lXTf}oDlfCTof{Y i^dTU^sJ, DELIVERED AT THE Opening of the Session of I875 ’75, — OP THE — Of S}V$]\fSVILI/tf OCTOBER 4th, 1 875. SUBJECT.—The Medical Profession,—What it is not, and what it is. Ij\f^f \01)iJ0 1\)Y I uates of the older institutions, and have been a credit to the profession, and to their alma mater. Why, indeed, may notour city, so promising in its educational features and facilities, become a great center of medical learning ? Let some philan- thropist, devoted to humanity and science, who is at the same time a friend of the city, apply a portion of his substance to this end, and the object is accomplished. The healing art seems to have been cultivated at a very early day. The Egyptians, from the amount of science and skill displayed in embalming the body, as exhibited by their mummies, one would suppose, must have possessed no small amount ol knowledge, even of human anatomy, at a period when histoiy was yet obscure and unreliable. In the writings of Moses diseases and physicians were referred to in such a fimil- iar way, as to show that the healing art, crude and inperfect as it was, could not even at this early day have been in its infancy amongst the Israelites. No bar seems to have been interposed by them to medical practice ; and it is not unreasonable to suppose, that to a great extent, their professional information was derived from Egypt, wherein they had recently sojourned. The process of healing, as spoken of in,the Mosaic writings, plainly implies the existence of a class of individuals who practiced the art. In 2d Cronicles it is stated, that Asa from a disease of his feet, sought not to the Lord but to the physi- cians ! From this time forward, as illustrated by the Old and New Testiments, physicians and healing are so often spoken of that the aj-t must have been cultivated more and more on enlightned principles, and improved by observation and expe- rience. The carbuncle described as the burning-boil, and the elephantiasis grecorum, designated leprosy, are not badly described in the Pentateuch. 5 It is generally admitted, that Esculapius was among the ealiest of the Greek physicians, and in accordance with the views of these early pagans, he was denominated after his death, the God of medicine. The religious rites of the ancients were not unfrequently brought into conflict with the duties of the physician. Thug, in extreme cases, in which the practitioner was supposed to have lost his skill, the next resort was the erection of a temple to Esculapius, and imploring his aid by suitable libations ; and, inasmuch as diseases were regarded as penalties inflicted for some sin of omission or commission, by the Gods, these appeals to the deified physician were supposed to mollify their rage, and effect a cure. Although there seems to be no doubt as to the mortal existence of Esculapius, the sum of his professional information, and his general history, remains obscured by the sable curtain of time ; so that at this day it is impossible to separate the truth from the fable. His daughter Hygiea secured immortality for her name, by its being adopted to designate the scientific principles adapted to the preservation of health. His two sons, Machaon and Podalirius, were medi- cal officers of the Greek army at the seige of Troy, and are so handsomely described by Homer, in the Iliad, as given to us by Pope, that I will yield to an impulse to borrow hie descrip- tion. He says: ( “With hasty zeal the swift Talthybius flies ; Through the thick files he darts his searching eyes, And finds Machaon where sublime he stands, In arms encircled with his native bands. Then thus ! Machaon to the king repair, His wounded brother claims thy timely care; Pierced by some Lycian or Dardanian bow, A yrief to us a triumph to the foe. The heavy tidings grieved the god-like man, Swift to his succor through the ranks he ran; The dauntless king yet standing firm he found, And all the chiefs in deep concern around; Where to the steely point the reed was joined, The shaft he drew but left the head behind. Straight the broad belt with gay embroidery graced, He loosed the corslet from his breast unbraced; 6 Then sucked the blood and soverign balm infused, Which Chiron gave and Esculapius used.’ Again; “The spouse of Helen dealing darts around, Had pierced Machaon with a distant wound: In his right shoulder the broad shaft appeared, And trembling Greece for her physician feared To Nestor then Idomeneus began: Glory of Greece old Neleus valiant son; Ascend the chariot, haste with speed away, And great Machaon to the ships convey; A wise physician skilled our wounds to heal, Is more than armies to the public weal,” Eurypalus, a wounded hero, is made to say : “But thou, Patroclus! Acta friendly part, Lead to my ships and draw the deadly dart; With luke-warm water wash the gore away With healing balms the raging smart allay. Such as sage Chiron, sire of pharmacy, Once taught Achilles and Achilles thee; Of two famed surgeons Podalirius stands, This hour surrounded by the Trojan bands; And great Machaon wounded in his tent, Now wants the succor which so oft’ he lent.” Some seven hundred years after the time of Esculapius, the illustriu8 Hippocrates, the sage of Cos and father.of ohysic, made his entree into the world. From the time of Hippocrates, the art medical was regularly and diligently cultivated, and practiced as a profession. About four hundred years later, and near the period of the Christian era, Dioscorides and Galen flourished among the Greeks, and Celsus among the Latins. All of these men became celebrated, and their names come down to our day as professional stars of the first magnitude. The talents and labors of Galen established a broad and permanent foundation for rational medicine, Sub- sequently to his time, and down to the present, medicine has steadily advanced, tardily however during the dark ages, and has fairly assumed the character of a science, and been en- riched by the observations and the rational deductions there- from of the generations that have succeeded it. Galen left a 7 system of medical doctrines, unfortunately destined for a long period to captivity, and influence