy, in 1854, "can there be named any profession, high or low, feeble or strong in numbers, that gives the proportion of a thousandth part of the amount of service to charity, or public weal, that is given by the medical profession annually, without fee or reward." Hygiene furnishes to the various institutions which public or private benevolence has established for the reception and cure of the sick and afflicted poor, the agents, without whose aid that benevolence would be exerted in vain—men who devote their time and skill to the public service, for no other compensation than the hope of improving themselves and their science, for the benefit of suffering humanity. To two of these institutions I shall give a passing 26 ANNIVERSARY DISCOURSE. notice. To the old, grey, ivy-clad hospital in Broadway, relic of the olden time, because it owes its origin to the zealous exertions of two illustrious members of our own profession, Drs. Bard and Middleton. To the other, because it is the offspring of the individual and untiring efforts and benevolent sentiment, assisted by private liberality, of a devout follower of Him whose errand was mercy and whose motive was love. Appropriately named after the beloved physician, the only representative of the medical profession in the chosen band to whom He delegated His powers of healing, and His task of doing good, it exemplifies in its internal discipline the apostolic theory and practice. A model institution, embodying all that is perfect in architecture and mechanical art, as applicable to the treatment of the sick, under the able guidance of sound medical science, it is the first, if not the only hospital in our country in which a Protestant sisterhood has charged itself with the personal care of the sick. Ladies of rank, wealth and education, the Phoebes and Tryphcenas of our day, are here to be seen, secluding themselves from the pleasures and frivolities of the world, and devoting themselves, from a pure sense of duty and of love to their Redeemer, to the good work of charity and religion j a noble example, soon, I hope, to be followed in other cities of our land. If Germany exults in her Fliedner and his Kaiserswerth, I see not why we in New York, may not point with pride to our Muhlenberg and his St. Luke's. The day, I hope, is fast approaching—nay, has 27 THE EULOGIUM OF MEDICAL SCIENCE. already arrived, when the vocation of Sister of Charity will open for woman that sphere of usefulness, which her gentle nature so admirably adapts her for ; and which will procure for her means of subsistence, less laborious, less menial, and less disgraceful even, than she now possesses. The ball is rolling, and may God give it speed! I will, in this connection, also observe, that it is ever from the ranks of the regular medical profession, that the medical officers of all charitable institutions, public or private, are selected, and it is in them, and not in charlatans, however ready it may be, at other times, to employ and confide in them, that, in times of prevalence of pestilence, the community reposes its hopes of wise counsel and efficient aid ; and it is observable that it is always those of the most eminent ability who are chosen to give their professional advice to the authorities. In proof of medical disinterestedness, let me add, that of 169 medical men, who, in 1854, were actively devoted to the service of the public charities of this city (and the number is now, doubtless, greatly increased), 103 received no pecuniary compensation whatever. But, it is amid the horrors of war, that the glory of Medical Science shines most brightly, far eclipsing that of the proudest conquerors of the earth. It is theirs to destroy ; it is hers to save ! Upon the battle-field, the enemy advancing, the shot and shell falling thickly around him, the surgeon goes calmly on in his work of mercy. How often, of late, has he been seen to lay down the scalpel and 28 ANNIVERSARY DISCOURSE. assume the sword ; to head some unofficered body of troops, charge and repel the enemy, and return again to the performance of his medical duties. No heroism is greater than his. In the crowded hospital, amid wounds, typhus and gangrene ; amid want and misery, despair and death ; upon the cholera-stricken plains of India, the snow-wreathed steppes of Russia, amid the severities of a Crimean winter, he steadily plies his task of affording to the sick and wounded the resources and consolations of his benevolent art. It is then that the verse of Homer meets with its true application : " A wise physician, skilled our wounds to heal, Is more than armies to the public weal." The confidence inspired by the presence of Pare, enabled the garrison of Metz to keep the city until the gallant army that lay around it perished beneath