".tyR',*' t INTRODUCTORY LECTURE DELIVERED AT THE OPENING 1 Jtfetrical eoWfle of tHe Stat* of So* <&*; November 12th, 1838. BY J Professor S. H. DICKSON, M. D A>3 Published by the Class. -fin- CHARLESTON: PRINTED BY A. £ MILLER, Na 46, East-Bay. 1838. INTRODUCTORY LECTURE. Once more, gentlemen ! I am permitted to enjoy the gratification of meeting you within these walls, and of welcoming you to the re-commencement of our mutual labors. With sincere pleasure I recognize among you many familiar faces, and gladly anticipate the day when even those countenances, now seen for the first time, will wear for me the delightful expres- sion of esteem and friendship. I resume with feelings of profound and solemn awe, the duties of my highly responsible station. It appals me to reflect, that unless I fail most egregiously in my efforts to gain your con- fidence and influence your opinions, I am about to be engaged in spreading abroad the knowledge of valuable truth on the one hand, or on the other, in dis- seminating error and delusion. Yet, amidst these anxieties, I am supported by a conscientious resolution to shrink from no toil however arduous, which may be necessary to fit me for my task; to inquire honestly for truth; to abandon error, as soon as I discover it; and to confess ignorance whenever I have failed to attain knowledge. Unless you aid me, however, by corresponding at- tention on your parts, unless you bestow upon your studies all your time, and devote to the objects of your present pursuit, every faculty of your minds, I can hope to effect nothing. Without your zealous co-operation, however faithfully my colleagues and myself may carry on the ordinary course of Academic exercises, instituted for your instruction, no single end will be gained, and time of infinite value to you and to us will have been spent in vain, and worse than in vain. But 4 we hope for better things. We trust that you have duly ponsidered the high standing of the profession of which you propose to become members, and the weighty ob- ligations you are about to incur in entering its ranks. From the earliest times, our order have set them- selves with unabated zeal and untiring patience, to mir tigate the sufferings of their fellow men. We have watched by the gray dawn, through the noontide heats, and all the livelong night, at the bedside of the sick, to catch the first ray of hope, to seize upon the first favo- rable moment in which to offer our kindly aid. While others have fled before the approach of pestilence, we have remained by the noisome couch, we have breath- ed the foul breath and inoculated ourselves with the deadly secretions of disease, to wrest even from the grasp of the poison some salutary instruction. Nay! to protect and preserve the living, we dare the very va- pours of the charnel-house, and inhale the revolting effluvia from the dead. Like the Prometheus of the Greek Poet, it has been our pride to struggle against Fate herself, and to traverse with unbending resolution the evil current of destiny. It is ours to stand in the breach—to arrest the contagion that infects whole nations; to check the course of the destroyer, and to put limits to the sway of the dread king of terrors. We are called upon to sustain the fainting spirit, and feed the flame of almost exhausted vitality ; to restore impaired vigour and lost powers of action and enjoy- ment. We are expected to " minister to the mind diseased;" to relieve the tortured imagination from the horrors of a gloomy delirium; to temper the violence of passion; to regulate the wildness of the will; and to seat the vacillating intellect upon a steady throne. These scenes—such entire and unreserved immo- lation of self—such devotion to the call of duty; de- mand a firmness and courage of more inflexible grade and of finer texture, than all the other avocations of life. No transient excitement can sustain us in this protracted self-sacrifice, no love of applause, no intoxi- cating impulse or exhilaration of sympathetic and mul- 5 tiplied feeling, We labor, we suffer, we die alone. No crowd surrounds us to increase by its huzzas the ani^ mation of victory, or cheer the gloom of the grave. Yet of the thousands of our brethren who have thus like Curtius leaped into the gulph, and thrown away their lives for their fellows, not one, as we fondly believe, not one has failed to find his obscure virtue, its own rich reward; its quiet daring, its patient endurance sustain- ed and illuminated by the delightful consciousness of doing good—by the divine luxury of benevolence. If there be one among you who does not find himself warmed and spurred forward by such examples, who does not anticipate with glowing enthusiasm the day when he too may join these shining ranks as a volun- teer and if need be a martyr, I tell him plainly, that he has mistaken his vocation—that he is not one of us— that he is not worthy to unloose the shoe-latchet of those glorious Philanthropists to whom I have alluded, and who to the honor of our profession and of humanity, are in every age and nation so numerous, that their bi- ography would fill another library of Alexandria. He may be gifted and useful, but it must be in another sphere. He may found a city, or improve the processes of Agriculture, or the machinery of manufactures; he may win a naval battle, or ride red-hoofed over the mournful field of conquest; but unless he can possess his soul in tranquillity amidst the busy solitude of a lazar-house, and perform without repugnance the most menial offices of kindness to an unknown pauper, he is not, he never will be a Physician. Let it not be supposed, that I am ignorant or forgetful of the infirmities of our nature, or unaware of the alloy and imperfection of the best human incentives to action. In the phrase with which the Persians conclude all treatises on every subject, I too would humbly acknow- ledge " There is nothing perfect but God! —but you will readily understand, that I speak of the ruling pas- sion the impelling motive, the master propensity. In the true Physician this must be benevolence, and