n INTRODUCTORY LECTURES AND ADDRESSES, ON MEDICAL SUBJECTS, DELIVERED CHIEFLY BEFORE THE MEDICAL CLASSES OP THE UNIVERSITY OF PENNSYLVANIA, BY GEORGE B. WOOD, M.D., LL.D., PRESIDENT OF THE AMERICAN PHILOSOPHICAL SOCIETY; PRESIDENT OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA; PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE, AND OF CLINICAL MEDICINE, IN THE UNIVERSITY OF PENNSYLVANIA, ETC. PHILADELPHIA : J. B. LIPPINCOTT & CO, 1859. 6 SCOPE OF THE PRACTICE OP MEDICINE. your assurance of the efficacy of medicine, of its frequently indis- pensable instrumentality in the preservation of life, should be based on positive and conclusive evidence. Of this nature is the testi- mony of the best informed, the most experienced, and the most honourable, not only among the living, but also in the long series of those, who have left behind their recorded experience for the benefit of mankind. This testimony, while it admits the in- curability of some diseases, and the occasional insufficiency of all known measures to the cure of others, is united upon the point of the great utility of therapeutics properly applied. These men cannot all have wished to deceive; it is scarcely possible that they can all have deceived themselves. Their combined evidence is, therefore, to a certain extent, irresistible to a sound and unpre- judiced judgment. Give due weight to their assurances, and you will be spared the skepticism which might possibly result from a one-sided direction of your confidence, and of your studies. But your rational convictions may be strengthened by personal observation. Watch the bedside of patients in private and hos- pital practice; observe the progress of various chronic diseases before and after the commencement of a course of judicious treat- ment ; compare the result with that of other similar cases aban- doned exclusively to nature; do all this in the most cautious manner, and with the most impartial spirit; and, depend upon it, you will come out warm advocates for the efficiency of thera- peutics. Besides, is it at all consistent with the general course of Provi- dence, to suppose that so great an evil as disease should have been allowed to exist, without some remedy at the command of the afflicted? In physical nature, do we not observe constant efforts for the repair of injury ? Floods devastate the earth. But notice the deposit upon their shores gradually rising, and rising, and at length confining them within due limits, and rendering them essential agents of good. Volcanos pour forth their over- SCOPE OF THE 'PRACTICE OF MEDICINE. 267 whelming torrents of lava, which hardens as it cools, and buries whole regions in a rocky tomb. But the winds and the rains soften the indurated surface, and clothe it in fine with a fruitful soil. The tempest, the earthquake, or other great physical agency, rends mountains asunder; and huge rocky masses topple from their heights, and spread ruin over the fruitful valleys at their base. But here again the flinty surface undergoes a gradual dis- integration ; the sharp angles are rounded off, the rough cavities are filled up ; and what was a wide scene of desolation becomes beautiful with swelling heights, and soft declivities, and meandering streams, smiling with verdure and with flowers. So also is it in animated nature. Look at the broken or wounded plant, and observe by what a beautiful process the injury is repaired, and even its vestiges ultimately effaced. Those of you who have paid the least attention to physiology know well, with what resources the animal system has been provided for the repair of injuries, and the restoration of lost parts. In the higher moral world the analogy with the physical is in this respect complete. The history of nations and of individuals is often but a series of successful efforts to avoid and repair injury. From the cradle to the grave we are called on to mourn for losses which are the inevitable lot of humanity ; and, but for the happy remedial influences which nature in various ways brings to bear upon us, our experience in this world would be too often of almost unmitigated suffering. What is the great scheme of Christianity itself, but a glorious remedy provided by the all-good and all-mer- ciful, to save a sinful world ? Is it possible then that Providence should have placed man in the midst of noxious influences, have given him an inquiring spirit to search, an intelligence to apply, and an inborn irresistible hope to use efficiently, means for counteracting these influences, and have done all this with no other purpose than to deceive and dis- appoint? To me the notion is inconceivable; altogether incon- 208 SCOPE OF THE PRACTICE OF MEDICINE. sistent with our convictions of the joint power and goodness of the Creator. There are remedies for our diseases; for all of them, I believe, not essentially fatal by an interference already exercised with the processes of life. Many of these remedies have been discovered ; many yet remain concealed to reward future research. Compare the past with the present, and from this comparison infer how much is to be hoped for the future. To refer simply to two in- stances, the one prophylactic, the other remedial; I would call to your attention the preventive power of vaccination over small-pox, and the curative influence of Peruvian bark over miasmatic dis- eases. These two scourges, which formerly devastated the globe, are now brought into comparative subjection to the power of man. Thus will it probably sometime be with diseases still essentially incurable, or extensively destructive by their violence. Cancer and consumption, yellow fever and cholera, are yet, it may be hoped, to come within the certain control of medicine. Guard, therefore, your faith, in the efficiency of the profession you are about to enter. But you have another office to perform. It will become your duty to impart faith also to the non-profes- sional community, and to cherish and preserve it when already ex- isting. For this purpose it will be necessary for you to employ all the resources of your judgment and reason; but beyond com- parison the most efficient agency will be that of your example. You must not only by your conduct show that you have faith yourselves, but must labour zealously for those qualifications, by which you will be able to set forth in practice the principles you inculcate by precept. Make yourselves conversant with all that is good in medicine, and you will through life exhibit to the pub- lic, in your persons and conduct, an ever-present and irrefragable proof of the real value of our science. When the whole profes- sion shall have elevated itself to a high standard of character and attainment, it may bid defiance alike to the open assaults and SCOPE OF THE PRACTICE OF MEDICINE. 269 covert stratagems of its enemies. Ignorance, superstition, and weak-mindedness will probably, until the mellennium shall come, afford a refuge for the frauds of charlatanism in ours as in all other pursuits ; but we can afford to be content with this when we shall have on our side the intelligence and worth of the com- munity; for these will, as a general rule, govern even the unin- formed masses ; and it will be only in the darkest quarters, and the most remote haunts of the moral world, that quackery will be able to show its face. I have at present but one further remark to make. All that I have said must have been uttered to little purpose, if it do not tend to confirm and stimulate you in all proper effort in the honourable course which you have entered. Keep ever before you the great ends of your studies, the incalculable importance of the duties which are to devolve upon you, and the awful responsibility connected with the discharge of those duties ; and you will spare no endeavours to avail yourselves to their full extent of the advantages now offered, so that, when you ultimately leave us, you may go forth accomplished physicians, prepared at once to encounter dis- ease most successfully, and to offer before the public, in your lives and character, a convincing proof of the truth, the power for good, and the pure and lofty aims of your noble profession. TWO INTRODUCTORY LECTURES, GIVING THE RESULTS or PROFESSIONAL OBSERVATIONS IN EUROPE. LECTURES THE MEDICAL PROFESSION IN EUROPE, Prefatory Remarks. The two following lectures were delivered as introductories, the first, in the year 1848, to the course of materia medica, the second, in 1853, to the course of the theory and practice of medicine, in the University of Pennsylvania. As my travels, during my first visit to Europe, were confined to Great Britain and Ireland, the first lecture refers exclu- sively to professional observations made in those islands. The visit made in the summer of 1853 extended also to the continent; and it is to the state of the profession in this portion of Europe that the second lecture is confined. In both, the statements made are extremely gen- eral ; as it was necessary to confine the matter within such limits as not to exceed the time usually appropriated to introductories. As regards Great Britain, some of the observations are no longer justly applicable, at least in their full extent ; as the state of the profession has within a few years undergone considerable change ; and a movement of reform has commenced, which will in all probability lead ultimately to 18 (2T3) 2T4 INTRODUCTORY LECTURES. the bost results. Of these one of the most important is the consolida- tion of the three pharmacopoeias, those, namely, of London, Edinburgh, and Dublin, into one, which is to constitute the pharmaceutical code of the whole empire. The benefits of the uniformity thus introduced, will be extended, in some degree, to this country, where British medical works are so much read, and where the confusion of British pharmacy has sometimes been productive of considerable embarrassment. LECTURE I DELIVERED OCTOBER 19th, 184S. The Medical Profession in Great Britain. It is a good general rule that an introductory lecture should have a close relation to the subject of study which it proposes to introduce. This rule I have generally observed in my preliminary addresses to the medical class. But the ways of man's conduct in life, like those for his feet, cannot always be rigidly straight. They must be accommodated in the one case to the irregularities of cir- cumstance, as in the other to the inequalities of surface. My posi- tion at present is, I think, such as to require of me a deviation from the ordinary course. Recently returned from travel in a foreign country, I may be reasonably expected to impart to those whom it is my duty to instruct some of that knowledge, having reference to our common pursuit, which I may have gathered while absent. I know of no opportunity better adapted to this purpose than that offered by the opening of a course of instruction, before the atten- tion has yet been engaged in a regular series of observation and study, which it might be inconvenient to interrupt. You will, there- fore, excuse, perhaps you may even commend me, if, on the present occasion, omitting all mention of the materia medica, the teaching of which is my special function, I shall in its place introduce to you a subject from abroad, and one no less important than that of (275) 2tG THE MEDICAL PROFESSION IN GREAT BRITAIN. the state of the medical profession in the British Islands. This is so peculiar, so different from what prevails in the United States, that it cannot but be an object of interest to all among you who have an inquiring spirit; and, considering the high civilization of that great country, the source of so much in every department of knowledge and art that we ourselves boast of, its arrangements in relation to a profession, so influential as that of medicine, must offer many valuable lessons, whether for imitation or for warning. The present organization of the medical profession in Great Britain, like her political constitution and common law, has been the gradual growth of her wants or necessities, without any pre- concerted or consistent plan. Unfortunately, accidental influences have been less successful in shaping institutions to the require- ments of the case in this than in the other branches of public con- cernment; probably because medical knowledge lies less within the scope of mere human reason, and demands more of slow, patient, and persevering research, than either the political or the legal. Place together a number of individuals of Anglo-Saxon origin, beyond the pale of established government or acknowledged law; and, by the mere force of judgment, they will arrange themselves, almost as by a process of crystallization, into a regular and orderly community, with an organic constitution, and a legal code, admira- bly adapted to their wants. But their medical system, unless under instructed professional oversight, will scarcely rise above the em- piricism of savage tribes; being withdrawn from the control of reason, which is powerless when unsupported by facts, and given up to the caprices of the passions and imagination. It could not be expected, therefore, that a medical polity, which has grown out of mere accidental circumstances, should exhibit the same beautiful appropriateness to the condition of the community as may charac- terize a similarly originating system of law and government. It is uuiversally acknowledged in England that the organization of me- dicine in that country is defective ; and that, with a vast amount THE MEDICAL PROFESSION IN GREAT BRITAIN. 211 of individual learning, skill, and devotedness, the general economy of the profession is not upon the same elevated level as the other great national interests. The medical and pharmaceutical professions in England embrace four bodies of practitioners more or less distinct; the physicians, the surgeons, the apothecaries or general practitioners, and the chemists and druggists. Of these, the physicians practise medi- cine either exclusively, or in connection with obstetrics; the sur- geons, strictly so called, are confined to operations, and the treat- ment of affections generally denominated surgical ; the apothecaries combine the occupations of the pharmaceutist, the physician, the obstetrician, and often of the surgeon, under the name of general practitioners ; and the chemists and druggists are restricted to pharmacy, in other words, are identical with the apothecaries of this country. The last-mentioned body, as they practise neither medicine nor surgery, but confine themselves to the preparation and sale of drugs, cannot be considered as belonging to the medical profession, and will, therefore, be omitted in the remarks I am about to offer. I will simply observe of them, that they are relatively few ; being confined for the most part to the larger towns, where they more than share their business with the apothecaries. They are, however, increasing in numbers, qualifications, and standing; and it is to be hoped that the time may come, when they may supersede their present rivals, and, compelling these into their medical func- tions exclusively, may get possession of the whole pharmaceutical business, at least in all places where the population is sufficiently numerous to support an independent drug establishment. Of the three divisions which together constitute the great medi- cal body of the country, the physicians hold the highest rank; though it cannot be denied that individual surgeons, by great talents and extraordinary success, have raised themselves to an eminence, not surpassed by any belonging to the more elevated branch of the profession. All are entitled to the name of physi- 278 THE MEDICAL PROFESSION IN GREAT BRITAIN. chin wlio have graduated in a British or foreign university, or have become licentiates of the Royal College of Physicians of London. But there are certain regulations which limit the privilege of prac- tising, at least the legal privilege, within narrower bounds. Thus, by the charter of the College of Physicians, that body has the power of preventing any one from practising as a physician in London, or within seven miles of that city, who has not submitted to its exami- nations, and received its license ; and may even enforce its privi- leges by fine and imprisonment against those who reject its author- ity. All the regular London physicians are licentiates or fellows of the College ; the latter being the proper members of the body, and supplied by annual election from among the former. In relation to England and Wales beyond the limits just mentioned, I find it stated in the London and Provincial Medical Directory, that the only legal physicians are the licentiates and extra-licentiates of the College of Physicians, and the licentiates of the Universities of Oxford and Cambridge, to whom I presume should be added the graduates of the London University. Extra-licentiates are those permitted to practise only beyond the bounds of London and its vicinity. They undergo a different and probably less strict exami- nation, and are required to pay less than one-half the diploma fees demanded of the licentiate, which are very large, being not much short of three hundred dollars. But, though physicians, in the legal sense, may be thus limited, yet, according to the same book, the graduates of the Scotch and foreign universities have long been admitted by the College as licentiates; so that the fact of graduation is in reality sufficient authority to practise. When attending the late annual meeting of the Provincial Medical Asso- ciation at Bath in England, I was accosted by a gentleman, who informed me that he had been one of my pupils, having attended lectures and graduated in the University of Pennsylvania. He was an Englishman by birth, had for some reason which I did not learn chosen to obtain his medical education in the United States: and, THE MEDICAL PROFESSION IN GREAT BRITAIN. 27 9 having received the honours of this school, had returned to his native country, and was now practising acceptably in one of its noblest cities, with no other authority than that of his American diploma. Having told you who the physicians of England are, I will next tell you what they do. It may seem strange to you that any in- formation should be needed on this point; and yet, if your notions were to be formed exclusively from what you are familiar with on this side of the Atlantic, you would have but an imperfect concep- tion of the professional habits of the English physician. Many of you, I dare say, fancy him to be a man out early and at home late ; riding from house to house on horseback, or in his one-horse vehicle ; at the beck and call of any one who may wish to see him whether by day or by night; carrying his medicines along with him ; turning his hand to everything that may offer ; at one time using the lancet, at another dressing a wound or an ulcer ; now perhaps extracting a tooth, and then superintending a labour; and, at the end of the day's work, noting the results in his account- book, and congratulating himself that, at the expiration of the year, he may, by sending out bills, gather in enough to feed, clothe, and warm his family. A London or even provincial physician in England would smile at this notion of his day's work. The fact is that he rarely touches a medicine, eschews all surgical offices as beneath the dignity of his position, would probably as soon think of performing the part of an executioner as that of a bleeder or tooth-drawer, and yields up obstetrics with the greatest possible good-will to the general practitioner, or to the few who make it a special duty. His business is purely to give advice and to pre- scribe. The metropolitan physician seldom leaves home before twelve or one o'clock, and then drives out with his chariot and pair; and a fine equipage is almost as necessary an appendage as a hat or a coat. Much of his most profitable business is at his own house, where he receives calls and gives advice after his breakfast 280 THE MEDICAL PROFESSION IN GREAT BRITAIN. hour; the patients being admitted into a reception room, and one by one entering the sanctum in their turn. Yery many of his visits are in consultation with the general practitioner, who is usually called upon at the commencement of the disease and in mild cases, and asks the aid of the physician when the symptoms become grave or obstinate. Not unfrequently he makes but one visit, waiting to be again summoned by the attending practitioner before repeat- ing it. The wealthy only can afford the luxury of continued and regular attendance from the physician. In this country, the nearest approach to the ordinary practice of the English physician is that of a medical man of established reputation in one of our larger towns, who, wishing to limit his business, confines himself as much as possible to the giving of advice at home, and a consultation business abroad. But here the analogy ceases. The mode of com- pensation differs entirely. With us, each piece* of service is noted in the day-book, and a bill rendered for the whole at stated periods. In England, the service is paid for when received. We charge one or two dollars a visit, they expect a guinea or about five dollars. We have a legal claim for our fee, and often lose it. They have no legal claim for theirs, and are sure to get it. A physician in this country may, if fully occupied, in the most favourable situa- tions, make eight or ten thousand dollars a year ; a London physi- cian of high repute not unfrequently receives five thousand pounds, equivalent to nearly twenty-five thousand dollars, and sometimes doubles that income. It is remarkable how our sensibilities accom- modate themselves to the peculiar circumstances of our position. The physician in England thinks that to send in a bill for attend- ance would level him with the mechanic, and looks with something like contempt on the practice. I confess that to hold out my hand for money, at each visit, would be repugnant to my sense of deli- cacy. I should feel as if I were reducing an honorary to a mer- cenary service. It seems to me that the practitioner, under such circumstances, though he may not absolutely repeat the servile THE MEDICAL PROFESSION IN GREAT BRITAIN. 281 formula — remember the physician — must have the words in his heart. The number of physicians is small, compared with that of the other classes of medical practitioners. They are almost all well- educated, many of them highly-educated men ; and, indeed, a good preliminary education is a necessary prerequisite to an examination for the medical diploma, in all the English institutions which have the authority to grant it. They are also men generally of culti- vated manners, and have the moral tone as well as exterior polish which characterize the gentleman. Though inferior in rank to the higher aristocracy of the kingdom, they associate often upon equal terms with the best society; and we occasionally see it announced in the Court Journal, that some physician of eminence has been honoured with a seat at the queen's own table. They frequently have great influence with men in power, and with the community among whom they live. I repeatedly met with physicians in the large provincial towns, who either were, at the time, or had been mayors of their respective corporations ; and that position is even more honourable and influential in England than in this country. Their professional success is very precarious. It is, for the most part, after long waiting, and many of those delays which make the heart sick, that they become firmly established ; and the greater portion can expect little more than to make a respectable liveli- hood. Now and then, however, an encouraging instance of great success occurs among them, leading to both fame and fortune, and serving as a beacon-light to ambitious aspirants. The system of high fees enables one who can obtain a large practice among the opulent to reap abundant emolument; while it does not altogether prevent others from obtaining practice among the middling and poorer classes ; for, though precluded by the general sentiment of his class, which has almost the force of law, from accepting less than a guinea for each visit, he may attain the same end by declin- ing compensation for every second or every third visit, or even for 282 THE MEDICAL PROFESSION IN GREAT BRITAIN. two out of three visits, so as to bring the fees in fact nearly on a level with ours. From the physicians of England I personally met, whenever I came in contact with them, the utmost courtesy, and to many I am indebted for very kind attentions. To Drs. Pereira and Christison especially, who may perhaps have recognized congeniality of pur- suit as a stronger claim on their hospitality than mere professional brotherhood, I would express a peculiar obligation ; and, should this acknowledgment ever reach them, I hope they will still further add to their kindness by excusing the use, which, under the impulse of feeling, I have ventured to make of their names on so public an occasion. The second division of practitioners before alluded to, or the proper surgeons, are those who profess to deal only with surgical affections, with the addition in some instances perhaps of ob- stetrics. They do not seek a diploma in medicine, and have no special designation to distinguish them from other members of the community. To the eminent surgeon it is offensive to be styled doctor; because the giving of a title, to which he has no claim, would seem to imply that his consequence may be added to by something extraneous to his own merits or position. Though none are prohibited by law from assuming the name and character of a surgeon, and some persons do so without any claims from qualification or otherwise, yet no one is recognized as belonging regularly to the profession, or can gain a respectable standing in the community, unless he has gone through a preparatory study and training, and received credentials from some authoritative body.* Such credentials are generally obtained from the Royal * This is one of the points in which the late act of Parliament has proved very useful. No one now can assume the title of surgeon or physician, who is not legally entitled to it. THE MEDICAL PROFESSION IN GREAT BRITAIN. 283 College of Surgeons of London, whose diploma of membership, given after a certain specified course of instruction, and a suc- cessful examination by the College, is everywhere received as suffi- cient authority to practise, and is sought for by most of those who have respect for themselves, or seek the respect of the community. A higher position still is that of fellowship in the College, which implies more ample literary as well as professional attainment, and is conferred, after a satisfactory examination, upon candidates who can bring the requisite certificates of previous preparation, such as that they are twenty-five years of age, have a competent knowl- edge of the Creek, Latin, and French languages, and have been engaged for six years in the acquisition of professional knowledge, in recognized hospitals and schools of medicine, either in the British islands or abroad. I found a distinction made in England, in conversation, between the surgeons and consulting surgeons, though I could not discover any very definite line between the two sections of the profession. The consulting surgeons, however, appear to be those who aim at, or have obtained the highest position among their fellows, who leave to others the humble offices of the profession, and confine themselves to the giving of advice at their houses, to the perform- ance of operations, and to consultations. They are men of the highest attainment, respect, and influence in the communities in which they move, not unfrequently acquire considerable wealth, and in many instances have, like the more successful physicians, been honoured by knighthood or a baronetcy; the highest title which has ever yet been conferred on any member of any branch of the medical profession in Great Britain. Sir Astley Cooper, Sir Ben- jamin Collins Brodie, Mr. Travers, Mr. Stanley, and Mr. Liston are, or were, examples of this higher grade of surgeons. Mr. Norman, an eminent surgeon of Bath, and at the time mayor of that city, presided over the late annual meeting of the Provincial 284 THE MEDICAL PROFESSION IN GREAT BRITAIN. Medical Association, though numerous physicians, and some of them of high standing, were present. In short, I could not dis- cover that any marked distinction in social standing existed be- tween the physicians and consulting surgeons. Both are, I think, generally deemed much superior, on the average, to the lower grade of surgeons, and to the general practitioners. This last class will next engage our attention. It is by far the most numerous, and, if I am not much mistaken, is destined to play an important part in the future medical history of the coun- try. It took root in the once humble and despised apothecary, gradually grew upon the wants of the community, and has at last attained an overshadowing magnitude, which, though each indi- vidual branchlet may be of little significance, will probably in time, by its very mass, shut out the sunshine of public patronage from the hitherto more elevated classes, and cause them finally to wither in its shade. The original and proper business of the apothecary was no doubt to prepare and vend medicines; and this it ought still to have continued to be. In the United States, he remains what he originally was; and the consequence has been, that, by a concentration of time and abilities upon his own pursuit, he has elevated pharmacy from the rank of a mere trade to the dignity of a profession, and increased in a corresponding degree his own per- sonal respectability. It was otherwise in England. There, the apothecary, though he continued to prepare and sell drugs, su- peradded the practice of the different branches of the medical profession to the pharmaceutical, which thus became secondary in his own estimation and that of the public. Without becom- ing a good medical practitioner, he ceased to be a good pharma- ceutist; and the name of apothecary came at length to signify a mongrel compound of doctor, man-midwife, surgeon, and drug vender; a true jack of all trades and master of none; willing to play second part to the regular physician, and, though used by THE MEDICAL PROFESSION IN GREAT BRITAIN. 285 the public, yet looked on by them with a sort of good-natured contempt.* It is not difficult to account for the different results in the two countries. With us, the practice of medicine, if not quite free, was trammelled with very few restrictions, and those by no means onerous ; so that it was easy for any one possessing moderate means to enter the profession, the ranks of which were thus kept filled up to the wants of the country; while competition placed the fees upon a level with the general means of the public. All the avenues to practice being occupied by those regularly trained to the pursuit, the apothecary had no opportunity or temptation to step over the legitimate bounds of his profession into the empty places of medicine. In England, on the contrary, the regularly educated physicians were comparatively few; and these, enjoying a kind of monopoly, were enabled to maintain prices at such a point, as to place their services beyond the means of persons in ( low or moderate circumstances. The poorer people, unable to pay for instructed advice, turned to the apothecary, who, as a vender and preparer of medicines, was naturally supposed to know something of their uses. He thus became the adviser and attend- ant of the lower classes ; and even those of the upper ranks gradu- ally began to employ him, first as a subordinate auxiliary to the physician, and at length as his substitute in mild cases, and the incipient stage of those of a severer character. Not being per- mitted to charge for his advice or his visits, he naturally sought to indemnify himself for his loss of time by an increased sale of his medicines ; and was tempted into various irregular modes of * It will be readily perceived by the context, that this sentence was in- tended to apply to the apothecaries as they formerly were. Their standing, at the time of my visit, was much more elevated; and, under the name of general practitioners, they constitute, upon the whole, a highly respectable branch of the profession. 280 THE MEDICAL PROFESSION IN GREAT BRITAIN. attaining this end, among which were excessive medication, the adaptation of the prescription to the pecuniary advantage of the prescriber rather than to the real wants of the patient, and a sys- tem of monstrous overcharging. I have been informed that it was formerly not uncommon for the apothecary to put up a dose of salts, worth two or three pennies, in half a dozen or a dozen potions, to be taken at intervals of an hour or two, each at the cost of a shilling. Conscience, and a proper sense of his interests, combined to in- duce the apothecary to render himself fitted, so far as possible, to the new office which had been in some measure forced upon him. He sought, therefore, in the hospitals and schools, and by a course of study, a competent knowledge of disease, and the recognized modes of treating it. Some attained great skill and reputation, and even raised themselves to the rank of regular physicians. Many, however, remained in contented inferiority or ignorance ; and the general standard of medical attainment among them was certainly not very elevated. The London Society of Apothecaries, who held the exclusive right, under the law, to grant licenses to practise their art, were by no means strict in their medical requisi- tions. The great majority of the people of England appeared to be doomed to intrust their health and lives to the chances of in- competent advice. But a new era has opened; great advances have already been made towards a better condition of things ; and, on looking down the long vista of futurity, we may see the prospect gradually widening and improving for this branch of the medical profession, and that portion of the public intrusted to them. Formerly, though the practice of medicine had been grafted on pharmacy, the latter continued to be the main object of solicitude, as it was the chief source of profit. Gradually the medical branch has acquired increased vigour, growing upon the nourishment that was thrown into it at the expense of the parent stem, until at THE MEDICAL PROFESSION IN GREAT BRITAIN. 281 length it has expanded into a luxuriance which almost conceals the latter from view. The Society of Apothecaries established a higher grade of medical qualification for their licentiates, and sus- tained that grade by more rigid examinations. The education now demanded of the apothecary, before he can obtain permission to practise, is of a character quite equal to the requisitions of our own schools. Independently of five years' apprenticeship, which is considered requisite for his due pharmaceutical accomplishment, he must be twenty-one years old, have attended three courses of winter and two of summer lectures in some recognized school, and at least a year in some recognized hospital containing one hundred beds. Of the different branches of medicine, surgery alone is omitted from the schedule of studies. The apothecary, though a medical practitioner, is not necessarily a surgeon. But most of those who enter into this division of the profession, qualify them- selves also, as I was informed, for the practice of surgery, and become members, after due examination, of the College of Sur- geons of London. They thus lay themselves out for the practice of every branch of our art, exactly as the country physician in the United States; and, in correspondence with this position, they are beginning to throw aside the title of apothecary, and to assume that of general practitioners. Until recently they were allowed to charge only for medicines; the advice and attendance being thrown into the bargain. At present, according to the decision of the courts of law, they can charge for both ; and one great and most absurd evil has thus been corrected. The English general practitioners are now almost precisely upon a footing with the greater number of physicians in the United States, diifering simply in the circumstances, that they do not take the degree of doctor of medicine, and, in most instances, continue to unite the business of the retail druggist with that of the physician. They universally make lower charges than the usual fee of the physician in Eng- 288 THE MEDICAL PROFESSION IN GREAT BRITAIN. land, receiving, I believe, generally, from those who can afford it, live shillings instead of a guinea for each visit. They enjoy the advantage, also, if it can be considered one, of having a legal claim for compensation for their services ; and, as with us, they render their bills at stated periods, instead of receiving their fee in hand. It is easy to foresee that, with increasing competence, and a still more enlarged instruction, they must raise themselves in time to be the almost exclusive medical practitioners of the land ; for low prices, with equal qualifications, will in the long run invariably carry the day. The very wealthy, and the high aristocracy, may long continue to cherish the distinction of a physician at a guinea a visit ; but even they will, I think, in time, come into the five shilling system, when they learn that the great point of health can be equally well secured. But, before this end arrives, a great change is yet to take place in the plans of the general practitioner. It will be necessary for him to devote an exclusive attention to the medical department of his profession, and to cut loose from the pharmaceutical, which must be abandoned to the chemist and druggist, or in other words, the legitimate apothecary. Were time allowed me, it would be easy to point out the evils which flow from the combination of these two pursuits in one. As it is, I must content myself with a hasty sketch of them. They who are but superficially acquainted with the various qualifications required in the practitioners of medicine and pharmacy, know well that either one of them is sufficient to engross all the time and powers of a single individual; and that he who undertakes to unite them must, as a general rule, do so at the expense of profi- ciency in one, or the other, or in both. This alone is an all-suffi- cient reason why they should be separated. But there are others. The medical practitioner who prepares and dispenses medicine is constantly exposed to the temptation of over-medication if he charge for his medicines, of under-medication if he make no THE MEDICAL PROFESSION IN GREAT BRITAIN. 289 charge ; and if, in his capacity of apothecary, he be called on to put up the prescriptions of others, he is again tempted to an un- due interference with the physician, by undervaluing whose skill he is indirectly raising his own in the estimation of the patient, and paving the way for an extension of his practice. The majority may resist these temptations ; but some undoubtedly yield to them, and thus affix a stigma to the whole body, which has a tendency to indispose young men of the highest qualifications from joining it, and consequently lowers somewhat not only its general reputa- tion, but its real efficiency. The general practitioners of England can never place themselves on a level with the physicians and higher grade of surgeons, until they shall have effected the separa- tion alluded to ; and we shall do well in this country to take warning from English experience, and scrupulously continue to keep the two professions distinct. In relation to practitioners in thinly peopled neighbourhoods, where apothecaries' shops are not accessible, it is necessary that the physician should himself dis- pense medicines to his patients ; but it is not necessary that he should make a business of their preparation and sale, and thus load himself with the burdens and responsibilities of another pro- fession. From what has been said you will have inferred that the organ- ization of the profession in England is very complex. It is even more so than I have described it, in consequence of the varying action of different bodies, having or professing to have peculiar legal powers, or at least exercising by prescription peculiar influ- ences which have almost the force of law. Thus, connected with the Royal College of Physicians are two if not three classes of practitioners; with the Royal College of Surgeons, two; with the Society of Apothecaries, a third ; while, in the instance of new regulations in any of the institutions, there is necessarily one class of those in existence before their adoption, and another of those 19 200 THE MEDICAL PROFESSION IN GREAT BRITAIX. who enter the profession afterwards. The degree, moreover, of different institutions is of different weight, that of Oxford and Cambridge being perhaps more highly esteemed than that of Edinburgh or Glasgow, or of the foreign universities. In fact, upon making inquiry of some of my medical friends in England, I found that even there all the entangled relations of the different sections of practitioners were not by any means universally under- stood. From this cause it has happened that the movements in the profession, which a sense of its imperfect organization has occasioned, and the extent of which indicates a general dissatisfac- tion and restlessness under the present system or want of system, have hitherto been productive of no very important results. The lawmakers have shown a disposition to aid the profession in work- ing its way out of these intricacies ; but a movement made in any one direction is apt to be met by the remonstrances of some op- posing privilege, interest, or prejudice ; and legislative interference appears to have been postponed until some plan can be presented, which shall unite the suffrages of the great body of those con- cerned. I cannot but think that the sagacity and judgment so characteristic of the English will ere long be brought to bear on this confused subject, and that measures will be devised calculated to bring about harmony if not perfect unity in the profession ; so that the struggle as to what peculiar interest shall be best pro- moted or defended, will give way to an emulous rivalry in further- ing the general good. There should be one education and one grade of honour common to all; and everything else should be left to individual effort. Some, as at present, would addict them- selves to medicine, some to surgery, some to midwifery, etc.; and many would combine the three branches together. The more special practitioners might be slower of success, but would in the end acquire greater skill and reputation, and consequently greater emolument ; and there would be an ample field for the gratifica- THE MEDICAL PROFESSION IN GREAT BRITAIN. 291 tion of an honourable ambition on the broad basis of equal rights and privileges to all.* The remarks hitherto made have had reference chiefly to the organization of the profession ; but the view would be very incom- plete in your eyes, were I not to present you some account of the plan of medical education, and the qualifications demanded of the candidate for the medical diploma, or in other words, for the certifi- cate of qualification to practice. You will be surprised to learn that none of the proper medical schools in England, and none of the literary institutions with which they are directly connected, have the power either of conferring degrees, or of giving a license. The only graduating bodies are the Universities of Oxford, Cam- bridge, and London. The first two grant medical honours to those exclusively who have completed a course of academic study under their own supervision, unless perhaps the graduates of the Dublin Univerity may constitute an exception; the last extends them to all who can present the requisite credentials, and undergo the requisite examinations, no matter in what school or schools their medical education may have been conducted, provided only that the school be one recognized by the University, and, of the four years of scholastic attendance required, one year at least shall have been in connection with one or more of the schools of the United Kingdom. Attached to the Universities of Oxford and Cambridge there are professorships in the medical sciences, and, in the latter, courses of instruction are given ; but in neither is there a complete school. The University of London has not even the shadow of a school attached to it ; for the University College of London, whose medical class is I believe the largest in England, has no more con- * I scarcely^need repeat that, since this lecture was delivered, an act of Parliament has been obtained, -which, though it is not all that could be ■wished, has enabled the profession to organize itself, and promises to lead to very useful results. 