the medical world. During the 10th century, Avicenna and Rhazes arose amongst the Arabians. Rhazes was one of the earliest writers who described the small-pox, and it is not improbable, that the world is in- debted to the East for this great scourge, if not for many others of its loathesome diseases. Before the system of Galen had fairly been subjected to the test of educational criticism, the dark ages began to encircle the earth, as a murky cloud above the mental horizon. Now for a long period an intellectual slumber paralyzed the human mind, and in common with other branches of phyloso- phv, extended its shadow over medicine. During this period of darkness, the duties of the physician generally devolved upon the priesthood, and they, not being permitted to shed blood, surgery with its necessary counterpart, anatomy, was necessarily much neglected. In the course of the 16th century the profession was awaken- ed from its long sleep, by such meteors appearing above its horizon, as Pare, Boerhave, Vesalius and Fallopius. Harvey too makes his appearance about this period, and discovers the circulatiou of the blood. Before the time of Harvey, however, the lesser circulation, or that through the lungs had been discribed by Servetus, a Spaniard. But the honor of discover- ing its circulation through the arteries and veins of the whole body, belongs to Harvey, thus immortalizing him, and adding a luster to his native England. It appears a matter of wonder, in our day of scientific investigation, that the circulation of the blood through the arteries should have been so long overlooked, and it can only be accounted for, by the prevailing prejudice against the study of human anatomy. No less wonderful is it* that the profession itself should for a long period call into ques- tion the truth of Harvey’s great discovery. Simple as is the phenomena of the circulation when understood, its demonstra- tion is not unattended with difficulty: Malpighi and Leuwan- hoeck learnt themselves readily to establish beyond dispute the true physiology of the circulation. Through the micro- scope, the motion and direction of the blood were revealed, as 8 its red globules rolled as it were along the arterial capillaries. The empty state of the arteries after death, had established the conviction thai they were simply air vessels, and the profession, always incredulous of new discoveries, abandoned reluctantly an old opinion. From this down to the present period, many shining lights have appeared among the brotherhood of the profession. These are too numerous to refer to or even to name. Amongst them however we find Callen, the Hunters and our own Rush. Under the supervision of such men, medical science assumed an elevated position, and now clains as its collaterals all other departments of science. Not all, however, who call themselves physicians are entitled to exalted honors, and many in the ranks of the profession are by no means giants. Among the anomalies of the Medical Profession, it may seem strange, but it it no less strange than true, that its most bitter traducers, have frequently been found amongst its own ranks ; or at least of those who styled themselves physicians. Ignorant pretenders have appeared in all ages ; and even of the better informed, we find them occasionally appealing to absurd super- stitions, and assumptions the most unreasonable, to mislead the uncultivated mass into an undue confidence in their skill. Almost of equal antiquity with the protessson of Medicine, appeared what is generally styled empiricism, or the spurious article. Alchemy so called, was one of the forms it assumed during the dark ages. Basil Valentine lent his name and gave something of a luster to this wild delusion. The aim of these enthu- siasts was to discover a substance that their own imagination had materialized, that was to change all the baser metals into gold, and also to find a universal panacea that would restore the vigor of youth, and cure all diseases. Thus wealth, health and immortality, were the boons that alchemy was to confer upon mankind. Science was to secure the unalloyed enjoyment of this present life, and to make it endless. Paracelsus, who had flourished in the early part of the sixteenth century, is accused of lauding his own professional excellence, with an unblushing boldness, at par with the pretensions of some of the moderns. History represents him as an itinerant practitioner, devoting much of his time to travelling and lecturing. Amongst his 9 modest eulogies of self, he is represented as declaring, “that he possessed more learning in his bald pate than all the schools, and more experience in his linger nail than all the physicians.” He professed to rely upon chemical remedies for his means of cure, and solemnly burnt the books of the ancients, as no longer needed, and as interfering with the adoption of his own favorite dogmas. His career was, however, comparatively of short duration, and was finally closed in a hospital, at the early age of 47. Even at the present day, it may justly be said, that many of the pretenders who are found hanging on the verge of the pro- fession, are uncandid and like Paracelsus, depend upon brag and bluster to advertise their merits, and to recommend them to patronage , whilst many others, misled by ignorance, hon- estly imagine themselves to be possessed in some mysterious manner, of extraordinary skill. Hence, it has been said with some show of reason, that imposture in medicine, is always dependent either upon ignorance or fraud. The term charla- tan was formerly applied to a class of pretenders, who, without any proper residence, went from place to place to practice their art; it is now used to represent generally, ignorant imposters in medicine. Quack is supposed to come from quacksalver, a secret medicine, and has probably given the name to quick- silver, because the salts of this metal, previously condemned as poisons, were introduced as nostrums. How different is this from the practice of the present day ; now a mercury or calo- mel doctor is used as a scarecrow, when an appeal is made to the prejudices of the ignorant. Mercury, an original