can be pothing lower. Its energy may be increased perhaps, 6 its efforts certainly may be doubled, by the stirring in- citements of ambition, by the hope of wealth, by the wish to attain importance and influence in society; all these are allowable, it may be praiseworthy, if the hand be pure and the heart be right, and every other feeling be kept subservient to the engrossing purpose, the ab- sorbing desire of doing good. Do I require too much of the aspirant after medical honors 1 Surely not. Without the support of such principles as I have indi- cated, and of such enthusiasm as I have pronounced necessary, he will fail in the hour of trial. His wea- pons, if of less than this celestial temper, will shiver in his hands when he has entered upon the strife which awaits him, and finds himself jostled in fierce collision with all the difficulties which are to surround and press upon him. Nothing else can preserve him from the arrogance of dogmatism, the bitterness of rivalship, the stings of jealousy and envy, the mean subservience to popular prejudice and vulgar clamour, in which he will make shipwreck of the proverbial honor, the pris- cafides of the profession, and in his anxiety to promote his own objects and aggrandize himself forget his patients, his concience and his God. It is easy to shew that I have exaggerated neither the extent of the sacrifices, the exhausting and weari- some weight of duties, nor the wide and lofty efforts demanded of the'profession. Armstrong mentions incidentally in his writings, that the students who walk the hospitals, and attend the winter lectures in London, are very generally bro- ken in health before the return of spring; and such is the experience also of the American schools in a nota- ble degree. One of the most eminent of our statistical inquirers, has declared his belief that the average du- ration of the lives of Physicians is less than that of any other class of men among us—not exceeding, as he thought, ten years of actual practice. I will not assert the correctness of this calculation, but its approach to the truth, may be inferred from the published re- searches of Caspar, on the average duration of life of 7 men of various classes in Germany. The chance of attaining the age of 70 is for the Physician, compared with the Theologian as 24 to 33—with the Agricultu- rist, as 24 to 40, and even including all the contingen- cies of a military life, with the Soldier, as 24 to 32. Of 1000 Theologians, the deaths in the prime of manhood, that is between 33 and 52, were 122. There past beyond the age of 80—no less than 70 of these. Of 1000 Physicians, 347 died between 33 and 52, and only 30 of them reached the 80th year. He concludes that barely one fourth of the class of Physicians attain the ordinary duration of human life. Of the 120 Graduates who received their education here within the three years preceding the last course of lectures, we had heard of the death of eight. This gives an average duration of life after entrance on practice, of considerably less than 15 years; a melan- choly result indeed, when we reflect that the subjects of this calculation were all in the very prime of youth- ful vigour. The intellectual labors of the Physician are as un- remitting as his responsibilities are burdensome, and his duties wearisome and exhausting. In every other branch of human science, the range of necessary at- tainments is comparatively limited, while medicine— the art of healing, is founded upon a basis no less wide than shall serve to include the entire circle of know- ledge, making tributary all science and every art. The Physiologist must be familiar with history, geo- graphy, and statistics, for without such research, he will be very partially informed of the condition of the numerous varieties of our race. The Pathologist must inquire into all the changing circumstances that affect the animal health; he must comprehend the nature and influence of manners and customs—occupations amusements, fashions, and modes of life. He must un- derstand the operations of all the laws both of the greater and lesser morals, and the results of breaches of these laws—die effects of all vice and excess. He 8 must be skilled to trace the connexion between cause and consequence, and prompt to detect a transient agent in its moment of efficiency. The Anatomist must be a mechanician, or how shall he understand the pe- culiar adaptations of the wonderful structure before him. He must know the properties of light, or how shall he perceive the beauty and fitness of the eye; the laws which govern the production, transmission and modification of sound, or how shall he compre- hend the formation of the ear and of the larynx. The Practitioner must be familiar with all this and much more. Earth, sea and air, which abound with so many and such diversified agents of evil, which furnish forth so many causes of disease—earth, sea and air must be ransacked by him for remedies; weapons with which he shall repel that enemy " whose name is Le- gion." All herbs, "from the cedar to the hyssop," must be infused, pulverized, distilled, must yield their most delicate aroma, their most recondite principle; all wa- ters must be analyzed, the pure distinguished from the impure, and the most offensive impregnations convert- ed into available medicaments. Many of the metals and most of the earths have been in some of their combinations, prest into his service—and the Miner and the Chemist and the Alchemist have become his useful allies. Still further, he must not only thus put nature to the question and force her to reveal whatever of medicinal virtue lies hid within her ample bosom, in the gross material universe, but he must contemplate her in her higher and more noble capacities and con- ditions; he must explore the moral and intellectual, no less closely and intently than the physical world. He must learn the force, quality and direction of the instincts, the propensities, the feelings, sentiments and emotions which rule within us, and by their develope- ment and preponderance, assimilate us with