its walls. The heroic courage of Desgenettes, in attending upon and touching the infected, and even inoculating himself with the plague to show its non-contagiousness, restored the prostrate energies of the French army in the East, under Napoleon, which had sunk, utterly disheartened, beneath the mere name of this terrible scourge. After the bloody battle of Eylau, Napoleon, in passing, found the eminent Larrey standing in the snow, under a slight canopy of branches, engaged in dressing the wounded ; on again passing the same place, at the same hour, next day, he saw the indefatigable surgeon still occupied as before. Thus had Larrey spent twenty-four hours uninterruptedly, except in the few minutes snatched 29 THE EULOGIUM OP MEDICAL SCIENCE. for a hurried repast! What finer display of benevolent zeal is upon record ? Let us for a moment consider what Practical Medicine does for suffering humanity. It comes to man at the first feeble wail of existence. It watches over his tender infancy, and protects him against the numerous ills which threaten his childhood with premature decay. It guards him against the dangers of his puberty and his adolescence, and watches over the decrepitude of his old age. It is with him in his hours of suffering, mental or bodily. It consoles his griefs ; removes his ailments ; allays his pain ; saves or prolongs his life ; stimulates hope and encourages patient endurance. " It lightens the load of human sorrow. It dispels, or diminishes the gloom of the sick chamber, and when it cannot cure, it renders less rough and painful the passage to the tomb. It smooths the dying pillow, and spreads tenderly the couch of our last long sleep. It brings rest, if not healing on its wings, and takes some drops of bitterness from the cup which it cannot remove." It is upon the physician that the fast-darkening and lacklustre eye turns, at this awful moment, for all of hope and consolation, save that derivable from religion, which the world can then bestow. Handmaid of Religion, it may, when baffled in its skill, calm, by words in season spoken, the terrors of the guilty, and infuse the balm of hope into the bosom of penitence and despair. It may reveal to the benighted mind, the attributes and mission of the Divine Redeemer. It may cast the radiance of the divine love and mercy, into the vista of that 30 ANNIVERSARY DISCOURSE. dark valley, into which the trembling soul is about to take its flight toward eternity, and cheer it on its lonely way. Thus, with ceaseless care, it follows man from the cradle to the grave ; always his best, often his only friend, when love is wanting, or powerless to aid. It is with Woman in her time of need ; that " hour of perilous hope," as it was beautifully called, by one who, alas ! did not survive it* Never are its benefits more strikingly displayed—never more gratefully acknowledged and deeply appreciated, than under these painful circumstances. Yes ! it is one of its noblest attributes, to minister to woman's need as no other profession can. Alone, it stands between her and those terrible conjunctures in her parturient condition, when nature retires from the contest; and the certain and inevitable death that impends, can only be averted by the judicious and skillful appliances of art, in aid of its exhausted resources. It assuages her fears. It allays the anguish which scarcely even the blissful prospect of maternity can enable her, with all her fortitude, to endure with patience. It rekindles the light in beauty's eye ; restores the roses to the pallid cheek ; replaces the smile and ruby on the livid lip ; gives new vigor to the failing limbs, new roundness to the wasted form, new animation and elasticity to the graceful step. It stays the hand of the Destroying Angel, when he hovers over her couch. It preserves to her the little treasure for whose possession she is perilling * The Princess Charlotte of England. THE EUL0GIUM OF MEDICAL SCIENCE. 31 her existence ; and restores the mother to the delighted embraces of her happy children, the wife to her fond husband's arms, to be once more the joy of the household and the charm of society. "What a revulsion is here, on their parts, from despairing grief to serenity and bliss ? And think you that in the filling up of this picture of domestic felicity, the thankfulness of the interesting patient herself, thus providentially rescued from her impending fate and restored to happiness and life —the gentle and affectionate pressure of the hand —the upward turning of the suffused eye, beaming with gratitude and confidence —the low tones of the feeble voice, breathing its heartfelt tribute to his skill, his patience and his sympathy —will be accounted nothing by him, whose well-directed science has been, under God's blessing, the agent