292 THE MEDICAL PROFESSION IN GREAT BRITAIN. nection with the University of London, notwithstanding the simi- larity of name, than any of the other respectable schools upon the island. The University is merely an examining and degree-con- ferring body, established by government in order that dissenters might be enabled to obtain academic and medical honours ; the graduates of Oxford and Cambridge being required, I believe, to profess adhesion to the national church. The schools are generally established in association with hos- pitals ; the prescribing physicians and surgeons of these institutions uniting to get up courses of instruction in the different branches of medicine and surgery ; and so necessary is the hospital connection deemed, that, when independent schools are instituted, they en- deavour to set on foot an infirmary, to be under the charge of the teachers, as in the cases of the King's College, and the University College in London. Had I time, I could easily demonstrate, to your satisfaction, that this plan of forming schools as subsidiary to the hospitals can never be permanently and greatly successful. The chief objection to it is that the officers are appointed, not in reference to their qualifications as teachers, but for the practical charge of the infirmary. It may accidentally happen that one or more of them may possess high teaching powers ; but a succession of such happy accidents can scarcely be expected ; and the reputa- tion of the school must be temporary. No great school of the kind has maintained a permanent existence in England ; no one in fact has ever risen into the eminence which institutions have attained, based upon the principle, that peculiar qualification for the duties to be performed should be the ground of appointment. The most successful school in London has been that of the University Col- lege, in which the professors are chosen for their professorial abili- ties, and not for their fitness, either from favour or qualification, for the office of physician or surgeon to an hospital. Schools are numerous both in London and the provinces. In the former, thirteen are recognized by the London University, in THE MEDICAL PROFESSION IN GREAT BRITAIN. 293 the latter no less than sixteen, of which the most distinguished are those of Manchester and Birmingham. Many of these schools are imperfect ; but, as the requisition for graduation or a license is that the candidate shall have attended courses on certain subjects, for a certain length of time, he may receive his instruction, if he see fit, in several distinct schools, attending to one subject in one and to another in another; so that any deficiency in the arrange- ments of a school, as to the subjects taught, may be easily supplied. Most of the schools are very slenderly attended; many having classes of considerably less than fifty pupils, while the most flour- ishing seldom exceed two hundred, or two hundred and fifty. The population of England cannot support so large a propor- tionate number of practitioners as ours, in consequence of the vast excess of the poor, who never pay for medical aid. This class of the population can contribute to increase the number of prac- titioners, only in so far as the medical assistance yielded them is paid for out of the public purse; but the compensation thus given is so ridiculously insignificant, and the numbers of the poor whom it is expected that each practitioner employed for the purpose shall attend is so absurdly great, that but a small addition can be made to the aggregate number of medical men upon this score. The inadequacy of the compensation made by the public for at- tendance on the poor, is one of the most common and loudest com- plaints of the profession ; and I have heard the strongest terms of reproach lavished on the wretched parsimony, which exhausts and impoverishes the medical practitioner, while professing to pay him for his services. I remember being told that the practitioners em- ployed by the government, during the prevalence of the typhous epidemic, which has recently been desolating Ireland, were expected to expend their whole time, and more than all their energies, in visiting the destitute sick over wide tracts of country, for the miser- able pittance of five shillings a day ; scarcely sufficient to pay for their necessary horse-hire. Why, it may be asked, should they 294 THE MEDICAL PROFESSION IN GREAT BRITAIN. submit to be thus treated? The answer simply is, that, placed as they are in the midst of the perishing poor, they are compelled by the ordinary feelings of humanity to make every possible effort for their relief; and the government, with the spirit of a usurer prey- ing upon the struggles of the unfortunate, speculates upon their benevolence. The consequent exposure and hardships prove ex- tremely destructive to the practitioners thus employed ; and I heard one of the most eminent of the physicians of Ireland say, in the most mournful and touching accents, that one-fifteenth of all the medical men of that island had perished in the year 1847, chiefly of typhus fever. The evil is not so great in England ; but it is even there universally looked on by the profession as a most crying grievance, a piece of enormous injustice, which the public are called on by every principle of right, and every feeling of humanity, to rectify. If the whole number of students is small, that of the candidates for the degrees in the universities is incomparably less ; and I was astonished to learn that the University of London does not grad- uate more than ten or eleven annually. I was told that, in all London, there were probably at no time more than from eight hundred to a thousand students of medicine ; and of these but a small proportion is engaged in attendance at the same time upon all branches ; so that, divided among the thirteen recognized schools, the average class of each individual teacher must be small. I do not know that it is a legitimate matter of boasting; but the fact is certainly worthy of notice, that, while London, the metrop- olis of the world, with two millions of inhabitants, has little more than eight hundred medical pupils, Philadelphia, with only one- sixth of the population, counts her thousand or twelve hundred every winter. It maybe expected that I should detail the qualifications deemed essential for admission into the different classes of practitioners re- spectively ; but time is wanting, and I must be content with stating THE MEDICAL PROFESSION IN GREAT BRITAIN. 295 that, in relation to preliminary education, length of study, amount of knowledge, and age of admission, the requisitions for the highest class are much greater than with us, while, for those of a lower grade, they are about the same. Thus, four years of study are de- manded by the University of London as preliminary to the degree of Bachelor, six years to that of Doctor of Medicine ; the Royal College of Physicians and that of Surgeons, require, the former five and the latter four years ; and the Apothecaries' Society exacts of every candidate for their license, which constitutes the only legal authority of the general practitioner, besides an apprenticeship of five years with an apothecary, an attendance upon not less than three winter and two summer sessions of lectures. Notwithstanding these higher requisitions upon paper, were I called on for an opinion as to the relative qualifications of the medical men in England and the United States, though confessedly not possessed of all the means of forming an accurate judgment, I should say, from what I have observed, that, if the higher grades of English physicians are superior in education to ours, the case is reversed in relation to the great mass of practitioners. The main cause of this superiority on our part, admitting it to exist, is prob- ably that the American practitioner reads much more, after the nominal completion of his studies, than the English, of which one of the strongest proofs is the comparatively small editions of medi- cal books sold in England. Their own best works are more read in the United States than at home. My friends in England ap- peared to be astonished when informed of the number of medical books sold in the United States. Perhaps one cause of this differ- ence may be, that the great body of English practitioners, being apothecaries, have their time too much engrossed by the pursuit of two distinct branches of business to allow much of it to be devoted to further study. It remains only that I should give a hasty sketch of the organ- ization of the profession in other parts of the United Kingdom. 296 THE MEDICAL PROFESSION IN GREAT BRITAIN. In Ireland, it is almost an exact copy of that existing in England : the same classes of practitioners; the same licensing and graduat- ing authorities; the same system of medical instruction. There arc in Ireland, as in England, physicians, surgeons, and apothe- caries. Dublin has its King and Queen's College of Physicians, its Royal College of Surgeons, and its Apothecaries' Hall, closely analogous in their constitution and privileges to the corresponding institutions in London. There is also the Dublin University or Trinity College, which confers degrees in medicine; but differs from the English universities in having a completely organized school of medicine connected immediately with it ; in this respect, resembling the Scotch universities and our own. But there are numerous other schools in Dublin, private or connected with the hospitals, in which the large classes of the surgeons and apothe- caries mostly receive their education ; but they neither confer de- grees, nor give any license to practise. Most of the students who aim at the medical degree resort, or until recently have resorted, to the Universities of Edinburgh and Glasgow. I was told that the class of apothecaries or general practitioners are not equal in attainment to the English ; as the Dublin Apothecaries 1 Hall is less rigid in its examinations, and less exacting in its requisitions than the analogous society of London. The two degrees of Bache- lor and Doctor of Medicine are conferred by the Dublin Univer- sity, the former being regarded as a sufficient license to practise, and the latter merely as an honour. In relation to Scotland, I confess that I have less precise inform- ation than of the two other sections of the kingdom. My journey through North Britain was so rapid, and my attention so much engrossed by other objects, that I failed to make full inquiries. But, from what I did see and hear, and from the comparative facility with which the degree of Doctor of Medicine, hitherto, I believe, the only one conferred by the Scottish schools, may be ob- tained, I have inferred, that physicians, or, in other words, grad- THE MEDICAL PROFESSION IN GREAT BRITAIN. 297 uates in medicine, are much more numerous proportionably in this than in the southern section of the island, or in Ireland ; and that, as with us, they perform all the offices of the profession; some directing a more exclusive attention to the pure practice of medi- cine, others to surgery, and others again to obstetrics. There is, however, a distinct body of surgeons, who practise under the license of the Edinburgh College of Surgeons, the Glasgow Faculty of Physicians and Surgeons, or some similar institution, without having obtained a degree. I heard of no class precisely analogous to the apothecaries or general practitioners of England. The bodies having the right to confer the degree of Doctor of Medicine in Scotland, are the Universities of Edinburgh, Glasgow, Aberdeen, and St. Andrews, and the King's College of Aberdeen. Of these, the Universities of Edinburgh, Glasgow, and Aberdeen, have medical schools connected with them, exactly as the Univer- sity of Pennsylvania. All profess to require four years of attend- ance upon medical lectures ; and most of the courses of lectures are required to be of six months' duration, which is the case also in the English schools. Besides these graduating institutions, there are three which have the power of licensing ; namely, the Royal College of Physicians and the Royal College of Surgeons of Edin- burgh, and the Faculty of Physicians and Surgeons of Glasgow. There is a respectable medical school in Glasgow, connected with the institution called commonly, from its founder, the Anderson University, which has not, however, I believe, any legal collegiate powers. The observations, already incidentally made, will spare me the necessity of speaking further of the general character of the medi- cal profession in the British Islands. Upon the whole, I presume, their relative social standing is equal or superior to that of the profession in any other country in Europe, though inferior to that which is enjoyed in the United States, where, I am proud to say, the medical men as a body maintain a position with the highest, 298 THE .MEDICAL PROFESSION IN GREAT BRITAIN. whether we take, as a measure of elevation, extent of attainment, sentiments of honour and of humanity, cultivation of manner, or the respect of the community. There is, however, one point of which I would speak before I close. I wish to call your attention emphatically to the hospitable qualities of the medical practitioners of the United Kingdom, and especially to their kindly disposition towards their professional brethren in this country. Wherever I went, throughout the isl- ands, it was only requisite that I should be known as a physician from the United States, of ordinary repute at home, to secure me the kindest reception ; and the want of time often compelled me to forego hospitalities that were urged upon me. I may be allowed, perhaps, to mention one instance in proof of what I have stated. Arriving towards the close of the day at one of the chief cities of England, I left my own card with another of introduction at the door of a physician of the place. After dark, he called upon me, stating that he had come immediately after receiving my card; and, having been told that we should depart on the following morning, insisted upon taking me at once over the town, and showing me as much of it as could be seen by the light of a beauti- ful moon, which had risen. I agreed to the proposal, and together we wandered through the streets and lanes, and about the walls of the city till it was nearly midnight. In the course of our peregrin- ations, I observed that remarkable respect was everywhere paid to my companion by the police ; and, before returning to my quarters in the hotel, learned that I had been under the guidance of the mayor of the city. This act of extraordinary courtesy, with others which greatly facilitated my objects in travelling through that sec- tion of the country, I shall always bear in very pleasing remem- brance. All of you know of the meeting of the American Medical Asso- ciation at Baltimore in May last. At that meeting, a delegation was appointed to represent the body in the British Provincial THE MEDICAL PROFESSION IN GREAT BRITAIN. 299 Medical Association which was to assemble at Bath in August. Among others, I myself, being in England at the time, was named upon the delegation ; and, wishing to give effect to the intentions of the Association, I made arrangements, though at the expense of my previous plans, to be present at the meeting. My reception was, beyond all expectation, kindly and respectful. The creden- tials were read ; resolutions of the most nattering character were passed unanimously; and the whole meeting rose to greet the messenger of good-will and brotherly sentiments from beyond the Atlantic. I was of course gratified; I can hardly express how highly gratified ; not so much at the honour done to me, as to my country through me. These expressions and evidences of mutual good-will are of the highest national importance. A reciprocity of kindly feeling can scarcely actuate distinct masses of intelligent men, such as compose the medical profession in England and Ame- rica, without radiating more or less through their respective com- munities, and thus serving as a bond of peace and amity between two nations, whose mutual good-will is essential to the prosperity and happiness of both, and which, if united in the prosecution of the great object of human advancement, will exercise the most happy influence over the destinies of the whole earth. Let me urge upon you, gentlemen, to do all that lies in your power, by the cultivation of this friendly spirit towards your British brethren, to further so desirable a consummation. LECTURE II. DELIVERED OCTOBER 14th, 1853. The Medical Profession on the Continent of Europe. Gentlemen : — Most of you are probably aware that I have been spending the season just passed in a tour upon the Continent of Europe. From the relations subsisting between us, you may very reasonably expect from me some fruit of this journey, that may be useful to you in your capacity of students of medicine. You will not, there- fore, I trust, ascribe it to presumption on my part, or an over- weening disposition to obtrude myself on your notice, if I attempt to answer such an expectation by offering to you some of the ob- servations and reflections, of a medical character, which I have had occasion to make in the course of the journey. Should you discover signs of haste and carelessness in my communication, I must beg of you to remember that it has been prepared in the course of a few days, amidst crowded occupations, and imme- diately upon returning from a long absence, and to make all due allowances. You will, I hope, excuse me, if, in the first place, I give you a very brief sketch of my route, so that you may know what have been my opportunities of observation, and thus be able to estimate more accurately than you otherwise could do the value of my (300) THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 301 statements and opinions. It is proper to say that I was accom- panied throughout the journey by my friend, Professor Franklin Bache, of the Jefferson School, and have consequently had the advantage of an excellent auxiliary judgment, in considering the various facts that came under our joint notice. Having made a rapid passage to Liverpool, and remained a short time in London, we reached Paris early in May, and, about the middle of the month, left that city for the south of France. Upon our route in this direction, we visited Bordeaux, Montpel- lier, and Marseilles, and afterwards, entering the dominions of the King of Sardinia, passed through Nice, Genoa, and Turin, and crossed Mont Cenis, then covered at its top with snow, though so late as the seventh of June. I would here incidentally remark that, during almost the whole of our journey, the weather was unusually cool, and at the very time that, here at home, you were scorching with the intensity of the heat, we found fires in the evening neces- sary to comfort, on the shores of the Mediterranean. I was told at Nice that the coldness of the weather was almost unprecedented at that place. The chief interest of this fact is the evidence it affords, so far as it goes, of a compensating influence in the distri- bution of terrestrial temperature, by which what is lost by one part of the earth is gained by another; so that the invalid may in- dulge the hope of escaping an uncongenial season in his own coun- try by a voyage over the ocean, now reduced to a mere trifle, in point either of time or trouble. From Savoy we entered Switzer- land, and, having visited Geneva, Berne, Zurich, and other noted towns of that glorious region, crossed the Lake of Constance, and prosecuted our journey through Augsburg, Munich, Saltzburg, etc., to the Austrian capital. From Yienna, where we spent a few busy days, we proceeded northward through Bohemia, Saxony, and Prussia, to the shores of the Baltic, giving, as we passed, a short time to the cities of Prague, Dresden, and Berlin. Descend- ing the Oder from Stettin, we steamed over the Baltic to Stock- 302 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. holm, visited the famous Upsala, once the capital of Sweden, and long the site of its most famous school, then returned to Stettin, and took a fresh start thence, up the Baltic and Gulf of Finland, to St. Petersburg. An interesting medical fact, in connection with this part of our tour, was that, notwithstanding the existence of quarantine regu- lations, enforced with extreme strictness, between Sweden and all the ports of the Baltic where cholera was known to have appeared, the disease, nevertheless, entered Stockholm, and had begun to spread with considerable violence before we left the north of Europe. Sweden is, I believe, at present the only country in Europe where quarantine laws are enforced against the disease; as experience has shown that they are altogether futile for any good result, while they prove of great inconvenience to the travel- ler, and the source of much commercial loss.* Another medical fact of some interest is the prevalence of a mild form of intermittent fever in the neighbourhood of Stock- holm, in the latter part of summer and beginning of autumn. I was much surprised at this ; for, though the country is full of lakes and inlets from the sea, and shows upon the map almost as much of water as of land, yet the region is, I believe, wholly granitic, and the latitude is considerably beyond the highest point at which marsh miasmata are usually supposed to be generated. But to return to my narrative, which was broken in upon by these reminiscences, I will merely further state that, having made a short visit to Moscow, we left Russia, and returned southward through Germany, Holland, and Belgium, to Paris, visiting by the way, among other cities, those of Frankfort-on-the-Main, Cologne, Amsterdam, the Hague, Leyden, Antwerp, and Brussels. From Paris, we came homeward by the route of London and Liverpool, * I have been informed that, since the period of our visit, the quarantine laws, so far as they related to cholera, have been abolished. THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 303 and, after a stormy passage of nearly twelve days, reached New York on the second instant, rejoiced once again to be in our own land, which all that we had seen abroad had but taught us to love and esteem the more. During the journey, of which I have thus given a very brief sketch, we availed ourselves of every offered opportunity of ex- amining the medical schools and hospitals, and making ourselves acquainted with the state of the profession in the several countries visited. I owe it to the medical men whom we met to state that, almost without exception, they treated us with courtesy and even kindness, and took apparent pleasure in facilitating our inquiries. The great rapidity of our progress, and the numerous objects of interest unconnected with medicine, which met us at every step, and required a portion of our attention, precluded a minute inves- tigation ; and it is, therefore, general views rather than detailed statement, or elaborate description, which I have to offer. Fortu- nately this corresponds with the requisitions of the present occa- sion, wherein time is not allowed, and attention could scarcely be commanded for minute and copious details. In a former address to the medical class, which they did me the honour to publish, I presented some views of the state of the medi- cal profession in Great Britain, which render further reference to that subject unnecessary now. The observations I am at present about to make will relate to the continent, and to that portion of it only through which our route lay; the Spanish, Italian, and Grecian Peninsulas, and the European dominions of the Sultan, not being included. The first and most important element in the consideration of the subject is medical education. No course of argument is required to show that this must lie at the foundation of the professional character in every country; and that, according as it is well or ill conducted, and to the special manner in which it is conducted, must, in great measure, be the condition of the profession itself, in 304 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. regard not only to its general efficiency and repute, but also to its peculiar and characteristic traits. Throughout all those parts of Europe referred to, medical edu- cation is carried on essentially in the schools. These are never, so far as I had the opportunity of noticing, independent establish- ments, like many existing in our own country, but are always con- nected with some great general school or university, from which the honours emanate, after compliance on the part of the candidate with certain regulations, among which the most important are a particular duration of study, and examinations at fixed and fre- quently recurring periods. The laws of the country have an important bearing upon medi- cal education. In general, no person is allowed to practise, who has not obtained a license or degree from a university or other analogous institution. This gives great authority to the schools, enabling them to make and enforce regulations, and exact an amount of attainment on the part of the candidate, which they could do in no other way so efficiently. Even with this advan- tage, however, they do not always succeed in making good and accomplished practitioners. Competition, so useful when properly restrained and regulated, becomes here, as in almost everything else, when left to an unrestricted course, the cause of some evils. In the large states, where one will, whether that of a despot or of a constitutional authority, controls all things relating to educa- tion, it is comparatively easy to proportion the number and extent of the schools to the wants of the community ; but the case is far otherwise when many small independent governments exist, each with the power to establish as many schools as it may see fit, but often not possessed of the resources and materials requisite for the support of one. In instances of this kind, the school must depend for its success upon a reputation extended beyond the limits of the state in which it has been established, and upon the inducements it can offer to students from all quarters. Now, such is the condi- THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 305 tion of things in Germany, where a large number of small sov- ereignties exist, each ambitious to distinguish itself by its scholastic institutions, and greedy of the advantages of various kinds which these institutions, when successful, yield to them. So far as the competition is limited to the earning of a reputation for efficiency of system, or excellence of instruction, it is productive only of good; but, unfortunately, all cannot win for themselves such a position, nor, having gained it through the extraordinary efforts of gifted men, can they retain it when no longer supported by the same talent and energy. Under these circumstances, the tempta- tion is sometimes irresistible to compensate for deficiency of merit by a reduction of the standard of qualification, and, if the enter- prising and highly gifted cannot be attracted, at least to secure the economical advantages by filling the rooms with materials of a lower order, and sending forth into the world, with the stamp of the school, unqualified men, who are more able or willing to pay for their honours than to earn them. I was informed, in Russia, that throngs of the inferior graduates of some of the German schools make their way into that country, and that it had become necessary there, though, from the vast extent and population of the empire, there is an almost unlimited field for the exercise of com- petent medical abilities, to guard the public against this sort of regular charlatanism, by a rigid system of examinations, to which every one must submit, before he can be permitted to practise. The long duration of the term of study in the European schools is one of their important characteristics. So far as my informa- tion extends, this varies from four to six years, being in no instance shorter than the former of those periods, which, as all of you know, is one year longer than the longest with us. This is certainly an advantage which they possess over us ; and it might be inferred, with apparent reason, that, supposing the capacity and industry to be equal, the result must be a great superiority of professional qualification in the European graduate. Yet, when examined in 20 300 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. all its bearings, the longer period will not be found to possess all the practical advantages which, on a superficial view, might be ascribed to it. The system of instruction in the schools of Europe embraces, not only the studies having a close and essential connec- tion with medicine, but also various accessory sciences, which, though creditable accomplishments, and to a certain extent useful to the physician, have little or no direct influence either in im- proving our knowledge of disease, or rendering us better able to treat it successfully. The various branches of natural history, in- cluded under the titles of mineralogy, botany, and zoology, are of this kind. The excess of the European period of pupilage over ours is, in a considerable degree, occupied with such studies as these; and thus the real difference, so far as concerns strict medi- cal science, is less than at first sight it might seem to be. Upon the whole, probably, the tendency of the European plan in this respect is to produce graduates of higher scientific attainments, and probably of more thorough anatomico-pathological knowledge than ours, but little, if at all, superior as practical physicians. Another highly important feature of the European system is the succession of studies, with periodical examinations. The whole period of instruction is divided into annual or semi-annual terms, to each of which are ascribed certain branches of study ; and, be- fore advancing from one of these terms to the next, it is required that the pupil should submit to an examination as a test of his proficiency. This is clearly the proper method of teaching. The pupil begins at the foundation, and regularly proceeds with the structure of knowledge, until the whole original design is com- pleted. He does not, as is too frequently the case with us, at- tempt to carry on all parts of the edifice at the same time, or, as we sometimes do, begin at the top and build downwards. The study is thus rendered at once more easy and more fruitful. In the United States we pursue to a certain extent the same plan, when the student resides for the whole period of instruction in the THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 30T near vicinity of the schools. But coming, as most of you do, from a distance, aud spending but the half of each year in the schools, it would not be practicable to carry the plan into full effect, unless by a prolongation of study, and an amount of pecuniary outlay, which would be extremely inconvenient, and for many next to im- possible. In a considerable degree, this inconvenience may be obviated by the system of private office instruction established in this country, by means of which the pupil may be carried through a regular course of studies and examinations upon the elementary branches in their due succession, and may thus come to the lec- tures, prepared to understand and avail himself of what he may hear upon all the branches. It is true that this, even when well carried out, is but a partial substitute for the plan of regular and successive attendance upon public instruction from the beginning ; but it is the best that can be adopted for the great mass in the circumstances of our country ; and it is very important that private teachers everywhere should feel themselves under a conscientious obligation to give it full effect, by a proper guidance of the studies of their pupils, and frequent and thorough investigations into their proficiency. Still another characteristic of the European schools is the im- portance-attached to clinical instruction. Instead of being, as with us, a subordinate and, as it were, incidental branch, generally more or less defective, and sometimes altogether neglected, it is there recognized as indispensable, and, indeed, constitutes one of the most prominent features in the system of the schools. On this account, hospitals are considered as essential accessories; and in all Europe I did not see a single medical school, which had not one or more of these establishments associated with it. In some instances, indeed, the hospital is the chief part of the school, and the only practical lectures given, whether in medicine or surgery, are within its walls. In general, however, it is subordinate, and made by legal arrangements dependent on the scholastic institu- 308 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. tion. I need not dwell on the vast advantages of this method of teaching medicine. The importance of demonstration in lectures upon all medical subjects is now almost universally admitted. It is the main point in which a system of oral instruction is superior to one of mere private reading or study ; and surely no mode of demonstrating disease is so effective as that of exhibiting the patient himself in all the different phases of his disorder, and in all the modifications of his condition produced by treatment. Every method of demonstration is more or less useful ; and hence, what have been erroneously called school-clinics, which have for some years past been in such great favour in this country, are not with- out their advantages. But it would be a great mistake to consider them as sufficient substitutes for hospital instruction. It is impos- sible by means of them, to demonstrate satisfactorily severe acute affections, the regular progress of disease from beginning to end, or the morbid anatomy of cases terminating in death. It is mainly in consequence of the number and easy accessibility of the hospi- tals, that Paris has gained its present enviable position as the great world-centre of medical instruction. In other respects, I could not discover that the student enjoyed better opportunities there than are offered to him in Philadelphia. In Paris, the hos- pitals not only serve the purpose of medical and surgical demon- stration, but afford also extraordinary facilities for the prosecution of practical anatomy, both normal and pathological. There were few thiugs in that magnificent city which more struck and inte- rested me than the establishment denominated " The Amphitheatre of the Hospitals." It consists of buildings admirably arranged for the purposes of post-mortem examination and anatomical dis- section, whither are brought all the unclaimed dead bodies from all the hospitals of the city, preparatory to interment. Students, who have been regularly enrolled in the "School of Medicine," have the privilege of gratuitous admission to these rooms, where to every class of five one body is given every ten days, as I was informed ; THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 309 thus affording them ample opportunities not only for pathological investigation and for dissection, but also for surgical improvement by the frequent performance of operations on the dead subject. So complete are all the arrangements, that a small plot of ground, in the immediate neighbourhood of the dissecting apartments, has been planted with trees, and furnished with seats ; so that, in the summer, the student, when tired of his work, may seat himself under the shade, in the cool air, and, while enjoying his rest, may add the luxury of a cigar, if it please him. Imagine him to your- selves leaning backward in one chair, with his legs, more Ameri- cano, stretched out upon another, and, as he puffs forth the smoke from the corner of his mouth, watching its curling ascent with a placid air, that speaks volumes of interior contentment. I think, gentlemen, if you ever visit Paris for the purpose of professional improvement, you will not overlook the amphitheatre of the hos- pitals. I will take my leave of the subject of the hospitals for the pre- sent, by remarking that it is impossible to value them too highly as auxiliaries to a course of medical instruction; and what we most need in this country, is a more thorough union, or at least, a more hearty and full co-operation of these institutions with the schools. The plan of private medical tuition in vogue throughout the Union has a tendency, in some degree, to supply the want of hos- pital opportunities. The student, in the intervals between the courses of public instruction, may often see and even manage cases of disease under the guidance and oversight of his preceptor, and, if both perform their parts diligently and conscientiously, may gain much in the way of practical experience ; though an impartial judg- ment will still pronounce in favour of the hospitals, where disease may be seen in much greater variety than is possible in the prac- tice of any one man, and where, besides, the pupil has generally 310 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. the advantage of instruction from men of experience, trained in the art of communicating knowledge by the bedside. I have before referred to the successive examinations in the European schools, each examination being as it were a sentinel placed at the door of admission into the several higher grades of study, and guarding them against intrusion from the incompetent pupil. I cannot, however, help believing that these examinations are in many instances not very strict, and are employed rather as implements of terror to alarm the idle or careless, than as real and effective tests of attainment. The same, however, cannot be justly said, as a general rule, of the final examination which is to deter- mine the fitness of the candidate for the license of the doctorate. This is usually performed in public, and invested with formalities which may even sometimes impress upon it a character of solem- nity. In most of the schools we visited, a large apartment is appro- priated to this special purpose, and is generally more elaborately furnished than any other public room in the building. Not unfre- quently its walls are hung with portraits of the deceased professors, perhaps from the origin of the school, who may be supposed to be looking down on the proceedings, prepared to frown upon any dereliction of duty, that may tend to lower the dignity of the school which they had founded or adorned. I remember well, at Ley den, having my attention especially engaged by the portrait of the famous Boerhaave, which hung with many others upon the wall, and both to myself and my companion recalled strongly the feat- ures of our great Franklin. In the medical school at St. Peters- burg, I was much pleased with a method which had been adopted to stimulate the student to extraordinary efforts. In the hall of examination, which is a magnificent apartment, a large marble tablet has been set into the wall, in a conspicuous place, with the names, graven in gilt letters, of those candidates who had most distinguished themselves from the foundation of the school. There THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 311 was generally one name for each year; but in some years there were two, and in one at least none at all. Much importance is attached, in Europe, to the examinations. They are almost exclusively relied on as the test of fitness. The student, after having inscribed his name upon the catalogue of the school, is left to his own course. He may attend what lectures he pleases, or none at all ; but he must, in some way or another, qualify himself for answering the interrogatories that may be put to him, whether in the preparatory or the final investigation. This, I think, is a defect. A certain amount and character of attendance upon the means of instruction provided should always be required, without which, admission to the examinations should be refused. These are not always reliable criteria. The student may be for- tuitously examined on points with which he may happen to be familiar, though generally ignorant ; or he may be drilled by per- sons who have made themselves acquainted with the routine of questions into which the several examiners are apt to fall, and may thus be enabled to answer tolerably with little real knowledge ; or, finally, the examiners may, from various interested motives, con- trive that the candidate shall be successful, however incompetent. If attendance upon lectures be exacted preliminarily to the exam- ination, the student will at least have been in the way of acquiring knowledge; and some additional guarantee of fitness is thus ob- tained. In some, if not in most of the schools, besides a series of ques- tions to be answered, and a theme to be written on, a patient is put before the candidate, who is required to investigate the case, to make a diagnosis, and to indicate the proper treatment. Clin- ical observation and experience are absolutely necessary here to enable the candidate to acquit himself satisfactorily. In consequence of the successively advancing steps of instruction in European schools, and the long duration of the whole course, it happens that the classes of any one teacher are seldom large, 312 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. probably never so large as they often are in some of the most suc- cessful schools in our own country. I do not think I heard of one instance, in which the class exceeded three hundred in attendance at the same time on one professor; and this number is very rare. Much more frequently it is less than one hundred, even in the flourishing schools, where the whole number of matriculants may be not less than five or six hundred ; and I think I have heard of classes consisting of not more than one or two listeners. As the pupil is not bound to attend particular lectures, he makes a choice among several, and, of course, the most popular professors com- mand the largest attendance. It is not always the man of highest scientific reputation who has the greatest talent of teaching; and, not unfrequently, they with whose names the world resounds are compelled to address their great thoughts to empty benches. The number of professors is usually large, sometimes a dozen or more, and the subjects to be taught are consequently much sub- divided. This is another reason for the frequently slender attend- ance on the lectures. The lecture-rooms are generally small, and poorly furnished, even in the most celebrated schools. In the great school of medi- cine at Paris, the seats of the chief lecture-room are little more than an ascending series of narrow steps, arranged amphitheatri- cally, from the floor upwards, and I have no doubt are each day trodden by many feet, before they are occupied in the legitimate mode by their ultimate possessors ; and, in the largest room I saw at the University of Berlin, the seats of the audience were all placed upon the floor, and on the same level with that of the lecturer. Another remark I made in relation to the lecture-rooms was, that the benches frequently exhibited evidence of the use of the knife, showing that the whittling propensity is not exclusively American ; but I do not remember ever to have noticed an adorn- ment of the floors so common in our country, arising from the use THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 313 of tobacco ; this luxury being enjoyed in Europe much more in the way of smoking than of chewing. I was, I confess, surprised at the moderate scale upon which the lecture-rooms of the European schools were planned, in reference both to size and arrangements. On all the continent, I did not meet with an apartment of the kind comparable to that in which I am now speaking, however moderate it may seem to you. In all the schools we visited, the professors receive fixed salaries from the government. In some, as in those of Paris and St. Peters- burg, these salaries constitute the whole emolument of the profes- sors, as such ; in others, as that of Berlin, there is an additional income from the students, which is proportionate to the popularity of the lectures. The latter appears to me the best plan of com- pensation. The professor is secured against absolute want by the fixed salary, which is, however, too small for his comfortable sup- port, so that he is stimulated to exertion in order to supply the deficiency; and this exertion is beneficial to the pupil and the school, as well as to himself. I met with no instance in which, as with us, the whole compensation of the teacher was derived from the students. There is probably nothing in which Europe appears to greater advantage than in the number and character of the hospitals. This is one of the great triumphs of Christianity, and in itself an evi- dence of the superiority of our holy religion over every other faith that now prevails, or ever has prevailed upon the earth ; I may say, moreover, a strong argument in favour of its divine origin; for it seems to have been a conception above the weakness and selfishness of the natural man, that society owed a debt to the poor and the helpless ; and that, instead of treading the feeble under foot, in the headlong rush of our passions and interests, we are bound to halt in our course, and, at the sacrifice of our own pleas- ures, to support the weak, to heal the sick and wounded, and "bind up the broken-hearted." Every large city, and very frequently, 314 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. also, towns of little importance, are supplied with one or more hospitals, many of which are on a magnificent scale, and conducted in the most admirable manner. Those of Paris, "Vienna, and St. Petersburg more especially engaged our attention. If I were called on to decide the question of precedence between these hospitals, I should be inclined to say that those of Paris and Vienna accom- modate the greatest number of patients, while those of St. Peters- burg are superior in the style of the buildings, and in their interior arrangements. Two of the hospitals of that great city are pecu- liarly worthy of notice, that of St. Peter and St. Paul, and the General Military Hospital ; the former of which is exclusively civil, and the latter, as its name implies, exclusively destined for the army. The Military Hospital is a vast structure of brick, stuc- coed, and is completely fire-proof from within and without. That of St. Peter and St. Paul is provided, in addition to all the usual conveniences, with a broad hall of great length, into which the wards open, which is kept perfectly warm in the winter, and intended for a place of exercise for the convalescents, who are precluded from exposure to the open air, in consequence of the intense coldness of the weather. A peculiarity of both these