quack- medicine, is uow generally condemned by quacks. Let us, however, glance at some of the prominent deviations from scientific medicine, of the present period. In the latter part of the last century, a so called valuable remedy was introduced by Dr. Elisha Perkins, under the name of Perkins’ metallic tractors. It consisted of rods of two different metals, that were to be applied for the relief of inflammation or pain, by drawing them over the part affected ; they were supposed to operate through magnetism or galvanism. So great was the con- 10 fidence reposed in this contrivance, that they made their way into hospitals, and were hailed as a boon to the afflicted. By degrees all confidence in them was lost, and they fell rapidly into disuse ; they went up, as it were, like a rocket, and came down like a rock. The cures attributed to them, were at length with more reason referred to the patient’s imagination. This seems, however, to have been the pioneer period of nos- trums, since which time they have increased, until their num- ber has been legion, and they have been, comparatively speak- ing, gliding down the throats of the credulous in a constant stream. They have indeed been a plum to the printer, and in many instances to the proprietor, the score in all cases being paid by the consumer. Some years ago, the subject of granting letters patent for discoveries in medicine, was referred to a committee of congress ; this committee, after a thorough exam- ination of the composition of the various nostrums, for which patents had been demanded, reported that in every instance the pretended discovery was a fraud, and that the applicant was guilty of perjury in swearing that the medicine or compound was both new and useful, inasmuch as it appeared, that when- ever the article was new it was not useful, and whenever it was found to be useful it was not new. In fact, the useful com- pounds were pilfered from the Dispensatory, or some other medi- cal book. In suitable cases and in proper doses, nostrums it may be admitted will sometimes prove beneficial ; but their use by the masses, whose only source of information is some newspaper advertisement, cannot be otherwise than injurious. Empiricism, so frequentiy used as a term of reproach, comes from a Greek word, which signifies to try, and is not inappropri- ate to a class of practitioners, whose knowledge is chiefly derived from experience. Properly speaking, the name does not signify ignorance of the science of medicine, but a sort of self conceit which leads to the practice of giving too much credit to one’s own observations, and too little to those of others. The doubting propensity, and the disposition to take nothing on trust that may be proved by ourselves, is sound to a certain extent, in all philosopical investigations, but it may be carried to extremes ; inasmuch as it is not incompatible with solid learning, to credit 11 such as established truth, on the honest experiments of others. The illiberal plan of the empiric would result in the abandon- ment of the knowledge accumulated by our predecessors, for all past time. To limit medical progress to such a system, would be a retrograde movement by which the grandest monu- ment of learning that the world is in posession of, would be cast aside, and the profession would have to begin its labors over again at the starting point. Nevertheless, empiricism at the present day, contracted and defective as it is, finds too many votaries both in the ranks of the profession and outside of it. It is too often a cloak for idleness and vanity. One, too idle to study what is already known, together with the vast discoveries being made trom day to day, and who is vain enough to suppose that his own paltry observations are an adequate compensation, is a good specimen of an empiric. Some fifty years ago, Samuel Thompson, the originator of a system of medical practice, claimed a position in the medical world. His plan was duly patented, and hence his followers required no other preparation to meet the hydra-headed mon- ster disease, than to pay for the right, and study Thompson’s book. Ignorant of anatomy, chemistry and indeed every branch that goes to build up the structure known as medical science, he had the boldness to condemn them as superfluous and unnecessary. His materia medica embraced the steam bath, and six different medical compounds, designated by their particular number. A course of medicine comprised the administration of No. 1 to No. 6, and the external application of steam. He adopted the plan of steaming long in vogue amongst the Shawnee and other tribes of Indians, and claimed it as his own discovery. He prided himself also, upon discovering the medical virtues of the Lobelia Inflata, when in fact it had been already in use in the regular profession. His followers Were known as Thompsonians, or perhaps more generally as steam doctors. Besides the plan of steaming, the only pecu- liarity of Thompsonians worthy of notice, consisted of a bolder use of capsicum, lobelia and a few other active drugs, than had been the previous practice of regular physicians. Thompsonism, however, in its unadulterated form, was soon condemud as 12 inadequate to meet the demands of practice, and in its downfall it became the foundation for a new class known to the public as Botanical Physicians; professing to cure all the ills of flesh by the charmed productions of the vegetable kingdom. These medical philosophers however discovered that water and common salt, two of their most valuable medicines, could not be herbs, shrubs or trees. Hence, to meet this new dif- ficulty a new name became necessary, even if new principles were not super-added. In short, the Botanies were metamor- phosed into Eclectics, and these, from the very liberal name, filched from the profession proper, while they looked to botany for their remedies as a special right, did not refuse a useful medicament from the animal, or even the formerly repudiated mineral kingdom. The name eclectics, and eclectic physicians, is good enough for any one, if it had not suffered in reputation from the company it has kept. To give to the systems of Thompson