the Deity or the Fiend, rendering us amiable or hateful, happy or miserable. " All thoughts—all passions—all delights, Whatever stirs this mortal frame----—— 9 rriust be analyzed and carefully collated; for all our* modes of suffering and enjoyment, come within the scope of his investigation, as affecting the great ques- tions of Hygiene and Etiology. Well might the Coan exclaim, in reference to this immense field of research —Ars longa—-vita brevis! occasio preceps! But we must not allow ourselves to be discouraged by these views. It is true that an absolute ignorance of any of the departments of human knowledge, would be un- pardonable in the Physician ; it is also true that he may attain a high reputation, and a deservedly eminent rank in his profession, without a minute or technical familiarity with many that have been alluded to. In science as in art, the division of labor has facilitated our progress and rendered acquisition easier than of old. The Chemist, shut up in his laboratory, plies furnace and crucible, and after years of toil communicates an important result, or discovers a new and powerful agent. The Botanist in his walks through the green- wood or the valley, finds a plant of rare and impressive virtue. The Naturalist, the Phrenologist, the Meta- physician, the Philosopher, each in his turn ascertains some fact, and thus adds his quota to the mighty mass brought together from all quarters. The task of selec- tion has of late indeed assumed a new importance, and requires nice tact and sagacity in its performance. Our literature too has undergone a corresponding mo- dification, and compendious treatises on all subjects are loudly called for. It is the very spirit of the age to condense and concentrate, and he who wishes to be read at all must write briefly. Quartoes are almost un- known to the modern press, and the ponderous folio, in which the wisdom of the ancients delighted to expand itself, is no more. We have felt the value of time, and are content to accept and act upon the system of mu- rual instruction. Nor am I willing to admit that this state of things is attended with the evil and disadvan- tage that some have urged. To be useful, it is not al- ways necessary to be profound. It is often best to be satisfied with, and proceed to carry out results with 2 10 which others have furnished us. Let us remember. that all knowledge is comparative, and the most exclu- sive inquirer, the most devoted and ardent student, however indefatigable, however successful in his re- searches, may be termed in this sense superficial and a smatteror,—that he has failed, namely, to attain any ul- timate limit, and that the farthest stretch to which he may have urged his efforts, serves but as a starting point for his successors. Thus a Brewster finds employment in remodeling the philosophy of a Newton, and a Grant corrects the errors of a Cuvier. Let me not be understood however, at any rate, to lower in the least degree the standard of professional acquirement. It is infinitely easy to know too little— infinitely difficult to know too much. I would rather widen the field and extend the boundaries of inquiry. I would take in an ample horizon. With moderate attainments, I have said, it is possible to be useful, by the exertion of a conscientious and dilligent industry; but this must be in a small and narrow sphere, with which no youth of spirit or emulation would be con- tent. We may spend a few moments not unprofitably, in taking a rapid survey of the actual state of Therapeu- tics, or the Practice of medicine, properly so called, in the several countries of the globe, and in endeavouring to ascertain the true position of our science, the ground upon which is based the art of healing, as at present understood, practiced and taught. Let us inquire whe- ther any principles are established—any doctrines re- ceived as elementary. What is the complexion of mo- dern Medicine 1 Is it embodied in the shifting Kaleidos- cope of theory, or shall we look for it in the vagaries of a contradictory Therapeutic 1 Which of all the ve- hement and angry disputants who fill the arena and stun us with their noise and dogmatism, shall we pro- nounce to be in the right, or shall we venture to de- clare them all equally in the wrong] What clue shall we seek to guide us through this labyrinth 1 These ques- tions seem at first difficult and embarrassing, but if in- 11 vestigated with the proper spirit of philosophic rea- soning, adrrtit of a ready solution. No one will doubt or deny that facts ascertained by experiments sufficient- ly clear, and repeated sufficiently often, and observed by a sufficient number of competent witnesses, must be taken as the bases of all the sciences, and of ours among the rest. The ready reception of bold assertions, the prompt credulity which entertains without proper in- quiry statements and explanations confidently offered, these constitute Empiricism. The very phrase is odious to the professional ear, but we cannot escape from the alledged necessity. We must still search for, accumu- late and collate facts, in order to make any advances. It is obviously incumbent on us, however, to lay down for our safeguard and direction, some rules of evidence, and establish some definite test by which we shall separate truth from falsehood, and avail ourselves of the former, while we endeavor to shut out all error and deception. And here we may pause to pay a tribute to the memory of the illustrious Cullen, to whom more than any other of our revered predecessors, the Prac- titioner of the present day is indebted for whatever is most clearly established in the prevailing system of Therapeutics. To Cullen we owe the " rational Em- piricism," as it is styled by one of his recent eulogists, —which guides the practice and instructions of the British and American Schools of Medicine, constitu- ting indeed the peculiar stability of that Therapeutic which has so long withstood all the stormy changes of theory, and which, admitting to be interwoven with it all the improvements of every tributary science, grows with