hos- pitals is the connection with them of a slighter building or build- ings, admitting of a freer entrance and circulation of the external air, into which the patients are transferred during the hottest weather of summer. Throughout the interior of both, the greatest attention is paid to neatness, cleanliness, and the comforts of the inmates ; and, from what I witnessed of the ordinary condition of the lowest orders of the Russian population, I should suppose that they would deem admission into one of these establishments as a foretaste of Paradise. Yet I owe it to my own country to say that, in all Europe, though there were many institutions vastly larger, I saw none which, in the propriety, neatness, and I might almost say elegance of its interior, surpassed our own Pennsylvania Hospital. . Having heard what I had to tell you on the subject of medical THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 315 education, and the medical institutions of Europe, which might readily have been expanded into a volume had time permitted, you may perhaps expect to hear something upon the character and condition of the profession itself. It would be quite presumptuous in me, with the comparatively slender-opportunities which a rapid journey through the continent afforded me, to attempt to give you any very precise or positive information on the subject. I may, however, be permitted to state, in a few words, the general impres- sions I have received. In the first place, it cannot be doubted that the great mass of the physicians and surgeons of the continent consists of men well educated, both professionally and otherwise. In both these re- spects, they are probably superior, on the whole, to the medical men of our own country. But I must repeat what has been already said, that I do not consider them better practitioners. In Europe, value is attached to science for itself alone, independently of any practical benefit to accrue from it to mankind. This is true of medical science as well as of general knowledge. In this country, on the contrary, we seek especially what is practically useful, and that of which the utility can be readily appreciated. We are apt to neglect those kinds of knowledge which cannot be brought to bear upon the great end of life, that of success in the business or profession we may have chosen, and give the time, which these would consume in their acquisition, to the means of fitting our- selves quickly for entering upon our practical career, and after- wards of pushing our fortunes in that career as rapidly as possible. This being the general feeling, and general practice, individuals who might be disposed otherwise, did circumstances permit, are compelled to give way to the current. They who amuse them- selves with the refinements of knowledge, and consume time in storing up facts of no present value, will find the paths to success preoccupied by the more energetic and practical. In the vast competition, and eager haste towards their objects, which charac- 316 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. tcrize the people of this country, the votary of pure science, if not independent in his circumstances, will feel himself jostled in every direction, and in danger of being thrown off by the wayside, if not trodden under foot. The remark is not less applicable to the medi- cal than to any other profession or pursuit. Hence it is that the American physician is the more practical, the European the more scientific. The latter understands better the intimate nature of structure, and the changes produced by pathological influences, and is probably better acquainted with, or at any rate studies more profoundly the laws of our physical being as exemplified both in health and disease ; but, devoted as he has been to these investiga- tions, he gives less attention to therapeutics, is apt to be skeptical in everything which rests upon testimony, and turns out a compara- tively inefficient practitioner. The American, on the contrary, is apt to cast a careless eye upon the obscure depths where he can see no bottom, passes unheeding by the curious and beautiful re- sults of minute investigation, which, whatever may hereafter be the case, have yet, as he is disposed to think, yielded no practical fruits, and devotes himself to those inquiries by which he can most surely make the sick man well, and thereby at once satisfy his con- science and benevolence, and secure that good-will and favourable opinion upon which he hopes to build his fortunes. In making this contrast, I wish to be understood as by no means exclusive. There are a great many exceptions on both continents to the gen- eral rule, and not a few instances in which it is reversed. But I believe there really does exist a general difference, such as I have stated, between the medical profession of continental Europe and that of America; the former having a greater predilection for the abstractions of science, the latter for the practical realities of life, and both exhibiting the results of this predilection in their whole professional course. There is another circumstance which, I think, tends to make the American physician, other things being equal, a better practitioner THE MEDICAL PROFESSION IN CONTINENTAL EUROPE 3 IT than the European. In his eagerness for success, the former is seldom content with what he learns in the schools, but, throughout his whole active life, prosecutes his studies in a therapeutical direc- tion, and reads diligently everything upon which he can lay his hands having such a bearing; being impelled thereto not only by his sense of right, but by the absolute necessity of not permitting his neighbour to outstrip him in the race. The European, on the contrary, is apt to content himself with what he has learned, and makes little comparative effort for self-improvement, because he finds all things around him moving in fixed courses; so that, if young, he may await quietly the movement which is to advance him; if old and established, may rely with confidence upon the steady order that retains all in their due places. Whatever may be thought of the theory in this case, the fact is as I have stated. It is proved, I think, beyond reasonable doubt, by the vast differ- ence in the sale of medical books on the two continents. While in France, or Germany, a meritorious medical work may sell at the rate of from five hundred to one thousand copies annually; in the United States, though with less than two-thirds of the population of either of those countries, the sale of a similar work, in the same time, will amount to two or three thousand. In their social relations, I do not think that the members of our profession stand so high relatively on the continent as the higher ranks of the physicians and surgeons do in England ; and cer- tainly we have the advantage over them in this respect in the United States. In France, until a comparatively recent date, phy- sicians were upon a footing in general society by no means favour- able ; and, though the profession has, during the present century, been illustrated by many great men, who have much elevated their calling in the eyes of the community, yet practitioners of a high grade in Paris still eschew their distinctive title, and use upon their cards the same mode of designation as other men. Among the Germans, great scientific reputation, or the profes- 318 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. sorial office, gives a respectable position to medical men as to all others; but I am inclined to think that in itself the profession is not specially honoured, though I confess that my means of inform- ation on this point were limited. Upon the whole, it appeared to me that the medical profession in Russia, confining the term to the educated class exclusively, were upon a better social footing than in any other country of continental Europe. This opinion derives much support from one interesting fact, which is true of no other country, not even our own, where we claim social equality with the highest. In the army, which is the most honourable body in Russia, giving increased dignity to the nobles, and raising its officers, even those of humble birth, to a level with nobility, the surgeons have the same rights as the other officers, rising like them through suc- cessive grades of rank to the highest, with corresponding emolu- ment. Thus, I knew in St. Petersburg a surgeon of one of the regiments of the guards, who, though yet a young man, had the rank of colonel ; and Sir James Wylie, who is medical inspector- general in the army, has the grade of general in the third degree, which, I believe, is equivalent to that of lieutenant-general in the British service. As another evidence of the position of the profession in Russia, I would adduce the fact, that great attention has been paid by the government to the subject of medical education. Not less than seven schools have been established by law in different parts of the empire, all of which are mainly, if not exclusively, supported by funds from the imperial treasury. Of these schools I had the op- portunity of seeing only that of St. Petersburg ; but, if the others are to be judged by that example, there is assuredly no part of Europe, where more munificent provision has been made for the education of those to whom the health of the community is in- trusted. The Imperial Medico-Chirurgical Academy of St. Peters- THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 319 burg, as this establishment is officially designated, far exceeds in its visible arrangements any other medical school that I have seen. Time is not left us for a detailed account of this school ; but a few words will serve to give you some idea of its character, and conse- quently of the liberal views of its founders and supporters in regard to our science. An oblong plot of ground, within the limits of the city, having a large front on the river Neva, and extending, I pre- sume, more than half a mile in depth, is devoted to the purposes of the institution. Within these limits are several large buildings, two of which especially are magnificent in extent and proportion. In one of these, two vast wings are devoted to the accommodation of three hundred young men with gratuitous lodging and board- ing ; while the central portion is mainly occupied with one great hall, beautifully finished, which is appropriated to the purposes of a library, of public examinations, and of ceremonial observances in connection with the school ; and opening into it is a neat chapel for the religious services of the establishment. This edifice has its front on one of the longer sides of the oblong plot of ground before referred to. The second great building, scarcely less magnificent, presents a beautiful front on the Neva, and forms one of the most prominent objects in the view of this part of the city. It is occu- pied by the lecture-rooms, and the various illustrative cabinets or collections of the different professors, some of which are copious, and all finely displayed in consequence of the ample space allotted them. A separate building is appropriated to dissections; and there are in the grounds several low, isolated, wooden houses, which are employed for lodging-rooms, during the summer, of such of the students as do not take advantage of the vacation to scatter them- selves over the country. Besides all these appliances, there is a very large hospital, situ- ated on the opposite side of the grounds to the edifice first de- scribed, the patients in which, numbering more than a thousand, 320 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. are at the disposal of the professors of the school for the purposes of clinical illustration in medicine, surgery, and obstetrics. In addition to the three hundred pupils supported and educated within the walls of the establishment, four hundred others, who live in various parts of the city, have gratuitous access to the courses of instruction, and are admitted to all the advantages and honours of the school. The only prerequisites to admission are that the applicant should be a freeman, and should prove himself, on examination, to have had a sufficient preliminary education. The examinations, I was told, are strict; and, of the seven hun- dred pupils in various stages of instruction, only about sixty or seventy graduate annually. The Emperor, who has educated them, considers himself entitled to their services ; and, after completing their course of study, they enter the army in their medical capacity. This, however, instead of being a hardship, is a privilege ; placing them at once in a respectable position, and opening a field of indefi- nite advancement for the future. After this favourable view of the medical profession in Russia, I should be guilty of injustice did I not call your attention to a great man still living, though in the extreme of old age, to whom much of the good that I have referred to, with a great deal more that I have been unable to notice, is to be ascribed. This man is Sir James Wylie, of St. Petersburg. All the medical men with whom I conversed upon the subject in Russia united in the state- ment, that the profession in that country owed almost everything to him. Withdrawn from active life, though still holding some of the highest official dignities, he is looked on as a man of the past, and spoken of almost with the impartiality of history. We were happy enough to form his acquaintance, and to receive various kindnesses at his hands. A word from him was sufficient to open the door to us of all that it was desirable to see in Russia; and our very limited time in that country would have been much less profitably employed had it not been for his friendly aid. Perhaps THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 321 it is the grateful recollection of his kindness that in some degree prompts me to speak of him on this occasion ; but a stronger inducement is that I may bring before you the example of one who, by his own merits, has risen from an humble beginning to the summit of wealth and honour, and thus stimulate you, now in the very opening of your career, to take the steps which he took under the same circumstances, and without which he could never have risen, and no one can rise to eminence. i Sir James Wylie was the son of a farmer in Scotland in very moderate circumstances. He managed, I know not with what aid, to obtain a good education, and to complete a course of medical studies in the University of Edinburgh, the honours of which school- were conferred upon him when he was about twenty- one years of age. Immediately afterwards, in the spirit of bold adventure, he sailed for Russia, with nothing to depend upon but his own merits, and a determination to use every honourable effort to advance him- self in the new field he was about to enter. He had been extremely diligent in his studies, had employed his time to the greatest pos- sible advantage, and now went forth confident in himself, and pre- pared to seize upon and make the most of any offered opportunity. As one of my colleagues* said, the other day, in his elegant and truthful sketch of our common friend, the late Dr. Horner, f such opportunities come to all men, and the great point is to be pre- pared to take advantage of them. They will come to you, my friends ; and whether you shall avail yourselves of them, and, like the two men referred to, rise to usefulness, fortune, and eminence, or shall let them pass unimproved, and consequently remain in mediocrity all your lives, or sink into utter insignificance, will in great measure depend upon the course you may now adopt. Resist, like them, the seductions of idleness and of pleasure ; employ all * Dr. Samuel Jackson, Professor of the Institutes in the University, f Dr. Wm. E. Horner, late Professor of Anatomy in the University. 21 322 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. your time sedulously, with a due attention to the preservation of health, in the acquisition of professional knowledge; avail your- selves to the utmost of the advantages now offered to you; and, having obtained the honours of the school to which you may belong, persevere in the same course of self-denial, industry, and energetic use of opportunities ; and, depend upon it, should your health and lives be spared, though you may not become, like one of these exemplars, professor of anatomy in this school, or like the other the friend and counsellor of emperors, and the acknowledged head of the medical profession in a great country, you will, each in the sphere of his action, attain an equally desirable position, with the added consciousness that you have performed your parts well in the world, and the reasonable hope that a happy future may await you when called upon to leave it. Upon his arrival in St. Petersburg, Dr. Wylie found a field of action adapted to his attainments and powers. Having entered the army, he soon distinguished himself both as a physician and surgeon, and at the end of nine years was employed in both these capacities in the imperial family, being especially attached to the person of the Grand Duke Alexander, then a young man of about twenty-two, whose friendship and entire confidence he won, and continued to enjoy after he had become emperor, and through- out the life of that distinguished ruler. Thus favoured, he ad- vanced rapidly to the highest medical posts in the army, and was intrusted at various times with most important functions in refer- ence to the medical concerns of the empire. He was present in most of the great battles fought in that tremendous struggle which ended in the first overthrow of Napoleon ; and, after the entrance of the allies into Leipsic, had under his care at one time, as he himself assured me, 40,000 wounded, as well of the French as of the allies, the former having been left on the field of battle by Napoleon. It would be impossible, in the brief space allowed me, even to enumerate all the military engagements in which he par- THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 323 ticipated from IT 93, when simply surgeon of a regiment, up to 1828, when he attended the army in the campaign against Turkey in the highest medical capacity. Probably no man living has had under his professional care one-quarter of the number of wounded, whom it has been Sir James Wylie's lot to superintend. The confidence reposed in him by the Emperor Alexander, who consulted him on all occasions, enabled him to carry into effect the most important measures for the amelioration and improvement of the medical institutions, and in general of all that concerned the subject of health, whether in the army or the empire at large. He held the high posts of inspector-general of the health of the armies, director of the medical department of the ministry of war, presi- dent of the medical council of the same ministry, and president of the Imperial Medico-Chirurgical Academies of St. Petersburg and of Moscow. Through these positions he could bring his plans to bear upon every department of his profession ; and it is reasonable to suppose that the present excellent position of the medical offi- cers of the army, the general regulations of the medical military service, the very satisfactory condition and arrangement of the hos- pitals, and the superior character of medical education as conducted in the schools, have all owed much to his sound judgment, enlarged views, and almost unexampled opportunities. In his anxiety to produce regularity in the pharmacy of the army and the hospitals, he prepared a copious pharmacopoeia, composed in the Latin lan- guage, which has gone through several editions, and is, I presume, of legal authority in the empire. Sir James Wylie never relinquished his rights or allegiance as a British subject, and, consequently, notwithstanding his numerous offices and great influence in Russia, never became a subject of the Emperor. He could not, therefore, receive a Russian title of no- bility, which, under other circumstances, would undoubtedly have been at his command. But on the occasion of the visit of Alex- ander to England, George the Fourth, then Prince Regent, at the 324 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. request of the Emperor, conferred on him the rank of Baronet, whence he derives the title by which he is generally known. Hon- orary presents and orders have been showered upon him, not only by the Russian Emperors, but by various other sovereigns; and, if I do not mistake, he received from Napoleon the insignia of the Legion of Honour, in consequence of his attentions to the wounded French soldiers that fell under his care. Sir James was never married. His fortune is immense ; and, as I was told in St. Petersburg, he has made his will, leaving it mainly to the Emperor, having, as he says, derived it from the favour of the imperial family.* To the members of this family he appears to have the attachment of a friend ; and he spoke with a faltering voice, and tears in his eyes, of the recent decease of the Grand Duke Michael, the brother of the present Emperor, with whom he seems to have been upon terms of affectionate intimacy. The greatest merit of Sir James, in my eyes, is the conscien- tiousness with which he directed the influence he possessed with the Emperor to the elevation of his profession in dignity and use- fulness, and to the general good of the country in which he had taken up his abode. On this account, much more than for his wealth and honours, he is held at present in the very highest esti- mation ; and on this basis will rest his fame with posterity, who will appreciate in their own advantages the good he has done, while they will care nothing for mere personal possessions or endowments, which will have perished with the owner. In this point, also, my friends, I could wish you to imitate the example that I have placed before you. Do not live solely for yourselves. Do not seek wealth, station, influence, merely for your own personal gratification ; but consider them as means for doing * Sir James died not a great while after our visit, and is said to have be- queathed his fortune, as it was presumed that he would do, mainly to the Emperor Nicholas. THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 325 good, for spreading benefits around you, and for making an impres- sion on the world, which, when you are gone to your rewards, will cause grateful recollections to cluster about your memory, and your example to be held up to the young for imitation in all future time. Especially forget not your noble profession, and so act and so live as to increase its respectability and real worth, and thus render it an instrument of greater and greater good, not only to those who may enrol themselves in its ranks, but to the whole human family. If I have been able to derive, from my recent journey, any facts or considerations that may be useful to you now as students, or hereafter as practitioners of medicine, and if I have in any degree succeeded, according to my wishes, in placing these facts and con- siderations effectively before you, I shall consider the result as a great addition to the gratifications of the journey itself. Allow me to take an affectionate leave of you for the present, with the expression of the sincere hope that, in all our future meetings, we may co-operate cordially to the great end of our labours here, that of fitting you to become accomplished physicians, an honour to the school in which you will have been educated, and a source of unalloyed good to those among whom your lot may hereafter be cast. ADDRESSES TO THE MEDICAL GRADUATES UNIVERSITY OF PENNSYLVANIA. ADDRESSES TO THE MEDICAL GRADUATES. Prefatory Remarks. Most of my readers, I presume, are familiar with the fact that, in the University of Pennsylvania, which has been followed in this respect by most of the other medical schools, an address is delivered by one of the professors, at the time of the commencement, to the graduating class. The three following addresses had their origin in this rule. The first, prepared at the special request of the Medical Faculty, is occupied chiefly with an account of the history and character of the medical department of the University. In the others my aim was to impart lessons to the young men, which might be useful in their professional life. It may, perhaps, be thought by some that the expressions in relation to quackery, employed in these addresses, and in some of the preceding lectures, are unnecessarily strong; but they convey my real sentiments ; and it must be remembered that they were addressed to students, or recent graduates, with the view, not of exciting hostility against irregular practitioners individually, but of guarding the young men themselves against the possibility of falling into an empirical course, (329) 330 ADDRESSES TO THE MEDICAL GRADUATES. !))■ placing its degradation in true and strong colours before them. I have always, too, endeavoured to make a distinction between the irregu lar practitioners who have a more or less full faith in what they profess, and those who act against better knowledge, with the sole view of mak- ing money, no matter at what cost to those whom they deceive. Any self-appropriation, therefore, of language referring to the latter set of practitioners, must be received as a confession of membership in the class ; and I presume that there are few honest persons, of any profes- sion, who would not admit the justice of the severest possible expres- sions of censure in such a case. ADDRESS I. DELIVERED AT THE MEDICAL COMMENCEMENT, HELD MARCH 26th, 1836. Sketch of the History of the Medical Department of the University of Pennsylvania. Gentlemen : — It is by the appointment of the Medical Faculty of the Univer- sity, that I now have the honour of addressing you. I should be proud, on any occasion, of acting as their representative; I am peculiarly so on the present, when the object is to welcome your entrance into the ranks of our profession. Allow me, on behalf of ray colleagues, as well as for myself, to express a cordial sym- pathy with you in this most important era of your lives. We participate in the satisfaction of your retrospective view; in the delight of your present relaxation from toil and anxiety; in the buoyant gladness of your new independence ; in the lofty aspira- tion, the hope, the confidence, the joy of your eager glance into the future. We have the whole picture of your emotions indelibly traced upon our memory. In our sympathy with you, we live over again one of the happiest and most exciting moments of our own existence. Our congratulations, therefore, are not the mere expressions of cold formality ; they are the overflowings of a real participation in your feelings, and of a sincere interest in your welfare. (331) 332 HISTORY OF THE MEDICAL DEPARTMENT It is true that the relations which we have hitherto borne to- wards each other are dissolved. You have grown in knowledge beyond the need of our assistance, and are about to take your flight into the world of action, each trusting to his own strength, and selecting his own course, in the broad expanse before him. But, though we can aid you no longer, our earnest wishes for your true good will follow you always. One parting word of counsel, dictated by these wishes, will be received in the same spirit of kindness in which it is given. Let it enter deeply into your con- victions, that your success in life will depend mainly on yourselves. Trust nothing to fortune, or to the fancied advantages of your position. Labour diligently, in your intervals of leisure, to render yourselves more competent to the performance of your professional duties; guard your sentiments and conduct so as to command the respect of honourable men; and endeavour to cultivate such an exterior deportment, as may render your presence not unacceptable to those into whose society you may be thrown. Thus accom- plished, if you watch diligently the current of affairs, neither im- prudently rushing into the midst of adverse events, nor allowing any favourable opportunity for honourable action to pass unim- proved, you will as certainly prosper in the world, as the seed, sown in a good soil, and nurtured with due care, will spring up and ripen into harvest. The moral world is governed by laws not less uniform in their operation than those which regulate the physical. Much less is justly ascribable to accident than men are usually disposed to imagine. The successful often feel a pleasure in considering themselves the favourites of fortune ; while the un- successful are always willing to shift off from their own folly or carelessness the responsibility of their failure. But there are few men so purely fortunate as to be unable to point to some prudent forethought, or wise decision, or prompt action, as the real origin of their success ; and perhaps not one wretched man exists, who cannot recall numerous instances, in his experience, of time mis- OF THE UNIVERSITY OF PENNSYLVANIA. 333 spent and opportunities neglected. With this maxim always be- fore you, that you must rely upon yourselves, and with the stern resolution to leave no honourable means untried of promoting your advancement, you cannot fail to attain, if not the pinnacle of your ambition, at least a respectable station in life, with a competent provision against all ordinary mischances. But, gentlemen, your attention will not be occupied exclusively with your own worldly prospects. You will not compress the whole current of your soul within the narrow and turbid channel of selfishness. By a wise ordinance of Providence, the exercise of an expanded benevolence is not incompatible with our true in- terests. If it turns away the thoughts for a moment from schemes of profit or ambition, it more than repays the loss by its cheering effect upon the heart, and its ennobling influence on the character. The overflow of kindly feeling, at the same time that it enriches the soil upon which it spreads, clarifies and sweetens the stream from which it proceeds, and to which it returns again. If actuated, therefore, by no higher motive than a regard for our own happi- ness, we should cultivate good-will for others, multiply friendly relations with objects around us, and throw out in all directions the cords of endearing association, by which we may reciprocally draw and impart refreshing sympathy and useful support. Among the moral associations which are least tinctured with selfishness, and therefore tend most to elevate and refine our nature, are those which continue to connect the pupil with his preceptors, after the immediate tie between them has been severed, and he has been borne by the current of time and events far away into some new scene of action. I cannot doubt that you feel at this moment, in some measure, the force of such associations. You will probably feel it more, when the trivial pains and anxieties which have intermingled with your recent labours shall have faded from your memory, leaving only the recollection of benefits re- ceived, strengthened by daily increasing experience of their value. 334 HISTORY OF THE MEDICAL DEPARTMENT Often, hereafter, you will throw back your thoughts from the tur- moil of business into the quiet scenes of your professional study. The familiar countenances of your preceptors will then rise, with renewed freshness, before your memory. You will dwell with feelings approaching to those of filial affection upon their efforts to interest and instruct you ; at once to inspire you with a taste for knowledge, and to furnish the means of its gratification; to prepare you, in fine, so far as in them lay, for the high duties to which you are destined, and the noble reward to which the per- formance of these duties will entitle you. The school in which you were instructed will share in these feelings of affection. In the warmth of your imaginations you will inspire its corporate existence with the attributes of real life, will interweave into its character your conjoined estimate of all its teachers, and will love it as the centre of numerous pleasing recol- lections, the witness of your earnest labours and ultimate success. In order that you may know it more thoroughly, may appreciate its real deserts, and may thus be enabled to render it an enlight- ened support in the struggle of competition in which it is engaged, I propose to lay before you, on this occasion, a brief account of its origin, progress, and present condition. I can, perhaps, do this with greater propriety than my older colleagues; as, from the shortness of the period during which I have been officially con- nected with it, I cannot be supposed to appropriate to myself per- sonally any of the credit which may be found to belong to the school. The first conception of a plan for establishing a medical school in this country appears to have been formed by Dr. William Ship- pen and Dr. John Morgan, both native Americans, while prose- cuting their studies in Europe. If it be desirable to live in the memory of those who may come after us, the names of these gen- tlemen occupy a most enviable position. Placed at the source of a stream which must continue to flow on through ages, they will OF THE UNIVERSITY OF PENNSYLVANIA. 335 be a point of search for future inquirers while civilization lasts. Hundreds of men of brilliant endowments, after filling the ears of their contemporaries with their renown, and by the impetus of their great minds forcing themselves far into the memory of pos- terity, will, in the course of time, drop one by one into oblivion until all are forgotten. But the future historian, though, in threading his way through the past, he may sweep multitudes of once great names as rubbish from his path, must at least preserve those which stand at the commencement of any great course of action. The fame of Shippen and Morgan will, therefore, continue to be cherished in this country, so long as its inhabitants shall be subject to physical infirmities, and the healing art be deemed worthy of cultivation. So early as the year 1762, Dr. Shippen, in the introductory to a private course of lectures on anatomy, announced his belief in the expediency and practicability of founding a medical school in Philadelphia. In 1765, Dr. Morgan, upon his return from Europe, laid before the trustees of the College of Philadelphia, which had then been in existence as a collegiate establishment about ten years, a plan for the institution of medical professorships in con- nection with the seminary under their direction. The plan, which came strongly recommended by several influential friends of the College in England, was adopted by the trustees, who immediately appointed Dr. Morgan to the chair of the theory and practice of physic. In the same year, Dr. Shippen was chosen professor of anatomy and surgery. For a short time, lectures were delivered by these two professors on the various branches of science, then deemed essential in a course of medical instruction. In 1767, a system of rules was adopted for the organization of the new school ; in 1768, Dr. Adam Kuhn was appointed professor of materia medica and botany, and Dr. Thomas Bond of clinical medicine ; and, on the 21st of June, 1768, a medical commencement was held for the first time in America, at which the degree of Bachelor of 33G HISTORY OF THE MEDICAL DEPARTMENT Medicine was conferred upon ten individuals. The chair of chem- istry was added in 1769, and was filled by the appointment of Dr. Benjamin Rush. Such, gentlemen, was the germ of that school, w T hich has been so long scattering its fruit over every part of our vast country, and under whose broad shade we are now assembled, more than seventy years from its origin, to celebrate the return of its annual season of productiveness. Not less than three generations have partaken of its benefits ; for, in the catalogue of its first graduates, is the name of the grandfather of a young gentleman who now most worthily receives its honours, and whose father was also a graduate of the school.* It is beginning to be venerable in the eyes of men; for it is associated with the gray hairs of their fathers. But age, which has given it dignity, has taken nothing from its strength ; and it still stands erect and prominent among the numerous offspring which have risen up around it. Its growth at first was not rapid. Humble in its original organization, it gradually ex- panded with the increasing wants and resources of the country and thus acquired a solidity and permanence w T hich it would have failed to attain, if forced by injudicious management into a pre- cocious increase. In the year IT 6 9, when the Medical Faculty was fully formed, it consisted, strictly speaking, of only four professors; for the chair of clinical medicine appears to have been little more than nominal, and was abolished after the death of Dr. Bond. You will easily understand how imperfect must have been the courses of instruc- tion, when the three branches of anatomy, surgery, and obstetrics * Dr. Wm. Elmer, now a highly respectable practitioner of Bridgeton, Cumberland County, New Jersey. His father, of the same name, was also a graduate of the medical department; and his grandfather, Dr. Jonathan Elmer, at one time Senator of the United States from New Jersey, was, as mentioned in the text, a member of the first graduating class. OF THE UNIVERSITY OF PENNSYLVANIA. 337 were taught by one professor. With this deficient organization the school continued till 1782, when botany was separated from materia medica, and erected into a distinct professorship. In the mean time, however, a great change had taken place in the government of the College. In the violence of political excite- ment, its charter had been abrogated by the State legislature, and all its rights and property transferred to a new institution, which was dignified with the title of University of Pennsylvania. But this event, which took place in the year 1779, does not appear to have affected the Medical Faculty, which continued, in the new school, to be constituted in the same manner as in the old. In 1789, ten years after the act of abrogation, the legislature, admit- ting its injustice and illegality, restored to the College, by a new act, all its former privileges and possessions ; so that two institu tions now existed, distinguished by the titles of the College and the University. The Medical Faculty was thus, for a time, thrown into disorder, one portion attaching itself to the old school, and another to the new; and some modifications were made in the arrangement of the professorships, which, however, as they were of short duration, do not appear to merit particular notice. Hap- pily, the two institutions were soon afterwards reunited by a volun- tary agreement, which received the sanction of law; and an oppor- tunity was thus afforded, in the year 1791, for a new organization of the medical school. Six professorships were now recognized, under the titles respect- ively of 1. anatomy, surgery, and midwifery, 2. theory and practice of medicine, 3. institutes and clinical medicine, 4. chemistry, 5. ma- teria medica, and 6. botany and natural history. But this arrange- ment was dictated by the necessity of combining two faculties, and supplying places for the members of both, rather than by a sense of its general propriety. Hence, the chair of the institutes and clinical medicine was afterwards united to that of the theory and practice ; and the chair of botany and natural history ceased to be 22 338 HISTORY OF THE MEDICAL DEPARTMENT considered essential, when the opportunity was offered of transfer- ring its occupant to that of materia medica. In the year 1805, a great improvement was made by the estab- lishment of a chair of surgery, and another scarcely less important, in 1810, by the separation of obstetrics from anatomy, and its ele- vation to the dignity of a distinct professorship. From the latter period no material change took place in the organization of the school, until, by a recent regulation, the institutes were again sepa- rated from the practice, and placed upon an equal footing with the other important branches. From this hasty sketch you may perceive that the school has been gradually expanding from the time of its foundation; and that at no former period has it presented an organization, so nearly in accordance with the just demands of medical science, as at this very moment.* It would be a pleasing task to go up with you again to its origin, to introduce you to a more intimate acquaintance with its founders, and then, descending along the course of its history, to make you familiar with each of the great names successively that have illus- trated its various departments. But the attempt would be vain to compress so many merits within a space so short as we could now allot to them. Perhaps, moreover, the task would be useless. What name is there among the worthies who elevated and sus- tained this medical school, that is not in the memories and the mouths of all who have any pride of profession ? What medical man, who has at heart the honour of his country, is ignorant of the names of Rush, Barton, Wistar, and Physick, not to mention others, both dead and living, who have been associated with these great men in their labours and their fame? With two only of * I would call attention again to the date at which this address was de- livered; in the spring, namely, of 1836; at the end of the first course of lectures delivered by myself in the school. OP THE UNIVERSITY OF PENNSYLVANIA. 339 those I have mentioned has it been my good fortune to have any personal intercourse. One of these is now beyond the reach of human applause or censure ; and the other stands so high in personal dignity, fortune, and the respect of men, and is so far removed from the business and agitations of ordinary life, that sentiments of admiration may be allowed ample scope in their expression, without affording ground for dishonourable imputa- tions. You will excuse me if I yield for a moment to the impulse of my feelings, and throw in my mite of tribute to their deserts. The name of Wistar must have called up a train of affectionate and touching remembrances in the minds of many who are now present. They can recall the affable and courteous manner, the heart full of kindness, the tear for distress, the cordial smile of sympathy or welcome, the open hand, the generous, noble spirit that shone in every feature, and spoke in every act. They can picture him in their imagination, as he formerly stood in his lec- ture-room, full of his subject, inspiring into all the interest which he felt himself, unravelling intricacies and lighting up obscurities by an almost magic touch, with a countenance beaming with intelli- gence and affection; himself the centre of a love and respect which amounted almost to reverence. I might speak of his general knowl- edge, his scientific attainments, his professional skill, the large space which he filled in the society and business of the city, the esteem in which he was held in all parts of the Union. I might dwell also on that sensitive delicacy of conscience which he exhibited on all occa- sions, whether as a teacher considering himself answerable for the ignorance of his pupils, as a judge deciding upon their claims to a recognition of their capacity to practise, or as a physician lavish of his time, attention, and labour, upon the sick, without reference to their ability to afford him pecuniary compensation, and perhaps without a thought upon the subject. But even an outline of the qualities of his heart, mind, and conduct, would extend beyond the limits which I could here devote to them; nor do I feel myself 340 HISTORY OF THE MEDICAL DEPARTMENT adequate to their just representation. The sketch I have at- tempted is but a faint copy of the vivid impression, which must be stamped on the memory of all who knew him. It is far from doing justice to my own recollections of his rich and beautiful character. Not less impossible do I find it to embody in words the senti- ments of respect which are entertained by myself, in common, I am sure, with the whole of this audience, towards another illus- trious supporter of the school, the last survivor of those upon whom its fame was built, and now looked up to as the acknowl- edged patriarch and head of the medical profession in this coun- try. I need not mention the name of Physick. There is but one man in the Union to whom all would concede this pre-emi- nence. Who is there in this assembly, in this city, I might say, what intelligent man in the country, who is not familiar with his admirable skill in operative surgery, and with the numerous im- provements which the art owes to his genius? What medical man, who has had the opportunity of professional intercourse with him, is unacquainted with those high qualities which have placed him at the head of American practitioners ? his keen insight into dis- ease, united with the spirit of minute and patient inquiry ; his inex- haustible copiousness of expedient; his undaunted resolution, which never wavered under a sense of personal accountability; his perse- vering adhesiveness to an approved plan, alike against the remon- strances of the patient, the discouragement of medical associates, and the weariness of his own disappointed expectations. Hundreds are now living who owe life or limb to the exercise of these rare qualities, under circumstances which would have apparently justi- fied despair. Consider him as a man, without reference to his professional merits. What dignity of character and deportment ! what scrupulous regard for the just claims of others ! what perfect self-command ! — qualities which have placed their possessor upon an unassailable eminence, and have precluded the least show of OF THE UNIVERSITY OF PENNSYLVANIA. 