and those which may be considered as its regular sequelae full credit for any useful result from the practice they inculcate, it is possible and may be admitted, that the reckless- ness witn which their followers administered strong stimulants, may have led physicians generally, into a less anti-phlogistic, and more supporting practice than had formerly been in use. Although the system was founded on ignorance and error, even Thompsonism may have contributed its mite to the accumulated knowledge of the profession. Hydropathy, that has of late years been raised into a system of conservative medicine, has no doubt induced physicians to use water more freely as a remedy than had formerly been considered safe. A large part of this system, and perhaps the most valuable part, was derived from experiments made by members of the regular profession Doubtless the water-cure treatment was suggested by certain reports made by Currie, a medical officer of the British army nearly a century ago. Water as a remedy for disease was indeed used by Hippocrates, Galen and Avicenna, and conse- quently could not be regarded as a new remedy. But in early times its use seems to have been attended with unnecessary precautions. The experiments of Currie, in the cold water treat- 13 ment of fever, paved the way for more intelligent views, and of late years watei as a remedy, has come into general favor and been promoted to an exalted' position in the Mateiia Medica, About half a century atter Currie’s report had been made, Prieioitz opened a water-cure establishment in Germany. By the judiciouse use of water in the various modes of its application, hot, cold, tepid, externally, internally,’in the form of steam baths, water baths, wet sheet, sponging or pouring upon the body ; a6 a means of applying heat, cold or ablution, and in the different varieties of distilled water, rain water and water impregnated with common salt, or otherwise medicated, it becomes a valuable remedy, and may be profitably adapted to the treatment of various diseases, and especially those of per- sons injured by excesses, whether from eating or drinking. Such persons may sometimes be induced to submit to the rigid system °f hygiene, enforced at a water-cure establishment, much more willingly than they would do under the free and unrestricted habits of home The doctrine of contraries in therapeutics, when applied to the adaption of remedies to diseases, together with the humoral pathology, was among the peculiar speculations bequeathed by Galen, to the profession of a later day. Having made its way down to the 17th century, it was improved and made plausible by the genius and reputation of Boerhaave. The con- tinuance, however, of both these cherished theories, was des- tined now to be of short duration; they suffered and were apparently overthrown, by the severe criticism of such distin- guished masters in medicine as Hoffman, Stahl and Cullen. By and through the efforts of these men, the ancient theories were supposed to be eradicated, and the more logical ones which taught that the causes of disease operated only through the solids of the body, and that all remedies operated upon the principle of like cures like, established on their ruins. Stahl became the special champion of similia similibus curanter, but to make this doctrine plausible it was deemed necessary to sup- pose, that neither poisons nor medicines could under any cir- cumstances pass into the blood vessels. The contrarius of Galen 14 was supposed by the credulous, to have been superceded by the similia of Stahl, Attracted by the new doctrines taught by the distinguished schools of Halle and Edinburg, Hahneman very modestly stepped forward, appropriated the supposed dis- coveries of these greater lights, and made them the basis of his own medical system. This solid, or by some termed nervous pathology, assumed that the blood was uniform and unvarying in its composition, admitting into its mass neither poisons, the causes of disease, nor the medicines used for its removal. This solid pathology was the foundation for the infinitesimal doses, recommended by Hahneman. Remedies expected to produce their effects entirely through the nervous system, it was sup- posed, might be infinitely reduced in strength and volume, when compared with such as were necessary to medicate the blood. Unfortunately, however, for the late of this fancified system, physiological experiments soon after established the fact, that deleterious substances as weil as medicines, really do, and very frequently find their way into, and become a part however hurtful, of the circulating blood, Articles for- eign to the normal elements of the blood, after having been taken into the stomach, have repeatedly been detected in the secretions, and .even in the blood itself. These facts com- pletely undermine Hahneman’s system, and leave it without adequate support. The accidental circumstance of like curing like, or contrary curing contrary, cannot be made the basis of a principle, or a law ; they are simply coincidences. Like sometimes cures like, and contrary sometimes cures contrary; and remedies frequently cure, where the rule is inexplicable by either of these theories; hence, to found a system of medical practice on so feeble a support, is simply visionary and absurd. In regard to the small doses being a part of the Homeopathic system; Hahneman says in his Organon, “If one drop of the recent juice of any medicinal plant, be distilled with 99 drops of alcohol, in a vial capable of containing 130 drops, and the whole twice shaken together, the medicine becomes exalted in potency,'’ that is, in plain language, it becomes stronger by reducing its strength. He goes on to say. however ; “this pro- cess, to-wit, taking one drop for each 100 drops of each sub- 15 sequent mixture, and adding thereto 99 drops more of alcohol, raises it up to the 30th dilution, the 30th being the decillionth developement of power.” 