in bringing to a fortunate termination, this case so replete with doubt, with difficulty and danger ? Not so ! He is neither selfish nor insensible. There is a thrill of exultation in the triumph of every professional achievement, known only to the physician —which invests its objects with a tender and abiding interest; which, teaching him what can be done, and what he can do, nerves his arm to further and successful effort. It is at such a moment of professional enthusiasm and benevolent philanthropy, that he is tempted, rapturously, to exclaim, —where is the profession that can offer as rich a recompense for all the time, labor and expense of its acquisition ? What other boast of as exalted a privilege as mine ?" In how many occasions of daily occurrence in this chequered life of ours, of distress and anxiety 32 ANNIVERSARY DISCOURSE. to both patients and friends, is the aid of medical science earnestly invoked, and how seldom in vain. In apoplectic and paralytic seizures; in suffocation from asthma, from oedema of the glottis, from croup, from sudden congestions of the lungs from disease of the heart and great vessels, when the livid sufferer is gasping for the breath of life ; in cases of real asphyxia from drowning, choking, or hanging; in the gushing forth of blood from some great vessel, organ, or cavity, when life is being borne fleeting away rapidly on every crimson drop in its impetuous flow ; in inflammation of great organs, of the pleura, of the lungs, the heart, the bowels ; in the terrible and appalling childbed fever ; in hysteria, with its alarming spasms, and in colic, with its racking pains ; in cholera morbus ; in the heart-rending convulsions of children ; in alarming prostration and exhaustion : in the muttering delirium, or maniacal struggles of typhus, or delirium tremens ; in fever, with its tedious and wasting course of restless uneasiness ; in poisoning, and in many other casualties that might be enumerated, what would suffering humanity do without the aid of the physician ? How eagerly is his aid invoked; how anxiously is his opinion awaited! Whatever may have been our previous idea of the power and certainty of medical science ; however much we may have depreciated or derided it, it is then, to use the language of Byron, we call its votaries to attend us, " without the least propensity to jeer." The doctor is then all in all, and it may be safely said that Medical Science, in these disastrous emergencies, is true to its great trust, and worthy of its high vocation. 33 THE EULOGIUM OF MEDICAL SCIENCE. Scarcely ever does it fail to afford some, often complete relief —almost always prolonging, often saving life and curing disease. A little reflection on your own experience will convince you of the truth of these assertions. Which of you is there that cannot recall at least one instance, where the life of some dear friend has been saved, or his sufferings palliated, under one or other of the circumstances I have named ? And is this the science to be contemned? Are these the men to be slighted, treated with injustice and ingratitude, "insulted, often, by the offer of a pittance which even a day laborer would scorn?" How ready must be their knowledge ; how prompt, how energetic, how judicious their action? Upon the slightest error in judgment, or lack of memory or skill, or delay, or hesitation, or timidity in the physician, hangs the existence of the patient. It trembles in the balance, and the turning of the scale, for life, or death, is in his hands. Amid the alarm, the confusion, the tumult of excited friends— the frantic ejaculations, the heart-rending sobs of husbands and wives, of parents and children —amid all the horrors of the scene, in the gloom of night, as in the glare of day, without premeditation, with scarcely time for thought, or reflection, the physician is calmly to proceed at once to demonstrate the power and the triumph of his beneficent Art —"the power of Art, without the show. 11 " With heart affected, but with look serene, Intent, he waits through all the solemn scene." 