341 disrespect unless from audacity itself. But it was, perhaps, in the lecture-room that Dr. Physick appeared to most advantage. Those of us who have listened to his instructions in surgery can well re- member, how impressive was the dignity and earnestness of his manner, how clear and forcible his flow of fact and illustration. We can recall the absorbed attention, the profound respect ap- proaching almost to awe, which sat habitually upon the counte- nance of the class; we can recall too the delightful emotion, the almost electrical thrill of pleasure, which flashed through every breast, when his features relaxed, during the relation of some pleasing incident, from their usual earnest sobriety into the bright cheerfulness of a smile. With the title of Emeritus Professor of Surgery and Anatomy, Dr. Physick still lends to the school the influence of his great name, though prevented by feeble health from an active participation in its affairs. Long may the evening of his days continue to shed its mild radiance upon our walls! Long may he live to fill a place in the profession, in which he can have no successor! The school has in general been fortunate in enjoying, through a long series of years, the services of those among its teachers who were best able to advance its interests. One striking exception, however, is afforded in the instance of the highly gifted Dorsey,* whose meteor course was suddenly quenched in death at the mo- ment of its greatest splendour. He lived, however, long enough to add one flower at least to the wreath of fame which encircles the history of the institution, and to prove, that, had life been spared * Dr. John Syng Dorsey, chosen first as the adjunct of Dr. Physick in the Chair of Surgery, afterwards as successor to Dr. Chapman in that of Materia Medica, and finally, upon the decease of Dr. Wistar, in the year 1818, as Professor of Anatomy. He had, however, but just entered upon the duties of the last-mentioned office, when he was cut off by death ; so that he never delivered a course of anatomical lectures. 342 niSTORY OF THE medical department to him, he would have earned for himself a place in the memory of men, scarcely less elevated than any now filled by his prede- cessors. Bewees* also had a professorial career too short for the good of the school, though sufficient to connect his name indissolubly with its history, and to entitle it to claim his ample honours as among its own brightest ornaments. It is no mean boast of the institution to have ranked among its officers the man to whom all agree in assigning the highest place among American obstetricians, whether in relation to practical skill, to merits as an author, or to diffused reputation both at home and abroad. Of his kind and amiable nature, his unaffected simplicity of character, his cultivated taste for the fine arts, even of his abilities as a teacher, I do not intend to speak. They are too well known to you all to require any com- ment from me. The affecting testimony of friendship and esteem spontaneously offered him by the class, on the eve of his departure for a foreign land, must be still fresh in your memory. What a noble scene was your last meeting with your venerable preceptor ! I can still see him seated in the midst of the assembled throng, in the very scene of his former labours, enfeebled alike by disease and by the crowd of emotions which pressed upon him ; come to re- ceive your parting token of affection, and to bid farewell alike to you, and to the place in which he had so often before met you in the full vigour of his powers. Every breast was filled with sym- pathy, every eye was moist with compassion ; a deep silence evinced the absorbing interest of the scene ; and when the last thanks and the last blessings, which his feeble lips were unable to pronounce, f Dr. Wm. P. Dewees, who was appointed, in 1825, adjunct to Dr. Thos. C. James in the professorship of Obstetrics, and became full professor in 1834, on the resignation of Dr. James. He was seized with paralysis, as he was about to enter upon his course, in the autumn of 1835; and, being unable to make himself heard by the class, resigned the professorship. OP THE UNIVERSITY OF PENNSYLVANIA. 343 were read by a mutual friend, one common feeling of sadness and solemnity overshadowed the assembly, and one common prayer went up from the deepest recesses of the heart, that the remain- ing path of his life might be smooth, and the evening of his days unclouded and serene. In these brief sketches, I have not pretended to offer a history of the Medical Faculty from its first institution. In such a history, it would be unpardonable to pass over names, which on the present occasion have not been mentioned, or to give a subordinate place to others which have been merely alluded to. My object has been, in the utter impossibility of presenting a complete picture, to touch' off simply some points which were prominent in my own expe- rience or recollection, and to which, therefore, however imperfectly executed in other respects, I have at least been able to give the character of truth. Before the present audience, it would be superfluous to speak of the general prosperity of the school. It may be interesting, how- ever, to trace its gradually increasing success, as indicated by the number of those who received its honours, at different periods, from its foundation to the present time. I have already stated that the number of graduates, at the first public commencement in 1168, amounted to ten. This was exceeded only on three occasions during the remainder of the century, on one of which, in the year 1T97, the graduating class consisted of fifteen. The average annual number from the origin of the school to the year 1800 was only seven. From this period it appears to have rapidly increased. In 1810, the annual list of graduates had swollen to sixty-five, in 1819 to one hundred and two, and in 1831, when it attained its maximum, to one hundred and fifty-one. Dividing the present century up to 1830 into periods of ten years, we find that the average number yearly in the first period was about thirty-three, in the second seventy-one, and in the third one hundred and seven; 344 HISTORY OF THE MEDICAL DEPARTMENT and since 1830, it has been one hundred and thirty-two.* But the number of graduates is not an exact criterion of the relative pros- perity of the school at different periods ; for, from a combination of various circumstances, it has happened that the proportion of those who have annually received the honours of the institution to those who have merely attended upon its courses of instruction, has been gradually augmented during the latter years of its existence ; so that its early success was in fact greater than might be inferred from the statement just made. Originally, two degrees in medicine were conferred, correspond- ing with those in the arts. The prerequisites to the lower degree, or that of Bachelor of Medicine, were the possession of a com- petent knowledge of the Latin language, mathematics, and natural philosophy, the serving of a sufficient apprenticeship with some respectable practitioner of medicine, a general knowledge of phar- macy, and an attendance upon at least one complete course of lec- tures, and upon the practice of the hospital for one year. The higher degree, or that of Doctor of Medicine, was conferred on the Bachelor at the expiration of three years, upon the conditions that he should have attained the age of twenty-four, that he should write a thesis, and should publicly defend this thesis in the Col- lege. This system was found inconvenient in practice, and, as it was productive of no counterbalancing advantage, was abandoned for that now in operation, upon the union of the schools in IT 91. The regulation formerly existed, that the theses of the successful candidates should be published ; but this too has been very pro- perly abandoned, as an unnecessary impediment in the way of graduation. * From 1830 to the present date, a.d. 1859, the average number of grad- uates has been 154. The highest number was in the session of 1848-9, when it amounted to 190; the matriculating class of the preceding session, that of 1847-8, having numbered 509, the largest in the records of the school, up to the present winter, when it is exceeded. OF THE UNIVERSITY OF PENNSYLVANIA. 345 We have thus, gentlemen, taken a rapid glance at the past his- tory of the medical school whose honours you now receive. May I ask your further indulgence, for a few minutes, while I attempt to represent to you the advantages of its present position, and the claims which it advances to' a continuance of the support which it has hitherto both merited and received ? I am sure you know me too well to suppose, that, in thus assuming the office of its advo- cate, I am actuated by any sordid views of personal profit. I wish you also to understand, that, in the remarks which follow, the Faculty of the University have not the least disposition to undervalue the merits of the numerous sister institutions through- out the country. A race is before us ; a noble prize is to be won ; we hail every honourable competitor with a friendly spirit. The very excitement of a fair and open contest is equivalent almost to the pleasure of victory. Let each school present its advantages in the strongest light, and exert its own strength to the utmost, leaving to its neighbour the same privilege unmolested; and, whichever may maintain precedence in the struggle, no just or honourable spirit will complain. Not the least among the advantages of this school are those connected with its locality. The city of Philadelphia, centrally situated in regard to latitude, far enough from the ocean for per- fect security, yet not so distant as to be of inconvenient access from abroad, sufficiently populous to insure ample opportunities for anatomical and clinical illustration, well supplied with libraries and cabinets of specimens, salubrious as a place of residence, and richly furnished with all the necessities and comforts of life, is peculiarly adapted to become the resort of medical students, and the focus of medical instruction for the whole Union. Another advantage of the University, and one peculiarly its own, is its relative antiquity, and the number of great names con- nected with it in the capacity of teachers or of pupils. The prin- ciple of association by which we appropriate to ourselves a portion 346 HISTORY OF THE medical department of the credit or censure attached to any cause, or set of men, or institution with which we are connected, a principle rooted in the very foundations of our nature, and the source of some of the noblest feelings with which it is adorned, extends in its influence not less to the past than the present. Who does not experience a glow of satisfaction at the mention of the virtues or praiseworthy deeds of his forefathers? Who does not glory in the former honours of his country ? Is there one of you, gentlemen, who does not value his degree the higher, as proceeding from the oldest medical school of this continent, as connecting him with the illus- trious names of those who raised it into fame, as ranking him in that band of three thousand graduates which embraces so large a portion of the medical reputation of our country for the last seventy years? Is it not something to have frequented the same halls in which your fathers were initiated into the profession, to go out to the contest under the same flag under which they tri- umphed? These are not fugitive or barren associations. They will attend you through life ; they will intermingle in your whole course of medical duty; they will elevate your tone of professional feeling, and serve as a light and guard to your path when beset with doubts and temptations. Your eyes will be constantly directed to the bright examples of those into whose fellowship you have been admitted; and, while spurred on by an honourable emulation to imitate their course, you will feel an additional obligation to avoid any disgraceful act, lest it may in some measure sully their fair fame. There is, therefore, something more than the mere gratifi- cation of feeling ; there is positive benefit in a connection with the age and reputation of the University ; and few, I will venture to say, have ever repented the choice which led them to this connection. But do not imagine that I recur to the past from any conscious- ness of present weakness. The University has not yet arrived at the period, when it will be compelled to resort to its hoarded capital of reputation. If success be accepted as a criterion of OF THE UNIVERSITY OE PENNSYLVANIA. 347 merit, it can still boast, amidst the powerful efforts of numerous rivals, a degree of support, not inferior, upon the average of a few years, to that which it enjoyed when it stood comparatively alone. It cannot be denied, that the new institutions which have struck their roots deeply into the soil once exclusively its own, have drawn off much nutriment that would otherwise have contributed to its further expansion ; but, though thus checked in its growth it has lost none of its ample proportions, and still throws out its undiminished limbs, the pride and boast of this continent. If it be judged by the character of its fruit, it has still less of which to be ashamed. Search for the rising professional merit of this country, the budding of future professional reputation ; where will you find it if not among the pupils of this school ? When did classes ever proceed from its walls, more rife with the seeds of honour and use- fulness to their country than those of the last few years ? Consider now the organization of the school. Has it not been advancing with the general march of improvement, and is it not at this moment more perfect than at any former period ? You are all aware of the addition of a new and most important professor- ship, that of the institutes, made before the commencement of the late session. What school in the Union can boast at present of so extensive a course of instruction ? Little more is wanting to ren- der its organization entirely equal to the present advanced state of medical science, so far, at least, as accords with the institutions and habits of our country. But it has been deemed safest to pro- ceed cautiously with changes ; to allow the new work to become consolidated by time, before venturing upon further additions. In the mean while, the attention of the Faculty has been directed to- wards the improvement of the several courses which enter into its present plan ; and as one of the means of such improvement, they have now under consideration the propriety of extending the winter session to five months, thereby relieving the pupil, and at the same time affording scope for more ample instruction. 348 HISTORY OF THE MEDICAL DEPARTMENT The resources in possession of the school for the illustration of the various demonstrative lectures, have accumulated beyond all example in this country. The chemical apparatus i3 probably in- ferior in variety, splendour, and costliness to none in the world. The anatomical museum, commenced by Dr. Wistar, has been augmented by the indefatigable industry of the present professor to an extent which leaves little to be desired. You can all bear witness to its richness in every variety of specimen, draw- ing, and model which can serve to illustrate the obscurities of anatomical structure; and it would be impossible anywhere out of Europe to find an equal collection of pathological specimens. Surgery also is illustrated in every mode of which the subject is susceptible ; and the magnified drawings connected with this branch, independently of their merit as pictorial representations, are worthy of notice as specimens of art. The same spirit of im- provement has been carried into the obstetrical chair; and you have been presented, during the last winter, with illustrations in this department such as have never before been witnessed in our school. It does not become me to speak upon the subject of materia medica. I may, however, be permitted to say, that my object has been to place this among the demonstrative branches ; and that, if I have failed to render the subject interesting and im- pressive, it has been from deficient ability, not from the want of assiduity in providing the requisite means. It is unnecessary to call your attention to the ample accommo- dations of the present hall for every department of medical instruc- tion. Among its recommendations, not the least is the opportunity afforded by its open precincts for free ventilation, and the conse- quent prevention of that injurious influence upon the health which always results from the confined air of close and crowded apart- ments. The system of clinical instruction, which, in its present form, owes its origin to the professors of this school, has been carried to OF THE UNIVERSITY OF PENNSYLVANIA. 349 a perfection before unknown in the United States. By the ample arrangements of the two hospitals, particularly of that attached to the Philadelphia Almshouse, it has been found possible to afford the advantages of practical illustration in medicine and surgery to the largest classes ; and you must all be sensible, from your experi- ence during the past winter, of the benefits which flow from this mode of instruction. To complete a view of the present condition of the school, it would be requisite to portray the qualifications of the several pro- fessors ; but upon this subject I am not permitted to speak. Were I to express all that I think in relation to my colleagues, I should incur the suspicion of being influenced by the partiality of interest or of friendship. This much, however, may be said, that one com- mon feeling animates all the Faculty; a disposition to promote, so far as lies in their power, the usefulness of the school, and a deter- mination to exert, to the utmost, whatever abilities they possess, to render their courses instructive and interesting to the pupil, and honourable to the institution. I have addressed you on the subject of the school, without re- serve. By the possession of its honours, you have become, in some measure, partners in its fame. Sympathizing with those who have its prosperity at heart, and disposed to participate cordially in the furtherance of their honourable views, you have a right to all the information which it is in our power to communicate. The Faculty rely on your good-will. They leave their cause confidently in your hands; and I am much mistaken in the nature of those feelings which serve as the bond between you and them, if they will ever have occasion to repent the trust. You are now about to leave us, in order to enter upon the active business of life. I see a varied scene before you ; but hope at present sheds her bright sunshine over all. I would not damp by one word the ardour of your young wishes, or the warm energy of your resolves. I would not repress, if I could, that eagle gaze 350 HISTORY OF THE MEDICAL DEPARTMENT into the future, which pierces through cloud and storm, to fix upon the bright sun beyond. The loftier your aim, the more vigorous and sustained will be your flight, and the higher your ascent into the fortunes and honours of this world. But there is one point of the utmost importance to your happiness, wherever your course may lie, whether high or low, in light or obscurity, among abund- ance or want; a strict observance of the rules of honour and morality. Without this, your greatest success will be nothing more than a splendid failure. A secret consciousness will poison every pleasure, mingle a sense of disgrace in every triumph, and darken the whole soul, even amidst the sunniest fortunes. With it, on the contrary, scarcely any condition can be absolutely des- perate. The storms of adversity will never find you without a cloak to protect, nor the fiercest assaults of grief without a solace to comfort you. But, while such are the advantages of an upright life in the lowest extreme of fortune, it very seldom happens that they who adhere to it have occasion to invoke its consolations under such unhappy circumstances. The scriptural declaration, "never have I seen the righteous forsaken," is but the expression of a general law of nature. The exercise of a conscientious guard over our propensities to evil, will be found an almost certain road to respect and confidence; and, united to a spirit of enterprise and the habit of industry, will prove a powerful instrument of elevation to the highest stations attainable in well-regulated communities. In your pursuit, therefore, of fame and fortune, never lose sight of this polar star. Turn not to the right or the left at the bright but delusive promise of the meteor lights which will entice you. In the path of your ambition, if duty or honour place but a straw in your way, pass not regardless by, but remove it before venturing to proceed. We feel a deep interest in your honour and success ; we point to the path in which you may almost surely prosper ; and if, in this parting moment, our wishes and admonitions assume a character OF THE UNIVERSITY OF PENNSYLVANIA. 351 of solemnity, it is in accordance with the occasion ; the last of our meeting together, after a long and satisfactory intercourse. Yes, gentlemen, it is a solemn occasion. In thus parting forever, we stand, as it were, upon the brink of eternity; and our thoughts irresistibly rise up to that power which rules the vast obscure into which we are about to enter. If, weak and faulty as we are, we may venture to approach the pure majesty of His presence, we would earnestly ask for those who are about to embark upon the untried ocean of active life, a long course of virtuous prosperity ; a career full of happiness to themselves, and of blessings to their fellow-men. Gentlemen, farewell ADDRESS II. DELIVERED TO THE GRADUATING CLASS AT THE COMMENCEMENT HELD APRIL 2nd, 1841. Gentlemen : — In compliance with custom, and with the dictates of their own feelings, your teachers propose to address to you a few words of congratulation, of counsel, and of good wishes, before they and you part, never to meet again in the same relation. We have endeav- oured, to the best of our ability, to aid you in preparing for the duties upon which you are about to enter ; we have carefully and solicitously examined your qualifications for these duties ; and we have had pride in presenting you to the authorities of this school as meriting its formal testimonial iu your favour. That testimonial you have received in the degree of Doctor of Medicine which has just been conferred upon you. We congratulate you upon your honourable entrance into the ranks of our profession, and gladly offer you the hand of fellowship. But we shall not have fully dis- charged our obligation, without adding to the lessons you have already received some hints, out of the stores of our experience, which may be found useful in the long and arduous course of life you this day commence. You have gained one great requisite to success; a good start- ing-point from which to throw yourselves forward into the future. With the aid of your teachers, you have risen above the obstruc- tions which impede every attempted flight from the surface, and (352) AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 353 have reached a spot in the ascent of knowledge, whence enterprise may boldly spread her wings in the air, and be assured of support. But it would be a great mistake to content yourselves with this advantage. No error is more fatal to the young physician, than the notion that the period of study is passed, and that hereafter he has only to act. To sustain a vigorous advance, it is necessary that, to the store of intellectual strength which he has accumulated in youth, he should make incessant additions at every stage of his progress. His ascent, unlike that of the projectile whose velocity diminishes constantly as the original impulse upon which it de- pends is exhausted, should rather resemble the flight of the eagle, who draws in new strength with every inspiration, and mounts steadily towards his goal. The knowledge which you have ac- quired should be considered only as a key to the vast storehouse whose riches are now open to you. If you aspire after excellence in your profession, merited success in life, and an honourable dis- tinction ; and there is probably not one among you who does not cherish such aspirations ; you will look upon the present merely as a period of holiday relaxation, to be followed by renewed labour in the attainment of medical knowledge. It is not probable that your time will for some years be quite absorbed in practical duties. The course of things, in this world, is much better ordered than if left to our own wishes, wilich, in the eagerness of pursuit, would leap over all obstacles, and if possible annihilate time and space. Existence, under our own guidance, would be nothing more than a rapid succession of wish and frui- tion ; a thunder-storm in the night, with its flashes and its peals, and darkness between. We should lose the gentle excitement of alternate hope and fear, the pleasingly changeful sunshine and shadow of the landscape of life. We should lose the sweet reward of mental and bodily toil ; the sense of enjoyment, namely, which Providence kindly mingled with the cup of labour which he gave to all men to drink. We should lose, moreover, those luxurious 23 354 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. intervals of repose, when, seated beneath our own arbour, at our own household door, with all that is most dear about us, we look out upon the green, the blossoms, and the fruits, and feel that they are all ours, and that we have earned them. Be assured, gentle- men, that rapid and unearned success in life is not desirable. It is well, therefore, in reference merely to your own good, not to speak of the good of others, that you should have further time for prepa- ration ; that the practical business of your profession should come gradually, so that while your circle of duties is widening, you may have the opportunity of extending equally that of your qualifica- tions. You may ask for instruction as to the course of study best calcu- lated to advance you in the knowledge of your profession. In the first place, it is highly important that you should proceed with sys- tem. Desultory medical reading may furnish you with a mass of rich materials ; but they will be irregularly heaped together in your memory, and mingled, moreover, with much that is merely rubbish; so that, in answering the demands of practical emer- gencies, you may ransack your store in vain for the desired object, and, in your haste and confusion, will even be liable to draw forth for use something wholly inapplicable to the end proposed. There is, moreover, in this sort of reading a dissipation which, as in every other pursuit, whether mental or physical, enervates the faculties which are called into play, and, if long indulged, unfits for any steady and laborious effort. In your medical studies, therefore, we would advise you to fix upon some systematic course, beginning with those elementary subjects which lie at the basis of the science, and, in your progress upwards, endeavouring always to master first those points in the ascent, the possession of which will facilitate your attainment of something higher. But our science includes several distinct practical departments, in all of which it is scarcely possible for any one individual to attain great proficiency. We may err almost as much by perse- AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 355 veringly endeavouring to carry more than our arms will hold, as by being content with less. The greedy little child, who, unwilling to relinquish any portion of the desirable things within his reach, finds one thing after another falling from his arms as fast as he fills them, and at last, after repeated efforts, lets them all drop and begins to cry, is but the miniature of the ambitious student who wishes to learn everything, and, failing in the attempt, gives up in despair, and abandons study altogether. The best course is that each one should consult his peculiar turn of mind, and, as far as possible, his capacity, and give a corresponding direction to his studies. In medicine, a certain degree of acquaintance with all the branches is desirable, and to one whose sphere of action may lie in the country, is indispensable ; but special skill is attainable only by a concentration of effort; and he who wishes to excel should push his investigations preferably along some one route, though he may profitably cast his eye over the neighbouring tracts as he proceeds, and may occasionally diverge so as to get a general view of the whole region. The steady pursuance, however, of a certain course of study should not prevent you from paying a particular attention to those forms of disease which may happen to come under your notice. We always read more intelligently, aad better remember what we read, when the object of study is before us. Whenever, therefore, a case may occur to you, upon which you may be conscious of insuf- ficient information, suspend for a time your regular plan, until you have investigated, in relation to the complaint, all the authorities within your reach. Such interruptions, though they may break the continuity of the stratum of your studies, will, like cross-veins of some precious metal, greatly enhance their value. In exploring your memory for resources in any case of difficulty, you will find these deposits at once most obvious to your researches, and most productive of the aid you seek for. I cannot leave this subject, without again endeavouring to im- 356 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. press upon you the importance of devoting the early years of your practical life to the continued prosecution of your medical studies. The physician who considers his degree as a dispensation from future intellectual labour, and henceforward looks only to the fruits of his profession, will be apt to reap but a scanty harvest; or, even should fortune cast his lot on some rich prairie soil, which yields abundantly to a very careless culture, he will find himself unpre- pared to gather in the abundant crop, which may thus perish upon his hands. It will be in vain, when he begins to experience the want of more ample professional resources; when he finds the magic stream which he has set in motion by an accidentally discovered word, flowing in upon him, and threatening to overwhelm him, because unprovided with that other word which would enable him to control its movements ; it will be in vain, at this late period, that he may strive to repair the consequences of early neglect, and seek safety for his reputation, and peace for his conscience, by a late pilgrimage to the shrine of science. Knowledge, like the fabled Roman sibyl, makes the offer of her treasures once, twice, thrice, on each successive occasion diminishing the amount offered, and at length threatening to withhold all if her last offer is rejected. As we advance in life, we find it impossible to break through the crust, which early neglect may have allowed to gather around our faculties, and which has become hardened by habit. It is only by a constant expansion that, like the young growing shellfish, the intellect can prevent that concretion which is ever disposed to form about it, from becoming so firm as to restrain all future increase. A neglect of your early opportunities will prove in great measure irreparable, when time and experience shall bring with them a due sense of their importance. On the contrary, by cultivating assidu- ously those opportunities, you will find your knowledge growing with the growing demands upon it; you will experience a happy harmony between your avocations and your capacity ; and, when in the full career of business, with the life and temporal happiness AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 357 of great numbers in your keeping, though you may feel sensibly the deficiencies even of the highest knowledge, you will at least escape the ever-present and ever-gnawing consciousness, that your capabilities are not only beneath the level of your times, but also far beneath what nature and opportunity would have enabled them to become. The point, perhaps, next in importance to the acquisition of a due store of medical knowledge and skill, is the cultivation of a proper professional spirit. This is to the physician the very soul of his occupation, which, without it, would be a mere lifeless in- strument for the supply of his necessities, a dead compost to quicken and nourish the crop of his sordid enjoyments. He who considers his profession as an avenue to nothing higher than pecu- niary gains, and limits his efforts accordingly, will find his capacity, and, unless under strong religious influences, his conscience -also dwindling to the measure of his views. Next to an ever-present feeling of responsibility to a higher power, there is no principle so influential in promoting every liberal and useful effort, in restrain- ing every irregular or sordid act, in giving a high tone at once to sentiment and conduct, as a true professional spirit, which looks beyond personal profit to the respectability, honour, dignity, and general usefulness of a calling. But this principle should not be confounded with the esprit de corps, which is nothing more than a sort of cohesive affinity be- tween the constituent particles of an aggregate body, a selfish principle which yields for the sake of receiving support, which has no reference to the aims of the mass which it actuates, and is quite as efficient for evil as for good. The true professional spirit for- gets the individual in the great objects of the profession; the esprit de corps thinks of the calling only from its connection with the individual. The former can exist only where there is some- thing great, or noble, or useful to support it, and breathes most freely in a pure atmosphere ; the latter lives as well on garbage as 358 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. on luxuries, and finds a congenial air wherever there is a crowd. The esprit de corps requires no cultivation. It springs up spon- taneously in the soil of association, and flourishes vigorously upon the passions, the interests, and the selfish calculations which are everywhere abundant. The true professional spirit, on the con- trary, is a delicate plant, which is developed only under the warmth of generous feeling, requires the careful nurture of good principles and dispositions, and is in constant danger of being choked by the sordid growth around it. But then it is exceedingly sweet and beautiful ; and its fruit is honour to the profession and benefit to mankind. * This feeling naturally arises, in a well-constituted mind, upon the perception of an elevated character, and of noble and benefi- cent objects in the profession to which it is attached. Let us ex- amine how far the profession of medicine offers such claims to the devotion of those who have enlisted themselves under its banner. You will surrender yourselves with a more complete and more hearty self-abandonment to the service of your new mistress, should she be found worthy at once of your highest esteem and your warmest affection. In estimating the character of a profession, we should consider the nature of the qualifications required for its due exercise, the end towards which it is directed, and the influence it is calculated to exert upon its votaries. Deficiency in any one of these re- spects would be a serious drawback to its merits ; while excellence in all would give it a claim to the very highest consideration. A few words on each point will serve to indicate the proper position of our profession. I know of no calling which requires a wider extent of knowledge for its due exercise. The study of medicine considers man both physically and morally, both in a healthy and diseased state, and in all those relations which have any bearing upon the soundness of his body or mind. It goes out into exterior nature, and AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 359 investigates intimately every agent which has the power to pro- duce, to prevent, to cure, or to alleviate disease. It inquires into the mutual action and reaction of bodies, and into the changes in nature, form, or position resulting therefrom, so far at least as these circumstances are connected with the functions of the human system, the operation of exterior agencies upon that sys- tem, or the modification of such agencies by natural or artificial causes. Anatomy,, physiology, pathology, psychology, botany, mineralogy, zoology, chemistry, and natural philosophy, are but a portion of the sciences which contribute to the constitution, or themselves form a part of the complex science of medicine. The accomplished physician is also expected to have some acquaint- ance with the languages of Greece and Rome ; and, if he wish to avail himself of all the resources within his reach, must cultivate also those modern languages, such as the French and German, which are the most frequent vehicles of new medical thoughts, facts, and disquisitions. As a gentleman, moreover, associating intimately with the best instructed and most polished members of the community, he should be more or less conversant with polite learning, and familiar with the various topics of the day, whether literary, scientific, or political. But knowledge is not his only essential qualification. He should possess, in addition, a practical skill derived from a close personal observation of disease, and of the application and effects of remedies. He should have the graces of a gentlemanly deport- ment, and familiarity with the conventional forms of good breed- ing; so that he may avoid wounding the often morbid delicacy of his patients, and adding the irritations of an offended taste, or ruffled temper, to the evils of the disease. He should be endowed, in an eminent degree, with the qualities of a good heart, rectitude of principle, and firmness of purpose; for in no profession are the temptations to a relaxation in the per- formance of duty stronger; and in none are the consequences of 3G0 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. such relaxation so fatal to comfort and happiness in this world. I need scarcely say, in fine, that a good, native intellectual basis, is essentially requisite for the erection of that superstructure of knowledge which is expected of every physician ; and that the faculties of a quick perception, good judgment, and accurate reason, are indispensable to a just solution of the intricate pro- blems, which disease frequently presents both in its nature and mode of cure. It is a great mistake to select medicine as a sort of hiding-place for deficient intellect; for, though a solemn ex- terior may for a time impose upon the public, it cannot long con- ceal the vacancy within from penetrating eyes ; and the mischief which may have accrued, in the mean time, is incalculable and irre- mediable. Such, then, are the qualifications in knowledge and character which the accomplished physician brings into the practice of his profession. Let us inquire whether the objects for which he em- ploys them are of equivalent importance. These objects are the preservation of life, and the restoration and maintenance of health. None, certainly, can be of higher value in reference to this world alone. But the mere mention of them produces little impression. When life first opened upon us, there seemed about it a holiness, like that of the ark, which it was sacrilege to touch. We shrank with a shuddering fearfulness from the thought of its extinction; and the word which spoke of our mortality, thrilled through us like a summons to judgment. Language was then a true picture of reality. But we have subsequently heard so much of life, death, and futurity, that our sensibility to the awful import of these sounds has become exhausted. Like the oft-repeated tolling of the church bell in our vicinity, they fall upon our ears, but we do not hear them. We are told of the value of life, and readily admit the fact; but it makes no impression, and we turn away to some indifferent object. We acknowledge the great importance of the profession whose business it is to save life ; but we do not feel it. AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 361 To realize its importance we must be, or imagine ourselves, in a situation to require its aid. Let this touchstone be applied to the profession of medicine. Suppose yourselves upon a sick bed, in the crisis of a very dan- gerous disease, with the full consciousness of your condition. You look through the portals of eternity, and view an awful obscurity before you. The past, with its joys and its troubles which now seem joys, its hopes and fears, its host of things done and undone, its certain faults and doubtful virtues, whirls through your recollec- tion like a long dream of enchantment, from which you are about to awake into some dread reality. The sweet affections of this world entwine about your retreating form, and strive to hold you. Connubial and kindred love cling with fond arms around you, and with tears entreat you not to desert them. But an irresistible force seems to impel you onward. You are on the brink of the abyss ; a dizzy mist comes over your senses ; you are on the point of falling. But the eye of professional skill is watching over you, and, at the moment of despair, an arm is extended to save you. With its support and guidance you return to life and health ; and, oh! what joys attend your path. How beautiful is every object; how balmy the air ; how delicious the fragrance ; how sweet the music around you ! Nature springs with radiant smiles and ex- tended arms to meet you. Every sense appears to have been bap- tized into a new and exquisite susceptibility of enjoyment. Life and its affairs have acquired new interest to your regenerated feelings. Your bosom swells with kindly emotion towards every animated thing; and your thoughts ascend, from the midst of the temple of your enjoyment, with deep humility and ardent thankful- ness, to the author of all. This is no fictitious picture. Thou- sands and tens of thousands are realizing it every day. But it is not our own lives only, with all their renewed enjoy- ments, that we sometimes owe, under Providence, to the skill of the physician. We are often in want of the same aid for those 362 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. most dear to us. There are many present, I have no doubt, who have sat by the bedside of some near relative in alarming illness, watching with anxious eye each movement of the patient, fearful that every breath might be the last, and longing, with a scarcely repressible impatience, for the approach of him upon whom every earthly hope depended. And when at last the physician came, with what trembling eagerness was he greeted ! How intensely did the strained eye scan his features, to gather from their ex- pression the message of hope or despair! What relief, what joy, when the inquiring gaze was answered by a smile of encourage- ment and confidence ! How did the heart overflow with gratitude for that kind watchfulness, that unwearied attention, that skill, which had brought the tempest-tossed bark, laden with so many hopes, once more to a safe haven ! It is in such moments as these that we feel the full value of medical services. Even when the efforts of the physician are unsuccessful, there is a priceless consolation to the survivors in the reflection, that nothing has been left undone which skill could accomplish. The practitioner, indeed, often finds, with some surprise, that his warm- est and firmest friends are those who have lost some dear relative under his care. His kind attentions are indissolubly associated with the memory of the dead; and no petty feeling of self-love, which too often endeavours to lighten a burdensome sense of obli- gation by undervaluing the favours received, can, in this instance, mar the first impression of affectionate gratitude. Were our profession unable to prolong life, were its only service to shorten and alleviate disease, and render life more comfortable, it would still be the instrument of great benefit to mankind. How often do we see pains almost beyond human endurance, which ex- tort groans and even cries from the strong man, retiring at the command of the physician, and leaving the patient, to use a fre- quent expression of his own, in a heaven of relief! How often are the discomfort and unfitness for any useful exertion, which have AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 363 been running through months of some chronic malady, cut short in a few days, or in a few weeks, by medical interference ! Not to speak of the immense mass which is thus, in the aggregate, taken off from the load of human wretchedness, the contribution which is made to the productiveness of human industry, in all its forms, by augmenting the time and capacity for labour, is altogether in- calculable. Not only, therefore, does our profession accomplish its own immediate ends of preserving life and health, with all their abundant blessings, but it indirectly also promotes the ends of every other profession, by augmenting the agency through which these ends are attained. It yet remains to inquire what are the influences of our profes- sion upon its own members. At the very threshold of this inquiry we are met by two notions, to a certain degree prevalent, that the study of medicine disposes to infidelity, and its practice to disputa- tion and strife. That there have been many unbelievers among physicians, and that public attention has been occasionally called to our disputes, is not denied. But of what profession or pursuit in life cannot the same be said ? The chief cause of our peculiar