3000 drops of this 30th potency, would contain just one drop of the original medicine so operated on : This, he says, is the form in general use. Again, Hahneman says, “the suitableness of a medicine does not depend solely upon its being Homeopathic, but also upon the minute quantity of the dose in which it is administered.” He says further, “the latest improvements in our art demonstrate, that the administration of a single smallest sized pillet, (a sugar globule size of a mustard or poppy seed), moistened with a decillionth attenuation of the drug would have been fully sufficient to per- form this cure, [referring to a particular case], nay, it is equally certain, that even smelling of it would have sufficed.” Now when we consider that the 3000 drops, or a little over 6 ounces of alcohol, must contain only one drop of the medicine, it is very plain, that however much the medicine may be changed, the alcohol at least would not be much damaged. Hahneman denominates his treatment homeopathic, derived from two Greek words, which being translated into Latin, make similia similibus curanter, or in plain English, like cures like. In con- tradistinction to this he assumes that the exploded doctrine of Galen is that of the regular profession, and also from the Greek names it Allopathy, or Heteropathy, in Latin, contrarii contra- riis curanter, and in English contrary cures contrary. The first of these so called systems, may be illustrated by the effects of belladonna; this drug in certain cages producing redness of the skin, is therefore supposed to be a remedy for eruptive diseases, and hence, like is said to cure like : the second is illustrated by bleeding as a remedy for inflammation, by which contrary cures contrary, on the theory of Galen and Boerhaave. Dr. Chas. Neidhard, an accredited Homeopathic writer, says: “the Homeopathic law and small doses occupy the same plat- form.” Dr. Holcomb, Homeopathist of Cincinnati, after a labored effort to explain homeopathic treatment, says; “we concede that it is insufficient and unsatisfactory.” Herring, the American editor of Hahneman’s work, says : I have never 16 yet accepted a single theory in the Organon, as it is there pro- mulgated !” According to statements in the Homeopathic work of Morse & Hunt, “Hahneman’s theory was only a corol- lary of the Brunonian svstem.” Now the system of Brown, being published in opposition to the views of Cullen, and prob- ably as much to aggravate this great teacher, as to promulgate a system never secured the confidence of any considerable por- tion of the medical world. The solid pathology of Cullen and his co-laborers in the work of reform, was soon overthrown as too exclusive a system, and the humoral pathology in a modi- fied and more rational form than of old was to a certain extent reinstated—that is, it is now universally conceded, that reme- dies may operate by entering into the mass of blood, and very often do so, as well as by sympathy ; independently of their operating chemically and mechanically. The doctrine that like cures like, seems to be allied to some old theories, or rather fancies, known as the color and torm therapeutics, that have scarcely been deemed worthy of scientific investigation. It was supposed, for instance, that jaundice might be cured by the administration of saffron or turmeric, yellow remedies being adapted to yellow diseases ; and also substances shaped like the liver, should be remedies for the derangemeuts of this organ. Unreasonable as such speculations may appear, they are little less so than to suppose that because belladonna may cause an.efflores- cence of the skin, therefore it must be adapted to the cure of eruptive diseases. True, the special qualities referred to in these remedies, would not prove their unsuitableness to the particular cases mentioned, yet, to base their virtues on so imperfect an analogy, would be entirely untenable. Formerly it was custo- mary in surgery, instead of applying dressings to the wound, to apply them to the instrument by which it was inflicted . Would such a ridiculous proceeding be tolerated at the present day? would it not make a laughing stock of the pretended surgeon ? The application of boiling oil to gunshot wounds to destroy some imaginary poison, was a practice coming down almost to our own times. A more enlightened surgery among the moderns, has abandoned all such absurdities, and now resorts to simple dressings, knowing that nature is in reality the surgeon that 17 cures the wound. Such errore, as errors generally do, have fallen under the corroding tooth of time ; such too has been the fate of the solid pathology, on which homeopathy was chiefly founded ; and so in time, will the use of infinitesimal doses become obsolete, as well as its fanciful adjunct, similia simili- bus curanter. Doubtless however, some other visionary theory will spring up to take its place ; otherwise, a singular craving of the human mind for the new and the marvelous, would remain ungratified- But we are told, that the value of homeo- pathic remedies is verified by experience ; cures have followed their administration. The plea of experience may be used to support the use of any remedy, however worthless. The most arrant imposture that has ever been practiced, has appealed with apparent success, to the test of experience. This is not of difficult explanation when we consider that most diseases tend strongly to recovery: and it is not difficult to ascribe an apparent cure to the medicine used, when the whole credit is due to na- ture. The recovery frequently takes place, not only without the aid of the supposed remedy, but in spite of its baneful effects. It has generally been the verdict of intelligent physicians, that such cures were more properly coincidents, or perhaps, in over credulous persons, the salutary influence of the imagination. Regular physicians, properly speaking, are not allopathists, inasmuch as they do not recognize any such principle, as con- trary curing contrary, in the curative operations of medicines. Scentific medicine cannot be designated as any pathy, the only proper title of its followers being scientific or regular physicians. I may be told that we cannot disprove the assumption, that as a general rule, like cures like. Admitting the difficulty of proving such a negative, the same argument applies equally to all erroneous