3 34 ANNIVERSARY DISCOURSE. I will not speculate upon what may be his reward. Lastly, as further proof of what Practical Medicine has done for mankind, let me instance the material prolongation of life during the last fifty years, the average duration of which has increased, since the 16th century, from eighteen years to forty-three. The vast increase in the number of Life Insurance Companies, in this and other countries, whose table of rates are based upon the most accurate calculations derivable from the statistics of longevity, the moderation of their rates of charge, and the profitable nature of their business, are additional evidences of the increase of duration of human life, due solely to the improvements made in Medical Science, during the last fifty or sixty years. Let us consider for a moment what was, less than fifty years ago, the condition of those who labored under what Dr. Johnson has called "the greatest of human calamities, the deprivation of reason," and contrast it with the present. I will offer you but a single instance, which may serve as a specimen of all the rest. It is taken from Brown's, " Asylums as they were and as they should be," and is the description of a prominent institution for the reception and treatment of the Insane, in 1815, only forty-four years ago. I will take " not a single captive," but several, and " having shut them up in their dungeon, we will look through their grated door and take their picture."—{Sentimental Journey.) * ' The first common room you examine, measuring 12X7, with a window which does not open, is perhaps for females. Ten of them, with no other covering than a rag around the waist, are chained 35 THE EULOGIUM OF MEDICAL SCIENCE. to the walls, loathsome and hideous ; and, if you ask where these creatures sleep, you are led to a kennel 8 feet square, with an unglazed air-hole of 8 inches in diameter ; in this, you are told five women sleep. The floor is covered, and the walls bedaubed with filth—no bedding but wet, decayed straw is allowed, and the stench is so insupportable that you turn away and hasten from the scene. Each of the sombre colors of this picture is a fact. And these facts are but a fraction of the evils which have been brought home to asylums as they were." Look from this loathsome picture to that of my painting. In a spacious, well-lighted, well ventilated, well constructed edifice, exclusively destined for his reception, situated in some picturesque locality, dwells, cleanly, neatly, and warmly clad, well fed, and retiring at night to a comfortable dormitory, the object of soothing kindness to all about him, in quiet, comfort and security, the pauper lunatic of the present day. In these noble examples of governmental and medical philanthropy, the clank of the chain, the echo of the lash, is never heard. No piteous screams of suppliant agony appall —no fetid smell or sickening sight disgusts the gratified observer. No blow is ever given, or returned, on pain of the instant dismissal of the offender. No instrument of coercion is employed, save occasionally and rarely, a leather wrist-cuff, or a camisole. No punishment is inflicted beyond a slight showering, or a temporary seclusion, in cases of extreme refractoriness. Medical experts minister to his physical needs and to his mental 36 ANNIVERSARY DISCOURSE. ailments, and a large proportion of cures, in curable cases, reward their devotion. The insane are judiciously classified. Besides skillful medical treatment, every means of amusing, occupying and interesting the minds, and dispelling the hallucinations of these unfortunates, is had recourse to. Dancing and music resound through the spacious halls. Libraries and work-rooms afford agreeable occupation and distraction. Newspapers, periodicals and prints abound. Baths are provided, and their use insisted upon. Spacious grounds and gardens afford the means of pleasant exercise, repose or occupation. In many of our Insane Asylums, lectures and orations are delivered, microscopes and magic lanterns exhibited, and even plays performed ; while weekly concerts and balls, in which the sexes happily intermingle, fill up the measure of enjoyment.* Nor are the soothing influences of religion denied to the afflicted. All outward appearance of restraint is carefully avoided, and reliance had, in cases of violence, solely on the aid of resolute, but gentle and skillful attendants. What contrast can be greater! And it is to the labors and philanthropy of medical men, and the improved state of medical science, be it recollected, that this ameliorated physical condition, these extraordinary privileges and indulgences, these increased chances of * The Tennessee Hospital, six miles from Nashville, is 405 feet long, by 210 wide. It is warmed by steam, and ventilated by a centrifugal fan, driven by steam. An extensive greenhouse, well-stocked, has recently been added, in which the patients take a lively interest. In two years, 28 patients have been cured and 8 improved. 37 THE EULOGIUM OP MEDICAL SCIENCE. restoration to mental sanity, on the part of the insane, are due. This I say with pride, as a physician. With equal pride I say it as a citizen, that in few countries in the world can our own benevolent Institutions of this class be approached —in few equalled —in none can they be surpassed. They constitute, amid so many titles to that honorable distinction, one of the strongest claims on the part of the United States of America, to be ranked as a humane, an intellectual, and a Christian community.