reputation in these respects, is probably the circumstance that we are distinguished by a peculiar designation, which reflects more or less upon the whole class the credit or discredit of each individual. If a lawyer, a soldier, a merchant, or a gentleman without profes- sion, should happen to be an unbeliever, or should be so unfortu- nate as to quarrel with his neighbour, the imputation rests with .himself, and no one thinks of inquiring to which of these several classes of men he belongs, much less of fixing his fault or his mis- fortune upon his calling. But if a physician fall into the same predicament, his title of doctor directs the public attention at once to the great body of doctors, and we are compelled to pay for the very doubtful honour of our distinctive designation, the very extra- vagant price of public odium. Nay, the faults and follies of those who bear the same title as ourselves, without belonging to us, go 304 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. to swell the charges against our profession ; and I doubt not that, by many, the crimes of the late notorious Dr. Francia himself are In id at our door. The truth is that, among physicians as among other men, there are believers and unbelievers; and that, as other men, we occasionally differ among ourselves, and are so unwise as to bring our differences before the public ; but that there is any peculiar tendency in the profession to either of these results, is altogether a mistake. On the contrary, the natural tendency of medical studies, by bringing before the mind innumerable instances of the wisest and most benevolent design, is to impress strongly upon the conviction the existence and attributes of Deity ; and, at least within the circle of my own observation, a remarkable har- mony prevails in the profession, even in iustances where there is an apparent opposition of interests. It scarcely consists with the occasion to enter into a philosophi- cal disquisition upon the influences of profession in the formation of character; otherwise it would not be difficult to prove, that each practical pursuit has a tendency to stamp its own peculiari- ties, in a greater or less degree, upon the individual; so that, if the course of study be comprehensive and liberal, and the course of action nobly directed, the intellectual and moral character will be in a corresponding degree expanded and elevated. Now it has been shown that the study of medicine covers a vast tract of human knowledge ; and it may be said to join, by an indefinite boundary, many of those departments which do not absolutely fall within its limits. It has been shown, also, that its practice is directed to the noblest results of human pursuit, short only of those which are to be found in a future existence. If, then, there be truth in human reason, the general character of the profession, wherever circum- stances admit of its legitimate and full development, should be at once liberal and exalted, embracing a wide expanse of diversified interest, and elevated above mean and sordid views and calcula- tions. And are not the deductions of reason justified by observa- AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 365 tion ? In those countries where medicine has been duly cultivated, do we not find physicians prominent among the competitors for honour in almost every branch of literature and science ? Are not their names enrolled, in large proportion, in the catalogue of every learned society ? Is there a feasible project of public usefulness which does not receive their support? Is there a charity to which they do not contribute largely out of their comparatively slender means, and still more largely by their services, professionally and otherwise ? Most assuredly there is no profession which gives up more of its time, and labours more assiduously, without reference to pecuniary compensation, than the medical. Endowed by its very constitution with peculiar faculties for the relief of human misery, it is impelled to the exercise of these faculties whenever occasion offers, and is thrown, almost by the necessity of the case, into a course of benevolent action. I presume that I am rather falling short of the truth than exceeding it, when I state my im- pression, that at least one-half of the time and service devoted by physicians to practical professional pursuits, at all events in large cities, is entirely gratuitous. It is indeed a question whether this disregard of their pecuniary interests is not carried by physicians to the very verge of injustice ; whether they have not so long accus- tomed the public to expect gratuitous service, that it has at length come to be considered as a right ; whether, in fine, the readiness, I had almost said eagerness, with which they seize upon every oppor- tunity for the charitable exercise of their skill, has not produced a general impression that, on all such occasions, they, and not the public, are the favoured party. Nor is it only in the prompt surrender of their time and efforts at each call of duty, irrespective of all direct emolument, that phy- sicians illustrate the generous and liberal spirit of their profession. In the ordinary avocations of life, a useful invention or discovery is considered as a just title to peculiar emolument; and no one hesitates to avail himself of the law which secures to him, for a 3f>G AN ADDRESS TO THE MEDICAL GRADUATING CLASS. limited period, the exclusive control of the new source of profit which lie has created. But it is not so with physicians. The re- sults of their labour and genius, whether new views of disease, new remedies, or new processes of cure, though years, nay a lifetime of labour and research may have been devoted to their discovery and elaboration, are unhesitatingly thrown into the lap of the profes- sion, and made the common property of all. It is considered alto- gether unprofessional to keep secret, with a view to pecuniary advantage, any valuable remedy; and few regular physicians or surgeons have deigned to resort to the protection of the patent law. The only legitimate advantages to the individual, according to the strictest professional code, are the credit of the discovery, the consequent probable increase of profitable occupation, and the heartfelt satisfaction attendant upon the consciousness of having contributed to the honour of the profession, and to the general good. Such, gentlemen, in its character and tendencies, is the profes- sion to which you now belong. It is a profession of which you may well be proud ; affording scope for the exercise of your best faculties and affections; tending by its noble purposes to elevate you above all that is low and sordid ; and making you the hon- oured instruments of the greatest earthly good to your fellow-men. Open your hearts, gentlemen, to the spirit which it would breathe into you, and cherish this spirit, like a sacred fire, by the vestal ministration of your highest and purest feelings. Commingled with your moral sense, it will shed a bright light about your steps, which in the darkest period of temptation will enable you to keep in the true path of honour and usefulness. Before this light, the phosphorescent splendour which often beautifies corruption itself will fade away, and you will see the rottenness as it really is. The glittering exterior of dishonourable success, which so often reflects the images of proud triumph to the eyes of the multitude, will be found a mere tinsel cover to self-reproach and conscious degrada- AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 367 tion. What if, under a system of false pretension, of unworthy contrivance, of tortuous policy winding itself into every opening however foul and crooked, a physician should attain a certain amount of temporary success ; what if, in opposition to better knowledge, he should trim his sail to some popular breeze, and, raising the flag of homoeopathy, Thompsonism, or some other folly of the day, should glide out of the obscurity, in which he may hitherto have been concealed, into a short-lived notoriety; what if, abandoning all regard to decent appearance, he should hang out the meretricious allurements of the vender of secret nostrums, and gather wealth and splendour by the wages of his professional pros- titution ; is all the success, or ten times the success which he may meet with in the world, the slightest remuneration for that self- loathing with which he must look into his own corrupt interior, for that pity or scorn with which he is conscious that he is regarded by his former professional brethren, and by the most enlightened individuals of the community which he disgraces ? But I wish not to be misunderstood. It is only those who sin against better knowledge that are here referred to. Conscientious convictions should be respected, even though based upon ignorance and delu- sion ; and, so prone is the human intellect to every kind of aberra- tion, that we may readily admit the possibility of an honest con- version from orthodoxy in medicine to the wildest creed that ever sprang from a deluded imagination. We can even suppose that an educated physician may become a convert to some Mormonism in medicine, and, under the scourge of public contempt, feel all the consolations of a martyr. For such delusions there should be no other feeling than compassion, as there is no other cure than time. That the public should suffer is a misfortune ; but this is equally the result of ignorance and delusion on their part, and is probably one of the means, in the wise course of Providence, for the eradica- tion of error, and the ultimate diffusion of light and truth. Imbued with the true spirit of the profession, you will be ele- 368 A.\ ADDIM'SS TO THE MEDICAL GRADUATING CLASS. vated above all these sources of error in conduct and judgment. In shaping your own course, you will always have reference to the honour of your calling, which, as it is based upon truth, and aims only at the good of mankind, will, in your relations with one another, with your patients, and with the world, have a tendency to keep you within those great ethical rules which have the same origin and object. Under this influence, you will, in every doubtful case, ask yourselves the question, whether the proposed course will conduce to peace and harmony among physicians, to the welfare of those intrusted to your charge, to the general good of society, and to the due estimation and consequent influence of your profes- sion among men ; and, according as this question is answered affirm- atively or negatively, you will unhesitatingly .advance or recede, even though your apparent immediate interests may suggest a dif- ferent conduct. Nor, in the end, will you ever have occasion to repent the seeming sacrifice. The instances are few, indeed, in which perseverance in a strictly honourable professional course, with a due degree of enterprise and industry, has not led to ulti- mate success ; while, in our voyage through life, we are constantly passing the wrecks of hopes once as fair as our own, stranded upon the shoals of temporary interest and disreputable expedient. We have thus, gentlemen, in taking our last farewell of you as a body, endeavoured to leave with you, as a parting gift, some thoughts for your professional guidance, which I have no doubt will be received in the same kindly spirit in which they are offered. It gives us great pleasure to present you, in addition, with the acknowledgment of our entire satisfaction with your deportment and exertions during the past winter, and with the general success which has crowned your efforts. From the peculiar relations of our school towards the country, and towards the sister schools which have sprung up everywhere in such rapid succession, it has happened that a progressive improvement has been observable in the classes of graduates who have annually left our walls ; and I AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 369 am authorized by my colleagues to say, as their united sentiment, that the present class constitutes no exception to the general rule. We have, indeed, been exceedingly gratified by the result of the recent examinations, which, though assuredly not less rigorous than those of preceding years, have evinced a degree of preparedness on the part of the candidates, which has been equalled on no former occasion within our recollection. We send you forth, therefore, with entire confidence that your future course will be creditable to yourselves, and to the institution whose honours you bear. It is scarcely necessary to say that, wherever you go, you will carry with you our warmest sympathies. We have a personal interest in your conduct and success. Scattered over every part of the country, you will be the standard by which men will judge of the merits of the school in which you were instructed; and we are willing to abide the test. Whether your present grade of charac- ter and professional attainment, or the position you are hereafter to occupy, be regarded as the criterion, we are willing to rest our claims to public approval upon the result of an impartial judg- ment. Perhaps, the very consideration that the reputation of your alma mater is in some measure in your hands, may add a generous and effective impulse to the other motives which urge you onward in the course of honourable exertion. There is no purer source of satisfaction, in this world, than so to stand in the eyes of men as to reflect back honour upon those to whom we have been in any degree indebted for early culture. But, gentlemen, we must bid you farewell. Crowds of thoughts and emotions press upon us at this moment of separation, which time is wanting to express. We must content ourselves with refer- ring to your own good sense for all of counsel, and to your own hearts for all of feeling that we are compelled to leave untold. May the divine blessing attend you throughout this life, and follow you in the life to come. 24 ADDRESS III DELIVERED TO THE GRADUATING CLASS AT THE COMMENCEMENT, HELD MARCH 29th, 1856. Gentlemen : — Your state of pupilage is now passed ; and, by the solemn act just performed, you have been admitted into full membership in the great medical body. We, your late teachers, congratulate you on this fulfilment of your wishes, and receive you heartily into professional brotherhood. Custom, as well as our own feelings, prompts, along with the most kindly greetings upon the occasion, a few words of friendly suggestion, such as age and experience, and an interest scarcely less than parental, may perhaps be ad- mitted to warrant. But first we have the pleasing duty to perform, of awarding to merit its just meed of commendation. The Faculty are united in the statement, that with no class which has ever assembled under their tuition, have they had better reason to be satisfied, whether in relation to general demeanour, or industrious application to study. For some years, it has seemed to them that, in both these respects, a gradual advancement in successive classes has been observable; and the present assuredly affords no example of retrogression. It is due to the students of medicine who now annually flock to our city, that we should perform our part towards placing them erect, as they deserve to be, in public (3T0) AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 371 opinion. There is, perhaps, still lurking in our community some residue of that old prejudice, if prejudice it was, which regarded the young devotee of medicine as a little given to wildness ; as disposed to qualify the sobriety of his daily routine by an occa- sional effervescence of conduct, not strictly in accordance with the rules of law and good order. Now, whatever may have been the truth in relation to past times, I do most sincerely express the conviction, that the students of the present day are characterized by a regard for the proprieties of life, even beyond what is gene- rally observable of young men of the same age ; and that an equal number of any other calling whatever, not bound by peculiar reli- gious obligations, collected under the same circumstances of free- dom from restraint, would offer more frequent occasion than they for complaints of irregularities, and various indecorums. The very nature of their position has led to this result. With the in- crease of professional competition, and the widening of the circle of medical knowledge, there has been an increased necessity for exertion; and the student feels that, to secure the attainment of his objects, he must work more, and amuse himself less than his predecessors. That he does labour diligently ; that the scholastic hall and the quiet chamber are more familiar to his experience than the theatre and the bar-room ; that his feasting is mainly at the board of knowledge, and his intemperance that of study and not the bowl; are sufficiently evinced by the contrast between what he is in face and person when he arrives, and what he be- comes before departing. With this contrast I have often been struck. Fresh from active pursuits, he comes ruddy or em- browned, full of health, spirit, and physical energy. Five or six months of confinement and hard mental work follow ; and, when he goes, he carries with him not unfrequently pallid cheeks, a wasted body, and a spirit worn by anxieties and fatigue. How often have I been consulted for dyspeptic symptoms, headache, 372 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. mental dejection or disquietude, and various nervous disorder, for which I have been able to hold out the termination of the course of study as the only cure ! It is no dispraise to you, young gen- tlemen, to appeal to your present looks as confirmatory of what I have said. If your fair friends- do not see in you all the bloom and rotundity which may please the mere physical eye, I will ven- ture to pay them the compliment to believe, that they see and appreciate the deeper intellectual accomplishment, which has been gained at the expense of the outer man. Let them look on you some twelve months hence; and, unless my observation in similar cases has been strangely fallacious, they will discover no deficiency of health and manly vigour. But, with my opinion of the sex, I would infinitely prefer, to the mere admiration of external form, that feeling of inward approval, of respect for labours achieved and honours won by meritorious effort, which woman is so apt to evince, and which speaks so strongly of her own pure and noble nature. If, then, I may be permitted to turn for a moment from you to those who have honoured you and us with their presence this morning, I would beg of them to join us in the effort to give the character of the medical student that place in general estima- tion which it merits. They will thus not only be doing an act of justice, but will contribute to the still further elevation of that character, by offering to those who may hereafter come among us the strongest inducement to support and improve the reputation which their predecessors left them, and sedulously to avoid every- thing which might fix the least stain upon it. But let us return from this little digression into which the occa- sion tempted us, and set out upon a brief anticipatory journey through the future that lies before you. The dreamer crowds the events of years into a few minutes. Let us dream ourselves on the path of life together. Perhaps we may be able, by a rapid course, to reach the end of it before we part. Perhaps, too, some AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 3*73 thoughts may spring up, some hints be gathered by the way, which may remain when the dream is over, and serve a useful purpose on the real journey which is to follow. Your first steps are those of exultation and gladness. You have aspired, have laboured, have denied yourselves, and have won. The goal is reached ; the prize is in your hands. And now for home, sweet home ! Ah ! the delight of returning once more to assured affection. The father's benignant greeting ; the deep ten- derness of the mother's eye ; the mingled smile and tear of the sister; the boisterous glee of the young brother; and, it may be, the warm blushes of one not less loving or beloved ; what is there in life more delicious? All nature exhales sweets for you in this morning of your journey. Earth, air, and water; the field and the stream; man and his works; and lovely woman, the crown and the charm of all, spread for you the feast of enjoyment every- where upon your way. Soul and body expand under these genial influences. The sickly hue and languor of study give way to the bloom, the vigour, and activity of health. But this stage of excitement passes. Man was not made for self-indulgence. Your long labours have gained for you a brief period of exuberant gratification. It is the reward of toil. But nature has paid her dues, and in her turn puts forward the inevit- able claim, either labour or suffering. We have been gifted with powers mental and bodily. These powers were given to be used ; and the penalty for not using them is pain. The limb always at rest suffers with an aching void ; the body unexercised is punished with the tortures of dyspeptic and nervous disorder; and mental inertness is almost surely attended with the horrors of ennui. But nature is not unkind ; though she exacts labour under the penalty of suffering, she repays it with enjoyment. Every faculty has con- nected with it a chord, that incessantly vibrates pleasure when the faculty is duly exercised. Paradoxical as it may seem to you, I 374 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. believe that the purest and most lasting gratification in this world, is that which waits upon the full and even laborious exercise of each faculty to its legitimate end; whether of the bodily powers to their ends, the intellectual to theirs, or the moral, including the conscience, to theirs. The commencement of laborious efforts may be distasteful; there may be frequent occasions for painful self- denial ; and the firmest control of the passions may sometimes be necessary to restrain their irregular tendencies; but a balance fairly struck will show a great preponderance in the scale of enjoyment. The point in your life-journey that we have now reached, is one at which you are called on for a decision, upon which must turn the happiness of your whole future. Too many, intoxicated by the brief draught of pleasure, and indisposed to relinquish it, attempt to supply the first vague uneasiness of satiety, and to quiet the troublesome calls of conscience, by the aid of artificial excitement, of the short joys of intemperance, the delirious excesses of the passions, or the scarcely less noxious influence of mental dissipation. They fall off by the way. Some are lost, and heard of no more. Others linger out a miserable existence, with health destroyed by excess, and minds dead to enjoyment, useless to the community, and a burden to themselves. A few are arrested in their downward course of dissipation, vice, and wretchedness, and succeed in regaining the starting-point, after long and uncertain struggles, to begin anew the great work of life, with powers rusted by neglect, and feelings blunted by premature indulgence. Oh ! gentlemen, may no one of you incur this sad fate ! May yours, one and all, be the choice of prudence and wisdom ! Most happy is it for many of you, that you are not overloaded with this world's treasures ; that necessity will come in aid of your better resolutions, and urge you on in the right path. There are few misfortunes greater for a young professional man than to be AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 375 independent of the world. The temptations to self-indulgence are almost too strong for those not aided by long habit to resist. I have greater respect for no man than for him, who, with all the pleasures of the world at his command when young, holds a firm rein over his propensities, and mounts the laborious ascent of honour by his own determined efforts. He richly merits whatever eminence he may gain. But, in the mean time, those of you who are not exposed to his temptations, instead of repining at your lot, should congratulate yourselves on your exemption, and on the greater probability it affords you of one day attaining all that an honourable ambition can hold out as desirable in this world. Be assured that, if you consult those who have preceded you, and reached the eminence at which you aim, the great majority of them will tell you, that one of their greatest causes of thankfulness is to have escaped the dangers of wealth, and even of competence, in early life. Well, gentlemen, you are resolved to struggle manfully for pro- fessional success. But, you may ask, how are we to struggle when there is nothing for us to do ? Now, here again is a blessing in disguise. One of the worst results for you would be to rush at once into the full tide of business. Employed in practical duties, you would have no time, and probably no disposition for self-im- provement. You would be arrested at the point of progress at which you stand ; and, though a certain amount of income, and a certain professional position might be attained ; yet these would fall far short of the highest ; and you might, as you advanced in life, have the mortification to see yourselves outstripped by those who had, in their early career, enjoyed and availed themselves of the opportunity of enlarging their store of professional and general knowledge. The first few years of a physician's life, during which he is awaiting the slow incomings of a regular business, are a pre- cious opportunity, upon the proper use of which much of his sub- SIC) AN ADDRESS TO THE MEDICAL GRADUATING CLASS sequent prosperity must depend. In the schools, and the regular course of study, you have acquired the elements of your profession. You have had a foundation laid, upon which you are yourselves to build. Instead, then, of folding your arras in listless idleness, or dissipating your time in irrelevant pursuits, or repining in moody inertness over the slowness of your success, bend your energies to the acquisition of knowledge and skill; study the records of the past ; by a close observation, make the experience of your older contemporaries your own ; seize every opportunity which the suf- ferings of the destitute may afford you of improving yourselves, while you extend aid to them ; even wander out occasionally into the regions of general literature, and garner up thoughts, facts, and feelings, which may tend to enrich and adorn your mental structure, and give your whole character, both in itself and in the eyes of the world, the amplest development and fairest propor- tions. Depend upon it, your labour will not be thrown away. Opportunities occur to all men. They occur in vain only when there is a want of disposition or qualification to make use of them. Be prepared to meet the advances of fortune, and she will be sure to befriend you. The great danger is of premature discourage- ment. Many a professional man has thrown himself away, when approaching success was almost within sight; when it was about to turn the very corner, upon which his despairing eye had just taken its last look, before his departure into other scenes and struggles. Let me tell you of another rock on which young men too often split. It is the rock of false pride. Nothing is more disgusting than an over-pushing disposition, resolved to gratify itself at any sacrifice of honourable feeling, independence of character, or regard for the rights of others. But distaste for such an exhibition does not justify that absurd pride, which shuts itself up in its own shell, and expects the world to approach, and beg that it would come AN ADDRESS TO THE MEDICAL GRADUATING CLASS, 3T7 forth, and warm itself in the sunshine of its favour. The world has a right to expect that we should make known our ability to serve it; and he who neglects all honourable opportunities of favourably impressing the community in which he lives, has no right to expect its aid in the furtherance of his own purposes. I repeat that, with qualifications improved by culture, with all due personal efforts, and with a proper perseverance, you can scarcely fail of success in the end. It may be that all of you have not resources upon which you can rely until success may come. But there are honourable means by which an energetic young man may supply the deficiences of professional income ; and rigid per- sonal economy, with a prudent avoidance of premature responsi- bilities, will always enable him, if in health, to supply his essential wants, if not exactly on the spot which he might prefer, yet in some part or another of this vast country. Determine only that you will not live on the future, that you will not allow yourselves to enjoy pleasures that you have not earned, that you will not fall into the fatal error of supposing yourselves entitled to begin life, with all the comforts and indulgences which your parents may have won for themselves before its close; determine thus, and I can almost guarantee you against ultimate failure. But should your expectations be disappointed, should it seem evident to you, after due patience, whether with or without fault of your own, that satisfactory success in your profession is unattain- able ; do not, I beg of you, in your despair, descend into any de- grading practices. Leave the whole ground of quackery free to ignorance and imposture, without competition from you. Some regularly educated physicians, I say it with shame and sorrow, have deserted the banner under which they had enlisted, and thrown themselves recklessly into the empirical ranks. They may, in some instances, have received the pecuniary recompense they sought for ; but I need not tell you of the consciousness of merited 378 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. contempt, and of the self-loathing which fester under the gilded exterior of their fortunes. Ignorance may plume itself upon suc- cess in the stratagems and impositions of quackery; but intelli- gence never can sink to that miserable level, without an inward contempt and scorn of the baseness, which, brazen-faced as it may be before the world, will forever cling to the innermost conscience with a vulture-like tenacity. Anything but this, gentlemen ! If you cannot succeed regularly in your profession, leave it; seek your fortunes in some other honourable or honest calling; become lawyers, merchants, manufacturers, farmers, mechanics, labourers; if necessary, stitch, or cobble, or dig for a living; nay, starve, if it must be so ; but never turn to quackery. There is, however, no danger. You cannot be guilty of the baseness. I do not know whether an apology is not due to you for the mere hypothetical supposition. We will take it for granted that you have succeeded in your profession. You have merited and gained the confidence of your neighbours. Hundreds look to you as the guardians of their health, their main earthly hope in the agonies and dangers of dis- ease. Here is an immense responsibility. The sacred ark of human life has been intrusted to your keeping. You are an anointed priesthood in its service. How important that your hands should be clean, your hearts pure, and your souls deeply reverent in your ministrations. This, gentlemen, is the light in which you should habitually view your profession ; not as a mere business ; not as a mere avenue to competence or wealth ; but as a covenant with the Most High, by which you are devoted, soul and body, to the good of your fellow-men, so far as that may de- pend on life and health. The ox, however, must not be muzzled that treadeth out the corn. You have a right to expect from your labours a support equal to the dignity of your calling. But this should be looked on as incidental; as an important, or even AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 379 essential accessory, if you please; but not as the great end and aim. He who enters the medical profession with a mercenary spirit, will almost necessarily come short of its highest require- ments. Aiming at the appearance rather than the reality of skill, he will think more of the impression he may make on others, than of a proper understanding and treatment of the disease. Where nothing is to be gained but the consciousness of duty fulfilled, he will be little apt to spend time and labour, which might yield him more if applied elsewhere, or at least would be abstracted from his pleasures. For the frequent self-denial, the steady devotion of thought and energy, the unwavering guard over his precious charge, as well when unseen as when seen of men, which charac- terize the right spirited practitioner, he has no sufficient induce- ment. He will be almost necessarily more or less superficial. He never can be the true model physician. Just in proportion as medicine is cultivated in the mercenary, or in the pure professional spirit, will be its decay or advancement in efficiency, real dignity, and acceptance with God and man. Be this, then, gentlemen, your great care — to establish and culti- vate proper notions of your high calling ; to fix in your innermost convictions the truth that you are engaged in a great mission, and responsible to him who sends you forth for its due discharge. This feeling will be the best preservative against every temptation; against the solicitations of indolence or pleasure ; the hateful sug- gestions of envy ; the unkindly influence of opposing interests; and the irregularities of all sorts that spring up, like noisome weeds, in the rotten soil of an avaricious or grasping spirit. Time is not left to sketch that round of duties, of things to be done and avoided, of feelings to be cherished or subdued, of rela- tions to be preserved with the public, the sick, and your medical brethren, which constitute the ethics of your profession. But they all fall within the great general principle already referred to. Get 380 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. the true professional spirit, and all else that is needful or desirable will be added unto it. Nevertheless, you will find great aid from the study of those written rules, which the wise and good among your predecessors have deduced from an ample experience, culti- vated judgment, and enlightened conscience. Such a code of ethics has been adopted by the great national medical association, and published as a guide to the whole profession. I would urge on you to study it thoroughly, and make its rules the laws of your professional life. Based, as they are, upon sound morals and a lofty feeling of honour, they cannot but lead, if duly observed, to the elevation of our calling in usefulness, dignity, and respect, and consequently to the personal advantage of every conforming member. Before coming to the closing scene, let us picture to ourselves your position, when, in the middle or decline of life, having strug- gled manfully through early difficulties, you are firmly fixed in the confidence of the community, with a consciousness that you have lived up to the capacities with which heaven has endowed you, and endeavoured, so far as is compatible with human infirmity, to make yonr conduct conform with your convictions of social and profes- sional duty. Let us see whether there is not something in such a position worthy of the aspirations of the young, and calculated to encourage them in a course of honourable effort, and virtuous self- denial. You are in the midst of those who feel themselves indebted to you, either in their own persons, or that of their nearest friends, for the continuance of life and health, or associate you affection- ately with the memory of lost relatives, whose sufferings have been alleviated, and their last moments cheered by your kind and inde- fatigable attentions. If a soured temper, or perverted heart, may occasionally seek satisfaction in misinterpreting or misrepresenting your best exertions, it is only an evil which is incident to humanity AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 381 in every station ; a slight mixture of bitterness in your cup, which, though not agreeable to the taste, may have an invigorating influ- ence on the mental health. No profession probably offers less occasion for unkindly feelings. You thwart no interests in your progress ; your success is not attained at the expense of others ; yours is not the reckless course which crushes under its iron wheels whatever of respect, competence, hope, enjoyment, or any other pleasant or valuable thing, may lie in its ambitious way. Your aim is always the good of others; your triumph is also theirs. Wherever you go, you scatter hope, or joy, or consolation. Not only affection, but respect and esteem attend you. Social influ- ence, and the power to do good in other walks than the purely professional, are yours. The comforts of life, and not unfrequently even its elegancies and superfluities, are at your command. If without political power and station, it is only because these are incompatible with your pursuits, habits, and tastes. The highest in the world deem themselves not dishonoured by your association and friendship. Your name and character are a rich inheritance for your descendants for generation after generation. Is not this a position fully worth all its cost ? Is it not a sufficient compensa- tion for the early labours, the trials, the patient waiting, the watch - ings, fatigues, anxieties, for all, indeed, but the awful responsibili- ties of a physician's life ? For the burden of these responsibilities, an approving conscience, and the trembling hope that the most merciful may overlook the shortcomings of human weakness, are the only adequate recompense. And now, gentlemen, we have come to the last scene of life. This is usually looked on as an occasion from which the thoughts are to be turned away as from some fearful object, the contempla- tion of which is calculated to throw a shade of gloom over every present and coming enjoyment. But this is a great mistake. Death is inevitable ; and it is cowardice not to be willing to look it steadily 382 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. in the face. In the physician especially, whose path it constantly crosses, who cannot hope to exclude its presence, it is extreme weakness to shut the eye against it, and thus endeavour for a brief space to dream of an impossible exemption. We should accustom ourselves to regard it firmly, to strip it of imaginary terrors, to see in it whatever there may be of good or of evil, and calmly to pre- pare ourselves accordingly. This is the part not only of religion, but of philosophy. An habitual feeling of the uncertainty of life, in the properly constituted mind, is one of the best safeguards against all irregularities of thought or deed, and the surest guide back to the right path after any temporary wandering. Let us then cherish this feeling. We shall find it incompatible with no innocent pleasure; we shall even find it a consolation in trouble; and, should misfortunes overwhelm us, we shall see in it at least one star beaming through the tempest, and betokening a clear sky beyond. To the duly prepared mind, death, come when it may, whether in the morning, the noon, or the evening of life, is no evil. If in the midst of joys, it saves us from the sorrows that surely follow; if in trouble, it gives relief; if in a course of honourable usefulness, it embalms our memory sweetly in the common mind ; if at the close of a long and upright career, it comes as a kind friend, to free the spirit from the burden of flesh, which can no longer serve it as an instrument of action or enjoyment. May yours, my young friends, and may ours be the lot, when this mes- senger shall call, to be prepared to follow, with the calmness of a peaceful conscience, and the well-grounded hope of a happy futurity ! But, gentlemen, you may recollect that we have been occupied by a dream of life. We are now awake again, and back in the present. This is probably the last occasion upon which we shall all be in one place together. To-morrow ; and you will be scat- tered towards every corner of our common country. Allow me to AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 383 express the sincere hope, that you will carry with you kindly recol- lections of your teachers, and your alma mater; and that, in the varied experience that awaits you, your thoughts will now and then wander pleasingly back to these scenes of your young labours and success. Be assured that, wherever you may go, and whatever may be your lot, you will have with you our warm sympathies, and our zealous wishes for your welfare, present and eternal. BIOGRAPHICAL MEMOIRS. 25 A MEMOIR OF THE LIFE AND CHARACTER OF THE LATE JOSEPH PARRISH, M.D., READ BEFORE THE MEDICAL SOCIETY OF PHILADELPHIA, OCTOBER 23d, 1840. The office assigned me by the Medical Society of portraying the life and character of the late Dr. Joseph Parrish, is a trust most grateful to my feelings. To be appointed to speak of such a man before such an audience, is a mark of respect which no one could fail to value ; but a still higher source of gratification, in the present instance, is the opportunity afforded me of giving utter- ance to those sentiments of esteem and warm affection which I ever cherished for the deceased, and which I still cherish for his memory. I do not propose to enter into much minuteness of biographical detail. This is forbidden by the necessary brevity of an address like the present, and by the nature of the occasion, which calls less for a narrative of the ordinary incidents of life, than for the just representation of a medical character, pleasing by its beautiful traits, and useful as a rare pattern of what is most praiseworthy (387) 388 A MEMOIR OF DR. JOSEPH PARRISH. in our profession. The man, however, was in Dr. Parrish so inti- mately blended with the physician, his professional excellencies flowed so directly from the qualities of his heart and intellect, that no portrait of his medical character would be recognized, which should not also present the striking lineaments of his moral nature. In the following sketch, therefore, having offered some notices of his parentage, education, and general course of life, and especially such as may illustrate his character, or may appear to have had any influence in its formation, I shall endeavour to revive in your recollection his distinguishing moral and intellectual peculiarities, and then to trace those qualities as a physician-and medical teacher which rendered him so extensively useful, and so highly esteemed in this community. Dr. Parrish was descended from one of the early settlers of this country. His great-grandfather, John Parrish, who was a native of England, though of Dutch extraction, commanded a merchant vessel trading to the Chesapeake, and afterwards became surveyor- general of Maryland, where he took up considerable tracts of land, on a portion of which some of his descendants still reside. He perished in a storm by which he was suddenly overtaken while in a small boat on the Chesapeake, returning from a visit to a ship sailing up the Bay. The grandfather of the Doctor, also named John Parrish, died in possession of a landed estate, on which a part of the city of Baltimore now stands. This, however, was lost to his family, though the title to it is said never to have been sur- rendered; and application was made, at a comparatively recent period, to the subject of the present memoir, to join in an effort for its recovery, with the assurance that there were good grounds to hope for a successful result. The determination of Dr. Parrish, on this occasion, was strikingly characteristic. He promptly declined the proposition, on the ground that no advantage which could accrue to himself or his family would counterbalance the uncer- tainty, inconvenience, and positive distress into which numerous A MEMOIR OF DR. JOSEPH PARRISH. 