systems of medicine. The affirmative, as to any system of therapeutics being hard to prove, beyond cavil, how much harder must it be to prove the negative ? To believe, according to the doctrine of infinitesimal medica- tion, that potency is increased by dilution, is to believe that effects are not in proportion to their causes, or that small causes more than large, produce great effects. How then, it may be asked, can we explain the fact, that men of education and pro- 18 bity, should embrace so illogical a dogma? This can only be done by an analysis of the human mind, in its numerous pecu- liarites and phases; some take things for granted, on very slender prima facia evidence ; others again, from a reasonable array of facts and analogies, become convinced. Those who in some cases refuse to believe the evidence of their senses, will not hesitate to adopt some transcendental hypothesis, involved in absurdities. They seem to possess an ethereal quality of thought, too volatile for the exercise of plain common sense; rejecting fact and embracing folly ; abandoning the evidence of sense and reason for some fanciful delusion. Homeopathy, however, as a system of medical practice, is evidently curing itself; most of its followers have already abandoned the small doses as a universal practice ; some admit that similia is not always true, whilst others of its pretended friends, refuse to subscribe to any of its theories. Truly then, it is almost ready to abandon its essential tenets, and cease to exist as a system, if indeed, it is not already knocking for admittance into the ranks of the time-honored profession. Nature indeed, in her great kindness often comes to the aid of all classes of medical practitioners ; the vis medicatrix natu- rae is constantly at work in repairing losses of substance and vital energy, in curing both organic and functional diseases ; and is only defeated at length by the over balancing power of the destroying elements. When the tendency to decay reaches a certain point, chemical affinities are set to work and the unaided vital powers may become no longer sufficient to cope with the agents of destruction. Under such an emergency they claim the assistance of the intelligent physician. As all things in nature appear to be in some way useful, it may be enquired, what have been the benefits conferred upon mankind by the various irregular systems of medicine, to compensate for the evils, positive and negative, which they have inflicted ? There can be little doubt, that ere long, all the prevailing ir- regular systems will pass away, and if they are remembered at all, it will be because of their preservation in the curious liter- ature of the profession. Meantime, the industrious >analyzer will be at work, separating the gold from the dross, the latter 19 to be cast away, the former to be garnered among the permanent treasures of the healing art. By such a proceeding in part, has the whole sum of medical knowledge been, for the many past years accumulating ; here a letter has been added by acci- dent, or by the reckless experiments of some unlettered enthusiast, and there a little by the learned in science. Such contributions, having been tested and had their worth estab- lished by the vast body of experimenters, have been retained to constitute the armament of the physician. Like the delusive investigations of alchemy, the modern delusions will doubtless contribute their might of the purer metal, ere their flickering light goes entirely out. After this brief and imperfect reference to the spurious article, I will endeavor to illustrate some of the characteristics of the regular profession. The model physician is not a blus- terer ; he is not a braggart; he is not too cowardly to do his duty, even through fear of pestilence or other danger; he is not vain ; he is not a frequenter of the saloon or the gam- ing table ; he is not churlish'; he is not intolerant; he is not a flatterer; he does not advertise his merits by pretending to know more than he does, or more than other intelligent physicians ; 'he does not gossip about his patients, or of their surroundings; he does not seek to have his name published in the newspapers as the skillful attendant in some porticular case, or the hero in some* great surgical operation ; he does not abandon a case about to terminate fatally, in order that some other physician may have the odium of losing the patient ; he does not give false encouragement of recovery to prevent a change of physicians, or consultation being called in ; he does not make unreasonable promises of cure to secure employment ; he doss not magnify the danger that he may have the credit of curing a bad case'; he does not refuse his services to the poor, although there may be no hope of remuneration ; he does not shrink from any labor that promises to relieve pain or save life ; nor does he lawn upon the rich to secure their patronage ; he does not insinuate in a fatal case, that if he had been called sooner the result would hav£ been different. On the contrary, he is dignified in his manners, and courteous to all with whom 20 he is called to associate; he has both the will and the industry to perform his duties faithfully, even when menaced by the missiles of war, or the more insidious contagions of peace ; he treats other physicians with courtesy, deferring to their opin- ions in consultation, to as great a degree as he claims for his own, and as coming from a mind enriched by skill and science ; he gives up printer’s ink, in a measure, to the imposter and the charlatan When his patient is threatened with approaching death, he does not give him up to his fate, but is, if possible, more assiduous in his attentions than before, even to the last moment, striving to make more smooth and painless the fatal transition ; he does not discourage but favors consultation, so that friends may feel satisfied, responsibility be divided, and his patient have the benefit of increased professional skill. Should an irregular practitioner be desired by the friends of the patient, the attending physician will not make captious oppo- sition, but will retire gracefully from the