* It would be unjust and unpatriotic in me if I were not to take some notice, in this discourse, of the growth and progress of medical science in our own country. The history of medicine in the colonies before the Revolution, would not be uninteresting, had I time to present it to you. It allows only of my introducing the following extract from the pamphlet published on that subject, by the late learned and lamented Professor J. B. Beck. "The Revolutionary war succeeded. During that eventful period, our profession stood firm in their country's cause ; and the names of Warren, Mercer and Rush, show that they were not idle spectators of the fray. The Revolution accomplished, and an independent government established, a new career was commenced. Medicine, in common with everything * I am happy to add, in this connection, that encouraging progress has been made in the treatment of Idiocy, in this State and in Massachusetts, which affords a fair prospect of success even in apparently hopeless cases. An Asylum for the cure of Inebriates, has also been established in our State, which was much needed, and cannot fail to be attended with the happiest effects. Seclusion, with complete and compelled abstinence, is the only cure of this terrible and real malady. 38 ANNIVERSARY DISCOURSE. else, felt the sacred impulse ; and during the brief period of our independence, how has the scene changed? Instead of the feeble beginnings of one or two institutions, upward of forty well established medical colleges and numerous schools for private instruction, are now to be found in every part of the country. Every city has its hospitals, with able staffs of physicians and surgeons ; a thriving professional literature has sprung up amongst us. Excellently conducted journals disseminate their rich stores of information, and we can boast of writers whom we are not ashamed to mention, along with those of European birth and fame. What nation eve?'accomplished so much, in an equal space of time, and under equal circumstances" " If," says Sewell, {Led.) " in sixty years, with the limited means we have possessed, and with all the difficulties we have had to encounter, we have produced the best system of Medical Education, the most perfect code of Medical Police, that have ever been exhibited to the world ; if we have produced some of the best practical and elementary works, and some of the most eminent physicians and surgeons of any age or country —if we have done all this in the sixty years that are past, what will our advance be in the sixty years that are to come ?" On this triumphant pinnacle, I might safely leave the subject of American medical science. But memory, looking back upon the past, lingers with a fond regret beside a few hallowed graves j and sadly sighs forth an Alas! for the venerable Physick, father of American surgery, the pious Rush, Wistar and Dewees, of Philadelphia; for Warren, of Boston ; 39 THE EULOGIUM OF MEDICAL SCIENCE. for Bard, Post, Miller, Bayley, R. S. Kissam, the mighty Hosack, beau ideal of the physician and the lecturer, the learned and eccentric Mitchill, the intellectual Becks, the skillful and amiable J. Kearney Rodgers, the practical and benevolent Johnston, of this city ; all of whom are doubtless enjoying their well earned reward. But there are happily among us yet, their venerable heads silvered with the frost of years, but still toiling on in the good cause, and long, we hope, to be yet spared to do so, some to name whom can stir no envious feeling in a generous heart, and elicit no sentiment save one of regard and admiration. Men, whose names, when they too shall have departed from among us, will live, while it lasts, with those of their illustrious predecessors, on the brightest pages of their country's medical history ; and who, though dead, will yet speak, in the influence of their teaching and example, to unborn generations, for centuries to come! Batchelder, Delafield, Francis, Mott, Stevens, Jos. M. Smith, these, fellow members of the Academy, these are our jewels ; let us value them as they deserve. I desire, in conclusion, to say a very few words upon the certainty of medicine, and the relations of the public toward it. To borrow the language of the late Elisha Bartlett, M.D., in an eloquent little work on the " Degree of Certainty in Medicine, and the nature and extent of its power over disease M I am only stating what every one knows to be true, when I say, that the general confidence which has hitherto existed in the science and art of medi- 40 ANNIVERSARY DISCOURSE. cine, as this science has been studied and this art practiced, has within the last few years been evidently shaken and disturbed, and is now greatly lessened and impaired. The hold which medicine