389 individuals might be thrown by the agitation of the subject, who had honestly acquired their titles, and were now relying on them with undoubting confidence. Isaac Parrish, the father of the Doctor, was one of a consider- able family, who, upon the death of their mother, were left almost destitute, and were sent to Philadelphia, in compliance with her request, to be placed under the care of some near relatives of hers residing in this city. He had been intended by his parents for a physician ; but the means for carrying their intention into effect were found to be wanting after their death ; and he was placed as an apprentice with a very respectable hatter, whose daughter he afterwards married. Honest, frugal, and industrious, he succeeded well in his business, supporting and educating a numerous family, and retiring, in the decline of life, upon a decent competence, with the respect of all who knew him. He was especially esteemed in the Society of Friends, of which he was a consistent member, and in which both he and his wife held highly respectable stations. The reward of a virtuous life has seldom been more happily exem- plified than in the old age of this venerable couple. They lived sixty-six years together in unbroken harmony, and died within a short period of each other at a very advanced age. Their last years were cheered by the affectionate attentions of their few re- maining children. They who enjoyed the familiar intimacy of Dr. Parrish cannot but vividly remember his beautiful deportment towards his aged parents. The youngest of eleven children, of whom the greater part died early, he was their joy and consolation throughout life ; in youth obedient, in manhood affectionate and attentive, and, when the weakness of old age came upon them, all that was tender and respectful ; so that, when he finally closed the eyes of his venerable father, he could say with sincerity that he was not conscious of having ever offended him. Dr. Parrish was born on the 2d of September, 11^9. He re- ceived a good English education, and was taught Latin at the 390 A MEMOIR OF DR. JOSEPH PARRISH. Friends' school in Fourth Street, at that time in considerable repute as a place of instruction in the learned languages. He afterwards paid some attention to French, and still later in life to the Hebrew, which he cultivated exclusively in reference to the study of the Bible. He could not, however, be said to have a decided literary turn ; and, though he took care to qualify himself well as a physician by a somewhat extensive course of medical reading, and, in the few leisure intervals of a very active life, occa- sionally perused works of general interest, yet he was indebted, as well for his professional skill as for his extensive knowledge of men and things, less to books than to an extraordinary faculty of observation, and a memory unusually tenacious of facts. He never- theless always attached great importance to mental culture ; and, in his last will, while giving directions in relation to the education of his children, he expresses the sentiment, that he would rather a child of his should expend every cent of his inheritance in the acquisition of knowledge, than that he should arrive at maturity, in possession of a large estate, without the advantages of scientific attainment. The moral and religious education of Dr. Parrish was of the mpst guarded kind. He was brought up in strict conformity with the principles and habits of the Society of Friends, and early in life received strong religious impressions, which preserved him in a remarkable degree from the temptations of a warm and lively tem- perament. From some notes which he left behind him, made about the commencement of his medical studies, it appears that, even in youth, he was under the habitual guidance of that inward principle, in which the Friends recognize the Divine Spirit operating upon the mind, and the reality of which is one of the prominent points of their religious faith. Upon this subject I shall have occasion to speak more fully hereafter ; as there was scarcely an important act or event of the life of Dr. Parrish, which did not receive im- pulse or modification from his settled convictions in relation to A MEMOIR OF DR. JOSEPH PARRISH. 391 this monitor within him; and to leave it out of view would be to present an imperfect, if not an inaccurate picture of his character. But, while thus moral according to the strictest rules of his self- denying sect, he indulged freely in the innocent sports and recrea- tions of boyhood, and was distinguished among his companions by his skill in various athletic exercises. He was a swift runner, a good swimmer, and an excellent skater. In the facility, grace, and rapidity of his movements upon the frozen surface of the Delaware, few if any of his contemporaries surpassed him. This accomplish- ment he carried with him into manhood ; and it is related of him when in middle age, and in full reputation as a physician, that, having occasion to make a professional visit, during winter, upon the opposite bank of the river, he accepted from a friend the loan of a pair of skates, and astonished the spectators by some of those complicated and graceful evolutions which have now become almost an affair of tradition among us. His aversion to confinement and fondness for the free and fresh air never forsook him. Throughout the whole course of his life, he could not tolerate a close and heated apartment, slept always in summer with his windows up, and even during illness found a degree of coolness essential to his comfort, which was almost hazardous to his attendants. There is no doubt that this personal predilection influenced greatly his course of prac- tice ; and, long before the profession generally, in this place, were prepared to adopt the plan, he had introduced into the treatment of various diseases a system of exercise, exposure to cool air, and free indulgence in cool and refreshing drinks, which, to the great comfort of the patient and success of the physician, have at length, in many instances, superseded the old system of drugs, warm bev- erages, and confinement. His youthful partialities were strongly directed towards the study of medicine ; and those among his early friends who afterwards wit- nessed his extraordinary professional success, took pleasure in re- calling many evidences which he had exhibited, even in boyhood, 392 A MEMOIR OF DR. JOSEPH PARRISH. of a natural turn and natural qualifications for this pursuit. He was fond of reading upon the subject of diseases, exhibited an instinctive disposition to visit and nurse the sick, and, in the ab- sence of other modes of indulging his propensity towards the heal- ing art, is said to have exercised his skill upon the inferior animals, and to have exhibited some dexterity in the treatment of their fractured limbs. The fears of his parents, however, were for some time an obstacle to the gratification of his wishes in the choice of a profession. They were unwilling to expose the strictness of his religious principles, the purity of his morals, and the simplicity of his habits and feelings unnecessarily to the seductions of the world; and entertained a belief, much more common at that time than at present among the Friends, that a strict observance of their peculiar views and customs as a sect, was incompatible with the various temptations to which the student of medicine was subjected. Re- specting, though not acquiescing in these parental fears, he surren- dered his own wishes, and entered into the shop of his father with the view of qualifying himself for conducting the business of a hatter, rather, however, in a mercantile than a mechanical capa- city. In the most brilliant period of his subsequent career, he never had the weakness to look back with regret upon the occu- pation of his early life, or the remotest wish to conceal it from others. On the contrary, he always entertained great respect for mechanical pursuits, and considered a descent from honest and worthy parents, however humble their station, as a juster ground of self-congratulation than the highest splendour of ancestry with- out the accompaniment of virtue. In this position he continued till his twenty-second year, when, as his own inclinations remained unaltered, and the objections of his parents had yielded to more mature reflection, and perhaps also to increased confidence in his stability, he felt himself at liberty to engage in the study of medicine, and accordingly entered as a pri- vate pupil into the office of Dr. Wistar, at that time Adjunct Pro- A MEMOIR OF DR. JOSEPH PARRISH. 393 fessor of Anatomy and Surgery in the University of Pennsylvania. The advice and example of the late Dr. Samuel Powell Griffitts, who was in great esteem as a physician, and was at the same time a strict and conscientious Quaker, had considerable influence in bringing about this result. For this and numerous other friendly offices of that gentleman in promoting his professional interests, Dr. Parrish always entertained the most grateful feelings ; and a friendship sprang up between them, which was fruitful in mutual service, and continued without abatement till the death of Dr. Griffitts. The mode of conducting medical education was in those times very different from that which now prevails in this city. Physi- cians supplied medicine as well as advice ; and it was among the duties of the student to put up the prescriptions of his preceptor as they were brought to his office, and even to carry out the prepa- rations himself in cases of peculiar urgency. I have often heard Dr. Parrish speak of the errands on which he was dispatched, by day and by night, over all parts of the town, conveying the mes- sages of his preceptor, and distributing medicines among his pa- tients. The student also not unfrequently visited the sick, nursing them, sitting up with them at night, and occasionally affording his advice upon emergencies when immediate access could not be had to the principal. In relation to his reading, he usually received some general directions from his preceptor, to whose library he had access ; but was seldom subjected to a routine of study and close examinations such as are now common, and was therefore more or less deficient in that precision of elementary knowledge which char- acterizes the student of the present day. I am fully convinced that the plan of education which now prevails is the most efficient ; as it insures a good foundation, upon which experience may subse- quently build, and which, if wanting in the outset, is seldom after- wards obtained. But there were some advantages in the old mode, and among these were greater originality and independence of 394 A MEMOIR OF DR. JOSEPH PARRISH. thinking, greater practical facility arising from frequent intercourse with disease, and a more thorough acquaintance with medicines and the modes of preparing them. The peculiarities of his educa- tion were to be traced in the subsequent course of Dr. Parrish ; and to this origin we may ascribe the strong bent of his mind towards practical observation and experience, in preference to abstract reasoning and theoretical disquisition in medicine. He certainly availed himself fully of all his advantages, and, by his industry and close attention, as well as by a congenial goodness of heart and obligingness of disposition, succeeded in gaining the esteem and entire confidence of his preceptor, who loved him as a younger brother, and treated him throughout life with a kindness which gained in return his whole affections. Those of you who have listened to the medical lectures of Dr. Parrish, cannot but recollect how frequently and respectfully he quoted the sentiments of his old master, as he was wont to call him, and how unreservedly, on all occasions, he expressed his admiration of the character, and his grateful sense of the favours of that good and great physician. He received his degree of Doctor of Medicine in the University of Pennsylvania in June, 1805, having written an inaugural essay "Upon the influence of the passions in the production and cure of diseases," which was printed, in compliance with a rule of the Uni- versity existing at the time. This essay exhibits the practical turn of his mind even at that early period, consisting chiefly of a collec- tion of facts, gathered from various sources with no little industry. After his graduation, he spent a short time in the recreation of travel, and upon his return, about the close of summer or begin- ning of autumn, entered upon the duties of his profession, as resi- dent physician in the Yellow Fever Hospital. It was under a most solemn sense of his responsibility that he thus commenced his pro- fessional career. He felt habitually that he was in the immediate presence of his Maker ; and from his private notes it appears that, conscious of his own weakness, he constantly sought for aid from A MEMOIR OF DR. JOSEPH PARRISH. 395 that gracious power, whose will he endeavoured to make the rule of his life, and before whose judgment-seat, in his own breast, he strove to bring up every proposed act for approval or rejection With such feelings, it is superfluous to say that he distinguished himself in the hospital by a devoted attention to the duties of his station ; and his native benevolence co-operated with his sense of right, in leading him to apply every alleviation in his power to the miseries by which he was surrounded. The favourable impression, made by his services in this situation, was afterwards increased by the publication of some experiments in relation to the poplar worm, which were of great effect in allaying a very singular panic, at that time prevalent throughout the coun- try. An individual was found dead in his bed, and a living worm along with him, of that kind which frequents the Lombardy poplar, and is thence commonly called poplar worm. The public some- what unphilosophically leaped to the conclusion that the worm and the sudden death were in the relation of cause and effect. Rumour speedily collected numerous confirmatory observations; in the hot- bed of popular fear suspicions quickly ripened into facts ; and the belief came to be very widely diffused that this species of worm was exceedingly venomous, and that a frightful death was lurking in every Lombardy poplar in the country. A war of extermination commenced both against tfie worm and the tree which sheltered it. The one was slaughtered without mercy, the other given every- where to the axe and the flames ; and our streets would soon have been left without shade, but for the timely publication of the ex- periments alluded to, which conclusively proved that the worms were harmless, and the Lombardy poplar as guiltless of any nox- ious influence as it was of any extraordinary beauty. But the event which, in the early career of our late friend, con- tributed most to make him favourably known to the public, was the delivery of a course of popular lectures on chemistry, which he first gave in the winter of 180T-8, and repeated twice afterwards 396 A MEMOIR OF DR. JOSEPH PARRISH. in successive years. Popular lectures ou scientific subjects were then a novelty in Philadelphia. Their annunciation was much more calculated to attract attention, and a successful essay was much more striking and permanently influential than they would be at the present day, when the public has become accustomed to such claims upon its attention, and one impression is so rapidly followed by another, that a lasting effect is seldom produced. Dr. Parrish knew how to mingle the agreeable most happily with the useful, and his aim was always as much as possible to unite the two. To be merely amusing was contrary both to his principles and his taste ; but no one was better aware of the necessity of throwing about dry details the embellishments of happy illustra- tion and a pleasing delivery ; and, however strict in his religious opinions, he would have as little thought of denying to his subject whatever interest of this kind he could impart to it, as of strip- ping a vernal landscape of its leaves and flowers, or a summer shower of its rainbow. He endeavoured to give to his instruc- tions a practical bearing upon the ordinary pursuits of life, mingled with the chemical details various physiological observations calcu- lated to obviate the too natural tendency of the uninstructed to empiricism, and took advantage of the numerous opportunities, offered by his subject, to illustrate the wisdom and goodness of Providence, and to mingle lessons of piety with those of science. There is no doubt that he contributed by these lectures to awaken that spirit of popular instruction which has not since slumbered in our city ; while he earned for himself a reputation, highly advan- tageous in the prosecution of his professional views. In the mean time he had been attending diligently to practice, and was acquiring, in the arduous labours of the Philadelphia Dis- pensary, that experience of disease which was necessary to confi- dence in himself, and to inspire confidence into those who might from other causes be disposed to favour him. He was chosen one of the physicians of the institution in 1806, and continued to serve A MEMOIR OF DR. JOSEPH PARRISH. 39T it zealously until the increase of his private business compelled him to withdraw. Upon his resignation in 1812, he received the thanks of the managers "for the faithful discharge of the duties of his office for six years and a half." In 1818, he was himself elected a manager, and in 1835 was appointed one of the consult- ing physicians of the institution ; and the latter station was re- tained by him to the time of his death. In October, 1808, about three years after he had commenced practice, having been so far successful as to feel justified in incur- ring the additional expenses of a family, he married a young lady from Burlington, the daughter of John Cox, one of the most re- spectable citizens of New Jersey, and then as at present a highly esteemed preacher in the Society of Friends. This connection was in every way happy for Dr. Parrish. It threw an almost un- interrupted sunshine over the course of his domestic life, and sur- rounded him at its close with the consoling sympathies of a large and most affectionate family, whose love and reverence he had earned by a cordial participation in their feelings, and an ever- active yet well- regulated interest in their welfare. His wife sur- vived him, and he never had to mourn the loss of a child. Few men have been more exempt from the miseries which but too fre- quently invade the domestic circle, and few have better deserved such exemption. There has, perhaps, been no example in Philadelphia of more rapid professional success than that which fell to the lot of Dr. Parrish. Yarious causes contributed to this result. Among them may be mentioned his fellowship with the Society of Friends, always favourably disposed towards their own members, and at that time capable of extending an effective patronage, as there were few physicians among them; and the countenance of Dr. Wistar, who, on frequent occasions, exhibited confidence in the skill of his former pupil, and took every opportunity of promoting his professional interests. But it was undoubtedly to his own 398 A MEMOIR OF DR. JOSEPH PARRISH. qualifications and efforts that he was chiefly indebted. I shall have occasion, in the subsequent part of this memoir, to speak of those peculiarities of manner and of character by which he was so favourably distinguished, and which were so happily in harmony with his pursuit. They were powerfully instrumental to his suc- cess by inclining opinion favourably towards him, and thus giving full scope to the influence of his professional excellencies, which might have escaped attention if wrapped in the garb of a repul- sive manner, or have been neutralized in their effect if mingled with vicious propensities or opinions. I have before noticed certain events in his life which had the effect of bringing him advantageously before the public. He had already acquired a large practice, and was growing rapidly in reputation, when, in the winter of 1812-13, the great typhous epi- demic, which so long scourged this country, made its appearance in Philadelphia, and elevated him at once into the foremost rank of his profession. At its first appearance, this complaint was not fully understood. Physicians were not generally prepared to re- cognize a disease of debility, associated with apparently violent inflammation, and were in the beginning too apt to overlook the tendency to prostration, which lurked fatally beneath the show of excitement. The attention of Dr. Parrish had been strongly directed to the subject by the perusal of a treatise by Dr. North, who had seen much of the disease in New England, and who strenuously advocated the stimulant treatment. His aversion to theory in medicine left him open to the evidence of facts, however opposed to prevailing opinions; and he was quite prepared to encounter the disease by methods which had stood the test of ex- perience, rather than by those which analogy alone would appear to indicate. The epidemic approached Philadelphia through New Jersey, and hung for awhile over the opposite shore of the Dela- ware, before it burst upon our city. The inhabitants were alarmed by reports of a terrible disease in the town of Camden, which A MEMOIR OF DR. JOSEPH PARRISH. 399 appeared to bid defiance to medicine. Dr. Parrish was called in to the aid of the physicians of the neighbourhood. At the period of his first visit, seven cases had occurred and all proved fatal. He was told that the disease was of an inflammatory nature, and had been treated by the lancet and other depletory measures. Its malignant aspect at once struck his attention. He saw through the veil of inflammation which it had thrown over its ghastly fea- tures, and beheld the deadly weakness beneath it. He advised an immediate abandonment of the lancet, and the substitution of an actively stimulant treatment. The effects were most happy. Numbers now got well where before all had died. A disease sup- posed to be almost incurable was found to be, in the great majority of cases, under the control of medicine. The terrors of the first awful reports gave way before the happier intelligence which fol- lowed ; and the newly inspired confidence was directed especially towards the author of the change. When the epidemic reached the city, Dr. Parrish found himself in the midst of an ample busi- ness ; and the devotion which he paid to the sick, and the skill and success which marked his efforts, gave him a place in the opinions and affections of his fellow-citizens which he did not lose when the immediate occasion ceased. His views of the disease and its treatment met with much opposition ; and some decision of character was required to carry them into effect. On one occa- sion, a physician in attendance with him upon two cases of the disease in the same family, believing them to be highly inflamma- tory, strongly urged the employment of the lancet, and, upon being resisted by Dr. Parrish, who felt convinced that the proposed remedy would be fatal, retired from attendance, leaving the whole responsibility with his colleague. The ground of difference was known, and the eyes of the whole neighbourhood were directed with intense expectation towards the result. "You cannot con- ceive," said Dr. Parrish in relating the circumstance to his pupils, 400 A MEMOIR OF DR. JOSEPH PARRISH. "the anxiety I experienced." Happily, however, both patients recovered, and the event contributed to extend his reputation. But his attention was not restricted to the practice of medicine exclusively. From the commencement of his professional life he had exhibited an inclination towards surgery, which he cultivated assiduously whenever opportunities were offered. Towards the close of the year 1806, he was elected surgeon to the Philadelphia Alms House, where he had an ample field for observation and ex- perience, especially in that branch of the surgical art, always high- est in his esteem, which aims at repairing injuries by a judicious employment of the resources of the system, and, so far from seeking occasion for painful or deforming operations, endeavours to render them unnecessary. His reputation as a surgeon was of slower growth, but scarcely less distinguished in the end than that which belonged to him as a medical practitioner. His skill in diagnosis and judgment in the choice of therapeutic measures were highly appreciated by his medical brethren, by whom he was constantly called into consultation, not only in Philadelphia, but also in the country for many miles around it. As an operator also he took rank with the most prominent surgeons of the city, and, at the period of life when his physical powers were at their height, was second only to Dr. Physick, either in the number and magnitude of the operations which he performed, or in the extent of his repu- tation. In addition to his station in the Alms House Infirmary, he was in the year 1816 elected surgeon to the Pennsylvania Hospital as successor to Dr. Physick, and continued to discharge the duties of the two offices conjointly for about six years. His place in the Pennsylvania Hospital he retained till 1829, when the state of his health, which was at that time feeble, and a disposition to relin- quish the more fatiguing and severer offices of surgery to younger hands, induced him to withdraw entirely from professional connec- tion with the public institutions. He considered the decline of A MEMOIR OF DR. JOSEPH PARRISH. 401 bodily strength in a surgeon as an intimation from nature that the period for active service was passed ; and I have often heard him say, that the necessity of using spectacles was regarded by him as a call of duty to shun operations, in which a jet of blood from a divided artery might occasion temporary blindness. During the whole course of his service in the public hospitals, he was assiduous in the discharge of his duties, not considering the situation as one of mere personal advantage, but as involving higher obligations, and among these a watchful care over the inter- ests of the institution, and a strict attention to the comforts as well as the health of the inmates. I have never heard the breath of accusation against him in relation to the discharge of this high trust. It was in the Alms House Infirmary that he first attracted notice by his clinical lectures, and laid the foundation of that repu- tation, as a medical teacher, with which all who now hear me are familiar. In his regular rounds among the patients, both in this institution and the Pennsylvania Hospital, he seldom omitted an opportunity of giving useful practical lessons to the students who attended him ; and, so attractive was his manner, so impressive his instructions, and so obvious the high motives by which he was ac- tuated, that large numbers constantly followed him, who afterwards carried home with them, into almost all parts of the Union, a great and affectionate respect for his virtues, talents, and attainments. A natural consequence of his growing reputation as a prac- titioner and clinical lecturer was a great increase of private pupils. He was seldom without one or more students, even from the com- mencement of his practice; but it was not till the year 1814, or 1815, that their number became considerable. From this period they rapidly increased, till they amounted at length to about thirty; a number at that time quite unprecedented, in this country, among physicians not immediately connected with the great medical schools, and equalled, I believe, only in one instance where this 26 402 A MEMOIR OF DR. JOSEPH PARRISH. advantage was possessed by the teacher. Young men came to study with him from various parts of the Union ; but the greater number were of Philadelphia and its immediate neighbourhood; and, as this was the place where he was best known, and no ex- traneous motives influenced the choice of the pupils, the fact speaks strongly in favour not only of his reputation, but also of his real merits. Among the present practitioners of this city, there are, I presume, more of his former pupils, than of those edu- cated by any other physician. He was in the habit of lecturing to the young gentlemen in his office twice a week, during almost the whole year; in the winter upon surgery, and in the summer on the practice of medicine; giving in his lectures not so much that ele- mentary knowledge which is to be derived from books, as the result of his own experience and reflection. About the year 1818, he was induced by the great increase of his pupils, and by his own almost oppressive engagements, to pro- cure assistance in the instruction of his class, especially in those elementary branches of medicine which, though apt in their minu- tiae to escape the recollection of practitioners, are nevertheless indispensable to the student as the basis of all professional knowl- edge. The extent of this aid was gradually increased, till at length courses of lectures were delivered every year upon chemistry, ana- tomy, and materia medica, to which midwifery was afterwards added ; as he himself never cultivated this branch of our art, and did not feel himself competent to teach it. Besides lectures, a regular series of minute examinations upon all the different branches was also instituted; so that a complete system of private instruc- tion sprang up under his hands, which, if not antecedent to others of a similar character, was certainly original with himself and those who assisted him. Dr. Parrish, therefore, may be looked upon as one of the founders of that combined and more thorough scheme of private medical tuition, which constitutes a distinguishing profes- sional feature of our city and our times; and, upon this ground A MEMOIR OF DR. JOSEPH PARRISH. 403 alone, would have claims to a most favourable place in our recol- lections.* He sustained this system of medical instruction, with a number of pupils, varying from about ten to thirty, till the year 1830, when he yielded to the influence of an institution conducted upon a plan somewhat similar to his own, but combining the talent and profes- sional weight of some of the most prominent physicians of this city, of whom, moreover, several had the advantage of being con- nected with the most flourishing medical school in the country. But his peculiar abilities as a lecturer were not yet lost to the medical community. An association of physicians was formed, called the "Philadelphia Association for Medical Instruction," at the head of which he allowed his name to be placed, and in which he continued to labour faithfully as long as it existed. The object of this association, as many of you well know, was not to compete with the public schools, but merely to afford to the private pupils of the members those advantages which were enjoyed by others, and which it was not in the power of any one individual to bestow. It continued in successful operation for about six years, when it was dissolved in consequence chiefly of the advancing age of its main supporter, who began to feel that he had borne his share in the burdens of the day, and was justified in withdrawing from a portion at least of those labours, which, though they had not sur- passed his energies or will in the prime of his life, began now to press heavily upon him. * I have learned, since delivering the address, that the priority in the establishment of the combined system of private medical insti'uction alluded to in the text, belongs to Dr. Chapman, of the University of Pennsylvania. He associated Dr. Horner with him in the instruction of his private pupils in the year 1817; while the first step was not taken by Dr. Parrish till 1818, when he engaged my assistance. The statements, however, in the address are, I believe, literally correct; for, to the best of my knowledge, Dr. Parrish, at the time he commenced, was not aware that a similar arrangement had been made by any other individual. [Note to the address when first published.) 404 A MEMOIR OF DR. JOSEPH PARRISH. Let us here pause, for a few minutes, to consider his position at that period when his mental and corporeal powers were in their greatest vigour, his reputation at its height, and all his faculties in the fullest exercise. Few individuals have held in this city a more enviable station. His professional business equalled his highest wishes both in character and amount, lying chiefly among the most respectable inhabitants, aud being scarcely short of his utmost phy- sical capabilities. He was in the frequent receipt of letters from various parts of the Union, requesting professional advice ; per- sons often came from great distances on purpose to consult him in obscure and difficult cases; and such was his reputation out of the city, that his aid in consultation was habitually sought by numerous physicians in all directions around Philadelphia, and not unfre- quently at such distances as to render compliance impossible. With his medical brethren at home he was upon the most friendly foot- ing, enjoying in a remarkable degree their respect and confidence, and constantly consulted by them when additional aid was required. When we recollect that, to this great mass of private business, there were added a regular attendance as surgeon in our two great public hospitals, and the delivery of two courses of lectures in each year to his private pupils, we shall be prepared to understand that his time was fully occupied in active duties, and that little opportunity was afforded him for relaxation, or social enjoyment. But, though occasionally oppressed with the weight of these va- rious cares, he experienced that high gratification which always springs from the full exercise of our powers, when accompanied with the consciousness that they are properly directed, and often observed to his friends that he had never, on occasion of the severest trials, even for a moment, repented that he had devoted himself to the profession of medicine. He was cheered, moreover, by the affec- tionate kindness which everywhere met him, and which was but a just return for that general benevolence with which his own breast overflowed. Almost universally known, he never appeared in the A MEMOIR OF DR. JOSEPH PARRISH. 405 streets without meeting the grateful and cordial greeting of per- sons indebted to him for life, or health, or some other blessing; and in every sick chamber which he visited, his own bright smile was reflected from every countenance not overwhelmed with anxiety or grief. Affection beamed cheerfully upon his daily round ; and the kindnesses which he scattered like flowers along his path, re- turned in delicious fragrance to his own gratified sense. He enjoyed exceedingly those intervals of business in which he could unbend himself in the company of his family and friends ; and the sweetness of his temper, the cheerfulness and naivete of his manner, his fund of pleasing anecdote, and the goodness of heart which shone forth in all that he said and did, rendered him, on such occa- sions, the source of even greater gratification than he received. The social circle which habitually met at his house was, indeed, a happy one ; and they who have mingled in it will often recall its calm and innocent, yet vivid enjoyments, with a sigh that they are passed, and cannot retu/n. Though occupied as^we have seen, Dr. Parrish found time to contribute various medical and surgical papers to the journals, all of which are characteristic of his practical turn of mind, and some highly valuable. They are contained chiefly in the Eclectic Reper- tory, of which he was one of the editors, and in the North Ameri- can Medical and Surgical Journal. Among them may be men- tioned, as worthy of especial attention, "Observations on a peculiar catarrhal complaint in children, 1 ' 1 "On infantile convulsions aris- ing from intestinal spasm" "On affections of the mammae liable to be mistaken for cancer," "On pulmonary consumption 11 and "On the connection between external scrofula and pulmonary consumption.'' 1 His remarks on the last-mentioned disease are highly interesting, not only from their intrinsic value, but also from the fact, that his views in relation to its treatment were justified by the result in his own case. Attacked, when a young man, by a complaint of the chest which he believed to be of a consumptive 40 G A MEMOIR OF DR. JOSEPH PARRISH. character, instead of confining himself to his chamber, and going through a long course of medicine, as was then fatally common, he adopted the plan, which he always recommended to his patients, of vigorous exercise in the open air. Most of you recollect the un- pretending vehicle, in which he was accustomed to pay his daily professional visits. It was without springs, and its jolting move- ment over our rough pavements was anything but comfortable to its occupants. This, however, was its recommendation with the Doctor, who thus imitated, as nearly as possible, the effects of horseback exercise, and combined the pursuit of health with that of business. It is scarcely necessary for me to say that he entirely recovered from his pectoral affection. After his death, dissection revealed tuberculous cicatrices in the upper portion of each lung, and thus proved both the correctness of his diagnosis, and the effi- cacy of his plan of treatment. Were time allowed me, I might here expatiate with advantage upon his opinions and practice in consumption, and in various other complaints ; but this office must be deferred to another opportunity, if not to another hand. It will at present be sufficient to state, in addition, that he republished Lawrence on Hernia, with an Appendix, and, a few years before his death, put forth a work of his own upon Hernia and Diseases of the Urinary Organs. In the midst of his private engagements, he participated largely in the proceedings of those medical associations whose constitution and objects he could cordially approve. He was long an active member of the College of Physicians, in which he held successively the offices of secretary, censor, and vice-president, and in all whose transactions he took a lively interest. Of the Society, moreover, which I have the honour to address, he was a zealous member, and, at the time of life in which we are now considering him, was one of the most efficient speakers. They who are old enough to remember the highly animating scenes, which took place in the Medical Society about twenty years since, cannot have forgotten A MEMOIR OF DR. JOSEPH PARRISH. 407 the prominent share in the debates taken by Dr. Parrish, nor the life and vigour, yet perfect good nature and amiableness, which characterized his style of speaking. His undaunted opposition to the assaults, which the theory of Broussais was then making upon the old medical opinions, was fruitful in interest and results. It was on one of these occasions that he brought before the Society the stomachs of recently slaughtered animals, to show that those post-mortem appearances which had been considered as proofs of pre-existing inflammation, were often present in cases of violent death, occurring in perfect health. He was for some time vice- president of the Medical Society. That he did not hold a higher station was owing to an invincible repugnance, on his own part, to stand in the way of what might be considered the just or reason- able claims of others ; and not only here but in all other places, he would accept of no office, the access to which must be over the disappointed hopes, or wounded feelings of a medical brother. But his sympathies were not confined within the limits of his profession. He took a lively interest in the concerns of the com- munity in which he lived, and, whenever opportunity appeared to offer for useful interposition, was not slow in contributing his share either of advice, of personal service, or of money. He occasionally sent anonymous communications to the daily papers, in relation to objects which he deemed it important to press upon the public attention, especially such as seemed to fall peculiarly within the province of the physician. Among these communications may be mentioned a series of essays published in the Village Record of West Chester, in this State, in which he endeavoured to point out to the country people the various sources of miasmata existing in the decaying vegetation around them, as well as the best means of preventing the production of these effluvia, and of obviating their effects. A strenuous advocate, on all occasions, for the rights of his fellow-men, he suffered no motives of present convenience to pre- 408 A MEMOIR OF DR. JOSEPH PARRISH. vent him from interfering by word and deed whenever he believed these rights to be invaded. The wrongs of the poor Indian were not unfrequently the subject of his pen ; and his sympathy for the degraded negro was ever active, though preserved by his sound judgment within the bounds of propriety. Like all the members of his sect, au uncompromising opponent of slavery, he never hesi- tated to express his sentiments upon the subject, nor to yield his aid and counsel in individual cases. He was long a member, and ultimately president of the old Pennsylvania Abolition Society, in which office he had been preceded by Drs. Wistar, Rush, and Franklin ; was one of a committee deputed by the yearly meeting of his religious associates, to lay their views and hopes in regard to slavery before Congress; and was selected by the eccentric John Randolph, when on his death-bed in Philadelphia, to be a witness of his last wishes in relation to his slaves, and, as a neces- sary consequence, to be the organ of these wishes before the courts of Virginia. For the due performance of the offices thus imposed upon him, he was peculiarly qualified ; as, with the firmness which enabled him to adhere unswervingly to what he believed to be truth and justice, he combined a suavity of manner, a benevolence of feeling, an openness of character, and an obvious singleness of purpose, which disarmed hostility, and disposed even those who were most averse to his views, to admire and love him as a man. The same benevolence which impelled him to the relief of the helpless and oppressed, caused him to incline to leniency in pun- ishment; and, ever ready to forgive an injury to himself indi- vidually, he was prone also to forgiveness in his social capacity, at least was accustomed, in doubtful cases, to lean strongly to the side of mercy. He shared fully in that aversion to the taking of human life which is almost universal among the Friends, and car- ried on a newspaper controversy with a learned divine upon the subject of capital punishments, in which he endeavoured to show, by reference to the original Hebrew, that the Scriptural authority A MEMOIR OF DR. JOSEPH PARRISH. 409 claimed for them was without foundation, while he maintained their inexpediency, and their contradiction to the whole tenor of Christian morals. In the cases of individuals on trial for crimes, or already convicted, he was disposed to give the most favour- able interpretation to every equivocal point, and experienced the highest satisfaction when able, in his medical capacity, to screen suspected innocence, or conscientiously to interpose between a sen- tence of doubtful justice and its execution. In the instance of the maniac Zimmerman, who was confined at Orwigsburg under sen- tence of death for killing his daughter, he was one of a committee of the College of Physicians, appointed at his own motion, to visit and examine the prisoner; and was thus instrumental in saving a fellow-being from unmerited punishment, and the authorities from the guilt of a judicial murder.* * The following anecdote is so strikingly illustrative of Dr. Parrish's mode of thinking and acting in criminal cases, that I cannot deny my- self the satisfaction of inserting it here in the form of a note. A family consisting of numerous persons became suddenly ill, after partaking of a meal, and exhibited all the characteristic marks of poison. One of the family died, and dissection confirmed the evidence of the symptoms. Sus- picion fell upon a female servant, whose character, upon investigation, did not turn out to be in her favour. Though no proof of her guilt existed, a strong disposition was evinced to implicate her in the crime. Such was the hostile feeling excited towards her, that the coroner's inquest, which sat upon the case, needed but the slightest countenance from the physicians to bring in a verdict against her. Dr. Parrish believed it to be his duty to shield her from any possible injustice. He, and another medical gentle- man who was in attendance, testified that both the woman and a child of hers were affected in the same manner with the rest of the family. It was urged in reply that she had feigned sickness, and had deceived the physi- cians. It suddenly occurred to Dr. Parrish that, in all the cases which he had examined, there was a white furred tongue. He stated this fact to the jury, and proposed that they should examine the tongues of all who had been affected. This was assented to, and a display of tongues was accord- 410 A MEMOIR OF DR. JOSEPH PARRISH. Nor was his attention restricted exclusively to secular affairs. A zealous member of the church to which he belonged, and in which, towards the close of his life, he accepted the office of elder, he par- ticipated in all its business, entered with spirit into its controver- sies, and wrote much in relation to its interests and its tenets. It is well known, I presume, to all who hear me, that not many years since a division occurred in the Society of Friends, and that Dr. Parrish took a decided part with that section of the society to which he attached himself. Yet, amid all the difficulties of the separation, when excitement too often counselled violent measures, he was uniformly the advocate of peace, and, in his writings, sedu- lously avoided that strain of bitterness which is so apt to infuse itself into theological controversies, and to leaven all truly reli- gious feeling into its own evil nature. It was a source of comfort to him, that most of his nearest relatives and friends were of the same mode of thinking with himself; and that even with such of them as could not coincide with him in sentiment, he yet succeeded in maintaining an uninterrupted harmony of feeling, springing out of a just mutual appreciation of character and worth. Such as I have endeavoured to represent them were the va- rious engagements which crowded the time of Dr. Parrish, at the period of his greatest activity. As he advanced in years, the burden which had sat lightly upon his vigorous manhood became oppressive ; and, as he was in possession of a fortune amply com- petent to his wants, he began gradually to withdraw from the more onerous duties of his profession, and to confine his atten- ingly made. It was found that those of the woman and her child were at least as heavily furred as any of the others. The jury was satisfied, and refused to implicate her in their verdict. This, however, did not satisfy the family. Such a statement was made before a magistrate, that the poor woman was arrested and thrown into prison, where she remained several months awaiting her trial. Upon being brought before the grand jury, she was discharged, for want of testimony, on a verdict of ignoramus. (Note to the address when first published. ) A MEMOIR OF DR. JOSEPH PARRISH. 