their growth and expands as the boundaries of human knowledge are enlarged. Against this rock have beaten in vain the turbulent waves of Brownism, and Broussaisism and Hahnemanism. In contrast with it, all the antagonist heresies are shifting and transient; nay they cannot fail ultimately to contribute to its sup- port and confirmation. Each theorist appeals at last to facts—there is no alternative; each consents, and must consent to be judged by the observed results of 12 the application of principles or hypotheses suggested, If, says Broussais, the most ingenious and obstinate of dogmatists, in his late forcible strictures upon the numerical plan of Louis—"if it can be proved upon experience that Tartar Emetic will relieve a Gastro Entente, I will administer it; if Arsenic will do good, I will prescribe that." This then, we may recognize, as the primary rule, the elementary principle of our science. We may regard the Cullenian Philosophy of Rational and Eclectic Empiricism, as established beyond the reach or prospect of further controversy. All that remains is to define exactly what is meant by the qualifying adjective ■ rational,' and to lay down such rules of evidence as shall commend themselves to all men upon the universal grounds of reason, justice and truth. But we cannot set up any new methods for the exam- ination of testimony in reference to alledged facts—r we must employ the same tests which are resorted to in Logic, Law, Natural Science, Natural and Moral Philosophy. Our Empiricism will indeed be rational, enlightened and Eclectic, when it is thus guarded;. storing up recorded observations, cautiously considered, duly weighed, carefully collated, and from these, by the Baconian method of deliberate induction, proceeds ing to infer principles and wea\ e a tissue of doctrines. It may be, nay it must happen, that we shall be occa- sionally hasty in this deduction, and regard principles and doctrines as settled, which time shall overthrow by adducing new, clearer, and more precise facts in opposition or illustration. But this is obviously no, fault in the system ; it is merely the result of the known and admitted imperfection of all human knowledge, and the slow progress of all human attainments. We know we are in the right path; we must not expect to find it free from intricacy and impediments; we must exert ourselves with energy to overcome difficulties found to lie in our way. All extremes are proverbi- ally dangerous; they are almost universally erroneous in themselves, as well as in this, that they necessarily 13 imply error, from excess. But the golden mean in which truth and safety are only to be found, is of course distasteful to all formers of sects and their zealous followers, who unite to attack and disparage it. Thus the rational Empiricism, in which lies the whole philosophy of Medicine, is assailed with equal violence on one hand by the Dogmatists, or ultra- scientific Physicians, and on the other by the mere Empirics, properly so called, the nostrum mongers, the men of exclusive experience and observation; and in this crusade are allied the Physiological School, with the Brunonians, the Perturbers with the Pinelians or Expectants, and the Homoiopathists with their natural enemies, the extreme Allopathists or Contrast- imulators. But we defy them all! Nay more—as Eclectics, we select from the armory of each his best weapons, and make them useful in the interminable contest. From the champion of every school, we are willing to learn what he is eager and able to teach, and as in the phrase of Bacon " all error is founded upon some truth," we find instruction every where. In defence of the custom of members of the Bar, to advo- cate and uphold either the affirmative or negative of any legal proposition, it has been urged with some force and point, that "it is impossible for the human intellect to investigate both sides of any question at the same time." Perhaps we may find in this maxim, some apology for the perpetual dissentions which have deformed our science, and set in hostile array the successive schools which have risen on the ruins of their predecessors, soon to sink like them into disrepute or forgetfulness. Yet there is probably not one which has not left its peculiar mark and impress upon the Therapeutic, and from each we have derived more or less illumination. But for the arrogant and imperious Frenchman—the would be Napoleon of Medicine—we would not have known how often and to what extent local irritations, and lesions of the minute structure of tissues are connected with constitutional diseases. Warmed by their own vehemence, and pushed hard 14 by their dexterous opponents, he and his followers have displayed an admirable ingenuity and a most praise- worthy and untiring perseverance in research. We owe him much, and the time has come when we can render him his merited tribute of respect, without run- ning the risk of being considered by his antagonists as yielding to his inflated assertion of his own superiority, or of being rudely taunted by him and repulsed, as not yet sufficiently enlightened by the rays of knowledge to be admitted among his admirers. Had it not been for the Pinelians of the last generation, and the pupils of Broussais in this, we should have remained ignorant of the admirable capacity for resistance of the animal organism in the struggle with disease—how efficient are mere abstraction and rest in the management of the sick, and how much may often seem to be done with the most inadequate means, as Leeches and Gum- water. We know through their observations, that not all our patients will die even in the most pestilential maladies, although we abandon the whole apparatus medicaminum, and throw away all the resources which God and nature have placed in our hands. And I speak with no ill-meant irony—no sentiment of harsh- ness, when I say that to them, followed and aided by the cultivators of Pathological anatomy, we owe a far more precise acquaintance than had been before ob- tained with the essential and direct effects of disease upon the frame, when