has so long had upon the popular mind is loosened. There is a wide-spread skepticism as to its power of curing diseases ; and men are everywhere to be found, who deny its pretensions to a science, and reject the benefits and blessings which it offers as an art. The charges against our science are, that it deceives itself in these matters. That its pretensions are altogether false, or greatly exaggerated. That its knowledge of disease is vastly less than it professes to be, and especially, that its power of curing and mitigating disease has been immensely over-estimated and over-stated. It is held to be very limited in extent, and very uncertain in application. These are grave charges, robbing our science of its chiefest grace and glory, and taking away its highest claim to the regard and gratitude of man. And it is desirable for the interests of truth, of science and humanity, that they should be gravely met, and that the legitimate claims of medicine to the regard and confidence of mankind, should be indicated and maintained." Into this subject I would gladly enter did time allow. But it wanes apace. All that I can now say is, and you will not, I hope, incline to deny it, that "the obligations of mankind to the science and art of medicine, as they have been taught and practiced, and with all their shortcomings, are beyond all measurement or estimate. There is no process that can reckon up the amount of good which they 41 THE EULOGIUM OF MEDICAL SCIENCE. have conferred upon the human race : no moral calculus, which can grasp and comprehend the sum of their beneficent operations." — (Lib.cit.) "The millions of money expended in the vast military stores of Woolwich and Cherbourg, lack the ability to destroy human life to any such degree, as one drop of despised cow-pox matter, with its power of multiplication in the system, has to save it. The lancet of Jenner has, during the last half century alone, saved in the world more human lives, than during the past or any other century, in the history of man, warriors were ever yet successful in destroying."— (Simpson.) Although there are many diseases which would probably recover without any active treatment —and some which are in their very nature inevitably fatal; there are others again, in which it is impossible to doubt that their severity is mitigated, their duration abridged, and their issue successfully determined, and the life of the patient saved, by prompt, appropriate, and judicious medical treatment. In the second of these classes is shown less the uncertainty, than the impotence of the art; and for this it may be pitied, but it cannot be blamed. Yet, even in all these sad cases, treatment may alleviate suffering, protract life and render it less burdensome, blunt the arrows of death, and smooth the inevitable pathway to the grave. We must not expect from medicine a mathematical certainty. Probabilities more or less great and numerous, are all that are permitted to the physician. Differences of opinion will arise in obscure cases j less frequent, however, among medical men of equal learning and experience, than the public is disposed 42 ANNIVERSARY DISCOURSE. to believe. But medical science, like every other product of human intellect, is imperfect. " In respect to the uncertainty of medicine," says the eminent Dr. A. H. Stevens, in some published address to a graduating class, " it is less uncertain than law, and settled as much as theology. Of all these, the fundamental principles are clear enough, but the details are more or less uncertain, and the subject of inquiry and research." Why then, in an art so difficult in its very nature as medicine is, should unanimity of sentiment be looked for, or difference of opinion be condemned? There is a limit beyond which man cannot carry his researches ; and science then enters into the domain of the Infinite. For the diseases now considered as inevitably fatal, remedies may hereafter, perhaps, be discovered ; but it is, I fear, however sanguine we may be in our expectations of the future, in reference to the past, in the chance of removing their causes, and so preventing their occurrence, that our best hopes must lie. But while we claim for medical art no exemption from the imperfections and frailties of all human conconcerns, we may boldly, and without fear of contradiction, assert that, as it has been embodied in the lives and labors of its professors during 2000 years, it has been worthy its high vocation, true to its great trust, and faithful to its almost divine mission ; and that this is more true of it now than it ever was before. On the action upon the human organism of, and on the cure of disease by bark, iron, mercury, iodine and some other remedies, the physician may depend 43 THE EULOGIUM OF MEDICAL