411 tion chiefly to cases, in which there was less demand for active ex- ertion than for the judgment and skill resulting from experience. He could not, however, without doing too great violence to his feelings, abruptly break off from attendance upon those who had long intrusted their lives to his care. I have more than once heard him quote, as in some measure applicable to himself, a com- plaint made by Dr. Wistar, when desirous of declining business, yet unable to resist the solicitations of his old patients, that what had in early life constituted his highest hope, was now become his greatest source of discomfort. He succeeded, however, in gradu- ally transferring the most laborious part of his business to younger and more willing shoulders. He first resigned his station in the hospitals, then withdrew by degrees from operative surgery, and finally limited his professional occupation to attendance upon families who had long employed him, to the performance of a few favourite surgical operations, such as those for cataract, strangu- lated hernia, and diseases of the urinary passages, and to consulta- tions with his brother practitioners, which were always grateful to him, and continued to be numerous up to the time of his last illness. There was a short period after he had begun to contract his business, during which he again put forth all his energies, and laboured with the spirit and activity of youth. This was during the prevalence of the epidemic cholera in Philadelphia. At the approach of this disease, he felt like the veteran warrior, who, while resting upon his laurels, hears the distant sounds of invasion, and rushes once more eagerly to the contest. He was one of the most efficient members of the Sanitary Committee, took an active share in the organization of the hospitals, and exerted his influ- ence effectively in calming the fears, and overcoming the prejudices of the citizens, which threatened materially to interfere with the requisite arrangements. He had himself the special charge of an hospital, in which he spent much time in a close observation of 412 A MEMOIR OF DR. JOSEPH PARRISH. the disease, in prescribing and even administering to the sick, and in providing in every possible way for their comfort as well as res- toration to health. Believing that a cheerful and confident state of mind contributed much to recovery, he endeavoured to remove from around the patients, as far as circumstances would permit, everything of a depressing or alarming character, and among other means of producing a pleasing effect, procured a number of beau- tiful plants, which he distributed about the entrance of the hospi- tal, and in the open grounds in the rear. He was at the same time largely engaged with private patients and in consultations ; and answered numerous letters addressed to him by his former pupils and other practitioners seeking for advice, so that his opinions were widely diffused, and gave a tone to the practice in many places. But when the danger was over, and the health of the city, purified by the late storm, became sounder even than in former years, he felt himself justified in returning to his previous purpose. His life, however, was at no time a life of idleness. Few things were more abhorrent to his nature than mental inactivity ; and, in his last illness, he considered as among his greatest trials that de- bility of mind which he felt to be stealing over him, a few days before his close. Even in the intervals of business, his intellect was ever active. He has often told me, that many of his peculiar views, both general and professional, were the result of reflection during his solitary rides from house to house in pursuit of his busi- ness. His last years, therefore, though less cumbered by almost overwhelming engagements than those of his earlier life, were still fully and profitably occupied. Besides attending to his restricted practice, to his duties as the father of a large family and a promi- nent member of his church, and to the care of a not inconsiderable estate, he participated also in various public concerns of a useful or charitable character. He was especially active in the organiza- tion and subsequent management of the Wills' Hospital for the A MEMOIR OF DR. JOSEPH PARRISH. 413 lame and blind ; and was president of the board of managers in this institution from its commencement to the' time of his death. One of his prominent enjoyments, in his declining years, was the superintendence of arrangements for the setting out in life of his adult children, in whose hopes and efforts he largely participated, and in whom he used to observe that he was living over again his own younger days. Having now followed the current of his life till near its termina- tion, let us endeavour to sketch his peculiar mental lineaments, and form a portrait of his character, while still fresh in our memory. Of the moral attributes of Dr. Parrish, which he derived from nature, the two most prominent were, probably, love for his fellow- 'men, and a desire to stand well in their opinions. His preceptor, Dr. Wistar, who loved and esteemed him highly, used to say, that he had the ambition of Bonaparte and the benevolence of Howard. In the best sense of the word, he was undoubtedly ambitious. It is trne that he never sought for power, and was altogether indif- ferent to the distinction of office, unless in so far as it evinced the good opinion of those by whom the office was conferred. But no man was more desirous than he to stand high in the esteem of others, and none felt more keenly marks of respect and affection on the one hand, or of disrespect and ill-will on the other. Of this trait in his character he was himself fully aware ; and we find him in early life, when under strong religious impressions, struggling in secret against its tendencies. Among his private notes is the fol- lowing reference to himself, at a time when he was endeavouring to bring himself more completely under the influence of that in- ward light, in the supernatural origin of which he believed as firmly as in his own existence. " Thou hast certainly been at times divinely illuminated; but alas! the cares of this world, not its riches so much as its honours, how does a desire after them eclipse the Heavenly luminary!" He was never unwilling to admit the existence of this love of distinction. It constituted, indeed, one 414 A MEMOIR OF DR. JOSEPH PARRISH. of his most powerful impulses to action ; and in his case, as it will prove to be in that of every other person who may possess, and be able to regulate it, was a principle of usefulness both to himself and others. If, under any circumstances, it exceeded the proper bounds in the case of Dr. Parrish, it was by the pain which it occa- sioned him when he met with unkind or unjust treatment, or was at any time made the subject of injurious report. He could not, perhaps, sufficiently, and he certainly never pretended to despise unmerited censure. But, though he suffered from this cause, he never allowed it to influence his actions, and few have ever been more ready to forgive an injury, or to return good for evil. But benevolence was a still more striking trait in his character. His good-will to all around him was observable in almost every movement. Towards those in suffering it was peculiarly conspicu- ous. Hence the charm of his deportment in the sick chamber. Nothing could surpass the beautiful kindness of his manner to- wards the sick poor whom he attended. He spoke to them in the most friendly tones, soothed their anxieties, respected their inno- cent prejudices, and, in his rounds in the hospitals, uniformly had regard to their feelings, avoiding, in his clinical remarks, whatever could wound their sensibility, or excite needless alarm. They who have walked the hospitals with him must recollect how the coun- tenances of the patients were lighted up at his approach, as if they viewed in him not only their physician but their friend. He used to relate frequent instances of their grateful remembrance of his kindness, and never joined in that very common complaint of the ingratitude of the poor for medical services ; an ingratitude often resulting from a coldness or harshness of manner on the part of the physician, which leaves the impression that the service was performed merely as a matter of duty, and could claim only a cor- responding reward. The practice of operative surgery occasioned him often great distress, especially in children, upon whom he never inflicted pain without appearing to suffer it in his own person; and A MEMOIR OF DR. JOSEPH PARRISH. 415 operations in infantile cases became at length so distasteful to him, that he avoided them whenever he could do so with propriety. Nor was the benevolence of Dr. Parrish merely of a passive char- acter. It was, on the contrary, highly practical. Not only was he liberal with his purse on every suitable occasion, which is the easiest mode of charity to one who possesses the means, but contributed freely also his time and service, both professionally and otherwise. No physician in Philadelphia, I presume, has attended more patients gratuitously than Dr. Parrish. He was peculiarly cautious not to burden the slender means of those who, from comfortable or affluent circumstances, had been brought into comparative poverty, and were struggling, on reduced incomes, to sustain a decent appear- ance in the world. When he had reason to suspect that any of his patients were in this condition, he would often endeavour to satisfy himself of the truth by the most delicate means in his power, and would then contrive, in the manner least offensive to their feelings, to avoid receiving compensation for his services, without leaving behind an oppressive sense of obligation. He never, on any occa- sion, exacted payment of a medical fee; and so strong was his aversion to compulsory modes of collecting debts of this nature, that in his will he expressly and strictly enjoined on his executors to put no claim on account of medical services into legal suit. He made it a point not to charge for attendance in cases of injury received by firemen in the discharge of their duty. For at least twenty years, he was in the daily habit of receiving patients at a certain hour ; and, as he was well known never to refuse advice, and never to charge those who could not afford to pay him, crowds flocked to his house, which, on such occasions, often resembled a public dispensary rather than a private dwelling.* * The following anecdote, which was told me by an eye-witness, proves that his benevolence of character, though it may have been improved by cultivation, was innate. The event occurred, if I remember rightly, when 41 G A MEMOIR OF DR. JOSEPH PARRISH. His conscientiousness was not inferior to his benevolence, and tlie two often co-operated to the same end. Hence it was that cruelty, oppression, and every form of injustice were so abhorrent to his nature. Almost the only occasions upon which I have seen him really indignant, were those in which he conceived the rights of the weak to be invaded by the strong, or injuries inflicted where there was no power of resistance or redress. Perhaps his sensi- tiveness on this point, may sometimes have led him into misappre- hension of the motives of others, and a little temporary injustice of opinion ; but this was a very slight and scarcely sensible counter- poise to the amount of generous feeling which was called forth. The same feeling was extended towards the brute creation. The animals which he had occasion to use, were always treated with the greatest kindness ; and the provision made in his will for the old age of a favourite horse, which had served him long and faith- fully, is generally known. Old Lyon was a remarkable brute, and almost as well known in Philadelphia as his master. The dog-like docility with which he followed at the word of the Doctor, and the sagacity with which, when left to himself, he moved off with the vehicle to some shady spot in summer, or to some sheltered posi- tion in winter, were subjects of almost universal remark. In all his pecuniary transactions, Dr. Parrish was scrupulously just. He did not feel himself authorized to take advantage of another in a bargain, and never incurred any responsibility which he was not fully able to meet. He had insurmountable objections to indorsements, on the score of the temptations which their facility he was a boy about ten years old. Meeting a young child in the street, during winter, who was carrying something in his naked hands and crying bitterly, he put his arms about the little fellow's neck, and finding, upon inquiry, that he was suffering from the cold, took his aching hands in his own, and having warmed them, put upon them a pair of woollen gloves which he had with him, and sent him forward comforted on his errand. [Note to the address when first published.) A MEMOIR OP DR. JOSEPH PARRISH. 41*7 afforded to extravagant risk, and would never lend his name in this way to his nearest friend or relative, preferring a direct loan of the money, if in his power, to the loan of his credit. His conscientiousness was exhibited also in various other ways. All those who have studied with him must vividly remember the catalogue of evils, incident to the study and practice of medicine, called by him his " black list," which he held up to the view of young men upon their first application to him as their preceptor, so that they might not enter the profession with false views and expectations, or at least that no blame might be imputable to him- self for undue encouragement, should their expectations be disap- pointed. In his medical lectures he felt himself bound, in detailing his experience, not to conceal his mistakes, so that the pupil might have the benefit not only of his successes as an example, but also of his mis-steps as a warning. Few are capable of this magna- nimity, the great majority being satisfied if they tell only the truth, without in all cases telling the whole truth. One of the most striking instances of the influence of a sense of duty over his conduct, was in his declining to take the office of professor of anatomy in the University of Pennsylvania, which he believed, and I have no doubt upon the best grounds, to have been at one time within his reach. I have said that he was natu- rally fond of distinction ; and this was a post to which he believed himself competent, and in which he would probably have attained much credit, and a wide-spread popularity. An ordinary person, in his situation, would have seized upon it with avidity. But he regulated his conduct by a higher standard than that of personal gratification. He believed that a station in the University would bring what might be considered his duty towards the institution into frequent conflict with his peculiar religious sentiments and habits. He was unwilling to expose himself to temptations, likely to loosen his hold upon those principles which he conceived to be 27 418 A MEMOIR OF DR. JOSEPH PARRISH. the anchor of his safety. To his intimate friends, who urged him to avail himself of this opportunity, he was wont to answer, in his naive and cheerful but impressive manner, by pointing to his breast, and observing that lie wished to have all comfortable there ; that no worldly advantages would be any compensation for the loss of that heart-felt satisfaction, which attended obedience to the intimations of his inward monitor. This was, indeed, the great rule of his life. Believing most fully in that fundamental Quaker doctrine that the Divine Spirit communicates directly with men, that from this source is the "true light which lighteth every man that cometh into the world," and that consequently every indi- vidual has a sure counsellor in his own breast, which, if consulted in the right spirit, will never fail or mislead him, he was in the constant habit of looking inward for intimations of duty, and of submitting to them implicitly, however opposed to his apparent worldly interests. Now, whatever opinion may be entertained of these intimations, whether we agree with the Friends in consider- ing them as of supernatural origin, or believe them, as most men do, to proceed from the natural workings of the mind, under the influence of education, habit, reason, and conscience, it is never- theless the fact that, in any case of morals, an individual, brought up in a civilized and Christian country, will seldom go far astray, who uniformly consults them with a single eye to the truth. Dr. Parrish believed that he found peace and safety in this rule of action ; and no merely worldly temptation was strong enough to remove him from any position which he had taken in conformity with it. The same motives which induced him to forego the op- portunity of obtaining a professorship in the University, caused him also to decline offers, and resist solicitations afterwards made to him to join other incorporated medical schools. "My bark," he used to say, "was made for quiet waters." Firmness and courage were also among the moral qualities which distinguished Dr. Parrish. With all his kindness of heart A MEMOIR OF DR. JOSEPH PAERISH. 419 and disposition to please, though no man was less tenacious of opinion for opinion's sake, and none more disposed to yield in trifles to the convenience or even caprice of others, yet in all affairs which involved a point of principle he was immovable, and did not hesitate to do or to avow what he believed to be his duty, whatever personal injury or odium might accrue. Thus morally courageous, he was not wanting in that less noble attribute which leads to contempt of danger. During an intimate intercourse of many years, I do not remember to have seen him, in any one instance, exhibit the least evidence of bodily fear. In pestilence he was among the foremost at the post of danger. During the prevalence of yellow fever, I have seen him by day and by night, without the expectation of pecuniary recompense, and at a period of his professional life when he had nothing further to wish for on the score of reputation, enter the deserted precincts of infection, and expose himself to the most imminent danger, in at- tendance upon individuals, who had been seized by the disease while lingering behind the fleeing population. He delighted when young in the excitement and hazard of the fireman's duty, and, even at a comparatively late period of life, had not entirely relin- quished the habit of exposing his person in great conflagrations. I have known him, in times of public tumult, to venture into the midst of the excited multitude, and fearlessly oppose his personal influence to their mad purposes. On the bed of sickness and death, with a clear knowledge of his danger, he was quite com- posed, and never exhibited any of those fearful apprehensions which sometimes beset the closing scenes even of those best pre- pared to die. Such, indeed, was his natural temperament, that danger, attended with the opportunity for exertion, seemed to have charms for him ; and I have heard him more than once say, not in a boastful spirit, but quite naturally, as if merely giving expres- sion to the feelings of the moment, that, were he not opposed on principle to all wars and fightings, he should take a stern delight, 420 A MEMOIR OF DR. JOSEPH PARRISH. in a cause which he could approve, in leading the forlorn hope of an assault. In relation to his intellectual faculties, Dr. Parrish was char- acterized by quick perception, an excellent memory for facts, and an unusual correctness of judgment. Little that he had the oppor- tunity of hearing or seeing escaped his observation, and what he had once stored up in his mind was ever afterwards at his com- mand. He had, therefore, a fund of anecdote and material for illustration, which rendered his conversation highly interesting as well as instructive, and gave him great advantages as a lecturer. He had little imagination, and was without the taste and perhaps the ability for abstract and speculative reasoning, which too often busies itself in constructing edifices of conclusion upon slender premises, and wastes in vain attempts to establish general truths the time which would be better spent in collecting facts. But he was gifted, in an extraordinary degree, with that practical faculty which turns to useful account whatever comes within its reach; which, by a sort of intuition, distinguishes a truth amidst the rub- bish by which it is concealed, and out of a labyrinth of conflicting means selects that which most surely leads to the end in view. His was, indeed, eminently a practical mind, looking always to acts rather than to opinions, and disposed to measure the value of any system or project by its probable bearing on the condition of society or individuals, not by its mere beauty, or the ingenuity dis- played in its invention. But, while thus marked with strikiug traits, he was not without the graces also of character. His amiableness of temper, candour and openness of heart, liberality of sentiment, charity for the fail- ings of others, warmth and constancy in friendship, and love of order and punctuality, were often beautifully illustrated in his daily intercourse, and contributed to give him the charm of manner which rendered his presence everywhere so acceptable. The real politeness for which Dr. Parrish was remarkable, was in no respect A MEMOIR OF DR. JOSEPH PARRISH. 421 the result of cultivation, but flowed directly from the fountain of his own kindly feelings. It was the genuine coinage of nature, which art may counterfeit, but seldom equals. With a self-posses- sion resulting from his utter want of pretension, and the perfect simplicity of his character, and entirely free from that sort of diffi- dence of manner which is the frequent result of pride, he was never awkward in speech or movement, and in all the intercourse of life exhibited the deportment of a true gentleman. To the present audience, it is scarcely necessary to recall the personal characteristics of Dr. Parrish ; his fine, open, benevolent countenance, with small but expressive eyes, beautiful teeth, and generally regular features ; his form rather below the medium height and slightly stooping, but broad, full, well made, and vigorous; his gait rapid and energetic, as if in the eager pursuit of some important object ; his garb, that of the sect to which he belonged, and simple according to its strictest requisitions. Having thus endeavoured to portray our late friend as a man, we are next to consider him in his professional capacity as a physi- cian and a medical teacher. In the narrative of his progress in life already given, allusion has been so often incidentally made to those traits of his character which distinguished him as a practi- tioner of medicine, that comparatively little need be said on the present occasion. That little may be included under the several heads of his relations, first, to the disease, secondly, to the patient, and thirdly, to his fellow-members of the profession. He was peculiarly skilful in diagnosis. His acuteness of obser- vation led him often to notice symptoms or circumstances, which, though apparently trifling, and therefore liable to be overlooked by a careless eye, were yet of the highest importance towards the formation of a correct notion of the disease. He was at the same time careful not to decide rashly in doubtful cases, and was espe- cially cautious in surgical affections, in which a hasty opinion might lead unnecessarily to serious operations. An instance of 422 A MEMOIR OF DR. JOSEPH PARRISH. his acumen in diagnosis, familiar to most of his pupils, deserves perhaps to be mentioned here. He was invited to be present at an operation for the removal of a cancerous tumour of the breast. The surgeons had met, and the operator was about to proceed, when Dr. Parrish, having made an examination, and been induced to suspect the existence of a deep-seated scrofulous abscess, men- tioned privately his views of the case, and suggested that, pre- viously to the use of the knife, a lancet should be thrust deeply into the tumour. This was assented to, as at all events a safe ex- pedient, though rather in compliance with the wish of the Doctor than from a conviction of its propriety. A puncture was accord- ingly made, and a copious flow of pus followed the withdrawal of the instrument. The patient was thus saved a painful operation, and the surgeon the no less painful mortification which would have ensued, had he attempted the extirpation of the tumuor, and found himself in the midst of an abscess. The extensive experience of Dr. Parrish, and his tenacious me- mory, enabled him frequently to pronounce promptly, in cases con- sidered doubtful, by recalling others of a similar nature which had occurred to him ; and this process of inference by comparison was so rapid, that his conclusions often appeared, to himself perhaps as well as to others, the result rather of intuition than of an intel- lectual operation. A few years since, there appeared in the lower parts of our city numerous cases of a disease, which bore some resemblance to the common nervous or typhoid fever, but was more violent, and pre- sented pathological characters which seemed to mark it as a quite different affection. Dr. Parrish was consulted, and at once pro- nounced the disease to be the same typhus fever of which he had seen so much when it prevailed here epidemically in 1812, and sub- sequent years, but which had for a long time almost wholly disap- peared. The result of the treatment in these cases confirmed the correctness of the diagnosis. Active stimulation was found to be A MEMOIR OF DR. JOSEPH PARRISH. 423 requisite ; while bleeding, which is often well borne in the ordinary typhoid fever, was seldom admissible.* His correct judgment also was eminently serviceable to him in the investigation of disease. Though few circumstances connected with any case escaped his observation, yet, so far from being em- barrassed by the multitude of different and often seemingly con- flicting materials for an opinion, he had the talent of throwing out of view all but the important points, and was thus enabled to come to a satisfactory and usually just conclusion, when others of equal or superior knowledge, but less accuracy of judgment, were left in uncertainty, or led into error. The same good sense caused him to look always to the practical and useful in his estimate of disease. Though willing to explain facts in the manner which appeared to him most consonant with reason, he was utterly averse to mere speculation, and never allowed a theory, however plausible, to exert any influence over his decisions, when extended beyond the limits of rigid observation into the fields of mere conjecture. To the medical doctrines which arose in rapid succession during his life, and which, in some in- stances, exerted a wide-spread and not innoxious influence over the profession, he opposed a steady and active resistance, believing it to be his duty to protect not only himself, but others also, so far as lay in his power, from their fascinations. It was not that he dis- liked them merely as novelties. On the contrary, no one seized on newly- announced facts, or well-attested observations, more eagerly than himself; and ancient hypotheses had no more favour in his eyes than those of recent origin. But he was convinced that no * The diagnosis was positively confirmed by a careful comparison of the symptoms and course of the two affections, and by the results of post-mor- tem examinations. It was, indeed, through the investigations made at this period, that Dr. W. W. Gerhard was enabled to establish the diagnosis be- tween typhus and typhoid or enteric fever, and to determine the distinct nature of the two affections. [December, 1850.) 424 A MEMOIR OF DR. JOSEPH TARRISH. general theory of disease can be true, because we are not yet in possession of the materials out of which to form such a theory, and it has not been given to man to penetrate by conjecture the coun- sels of creative wisdom ; and he believed that false hypotheses are productive of the most dangerous practical results. He was in favour, therefore, of patiently making and recording observations, and only then attempting to deduce general truths, when the facts accumulated were sufficient for the purpose, without the necessity of a resort to supposition or conjecture. Happily, he lived to see this system of prosecuting medical inquiry become the fashion among us ; and I have no doubt that, so far as concerns this place, the result may in some measure be ascribed to his efforts. The peculiar intellectual qualities which aided him in the study of disease were no less useful to him in therapeutics, in which also he exhibited the same preference of experience over the sug- gestions of abstract reasoning, or the inventions of imagination. Though by no means distrustful of the powers of medicine, he yet had great confidence in the native resources of the system, and was much in the habit of relying on them in his course of treatment. He watched carefully for the indications which nature might pre- sent, and not unfrequently answered these indications, though op- posed to general opinion, or even to his own preconceived views. He attached great importance to the constitutional peculiarities of individuals, which he studied with care, and always consulted in his choice of remedies. The ordinary means by which life and health are sustained, such as pure air, cool drinks, wholesome food, a regulated temperature, exercise, etc., frequently became in his hands powerful therapeutical agents, especially in cases which seemed to have originated in the want of them. Yet when medi- cines appeared to be demanded, he was prompt and efficient in their use ; and was often very happy in the selection of those best adapted to the case, being greatly aided in his choice by a peculiar A MEMOIR OF DR. JOSEPH PARRISH. 425 sagacity, which suggested new modifications or contrivances to meet unforeseen emergencies, or unusual states of disease. To the practice of surgery he was admirably adapted by these same qualities, and, in addition, by those essential physical requi- sites, a good eye, a steady hand, and general firmness of nerve. I never but once saw his hand tremble under any circumstances of health or sickness. He used to have some pride in this important surgical qualification ; and I have frequently seen him, even when exhausted by severe and long-continued illness, hold out his hand in the position in which it was wont to grasp the knife, without the slightest discoverable motion other than that produced by the arterial pulsations. He used to say that, when he should perceive his hand to shake under these circumstances, he should consider it as an evidence that he was near his end ; and surely enough, in his last illness, a very short time before his death, while he was almost unconsciously repeating the same trial of his strength of nerve, I observed for the first time that failure which he considered so ominous. Towards the sick the deportment of Dr. Parrish was most happy. The cheering smile with which he accosted his patients, his sooth- ing kindness, his encouraging and confident manner while there was still ground for hope, and his affectionate sympathy and consola- tion when hope was over, remain indelibly impressed on the grate- ful recollections of thousands in this city. In dangerous cases, he was candid whenever there was not reason to fear that by being so he might greatly aggravate the danger ; and he never undertook a hazardous operation, without having previously made the patient acquainted with his condition, and obtained his consent, with a full knowledge of the possible consequences. When thus called upon to be the herald of danger, the kindness of his heart pointed out the mode of proceeding least likely to occasion unnecessary pain ; and his well-known character as a pious man enabled him to mingle very effectively the consolations of religion with the gloomy intelli- 426 A MEMOIR OF DR. JOSEPH PARRISH. gence which he had to announce. He was frequently consulted by his patients, in the capacity of a friend and counsellor as well as physician, and thus became the confidant of many private con- cerns, which he always considered as a sacred trust committed to his honour. He was scrupulously careful never to violate profes- sional confidence. Nothing ever passed his lips which could affect the reputation of those who had placed themselves in his hands ; and, when there was something in a case interesting in a profes- sional point of view, which, however the patient might wish to be concealed, he was most cautious, in relating the fact for the benefit of his pupils, not to mention the name, and even to avoid every allusion which could by any chance connect the event with the indi- vidual. When such a connection was unavoidable he was entirely silent; for he considered that no good which might possibly accrue to society from the publication, or promulgation in anyway, of any particular case, could justify a physician in violating even an im- plied trust. Upon his students he was always exceedingly solicitous to inculcate the great importance of professional secrecy, not only as essential to the respect of the world, but as in the highest degree binding upon their honour and conscience. I have already spoken of his liberality towards patients of slen- der means, and the delicacy with which his favours were conferred. This conduct arose from feeling and principle, and not from mere carelessness in relation to pecuniary concerns ; for in all his busi- ness transactions he was scrupulously exact, and, in relation to his fees for medical services, considered it a duty which he owed as much to his patients and the profession as to himself, to present his accounts regularly once a year, whenever peculiar circumstances did not require some relaxation of his general rule. He always, however, considered these accounts in the light of honorary claims, and not only never exacted payment, but declined it altogether when the patient expressed any doubt of its justice, or any great unwillingness to discharge it. I recollect being present, on one A MEMOIR OP DR. JOSEPH PARRISH. 42? occasion, when a countryman of some wealth, and no less covetous- ness, called at his house to settle a bill for medical attendance. He was probably not accustomed to the rate of charging common in the city, and demanded some abatement from the account on the score of its extravagance. The Doctor in reply told him that, if such were his views, he should decline receiving anything ; where- upon the gentleman, commending his liberality, took up his hat and left the house, apparently very well contented. Perhaps in no respect did Dr. Parrish appear to greater advan- tage than in his relations with his medical brethren. It was one of his maxims that no physician could have a satisfactory profes- sional standing, who disregarded the good-will and good opinion of his fellow- practitioners. He was, therefore, mindful of their rights on all occasions, never allowing any chance of immediate or prospective advantage to himself to interfere with their just inter- ests, and very often going out of his way to protect their reputa- tion, and to repair any injury they might have suffered in the esti- mation of their patients. He held in abhorrence that meanness of spirit which, for a little apparent profit, would insinuate evil of a brother, or even assent by silence to a mistaken estimate of his worth. He was strictly obedient to the ethical code, which wise and good physicians have established for the regulation of their intercourse with their patients and with one another, and which, however liable to reproach from selfishness or inexperience, is yet indispensable to the maintenance of harmony in our profession, and consequently to efficiency for the public good. No medical man could long remain in a hostile attitude towards Dr. Parrish. I do sincerely believe that he never purposely gave cause of offence to a fellow-practitioner; and any temporary ill-will, which may have originated in misconception, soon melted away before his amenity of manner and obvious goodness of heart. He never resented an injury, real or supposed, and not unfrequently repaid unkindness with benefits. 428 A MEMOIR OF DR. JOSEPH PARRISH. From his regard for his fellow-practitioners, it may be inferred that lie had pleasure in meeting them in consultation. He had none of the jealousy which fears a rival in every person with whom we may be associated in attendance, nor of the overweening and arrogant self-esteem which owns no fallibility of judgment. It was his custom, whenever he supposed a patient or his friends might desire additional aid, or when the case was one of a doubtful or embarrassing nature, to offer a consultation ; and when a sugges- tion to this effect came from the patient himself, he always promptly gave his assent, however inferior in age and standing mi it be his proposed associate. Another trait, which favourably distil rished his i course with the profession, was an extraordinary mctuality in ie fulfil- ment of his engagements. In consultati s he very rarely failed to meet at the time appointed ; and so j •■ us was he of his char- acter in this respect, that it was a habit ith him, which most of his medical friends must remember, to p ent his watch when he was second in entering the house, in order to prove that he was not after his time. Towards the younger members of the profession, he conducted himself in a manner calculated to win their affection as well as respect. So far from feeling the least touch of jealousy at their success, or exhibiting any of that overbearing temper which some- times attends an increase in years and honours, he was always gratified with an opportunity of promoting their interests, and regulated his intercourse with them upon the same principles as with his equals in age. He did not consider the tie between him- self and his pupils broken, when they had established themselves as practitioners. On the contrary, he felt towards them as towards younger brothers, rejoiced in their professional advancement, aided them by his advice and recommendation, and took every oppor- tunity of causing the superabundance of his own cup to flow over into theirs. It was a fine trait in his character, and one which has A MEMOIR OF DR. JOSEPH PARRISH. 429 endeared him to many now present, that when any of his young friends, through accident or other cause, acquired a footing in families which he had been in the habit of attending, instead of feeling unkindly or endeavouring in any way to interfere with their interests, he seemed to enjoy their success, and took pains to strengthen the impressions in their favour, through the influence which his long professional intercourse with the families naturally gave him, I know that there are many, who will heartily join me in this tribute of acknowledgment to the memory of our deceased benefact* .: : . and friend. But I feel that on my own part the tribute is inade< ^ate. When I call to mind his virtues, his many amiable qualitif and his numberless acts of personal kindness ; how he took m by the hand v ben young, admitted me into his intimate confidence, attended n .in illness, counselled and aided me when counsel and aid were ./f^ded, and throughout life gave me his warmest sympathy, my -east is filled with emotions which exceed the powers of language »nd I cannot but feel, that my efforts to exhibit him to others witii all his admirable characteristics as they present themselves before me, are as futile as would be an attempt, without the talents of a painter, to transfer to the canvas the vivid image of his form and features impressed upon my memory.* * In view of certain untrue statements which have appeared in print, in relation to my earlier life, I may, perhaps, he permitted here to say that the aid, referred to in the text, was purely professional. I never received, as I never needed, pecuniary assistance from Dr. Parrish. Our relations were as nearly as possible, without any blood-connection, those of an elder and a younger brother; at least my feelings of respect and affection towards him were such as would naturally arise out of such a relation; and I have reason to think that they were fully reciprocated on his side. During our long intercourse, whatever might be our differences of opinion, there was an unbroken intimacy; and, in his last illness, he showed his continued confi- dence by putting himself under my professional care, jointly with that of our mutual friend, Dr. John C. Otto. {December, 1859.) 430 A MEMOIR OF DR. JOSEPH PARRISH. A few words in relation to the peculiarities of Dr. Parrish as a teacher, will close this imperfect representation of his medical char- acter. Without having cultivated either rhetoric or oratory as an art, he was a fluent and by no means inaccurate speaker, and, when under the impulse of high principle or strong feeling, was often truly eloquent, attracting the fixed attention of the audience, and carrying their whole sympathies along with him. It appeared as if his own beautiful feelings were personified in the speaker, and that the hearers were listening to the very voice of benevolence, of charity, of compassion for the weak and suffering, of indignation against oppression, or of whatever other emotion was at the time predominant within him. On such occasions, as he was under no restraint from the rules of art, and unembarrassed by the conscious- ness of any evil in his own thoughts, he surrendered himself freely to the current of his emotions, which, as they were themselves pure, threw up to the surface nothing which required concealment. This pouring out unreservedly of all that he thought or felt, con- stituted the main charm also of his medical lectures. His instruc- tions did not consist of laboured treatises upon disease, presenting in a regular and compact arrangement all that was known upon the subject. They were rather vivid pictures of his experience, in which the pupil was enabled to see the very events as they passed, and to see them too with the trained eyes of their preceptor. They were made to enter into the very case, to share in the reflections, hopes, and fears of the speaker, and thus to take an almost per- sonal interest in the progress and termination of the disease. His lessons became in fact to his pupils a sort of experience of their own ; and I think it probable that many of us, who have been long in practice, would find some difficulty in discriminating between the recollection of what we have ourselves seen, and the strong impressions left upon our minds by the representations of our teacher. Through his lectures there ran a vein of cheerful good-nature, A MEMOIR OF DR. JOSEPH PARRISH. 431 enlivened with frequent touches of humour, which added much to their attractiveness. By his very mode of accosting his pupils upon entering the lecture-room, he contrived to place them upon a footing of friendly familiarity, which disposed them to attend to his instructions out of personal regard for the speaker, as well as from a desire to learn. "Well, boys," he would say, preparatory to some kindly greeting, or some friendly inquiry, and thus by a few words expressive of his own good feeling, attuned their minds into harmony with his own, and was enabled to carry their hearts, as well as their attention, along with him in his subsequent ad- dress. But the feeling of familiar companionship, with which he in- spired his pupils by his deportment towards them on all occasions, never passed the limits of perfect propriety. It was so mingled with reverence for his purity of heart, and elevation of character, that nothing but the spirit of evil could have, suggested anything likely to prove offensive to him ; and the guard which the student was thus induced to keep over any wrong propensity, in the midst of the otherwise unreserved intercourse with his preceptor, had the tendency to modify his own character favourably, and to make him in reality what he wished to appear. In his lectures Dr. Parrish was accustomed to introduce numer- ous illustrative cases, and endeavoured to strengthen the effect of mere description by the exhibition of pathological specimens, which, in the long course of his practice, he had been enabled to procure in great numbers. Indeed, his collection of diseased bones was probably unequalled in any cabinet, public or private, in this coun- try. He strove also constantly to direct the attention of his pupils to the practical observation of disease, and to the attainment of familiarity with all the instruments and means of cure. With the latter view, he recommended them to spend some months in the shop of an apothecary, in the earlier period of their studies, and to seize every opportunity of performing those minor opera- 432 A MEMOIR OF DR. JOSEPH PARRISH. tions, and exercising those manipulations, a perfect facility in which is so important to the practitioner, and especially to the surgeon. He urged upon them, moreover, a regular attendance at the hos- pitals, and, in his own private practice, sought occasions to enable them to see disease, to assist at operations, and in various ways to initiate themselves into the practical duties for which they were preparing. On the whole, few men have, I believe, exhibited a stronger in- terest in their pupils, or laboured more assiduously to promote their welfare ; and no one, certainly within my own observation, has gained a more ample return of love and respect. Having thus given a historical sketch of Dr. Parrish up to the period of his last illness, and endeavoured to delineate his char- acter as a man, a physician, and a medical teacher, it now only remains for us to consider him in the closing scene of his life. This is the touchstone which tries the value of the past, and dis- tinguishes what was sterling worth from the false glitter of profes- sion, and the deceptions of self-esteem. He only can be said to have been truly happy in life whose end is happy. To the friends of Dr. Parrish it is a source of the purest satisfaction, that he passed successfully through this last and severest trial, and that the close of his career was in harmony with its whole course. He was attacked in the summer of 1839 by the disease which ulti- mately proved fatal, but continued to attend to his various avoca- tions, though somewhat irregularly, till about the beginning of the present year, when he confined himself to his house, on account of a severe bronchial affection superadded to his former complaint. From this he partially recovered, so as to be able to drive out occa- sionally, and even visit patients; but he suddenly became worse about the close of February, and, taking to his bed, continued to sink gradually for nearly three weeks, and died on the 18th of March, in the sixty-first year of his age. Though somewhat lethargic towards the conclusion of the disease, he was capable, A MEMOIR OF DR. JOSEPH PARRISH. 