it has been allowed to riot un- checked through the vessels, changing charactreistic- ally the condition of the organs and the tissues. They offer us examples of death, in which no modification has been impressed by the poisonous influence of drugs of any kind—but all is natural, regular, and I need not say, highly instructive and explanatory. To Hahneman and his followers, we owe, besides tbe confirmation which their curious experiments on the minute divisibility of doses have given to the views and hopes of the Medicine Expectante School, the light which they have thrown upon the specific agency of certain causes of disease; their peculiar adaptation or 15 affinity to particular tissues and organs; the similarity observed between the effects of undefined poisons or modes of infection, and familiar drugs, in so many al- ledged instances, as for example, the resemblance af- firmed to exist between the influence of the contagion which produces scarlatina, and the active principle of belladonna. It is no little matter to direct us, as they have done, to this train of inquiries ; a wide field of Pa- thology has thus been opened, in which important dis- coveries are to be reasonably expected. While we are thus ascribing ' honor to whom honor is due,' let us extend our acknowledgements to the Pa- tent School of American Physic, which surely must de- serve this notice at our hands, patronized as it is even by educated men among us, who have purchased the ' rights' which shall entitle them to experiment upon the lives and happiness of their helpless families and slaves, (whom heaven protect from the disastrous results!) and sanctioned as it has been by certain Legislatures in the South and West, who have thus granted a premium to indolence and presumption. Since the earliest records of Cluackery, nothing has been heard of, to be compar- ed in audacity and recklessness with this Mormonism in medicine ; this system, which not only treats all diseases by rule and measure, but actually claiming to be de- rived from heaven by the express "gift of God!" sneers at all science and learning, and in the broad light of day denounces their votaries. It is well that igno- < ranee has been thus avowedly made its basis, as con- stituting the most available attempt at an apology for the tools of the shrewd old Patriarch—the only gainer by the invention. " Father forgive them, for they know not what they do !" From these Thomsonians or Bo- tanical Practitioners, we have learned that the credu- lity of the mass of mankind, in affairs which concern their physical health, is absolutely unbounded, and without a horizon; that the vanity of the rudest and most untaught disciple is flattered at being allowed to handle the instruments, instead of passively submitting to the skilful workman, while his conscience is quieted 16 by the ease with which all responsibility for conse- quences is shifted to the shoulders of the distant paten- tee; that the vapour bath, with certain emetics and stimulants are empirically applicable to a greater num- ber of cases by disease, than would have been sub- jected to the trial of any one less reckless than them- selves ; and that the most fiery cordials and alexi- pharmics given to a patient in fever, will not necessa- rily kill him, however indefinitely they may injure his constitution. In this latter point however, they were anticipated b}T the Scotch antagonist of Cullen. Brown taught us some lessons in regard to the utility of stimu- lants, in conditions where their influence had been previously too much dreaded to allow of fair experi- ment, in what was considered regular practice. He is entitled to our thanks too, for the extended develop- ment of the beneficial properties of Opium, the most indispensable of all the remedies which a bountiful providence has offered us, for the alleviation of human sufferings and the prolongation of human life, which before his time, and even by him was regarded too narrowly as a mere stimulant. Nay, I will go so far as to avow, that there is not one of all the numerous charlatans, compounders and sellers of nostrums—none of the itinerant lecturers upon Physiology, Phrenology, Animal Magnetism, diet, manners and customs, &c, from whose labors some good may not be extracted, and I am of council with Rush, who professed himself glad to learn from every quarter, and declared that "knowledge was a trea- sure too valuable to be refused, no matter by whose hands it may be offered to us." One descants upon modern dress, and derives all the diseases of our wo- men from the fashionable corset, and all the apoplex- ies of our men from the stock and cravat. A second at- tributes all the maladies that haunt us, to our food and drink, and would reduce us to support existence upon little more than water and baked bran. The pre- vailing spirit of the age is Ultraism, excess in every 17 thing. Let a fact be once discovered, or merely sus- pected and the most unlimited and visionary specula- tions are immediately deduced from it. Let it be shown that gases and other fluids may and do per- meate according to certain laws, the living animal membranes, and forthwith all secretion, nutrition and respiration, are argued to consist in the simple strain- ing by Endosmose and Exosmose of the requisite ma- terials through the proper glands and tissues set apart for these processes. Let it be acknowledged that glut- tony is hurtful, and that the stomach of the sedentary will refuse to digest an indiscriminate variety of ali- ment ; a Hitchcock and a Graham enlarge on this sim- ple text, and denounce with vehemence the whole tribe of cooks, bakers and confectioners. A poor scrofulous girl is detected in the endeavour to prop up and sus- tain her debilitated and distorted figure, by inflexible stays and tight lacing, and a Mussy rouses all his energies to undo the strings of the fatal corset, and give fair and unrestrained play to the female viscera. I rejoice that he has utterly failed in this unhallowed attack upon the privileges of the beau sexe ; for nom at- ron, not even the mother