SCIENCE. with a certainty almost as great as that of the chemist on the combinations which go on in his laboratory. Who can contemplate without emotion the horrors of syphilis, and the extent and variety of wretchedness which must have flowed from it, unchecked and uncontrolled by art, and reflect on its now comparatively easy, speedy and certain cure, and not acknowledge that in medical art there is both power and certainty, and that it is a boon and a blessing, which ought to secure for it the deep and lasting gratitude of mankind. There is, believe me, no royal road to the cure of diseases. The pompous, shallow and delusive pretensions of charlatanry may seduce for a while, but they will end in regret and disappointment, and, after a time, be heard of no more. New systems of practice, originating in the cupidity and ingenuity of needy individuals, and based neither upon fact nor sound principle, may, for a time, obtain an unmerited confidence, and seem to threaten a serious opposition to established methods of treatment. Such is that specious absurdity, that pseudo-scientific do-nothingism, homoeopathy. But, even as I write, its knell is being sounded by one of its own most consistent and fanatic disciples. "We all know," says Dr. Herring, of Philadelphia, " that the numbers in our homoeopathic ranks are not lessening; but it is the general observation that the numbers are year after year increasing, of those who, instead of deriving benefit from homoeopathy, are made incurable by so-called homoeopathic practitioners." Time disposes of all these chimeras. Nature as- 44 ANNIVERSARY DISCOURSE. serts her rights, and it is, at last, upon the good, old, true and legitimate system of medical practice, deduced from accurate observation and experience of disease, and the action of remedies upon it, that we must alone rely for its successful treatment; or else trust to the limitedly curative, and often most mischievous influences of the Vis Medicatrix Natures, or suffer it to hold, unopposed, its fatal sway. Medical science is the beneficent gift of a merciful God to suffering humanity, and, coming from such a source, is not to be despised. It has its defects and its inconveniences, but they are not of its own creation. They are inherent in its nature. The pain and annoyance to which it subjects us when sick, are necessary parts of a system derived, by the agency of human intellect, from the pure and everflowing Fountain of all good. The nauseous drug, which we swallow with such repugnance, contains, in its recesses, the active principle, or possesses the peculiar mode of agency which is to operate upon the human organization, and influence and overcome diseased actions. God has kindly permitted man to discover and obtain these remedial agents, and to learn to apply them more or less successfully in the cure of diseases ; and we must not despise or refuse them because of their unpleasantness. Such, indeed, has been our success in these investigations, that we may ask triumphantly, with Sir G. Blane: "Is there an organ or function in the animal economy, which cannot either be incited, or restrained by some natural agent discovered by man j 45 THE EULOGIUM OF MEDICAL SCIENCE. and is there a malady, which, even in the present imperfect state of the medical art, does not admit either of cure, or palliation by some specific remedy, or mode of treatment already found out ?" — (Med. Logic.) Let us avail ourselves of them, then, when needed, with patient and grateful endurance, blessing alike the Divine hand which provides them, and the human hand which presents them to our fevered lips. I have said that the hold which medical science has so long had upon the public mind was loosened, and that new and false systems threatened to contend with it for the public confidence. " But there is no danger. The work of 2000 years is not to be demolished by the noisy clamor of a few penny trumpets. As surely as truth is immortal, science progressive, and honesty and benevolence continue to be the characteristics of the votaries of medicine —as surely as zeal and good will go hand in hand with skill and energy, with observation and experience, so surely will the present distrust toward our science and our art pass away. The ancient confidence will be restored. The old love will come back again, truer and deeper for the transient and passing estrangement. " The light of the constellations may be temporarily obscured by the glare of the fire-work ; but when the blaze shall have died away, lo! the everlasting stars are still looking down upon us, with their dear, old, familiar smile of affectionate recognition, undimmed in their brightness and unchangeable in their beauty, from their blue depths in the firmament."