case, and give his successor a clear field. Should his patient be too despondent, taking a gloomy view of his case, the physician will afford him all justifiable encouragement; and when the case is evidently incurable, he will at least afford him the consolation of sympa- thy, and show that he is a kind friend, as well as a faithful physician. While it may not always be safe or prudent to com- municate in unfavorable cases to the.patient, the full danger that menaces him, the truth should at least be told to consider- ate friends, who have a right to know. He has no right to conceal the danger, any more than he has to exagerate it, for sinister purposes. The fastidious may urge that the medical practitioner ought to refuse his services to the degraded and the immoral: such a view should never be countenanced by the physician. It may indeed, be gratifying to know, that his patients have every desirable quality of head and heart, still, it is foreign to the office of the physician to rest his services on questions of morality. Bodily afflictions alone, establish the claims of his patient, and it becomes his duty to relieve his suf- ferings if possible, be he saint or f&lon. An investigation of the moral character of his patient is out of place; is he an afflicted 21 human being needing hie services, and placed by an all-wise providence under his care, should be the sum and aim of his inquiry. And allow me to say to those about to embark in the study of the profession, that you have not engaged in an expedition of unmixed pleasure, or pastime; the path of the physician is seldon carpeted with roses, but on the contrary, is generally found to be a thorny road to travel. You have selected an occupation for life, that will subject you to unceasing toil, study and self-denial. Your labors will be such that you cannot select the time of their performance; by night or by day, in fair weather or foul, frequently with scarcely to eat or sleep, the tread-mill of the physician’s life goes steadily on. All his leisure time must be devoted to study, else his competi- tors on every hand, will distance him in the professional race, and if not in procuring pacients, at least in treating them accor- ding to the best lights of the profession Add to this, he will in many cases be badly remunerated for his work and not unfre- quently be censured for the best intended and most meritorious services. He must learn to endure opposition, neglect and calumny, to an extent scarcely known in any other calling or profession. But even all this is in a measure compensated, by undue credit and gratitude received in other cases; by his being credited in short for cures effected by nature, One who has decided upon the profession as a calling for life, should take a complete survey of the advantages and disadvantages of the position he is about to assume. He should not be encumbered with a frail body, nor one not adapted to laborious employment, and irregularity in the habits of living ; for he agrees by impli- cation, at least, to undertake on the shortest notice, the perform- ance of arduous duties. Instead of comfortable nights, spent on downy couches and in quiet slumbers ; with the anticipation of the approaching Sunday, being to him a day of devotion and rest, he commits himself to a life of unceasing toil, which offers as his greatest and most certain reward, the consciousness of having faithfully performed his duty, and of not having been a cipher or negative among his fellow men. The aspirant to professional honors, should be possessed of an active and 22 enquiring mind ; he must have energy and ambition to excel, and either possess naturally or acquire habits of application to study. Feeble body or indolent1 mind, should be directed into almost any other pursuit in preference to medicine. A clear, well disciplined and comprehensive intellect, associated with diligence and aptness to learn, are among the indispensables. The medical man must be an accurate observer, quick to per- cieve phenomena, with capacity to trace them to their causes, and also, to comprehend tne peculiarities of other individuals ; a thorough knowledge of human nature should become one of his endowments. In tracing tne relationship of phenomena he must learn to the difference between what is only a coincidence, and that which is cause and effect. He must not suppose, because one incident follows another however closely, that it is necessarily the effect of the former, or antecedent inci- dent. Winter and Summer precede and follow each other, yet no one would argue hence, that one is the cause of the other. The physician whilst studying to read and comprehend the feelings and thoughts of others, must strive, at least so far as prudence requires, to be to them a sealed book, and to keep faithfully his own counsel. Many indeed, of the serious thoughth that occupy his mind, must be studiously concealed ; were they comprehended and correctly interpreted by others, they might betray secrets in violation of professional faith, and improperly gratify curiosity, or perhaps be followed by more serious consequences. He may see death, or some serious calam- ity menacing his patient, when to betray his apprehensions to the patient would perhaps cause to be confirmed his mental prog- nosis, or might hasten at least the fatal result. His worst fears should only be made known on mature reflection and to discreet Dersons. The physician absolutely requires a certain amount of literary education, but precisely how much is not entirely settled. No one would dispute, however, that the more preparatory educa- tion he posesses, the better will the prosecution of his studies be facilitated, and as a common rule, the greater in the end will be his professional reputation. Nevertheless, to pore over the classics and higher mathematics for an undue period, would 23 be only a waste of time, and would abridge to an unreasonable extent, the more necessary and practical studies belonging to his profession. Many of the languages, studied by lingual scholars, are not only dead, but measurably obsolete, and the diligent student could become a very skillful practitioner of