of Cupid, should venture to throw off the Zone which makes beauty itself more beautiful; the Cestus, without which the very Queen of Love, became less graceful and charming, and which the majestic Juno was fain to borrow, when about to visit her sovereign and husband. The most stupendous superstructure, however, which has ever been built upon a basis of few and ill under- stood facts, is offered to our view by fhe advocates of what is called Animal Magnetism ; and as our future meetings will offer us no special opportunity for its dis- cussion, I will detain you while I sketch a brief out- line of this alleged discovery in Physiology, Patholo- gy, and Therapeutics. We may arrange it under either or all of these heads, for the agency thus referred to is asserted to belong, at least in numerous examples, to the healthy and natural functions of the body—to devel- ope itself still more prominently in various cases of 3 18 disease, and to be available occasionally, and under diversified contingencies, as a remedial influence. I will not lay any stress upon the early notions on the sub- ject, connected with the name and reputation of Mesmer, or the metallic tractors of Perkins. Like oth- er delusions, if it be one—it has past t.irough varied phases; like other scientific discoveries, if this high claim be established for it—it has had its crude and un- defined condition. At present, it numbers among its assertors, men of note and name in the most enlighten- ed communities of the world, and must be viewed in the light in which they place it before us. In France, Husson, Bertrand, Recamier, Cloquet, Rostan and Fouquier—in England, Sigmond and Elliotson—and in our own country and in Germany, a host of aston- ished observers come forward as vouchers for some of the most extraordinary statements ever pressed upon human belief* The nature of the peculiar influ- ence to which all these wonders are ascribed, is as yet altogether unknown. The earlier magnetizers, dwelt much upon the analogy expressed in the phrase—their successors, little or not at all. Mesmer used plates, and Perkins, metallic points. The moderns employ no such implements, but simply describe certain move- ments in the air with their hands, not even regarding these as always necessary. These manipulations or passes are not invariably effectual, nor is it every one who possesses the faculty of magnetizing. Even when effectual, it is not cer- tainly, nor of course in the same mode. Some fall in- to a peculiar sleep or trance, a condition most errone- ously confounded with somnambulism, and now regu- larly referred to under that name. Some seem to sleep * Intha language of the Quarterly Review, " we are required to accept as in- dubitable facts that a person can see with the tips of his fingers, or the pit of his stomach; that the internal organization of his own frame or that of others, placed in magnetic connexion with him becomes visible, so as to enable him to detect hidden disease and prescribe the efficient remedy; that he knows the unexpress- ed thoughts of people, and can foretell future events ; that he can ascertain what is going on at indefinite distances and in defiance* of the intervention of opaque bodies; and that all these things are best accomplished when the senses are closed »nd the mind entrancod." 19 profoundly, and become insensible to all modes of irrita- tion. Cloquet amputated a breast for a magnetized patient in Paris, and Dr. Ware of Boston, is said to have extracted a tooth from a little girl twelve years of age in this state, each remaining unconscious of pain. Some talk incessantly while thus sleeping. Many enjoy clairvoyance—that is, they see through all obstacles and » to all distances. While one indicates the condition of her own viscera, and that of the organs of any person put in magnetic connection with her, another des- cribes what is going on in a neighbouring bouse, a re- mote street, or even in a distant town or city. This latter, is however, an American refinement, and has not often, if at all, occurred in Europe. Some enjoy pre- voyance, and foresee the effects of the application of remedies which they prescribe; they are endowed with " an intuitive knowledge of almost every thing upon which they are questioned, and especially the * faculty of detecting the cause and nature of their own ailments and those of other invalids however ob- scure, and suggesting almost infallible methods of cure." Some are not put to sleep; some retch and vomit; some are convulsed; some become cataleptic. The most uniform symptoms, are fu ness in the head, cold- ness and clamminess of the hands, accelerated pulse and hurried respiration. In the present stage of the dis- cussion, we attempt in vain to separate with precision, the true from the false, throughout this most miracu- 1 lous history, or to obtain the single grain of wheat from this mass of chaff. Who is the dupe, and who the impostor, does not clearly appear. Yet we cannot be satisfied, in the face of so much testimony as is brought forward, to conclude that all is delusion. Some of the pretensions brought forward, we reject at once. 1 he impossible must always be incredible. No testimony can establish the existence of intuitive knowledge, of prophetic foresight, of lucidity or prevision, of the transference of the powers of the senses. And even as to what remains, a degree of suspicion must attach to the proceedings from the circumstance, that a cer- 20 tain degree of imaginativeness, peculiar nervous sus- ceptibility, credulity or faith, and acknowledgement of superiority in the operator, seem essential to success. Hence almost all the magnetized are females—the magnetizers being males. Hence the failure of the efforts made to affect men of sense and firmness, in every instance in which the trial has been made. At any rate nothing useful is yet acquired by means of this singular power—nothing to aid us in Diagnosis, Prog- nosis, Pathological Anatomy, nor Therapeutics* each of which might expect much from the application of such faculties as lucidity, and intuitive