— Bartletfs Inq. To paraphrase slightly the beautiful figure, which 46 ANNIVERSARY DISCOURSE. forms the conclusion of Dr. Alfred C. Post's admirable anniversary oration for 1849 : The science of medicine is a lighthouse, built upon a rock. The angry billows of quackery may dash with impotent fury against its base, but they recoil in empty foam. The winds and rains of sarcasm and calumny may beat against its sides, but it will stand secure throughout all generations ; and from its lofty summit shall glow the beacon lamp of truth and reason, sending forth its lustrous beams of hope, consolation and healing, over suffering humanity, until time itself shall be no more. I commend, then, my kind hearers, the science and the art of medicine to your confidence, your respect and admiration, for they are worthy of them. I commend the physician, who labors so zealously for your welfare, and into whose hands you put the lives of all that are dearest to you, and your own : on whom, in sickness, you rest your hopes, and in whose honor and secrecy you safely repose your most sacred confidences, to your affectionate sympathy and regard. Look upon him as a friend anxiously striving for your relief, according to his best judgment, and the rules and resources of his art; not as a careless and indifferent haphazard experimenter and speculator in probabilities, or dealer in conjecture. Respect his feelings, for they are acutely sensitive, and easily and deeply wounded often, by acts that to you seem natural and trivial. Think of his responsibility, and be docile to his injunctions. Yield to him your entire confidence ; do not dictate to 1 him the course he shall pursue, but submit readily and hopefully to that which he shall indicate. You will thus inspire him 47 THE EULOGIUM OF MEDICAL SCIENCE. with courage and with zeal in your behalf. Be not influenced by the ever-mischievous, however wellintended, interference of friends and outsiders. Hold him not too closely responsible for results which lie, after all, in the hands of a greater physician than he, and which he may not be permitted to control. His lot is not an enviable one ; his life one of toil and anxiety j often a long struggle with adversity, ever in contact with misery, disease and death. At all hours, in all weathers, whether sick or well, fresh or weary, you claim his services, and he denies not the claim. He walks the dreary streets night after night, that others may sleep the sounder. The footsteps that echo on the drowsy ear of the citizen, as he lies ensconced in his warm bed, listening to the howling of the winter's wind, and congratulating himself upon escaping its fury, are those of the physician, as he speeds on, defiant of the pitiless pelting of the storm, on his errand of mercy. Whose benevolence is more practical and extensive ? How much of his precious time and hard earnings are devoted to the poor! How wise, how calm, how bold, how prudent, patient, prompt and self-possessed must he be on every unforeseen emergency ; his knowledge ready in his head, his skill at his fingers ends! How reckless is he of life, of fatigue, of exposure ! How much of man's caprice and petulance, injustice, insult and ingratitude must he not endure ! And oh! how often is the modest pittance claimed in compensation for all these sacrifices and these services, grudged him, disputed, or denied! If, by these imperfect observations, which I thank 48 ANNIVERSARY DISCOURSE. you for having heard so patiently, these aims shall have been answered, this " consummation so devoutly to be wished " shall have been attained, the labor of preparing them will not have been undergone in vain. Fellow-Members of the New York Academy of Medicine : Your hearts this night have, I trust, responded, with proud emotion, to the pleasing picture, imperfect as it is, which I have drawn, of the present state of our noble, our divine science, of our beautiful and beneficent art. More, indeed, I might have said, but less, I could not. Let us " To ourselves be true, And it will follow, as the night the day, We cannot then be false to any man." True to our one faith,* let us, upon our common altar, pour forth our libations of praise and thanksgiving to the Great Physician both of the soul and the body, for the success which has thus far attended their progress. Upon it, let us pledge ourselves, heart and hand, body and soul, to increased exertions in their behalf. Before it, let us invoke the continuance of the Divine blessing upon our work of mercy, that, year after year, we may derive a richer and a richer reward for our labors, in their increasing usefulness, and in the greater confidence and veneration of mankind. * Motto of the Academy: Una Fides, Commune Altare. The Eulogium of Medical Science. DR. WM. C. ROBERTS' ANNIVERSARY DISCOURSE. November, 1859.