medicine or surgery, without proficiency in them. An accurate knowledge of the learned languages, or how to square a sphere or a circle, may be left to those who devote themselves espec- ially to literary persuits, without detriment: ordinary knowl- edge of mathematics, and writing the English language with accuracy are the essential prerequisites, when narrowed down, as a respectable preparatory education for oue about to enter the medical profession. Whilst the physician must, learn to make correct observations, he must also be capable of writing them down, on suitable occasions, for the benefit of others. Any discoveries or improvements he may make, are not, ethi- cally considered, his own private property, but belong equally to the whole profession ; as a free gift, he has received the accumulated knowledge of his predecessors for ages that are past, now, as an honest debtor, it behooves him to repay the obligation under which he is placed, if possible with interest, by contributing his portion to that which shall be transmitted to those who come after him. The example of liberality and ingenuousness, found as an attribute of the profession, may be traced back to a very ancient period. It belonged to the ethics of Hippocrates ; let it not be lost by the greater which appears to characterize the present age. A little learning is said to be a dangerous thing, and if this be not strictly true in all branches of education, it is at least true as applied to medicine, “when practiced as a profession. Here there is no middle ground ; the tools of the physician, as well as those of the surgeon are double edged, and operate on organs essential to life. When judiciously used 'they may cure disease, or at least alleviate pain, so that life’s ills become endu- rable, but when these tools are used by the ignorant’or unskill- ful, the damage done by them may be irreparable, amounting to even death itself; such a physician is guilty of his brothers’ blood ; his ignorance under such circumstances being a crime. 24 I would not enlarge upon this idea, nor indulge in language sensationel or sentimental, but I may be permitted to say at least, that few would submit from choice, to the goadings of of conscience, which haunt that dispenser of medicines, who from carelessness or want of skill, kills instead of curing his patient. What must be his reflection on strolling through the grave yard, and reading the inscriptions on the tombstones of his former patients, to feel in his innermost conscience, that he has contributed culpably and largel}7, it making it a city of the dead. No other profession requires its votaries to have their knowl- edge at hand, and to be prepared to call it. into exercise sud* denly and without delay, to the same extent as the medical. The clergyman may almost always find time to prepare himself for the duties of his scacred office; the attorney may study his case and prepare his briefs at his leisure ; but the physician is liable to be called upon, and frequently is called upon, in cases involving life and death, without any time for preparation being allowed ; life, if the proper resources can immediately be made available, death, if he should be unprepared for the emergency. Apoplexy, acute inflammations, and many other sudden seizures or accidents must be met with, and the treatment inaugurated at once, the result being either to save the patient or seal his doom. True, in many surgical cases the surgeon may find time to examine his books, before deciding upon the most eligible operation or procedure for the particular case, before applying it; still, both in surgury and practical medicine, remedies must be applied on the spur of the moment, right or wrong, whatever may be the consequences. The life of the medical pretender destitute of skill, is a perpetual fraud upon the community he undertakes to serve His position is one, fairly, of implied con- tract with the public, agreeing on his part to perform his pro- fessional duties skillfully and in good faith, in consideration of the benefits, moral and substantial, conferred upon him. Though the substantial rewards may not be large, the moral ones are by no means to be despised. The demonstrations of gratitude and kind offices of his professional patrons, exclaiming, though it may be in unspoken and unwritten language, the 25 plaudit, “well done, good and faithful servant,” will make amends for other deficiencies, and go very far towards gratify- ing a reasonable ambition. It seems to be a prevalent opinion that benefits and burthens are equally balanced, in the different occupations of life, and probably the idea is not entirely inap- plicable to the medical profession. Wealth, accumulated by professional labor, is doubtless more the exception than the rule, yet, competency aDd an honorable position in the commu- nity, even of the better class, may reasonably be expected ; and this, with* an approving concience, should be regarded as a sufficient substitute for an accumulation of the much abused, though much coveted, and certainly very convenient lucre. There is no member of the community, who is not greatly interested in medical education ; in the training both moral and intellectual of the physician. In all civilized countries he is of necessity, a trusted companion, from life’s beginning to its close. He is our earliest and our latest friend ; by the funct- ions of his office, he is called upon to bid us welcome, and to usher us upon the stage of this mysterious and wonderful world • a world, that opens upon the untutored and bewildered senses, with all the dazzle and sublimity of a new creation ; a world as we soon learn by our more matured experience, singularly diversified by pains and cares, to be supplanted or mitigated by pleasures; and by poignant griefs alternated with enjoy- ments. And finally in the performance of duty, the physician is required to soften as far as practicable the bed of sickness, and to smooth the pillow that supports the aching head ; and at length to receive the last and sad farewell, ere the final plunge is taken into the dark cold river, which separates this mortal life from the life eternal.