peiception and suggestion In thus summing up what we owe to the several Enthusiasts, Dogmatists, and even Impostors, wko, in pursuing their own selfish objects, have sometimes un- consciously opened new views of truth, and brought to light important and valuable facts, I must not omit to give place to the Phrenologists,^and they deserve I am ready to acknowledge, a special and respectful distinction. Far be it from me to mention, without due reverence, the names of the honored dead, or tread carelessly on the ashes of the viituous and renowned. Gall reposes in the cemetery of Pere la Chaise, and the remains of the philosophic Spurzheim, lie within the beautiful precincts of Mount Auburn, each far from his native home ; the latter, separated by the waves of the wide Atlantic, from the frien s he loved so well, and by whom he was so profoundly venerated. Their works cons itute their best monument, and their memory is imperishable. We owe them much, and no consideration, which we may entertain of the un- certainty and error of their peculiar doctrines, should induce us to detract from the high merit of their labors. Like the Astrologers of old, who, while prying into the secrets of the future, and questioning the stars of the destinies of princes and nations, were led to observa- * We must except the late assertions of Sigmond, who seems to have employed it as a Narcotic, but with extreme uncertainty and some trepidation. 21 tions on which rest the sublime science of Astronomy ; like the Alchemist, who, while putting nature to the rack, to discover the Philosopher's store, and the uni- versal solvent, laid the foundation of Chemistry, the mother and nurse of useful arts; like the sons of the farmer, who, in ploughing deeply the soil, to find a hidden treasure, prepared it for the production of a rich harvest—these intellectual giants have unfolded many of the mysteries of the-mind, and opened new avenues to self-knowledge. None of their living fol- lowers, it would seem, can prevail to " bend the bow of Ulysses ," yet from their zealous perseverance, we have a right to expect, and may indeed safely anticipate • some useful results, even if we do not venture to flatter ourselves with the hope of any brilliant discoveries. This then is our present position. The prevailing system of opinions in Medical Science, is decidedly Eclectic, and the Rational Empiricism of the Cullenian Philosophy, is in the ascendant. The Physiological School, self-styled, the most recent in its pretensions, is already fast falling into decay, nor can we wonder at at its fall. It professed to teach a priori what we must be content to learn by the more modest and humble reasonings a posteriori. It inverted the safe process of intellectual movement, and instead of leading onward from things known to things unknown, rashly assumed the obscure and undiscovered, and thence inferred the more obscure and remote. It overlooked the truth that the greater proportion of our Physiology has been de- duced from observations and experiments in Patholo- gy ; the functions of all our organs becoming better known, by lesions of their structure, and impediment to their action, than by all other modes of inquiry. Hahneman still lives to mystify his Homoiopathic followers, and his credulous patients, with the promise of impressive control over the morbid action in disease, through the operation of infinitesimal quantities of ordi- nary drugs, the similar action of which will uproot and put an end to the previous morbid condition. Where but in Germany, could such a delusion spring up and take 22 root.—Germany, the land of pure Idealism, unshack- eled imaginations, and the transcendental Philosophy. A few of these dreamers are to be met with, never- theless, in other regions; near the English throne it is said they were received with favour during the last reign, and one or two stragglers have established themselves in our own Northern cities. The contrasted system of contra-stimulant Medi- cine, a pure Allopathy, predominates in the Southern and Adriatic section of Italy. Its advocates propose to subdue disease directly, by arousing with well cho-en remedies, modes of action positively opposed to it in nature. Ordinary Perturbers are content to substitute any new action for that which constitutes a given mala- dy, believing that the disorders generated by the judi- cious employmentof familiar medicaments, will be tran- sient and manageable—or at least much more so than those which they are applied to supplant. The Pine- lians, the followers of the Medicine Expectante, and of the Physiological system, neutral between the patient and his disease, as well as between Allopathy and Ho-^ moiopathy, abstract merely without perturbation or other direct interference; deeming it safest to dimin- ish the violence of the contest by exhausting the en- ergy of all the forces set in action. In France, it is universally admitted, the depart- ment of Pathology has been most successfully cultivated. Her records are full of illustrious names, at the head of whom we shall place without hesitation, Andfal Magendie and Louis, among the living, and of the re- cently dead Bichat and Laennec. Of this last it is re- corded by Crawford, that he had personally made more than 5,000postmortem examinations—an unpreceden- ted exhibition of zeal and persevering diligence. We are indebted to him, beyond dispute, lor the present improved Diagnosis of Pulmonary Affections. The Stethoscope invented by him for the exploration of the chest, must become familiar to you all as affording signs and indications which collated with those obtain- ed by Percussion, and by the ordinary modes of in-t 23 quiry, render our knowledge on this set of subjects singularly clear and definite. Louis is the founder of the numerical system, whose characteristic purpose it is to institute a course of statistical experiments upon diseases and their remedies, noting in minute detail, and recording in tabular form, the whole history of conduct and results upon both the living and the dead body. Crude and unfounded assertions in regard to various methods of treatment, are thus put to the test, and much light is thrown upon the influence of medi- cines in the production of alleged changes of condition and alterations of structure. When we cross the Channel, it is striking to notice how much more attention is habitually paid to Thera- peutics proper, and how mucn less to what we may call doctrinal Pathology, than u pon the continent. Since the days of Brown, no theorist has obtained in Great Britain any considerable number of proselytes, ormadeany de- cided impression on the public sentiment. Yet this has not been for the want of men of fine genius or dazzling brilliancy of intellect, as we prove by the mere recital of the names of Darwin, Beddoes, Parry and Good. The spirit of English Medicine is eminently practical, and an unbroken line of illustrious practitioners from Sydenham to Copland, have been engaged in adding to the number and usefulness of our remedies and in lessening the sufferings and prolonging the lives of their fellow men. Armstrong. Hall, Ay re, Smith, Tweedie, Johnson, and a host of others might be men- tioned, whose recent contributions to the practice of Physic, richly entitle them to our gratitude. Nor is the native land of the great Cullen, at all behind her sis- ter, England, while she can boast of a M'Intosh, whose death within a short period, has occasioned a much la- mented chasm, a Craigie, and an Abercrombie—crown- ed with various laurels, gathered from the fields of re- ligious and moral philosophy, as well as from those of benevolence and science. Ireland also shews a galaxy of talent and worth, of men devoted to the arduous duties of the healing art, benefactors of the poor, and 24 emulous to diminish the evils of famine and pestilence— such as Cheyne, Percival, Marsh, Grattan and Stokes. All these, and a long catalogue of such as these, highly and deservedly esteemed, are Eclectics and Rational Empirics, believing and acting upon the belief, that in- finitely more is to be done toward the improvement of our divine science, by free and varied experiment upon the persons, and observations faithfully made at the bedsides of the sick, than by the most minute and pre- cise records of symptoms and autopsies, and the most logical deductions from such premises. Nor do I shrink from offering the claims of my own countrymen to the meed of praise and admiration. With more limited means, and pressed by severer diffi- culties than are known elsewhere, they have done as much in proportion as their brethren in more favored regions, and their published labours will bear a fair com- parison with those of their transatlantic rivals and coad- jutors. We have inherited too much of the practical propensities and habits of our British ancestry, to run great risk of being led far into the misty fields of Hy- pothesis. Permanent reputation and eminence are to be attained among us, only by direct usefulness, and an immediate application of scientific acquirements, to the purposes of philanthropy. All our successful medical works are therefore of a strikingly practical character, and so thoroughly Eclectic are we, (I had almost said by instinct) that every effort to put forward the exclusive claims of any school whatever, has not only failed alto- gether, but has recoiled promptly upon the head of the rash advocate who consulted so little the genius of his compatriots. We have determined, as well in science, as in government, " to call no man master."—Our Chal- mers, Rush, Irvine, Hosack, Eberle and Physick, were all Eclecto-Empirics, and their successors, whether in the cold and calculating East, the ardent South, or the fer- tile valleys of the West, pursue the same course, and with every prospect of fullfilling the same happy des- tiny, of enlarging the bounds of useful knowledge, and 25 subtracting something, each in his turn, from the vast mass of human misery. For myself, I need not, at this day, avow my deter- mination to be guided by these principles of Rational and Eclectic Empiricism, from which only, as I have always publicly maintained, we are to look for illumi- nation in the dark and intricate researches to which we have devoted ourselves. In the language of Brous- sais, I profess myself ever ready to administer any me- dicine in any form of disease to which a fair and pre- cise experience may prove it to be adapted : no matter how inconsistent its influences may seem a priori with the accustomed management of such disease.' Yet, while I advocate a frank and open reception of testi- mony, I repeat the caution, that we must look well to its nature, its source, and its relevancy. Nothing can be more essential in a physician, than a deliberate judgment, as free on the one hand from weakness and&credulity, as on the other from the bias and obsti- nacy of'foregone conclusions.' You have a right to expect from me, as we proceed in the series of lectures this day begun, a fair and im- partial discussion of every question that may pass in review before us, and an uncolored statement of all facts from which important principles are deduced. I shall exert my best energies to fulfill these, your reasonable anticipations, and to discharge the deeply responsible duties of my connexion with you. From you, it is my right to ask a patient hearing, and a persevering dili- gence in the employment of the opportunities which my colleagues and myself will eagerly offer you, for' preparation to assume the high character and impor- tant officies of the Physician. The profession you have selected is arduous and difficult, toilsome at every stage of your progress, and jealous in its demand of all your energies, both of mind and body. Yet its very labors are attractive and ex- hilarating; its purposes benevolent; and its aims noble and lofty. Its pursuits elevate and expand the intel- lect, refine the manners and purify the heart; its 4 26 failures, though full of melancholy disappointment, are free from stain or degradation; and the rewards of its success, are more gratifying than all the triumphs of War and of Literature.