433 when roused, of thinking with perfect clearness, and of fully ap- preciating his condition, till a day or two before death. In the midst of much bodily distress, and great derangement of his ner- vous system, he preserved unimpaired those amiable traits of char- acter by which he was distinguished in health, frequently expressing a grateful sense of the kindness of those who administered to him, and carefully avoiding any expression which could wound their feelings. With the full conviction of the fatal character of his disease, and with the near prospect of its termination, he was per- fectly calm and self-possessed, made all the requisite arrangements in his affairs, spoke to his family as a tender husband and father, solicitous for their present and eternal welfare, might be expected to speak, and uniformly expressed his reliance upon the goodness and mercy of Providence, and his hope of a happy hereafter. Under the feeling of his utter bodily prostration, he used to say to his physicians that he was like a log of wood on the Delaware, floating about at the discretion of the winds and tides. At one of their latest visits, when hearing and sight were failing, and the power of articulation was almost gone, he repeated this expressive figure, and could but just be heard to say in addition, "but even the log on the Delaware has its care-taker." Thus, the reliance upon a superintending Providence, which was one of the governing principles of his life, did not fail him in death ; and, if love for his fellow-men, unceasing beneficence, and a reference in almost all that he said and did to the will of his Maker, may be considered as the indications of a spirit prepared for immortality, his friends may confidently indulge the belief, that, in dying, he has but exchanged the uncertain gratifications of this world for the sure happiness of that to come. The almost unprecedented array of his fellow-citizens of all classes who attended his remains to the grave, the general expres- sion of regret for his loss, and the measures taken by the various bodies to which he belonged, to procure some public commemora- 434 A MEMOIR OF DR. JOSEPH PARRISH. tion of his worth and services, are evidences of a general esteem and affection such as seldom fall to the lot of individuals, uncon- nected with public life. Perhaps no one was personally known more extensively in the city, or had connected himself, by a greater variety of beneficent service, with every ramification of society. It is true that no marble has been erected over his remains, and that the very spot where they are laid will soon be undistinguishable to every eye save that of conjugal or of filial love ; yet the remem- brance which he has left behind him, the only monument which the rules of his unostentatious sect allow, is far more precious than the praises of carved stone, which gold may purchase, or power com- mand. Should this humble tribute to his worth add in the least to the brightness or the duration of that remembrance, the author will feel the sweet reward of having paid a double debt, to gratitude and to truth. A BIOGRAPHICAL MEMOIR OP SAMUEL GEORGE MORTON, M.D., READ BEFORE THE COLLEGE OF PHYSICIANS OF PHILADELPHIA, NOVEMBER 3d, 1852. In accepting the appointment with which the College honoured me, of preparing a biographical sketch of our late Fellow, Dr. Samuel George Morton, it may be remembered that I requested indulgence on the score of time ; as the urgency of my then exist- ing engagements rendered immediate attention to the duty impos- sible. The delay has been longer than I could have wished ; but, happily, there was little occasion for haste, as the Academy of Natural Sciences, with which, through official position and long co-operation, Dr. Morton was more closely connected than with any other public body, had already provided for that commemora- tion which society owed to him, as to one who had faithfully and honourably served it. In what manner this duty was fulfilled need not be told to those who have perused the memoir, prepared by Dr. C. D. Meigs, so characteristic of the author in its easy and copious flow of expression, its genial warm-heartedness, its glow- ing fancy, and the cordial, unstinted appreciation of the merits of its subject. It may be proper to mention here, that to this me- (435) 43G A MEMOIR OF DR. SAMUEL GEORGE MORTON. raoir I am indebted for many of the following facts. Having been prepared under the auspices of an association devoted to the natural sciences, though treating of our departed colleague with greater or less fulness in all his relations, it very appropriately directs a special attention to the scientific side of his life and cha- racter. With equal propriety, as appears to me, a professional body like the present may expect a particular reference to his medical history ; and I shall, accordingly, endeavour to place him before you, rather as a physician than as a man of general science. It was in the former capacity that Dr. Morton was best known to the writer, who had the honour of aiding in the conduct of his early medical studies, was afterwards for a time associated with him as a medical teacher, and, throughout his whole professional life, maintained with him a frequent and friendly intercourse. The delineation which follows is necessarily in miniature ; for, independently of the comparatively short time which can be de- voted to such communications in the business of the College, the pages of our journal, to which it is customary in the end to con- sign them, are too limited to receive in its fulness a portraiture, which might readily be made to occupy volumes. I shall, how- ever, endeavour, by excluding irrelevant commentary, and by ex- pressing myself as concisely as possible, to introduce within the limits assigned the greatest practical amount of biographical matter. Dr. Morton sprang from a highly respectable family, residing at Clonmel, in Ireland. His father, George Morton, the youngest of four brothers, emigrated at the age of sixteen to this country, with another brother somewhat older, who soon afterwards died. He settled in Philadelphia, and, having acquired the requisite ex- perience in a counting-house in a subordinate capacity, afterwards engaged in mercantile business on his own account. Here he mar- ried Jane Cummings, a lady having a birthright in the religious Society of Friends, which, according to a well-known rule of that A MEMOIR OF DR. SAMUEL GEORGE MORTON. 43 Y Society, she lost upon her marriage with one who was not a mem- ber, Mr. Morton belonging to the English Church. He died on the 2Tth of July, 1199, leaving his widow with three children, a daughter and two sons, the youngest of whom was the subject of the present sketch, and at that time an infant in arms. The older boy, James, was soon afterwards sent to an uncle in Ireland, who adopted him ; but he died before maturity. The sister still sur- vives to lament the loss of both her brothers. Dr. Morton was born on the 26th of January, 1199, and was consequently about six months old at the death of his father. In her bereavement the widow sought consolation in religion, and, still entertaining the faith in which she had been educated, applied for restoration of membership in the Society of Friends, and was received. With a view to be near a beloved sister, she removed from Philadelphia to West Chester, in the State of New York, but a few miles from the metropolis, where her sister resided. Wish- ing that her children should be brought up in her own religious faith, and surrounded in early life by those safeguards which are eminently provided by the discipline of Friends, she sought for their admission into the Society ; and they were accordingly re- ceived as if members by birth. Custom, if not positive rule, requires among Friends that chil- dren should as far as practicable be educated in schools under the care of the Society, so that their tender years may be protected until their principles shall have sufficiently taken root to resist the seductions of the world. As no school of this kind existed in her immediate neighbourhood, Mrs. Morton felt herself compelled, when no longer satisfied with her own tuition, to send her young son from home ; and, for several years of her residence at West Chester, he was placed in one or another of the Friends' boarding- schools in the State of New York, where he acquired the usual rudiments of an English education. At this early age, the boy evinced a literary turn of mind, being 438 A MEMOIR OF DR. SAMUEL GEORGE MORTON. extremely fond of historical reading, and frequently trying his hand in writing verses, an exercise very useful to the young, by giving them a command of language not so easily attained in any other way. I am told that his bent towards natural science was also received at this period. Among the visitors of his mother was Thomas Rogers, a gentleman belonging to the Society of Friends living in Philadelphia, who had a great fondness for mine- ralogy, and imparted a portion of the same fondness to the young son of his hostess, whom he delighted to take with him in his ex- ploratory walks in the neighbourhood. The visits of Mr. Rogers resulted in his marriage with Mrs. Morton, and her return with him to Philadelphia, along with her two children, whom he loved and treated as if they were his own. Dr. Morton always spoke in the kindest and most affectionate terms of his step-father. He was about thirteen years old when this change took place. After the removal to Philadelphia, he was sent for a time to the famous boarding-school of Friends at West Town, in Chester County, Pennsylvania; and subsequently, in order to complete his mathematical studies, to a private school in Burlington, New Jersey, under the care of John Gummere, a member of the Society of Friends, and eminent as a teacher. Having remained for one year under the instruction of Mr. Gummere, he left the school, in the summer of 1815, and entered as an apprentice a mercantile house in this city, in which he con- tinued until the death of his mother in 1816. His heart was not in his business; and, though there is no reason to believe that he neglected the duties of his position, he devoted most of his leisure hours to reading, and gave his thoughts rather to history, poetry, and other branches of polite literature, than to mercantile accomplishment. The last illness of his mother was protracted, requiring the fre- quent attendance of physicians; and several of the most distin- A MEMOIR OF DR. SAMUEL GEORGE MORTON. 439 guished practitioners of Philadelphia were in the habit of visiting her professionally. Drs. Wistar, Parrish, and Hartshorne were men calculated to impress favourably the mind of a bright, and at the same time thoughtful youth ; and the attentions they paid to him, elicited no doubt by their observation of his intelligence and studious tendencies, had the effect of greatly strengthening the im- pression. His respect and affection for these eminent physicians naturally inclined him to their profession, and suggested the wish that he might be prepared to tread in their footsteps. This, I am informed, is what first directed his thoughts towards the study of medicine ; though, as stated by Dr. Meigs, it is not improbable that the reading of the published introductory lectures of Dr. Rush may have been the immediate cause of his change of pursuit. In the year 1811, being in the nineteenth year of his age, he entered as a pupil into the office of the late Dr. Joseph Parrish, then in the height of his practice, and distinguished as a private medical teacher. It was here that I first formed his acquaintance, being about to close my pupilage under the same preceptor, when he began his. As I was, soon after graduation, engaged by Dr. Parrish to aid him in the instruction of his rapidly increasing class, I had, both as a companion and teacher, the opportunity of witnessing the industry and quick proficiency of the young student, and formed a highly favourable opinion of his general abilities. He attended the lectures in the University of Pennsylvania regu- larly, and, having complied with the rules of the institution, received from it the degree of Doctor of Medicine, at the com- mencement in the spring of 1820. During the period of his medical studies, he continued to reside with his step-father, and to this association probably owed in part his continued predilection for the natural sciences. It was to be expected from such a predilection, that he would give especial at- tention to anatomy, which, indeed, he cultivated with much dili- gence and success. Similarity of taste and pursuit in this respect, 440 A MEMOIR OF DR. SAMUEL GEORGE MORTON. led to a friendly association, about this period, with the late Dr. Richard Harlan, who superintended the anatomical studies of Dr. Parrish's pupils, and subsequently became distinguished as a naturalist. Soon after his graduation, Dr. Morton became a member of the Academy of Natural Sciences, thus commencing his professional career as a member of that body, over which he presided at the time of his death. Having been pressingly invited by his paternal uncle, James Morton, of Clonmel, before commencing the practical duties of life, to pay a visit to his relatives in Ireland, and eagerto improve both his professional knowledge and his knowledge of the world, he concluded to make a voyage to Europe, and accordingly em- barked for Liverpool in May, 1820. On arriving in England, he proceeded immediately to Clonmel, where he spent about four months in a delightful intercourse with friends and relatives pro- verbially hospitable, improving in manners through the polishing influence of refined society, and cultivating his taste by varied read- ing. It is probable that, in this association, whatever bent his mind may have received, from early education, towards the peculiari- ties of Quakerism, yielded to the influences around him ; for though, throughout life, he reaped the advantages of that guarded educa- tion, in an exemplary purity of morals, and simplicity of thought and deportment, he connected himself subsequently with the Epis- copal Church, to which his forefathers had been attached. The uncle of Dr. Morton very naturally valued a European de- gree more highly than an American, and was desirous that his nephew, before entering on his professional career, should obtain the honours of the Edinburgh University. The Doctor yielded to his wishes, and left his Irish friends, to enter upon a new course of medical studies at the Scotch capital. In consequence of exposure, in his journey from Dublin to Belfast, on the top of a coach, he was seized with an illness, believed to be an affection of the liver, which A MEMOIR OP DR. SAMUEL GEORGE MORTON. 441 confined him for some time to his bed in Edinburgh, and probably served as the foundation of that delicacy of health, which attended him for the rest of his life. On his recovery, he commenced an attendance upon the medical lectures, and at the same time upon those of Geology by Professor Jamison, thus showing that his attachment to natural science still continued. Another attack of illness, early in the year 1821, interrupted his studies. Recovering from this, he made an excursion into the Highlands of Scotland, and afterwards returned to the relaxation and enjoyments of a residence among his friends at Clonmel. In the autumn of the same year, he made a journey to Paris, where he spent the winter very profitably in the prosecution of his studies, and in improving his knowledge of the French language. In the following spring, he left Paris upon a tour through France, Switzerland, and Italy, in which he consumed the summer. In the autumn of 1822, we find him again at Edinburgh, where he continued through the winter, attending lectures, making up for early deficiencies in classical education by the study of Latin, and otherwise preparing himself for graduation. Having written and presented a thesis in Latin, De Corporis JDolore, and undergone satisfactorily an examination on medicine in the same language, he received the honours of the University in August, 1823. He had thus been six years occupied, more or less steadily, in the study of medicine, carrying on, during the same period, a pro- cess of self-education, which more than compensated for the de- ficiencies of his early life, and attaining a proficiency in various branches of natural science, which contributed greatly to his future eminence. In June, 1824, he bade farewell to his friends in Ireland, and, returning to Philadelphia, immediately engaged in the practice of his profession. His success was gradual. Young physicians are apt to complain of their slow progress in a remunerative business ; but what they Ill' A MEMOIR OF DR. SAMUEL GEORGE MORTON. consider a misfortune is in fact, if properly used, a blessing. Their early years have been devoted to the acquisition of elementary knowledge, their later will be occupied by practical duties. It is iii the intermediate period that the opportunity is offered of ex- tended research into the records of science, of confirming or cor- recting the results of reading and study by observation, of making original investigations into the worlds of matter and of thought, and thus bringing forth to the light truths which may benefit man- kind, and at the same time serve as the basis of honour and success to their discoverer. He who leaps at once from professional study into full professional action, finds all his time and pow r ers occupied in the application of the knowledge already attained, and seldom widens materially the circle of science, or attains higher credit than that of a good, or a successful practitioner. It was undoubtedly fortunate for Dr. Morton's reputation, that his time was not, at the outset, crowded with merely professional avocations. He had thus the opportunity of going out into the various fields of natural science; and, while he neglected none of the means requisite to the honourable advancement of his business as a physician, he pushed his researches and labours in those fields to the most happy results. As an aid and stimulus to his researches in this direction, he entered at once into hearty co-operation with his fellow-members of the Academy of Natural Sciences, and took an active part in the affairs of that institution. He was almost immediately made one of the auditors; in December, 1825, was appointed to the office of Recording Secretary, which he held for four years ; served actively for a long time on the Committee of Publication; aided materially in increasing and arranging the collections ; delivered before the Academy lectures on mineralogy and geology during the years 1825 and 1826; drew up a report of its transactions for these two years ; and began a series of original papers upon various subjects of natural science, which have contributed greatly to his own credit, and that of the institution. A MEMOIR OF DR. SAMUEL GEORGE MORTON. 443 His first medical essay was on the use of cornine in intermittent fever, and was published in the Philadelphia Journal of the Medi- cal and Physical Sciences (xi. 195, a.d. 1825). Under the name of cornine, a material had been given to him, purporting to be an alkaline principle extracted from common dogwood bark, and, having been used by him in several cases of intermittent fever, proved to be an efficacious remedy. Dr. Morton was responsible only for the correctness of his own statements as to the effects of the substance given to him, and not for its chemical character, which must be admitted to be at best doubtful. Positive proof is still wanting of the existence of any such active alkaline principle. His first strictly scientific papers were two in number, both read on the 1st of May, 1827, before the Academy of Natural Sciences, and afterwards printed in the Journal of the Academy. They were entitled respectively, "Analysis of Tabular Spar, from Bucks County, Pennsylvania, with a notice of various minerals found at the same locality," and "Description of a new species of Ostrea, with some remarks on the Ostrea convexa of Say." These were followed in rapid succession by other scientific com- munications ; and the Transactions of the Academy continued to be enriched by his labours from this date till within a short period before his death. There were not less than forty of these contri- butions, besides others to the Transactions of the American Phi- losophical Society, and the American Journal of Science and Art, edited by Professor Silliman. They were on the various sub- jects of mineralogy, geology, organic remains, zoology, anatomy, ethnology, and archaiology; and, by their diversified character, richness in original matter, and accuracy and copiousness of de- scription, speak more strongly than could be done in mere words of the industry, scientific attainments, powers of observation, and truthfulness of their author.* * For a catalogue of these and of the other works of Dr. Morton, the reader is referred to the Appendix of the Memoir prepared by Dr. Meigs. 444 A MEMOIR OF DR. SAMUEL GEORGE MORTON. But, in this slight sketch of his contributions to periodical works of science, I have been anticipating the course of his life, and must return to a period but shortly subsequent to the commencement of these labours. He had at that time considerably widened his social circle, had formed intimacies with many persons of distinction in science and in the common walks of life, had become favourably known in the community at large, and was rapidly extending his business as a practitioner of medicine. Only one thing was wanting to give permanence to his well-being, by affording a point towards which his thoughts and energies might ever tend, as the centre of his life. This want was supplied by his marriage, October 23, 1827, with Rebecca, daughter of Robert and Elizabeth Pearsall, highly respected members of the Society of Friends, originally of New York, but at that time residing in Philadelphia. This connection was, in all respects, a most happy one for Doctor Morton. He secured by it not only a devoted companion, who could appreciate, if not participate in, his pursuits, and lighten by sharing with him the burdens of life, but the blessing, also, of a loved and loving family, which gave unwearied exercise to his affections, and sus- tained a never-ceasing strain of grateful emotion, that mingled sweetly with the toils, anxieties, and successes of his professional career, and gave an otherwise unattainable charm to his intervals of leisure. It is reasonable to suppose that his professional business was increased by his marriage. That he possessed, in some measure, the confidence of the public as a practitioner, is shown by his ap- pointment, in the year 1829, as one of the physicians to the Phila- delphia Alms House Hospital. Here he enjoyed ample oppor- tunities for pathological investigations, of which he availed himself extensively, especially in relation to diseases of the chest, towards which his attention had been particularly directed by attendance on the clinical instructions of Laennec, during his stay in Paris. A MEMOIR OF DR. SAMUEL GEORGE MORTON. 445 The fruit of these investigations will be seen in a work which will be more particularly noticed directly. In the year 1830, Dr. Morton added to his other duties those of a medical teacher. A brief notice of the association with which he was connected may not be amiss ; as it was one of the first of those organizations, now familiar to the profession in Philadelphia, in which a number of physicians unite, in order to extend to their private pupils advantages, which, separately, it would be impossible for them to bestow. It is quite unnecessary that I should speak of the benefits which have accrued from this plan of instruction to the profession in this city. Most of those who now hear me have, I presume, been taught under that system, and some are at this moment teachers. You can, therefore, appreciate its advantages ; but it is only the older among you who can do so fully, as it is only they who can compare it with the irregular and inefficient plan of private tuition that preceded it. Another incidental ad- vantage has been the training of a body of lecturers, from among whom the incorporated schools have been able to fill their vacant professorial chairs with tried and efficient men, and thus to sustain, amidst great competition, the old pre-eminence of Philadelphia as the seat of medical instruction. The late Dr. Joseph Parrish, from the increasing number of his office pupils, was induced to engage the services of a number of young medical men, to aid him, by lectures and examinations on the different branches of medicine, in the education of his class. This arrangement was in efficient operation for several years, but was at length superseded by another, in which all the teachers were placed on a footing of perfect equality; the private pupils of each one of them being received on the same terms, and those of other private teachers, not belonging to the association, being admitted on moderate and specified conditions. It was in January, 1830, that this little school was formed. In accordance with the simple tastes of its most prominent member, it took the modest name of 446 A MEMOIR OF DR. SAMUEL GEORGE MORTON. "Philadelphia Association for Medical Instruction," a title which still survives in a highly respectable existing summer school, though the original association has long been dissolved. The first lectur- ers were the late Dr. Joseph Parrish on the practice of medicine, Dr. Franklin Bache on chemistry, Dr. John Rhea Barton on sur- gei'y, Dr. Morton on anatomy, and myself on materia medica. About the same time, another combination of the same character was formed, denominated, I believe, the "School of Medicine," in which Dr. C. D. Meigs taught midwifery. By an arrangement, mutually advantageous, the services of Drs. Bache and Meigs were interchanged; the pupils of the "Association" attending the lec- tures of the latter on midwifery, and those of the " School of Medi- cine" the chemical instructions of the former. Dr. Morton con- tinued to deliver annual courses on anatomy in this association for live or six years, when it was dissolved. His instructions were characterized by simplicity and clearness, without any attempt at display, and, so far as I have known, gave entire satisfaction both to his associates and pupils. On the 28th of November, 1831, he was chosen Corresponding Secretary of the Academy of Natural Sciences, and was thus brought into official communication with many scientific men in Europe and America. Reference was a short time since made to a work, based mainly upon his pathological investigations in the Alms House Hospital. It was denominated "Illustrations of Pulmonary Consumption," was printed in the early part of 1834, and contributed no little to the increase of his reputation as a practitioner. The work is an octavo of about 180 pages, treats of phthisis in all its relations, and is illustrated by several painted plates, executed with skill and accuracy. At that time little was known in this country of the admirable work of Louis on Consumption ; and the book of Dr. Morton no doubt contributed to the spread of sound views, both pathological and therapeutical, upon the subject. He particularly A MEMOIR OF DR. SAMUEL GEORGE MORTON. 447 insists on the efficacy of exercise in the open air in the treatment of the disease, following in this respect in the footsteps of his pre- ceptor, Dr. Parrish, to whose memory great honour is due, for his successful efforts to revolutionize the previously vague and often destructive therapeutics in phthisis. Yery soon after the publication of this work, in the year 1834, Dr. Morton had an opportunity of making a voyage to the West Indies, as the companion and medical attendant of a wealthy in- valid. On this occasion he visited several of the islands, making- observations as he travelled in relation to their geological struc- ture, and at the same time investigating, with peculiar attention, the influence of their climate upon phthisis, and their relative fitness as places of resort for consumptive patients from colder regions. Some time after his return from the West Indies, he edited an, edition of Mackintosh's Principles of Pathology and Practice of Physic, adding explanatory notes, and making numerous additions to supply deficiencies in the original work. A second American edition was published in 1837, under his supervision. When it was that he began to turn his attention especially to ethnological studies I am unable to say; but it is probable that the idea of making a collection of human crania, especially those of the aboriginal races of this continent, both ancient and modern, originated soon after he entered into practice, if not even pre- viously ; and, among the earliest recollections of my visits to his office, is that of the skulls he had collected. It is well known to you that much of his time and thoughts, and not a little of his money, were expended in extending and completing this collection, in which he was also materially assisted by his own private friends, and the friends of science in general, who were glad to contribute their aid to so interesting an object. The cabinet thus commenced was gradually augmented, embracing the crania of the lower ani- mals as well as those of man, until at length it grew to a magnitude almost beyond precedent; and, at this moment, it forms one of the 448 A MEMOIR OP DR. SAMUEL GEORGE MORTON. greatest boasts of our country in relation to natural science. It is ardently to be hoped that means may be found to secure its reten- tion here, and that it may ever continue to enrich the varied col- lections of our Academy, among which it has been deposited.* The possession of such materials naturally led to the wish to give diffusion and permanence to the knowledge which they laid open. Hence originated Dr. Morton's great work on American Crania, in which accurate pictorial representations are given of a great number of the skulls of the aborigines of this continent, with descriptions, historical notices, and various scientific observations ; all preceded by an essay on the varieties of the human species, cal- culated to give consistency to the necessarily desultory statements which follow. The preparation of this work cost the author a vast deal of labour, and an amount of pecuniary expenditure which has never been repaid, unless by the reputation which it gained for him, and the consciousness of having erected a monument to science, honourable to his country, and likely to remain as a durable memo- rial of his own zeal, industry, and scientific attainment. It was published in 1839. It is due to Dr. W. S. W. Ruschenberger to state, that the work was inscribed to him by Dr. Morton, with the acknowledgment that some of its most valuable materials were derived from his researches in Peru. In September, 1839, Dr. Morton was elected Professor of Ana- tomy in the Pennsylvania Medical College, the duties of which office he performed until November, 1843, when he resigned. In * I have been informed, on the very best authority, that, independently of all the assistance in making this collection afforded by others, it cost Dr. Morton somewhere between ten thousand and fifteen thousand dollars. Through the contributions of a number of gentlemen, interested in the scien- tific reputation of our city, this collection was secured for the Academy, and now forms a portion of its invaluable museum. It is due to the heirs of Dr. Morton to state, that the sum received for the collection bore but a small proportion to that expended in its formation. A MEMOIR OF DR. SAMUEL GEORGE MORTON. 449 that institution he was associated with the late Dr. George McClel- lan, who may be looked on as its founder, and for whom he formed a friendship which ended only with life. On the 26th of May, 1840, he was elected one of the Vice-Pre- sidents of the Academy of Natural Sciences, in which capacity he very often presided at its meetings, in the absence of the President. He was engaged about this time in preparing a highly interest- ing memoir on the subject of Egyptian Ethnography, based mainly upon the observation and comparison of numerous crania, in the collection of which he was much aided by Mr. George R. Gliddon, whose residence in Egypt gave him opportunities, which an ex- traordinary zeal, in all that concerns the ancient inhabitants of that region, urged him to employ to the best possible advantage. This memoir was embraced in several communications to the American Philosophical Society, in the years 1842 and 1843, which were pub- lished in the Transactions of that Society (Vol. ix., New Series, p. 93, a.d. 1844), and also in a separate form, under the title of " Crania Egyptiaca, or Observations on Egyptian Ethnogra- phy," with handsomely executed drawings of numerous skulls, de- rived from the pyramid of Saccara, the necropolis of Memphis, the catacombs of Thebes, and other depositories of the ancient dead in that region of tombs. In January, 1845, Dr. Morton was elected a Fellow of this Col- lege. That we did not more frequently see him among us, was probably owing to the unfortunate coincidence, at that time exist- ing, of the meetings of the College and Academy, which would have rendered necessary a neglect of his official duties in the latter institution, had he attended at the sittings of the former. It may be proper here to mention, though not in strict chronological order, that, by the appointment of the College, he prepared a brief biographical sketch of Dr. George McClellan, which was read in September, 1849, and published in the Transactions of that date. 450 A MEMOIR OF Dlt. SAMUEL GEORGE MORTON. In the years 1846 and 1847, he prepared essays " On the Eth- nography and Archaeology of the American Aborigines" and "On the Hybridity of Animals and Plants in Reference to the Unity of the Human Species," which were read before the Aca- demy, and afterwards published in the American Journal of Science and Arts (III., 2d ser., a.d. 1847). In these papers he advanced opinions upon the origin of the human family, which led to an unfortunate controversy, that, with his delicacy of feeling, could not but have in some measure disturbed the tranquillity of the latter years of his life. It is due to Dr. Morton to say that he did not consider the views, advocated by himself, as conflicting with the testimony of Scripture, or in any degree tending to in- validate the truths of revealed religion. During the year 1848, much of his time was devoted to the pre- paration of an elementary work on "Human Anatomy, Special, General, and Microscopic," illustrated by a great number of figures, and aiming to be an exposition of the science in its present improved state. Among his inducements to this work, not the least, as he states in the preface, was the desire to be enrolled among the expositors of a science that had occupied many of the best years of his life. Though laying no claim to originality in its facts or illustrations, the treatise cost him a great deal of labour, not only in the arrangement of the matter, the care of the en- gravings, and the superintendence of the press, but also in the verification, by microscopic observation, of the accuracy of the pic- torial representations of minute structure in which it abounds. It was issued from the press early in 1849; but, even before its pub- lication, he had begun to feel the effects upon his health, never robust, of the toilsome task he had undertaken, in addition to pro- fessional and official engagements, which alone would have been sufficient for the wholesome employment of his time and energies. Scarcely had his last duties in connection with this work on A MEMOIR OF DR. SAMUEL GEORGE MORTON. 451 Anatomy been performed, when, in December, 1848, he was at- tacked with a severe pleurisy and pericarditis, which brought him into the most imminent danger of life, and from the effects of which he never fully recovered ; for though, after a long confinement, he was enabled to go about, and even to resume his professional duties, he was left with great and permanent derangement of his thoracic organs. The very obvious depression of his left shoulder, and the falling in of the corresponding side of the chest evinced, at a glance, that with the absorption of the pleuritic effusion the lung had not ex- panded; and the loud murmur, obvious upon auscultation over the heart, proved to his professional friends that this organ had not escaped without serious injury. Notwithstanding, however, the amount of local derangement, his system rallied; and, after an ab- sence of some weeks from the city, he returned so much improved in health and strength, that he felt himself authorized to resume his active professional avocations, and general previous course of life, though with some abatement of his labours in the fields of original investigation and of authorship. Could his sense of duty, at this period, and the disposition to strong mental activity, which had probably become by habit almost a necessity of his nature, have permitted him to withdraw from all vigorous exertion, and to devote his time for the future rather to quiet enjoyment than to laborious effort, it is not impossible thas his life might have been considerably prolonged. Such was the advice of some of his medical friends ; but stronger influences im- pelled him to exertion ; and, like most men who feel themselvet irresistibly drawn into a certain course of action, he succeeded in reconciling this course- not only to his general sense of duty, but even to his views of what was required under the particular cir- cumstances of his health. He was convinced that, by active bodily exertion, he should be most likely to bring his defective lung back 452 A MEMOIR OF DR. SAMUEL GEORGE MORTON. again to the performance of its function ; and certainly, for a time, his improving appearance and increasing strength under exercise seemed to justify the system he had adopted. Before adverting to the closing scene, let us stop, for a very few- minutes, to take a view of his character and position at this period, which, if the consideration of his health be omitted, was the most prosperous of his life. His election to the presidency of the Academy of Natural Sciences, which took place December 25, 1849, had given him an official position than which he could not expect to gain one more honourable, and than which society in this country have few more honourable to bestow. Of an amiable and benevolent temper, in- disposed to give offence, or to wound the sensibilities of others, he had conciliated general good-will; while his affectionate disposi- tion, his deep interest in those to whom he was attached, and his readiness to serve, secured him warm friends, especially in the circle of his patients, who in general had much regard for him personally, as well as great trust in his skill. Powers of quick and accurate observation, and a sound cautious judgment were perhaps his most striking intellectual characteristics, and naturally led him into those departments of science where they could be most efficiently exercised. By strict attention to his professional duties, even in the midst of his scientific researches, by an affectionate interest in his patients, inspiring similar sentiments on their part, and by a system of cau- tious but successful therapeutics, he gained a large, and for Phila- delphia, a lucrative practice, which, with some income derived by inheritance from an uncle in Ireland, enabled him to live hand- somely, and not only to entertain his scientific friends and asso- ciates on frequent occasions at his house, but also to extend hospi- talities to strangers, whom his reputation attracted towards him upon their visits to our city. His friends will not soon forget the A MEMOIR OF DR. SAMUEL GEORGE MORTON. 453 weekly soirees, at which they enjoyed the pleasure of combined social and scientific intercourse, and had the frequent opportunity of meeting strangers, distinguished in the various departments of learning and philosophy. His extensive professional relations, and his reputation both as a practitioner and teacher of medicine, attracted to his office many young men disposed to enter into the profession ; and he usually had under his charge, towards the close of his life, a considerable number of private pupils, to whom he devoted much time, and his most conscientious endeavours to qualify them to be good physi- cians. Numerous learned and scientific associations in different parts of America and Europe had enrolled him among their members; and perhaps few men in this country had a more extensive correspond- ence with distinguished individuals abroad.* To be praised by the praised is certainly a great honour ; and this Dr. Morton was happy enough to have won in no stinted measure. With these meritorious qualities, these well-earned distinctions, and these diversified sources of comfort and enjoyment, with the crowning pleasures, moreover, of domestic confidence and affection, and bright hopes for a rising family, our late friend and fellow- member may be considered, at this period of his life, as one of the most happy of men in all his exterior relations. The only draw- back was the uncertain state of his health. From early manhood he had been of delicate constitution. Two attacks of severe haematemesis had on different occasions threat- ened his life ; and for a long time he suffered much with excruciat- ing attacks of sick headache, which most painfully interrupted his scientific and professional avocations, and not unfrequently con- * For a list of the societies of which lie was a member, see the Appendix to Dr. Meigs's Memoir. 454 A MEMOIR OF DR. SAMUEL GEORGE MORTON. fined him for a time to his bed. For many years of his earlier life, his pale complexion and spare form indicated habitually feeble health; but at a more advanced period he seemed to have greatly improved in this respect, exhibiting a more healthful colour and more robustness of frame ; and, but for the terrible attack which prostrated him in the winter of 1848-49, there seemed to be no reason why he should not live to a good old age. But the fiat had gone forth ; and, though a respite was granted, it was des- tined to be short. A painful incident, which happened about this time, may possibly have had some effect in aggravating the morbid tendencies, already unhappily strong. I refer to the illness and speedy death, in May, 1850, of an affectionate, dearly loved, and highly promising son, to whose future he was looking forward with much, and appa- rently well-founded, confidence. Perhaps at no time was Dr. Morton more busily occupied in practical duties than during the year or two which preceded his death. He was indefatigable in attendance upon his numerous patients, devoted no little time to the instruction of his private pupils, and never voluntarily omitted the performance of his aca- demic functions. In the midst of this career of usefulness, he was seized with an illness, which, commencing on the 10th of May with a moderate headache, became more severe on the following day, and, though afterwards relaxing so much as to give hopes of a return to his ordinary health, ended in an attack of stupor and paralysis, which proved fatal on the 15th, the very day upon which, one year previously, he had witnessed the death of his son. Dr. Morton was considerably above the medium height, of a large frame, though somewhat stooping, with a fine oval face, pro- minent features, bluish-gray eyes, light hair, and a very fair com- plexion. His countenance usually wore a serious and thoughtful expression, but was often pleasingly lighted up with smiles, during A MEMOIR OP DR. SAMUEL GEORGE MORTON. 455 the relaxation of social and friendly intercourse. His manner was composed and quiet, but always courteous, and his whole deport- ment that of a refined and cultivated gentleman. He left behind him a widow and seven children, five sons and two daughters, several of whom have advanced to adult age, and are engaged in active life. In the remembrance of the virtues, the attainments, the fruitful labours, and the well-earned reputation of the husband and father, they have a legacy far more precious than the gifts of fortune ; an inheritance which no mischances of this world can impair, and which will be handed down as a priceless heirloom to their latest posterity. INDEX. Abuses of the Materia Medica... 124 Address at the Medical Com- mencement in April, 1841 352 Address at the Medical Com- mencement in March, 1836 331 Address at the Medical Com- mencement in March, 1856 370 Addresses, Pharmaceutical 1 Addresses to Medical Graduates.. 329 Address to the Graduates of the Philadelphia College of Phar- macy 30 Addresses to the Medical Grad- uates of the University of Pennsylvania 327 Address to the Members of the Philadelphia College of Phar- macy 3 Allopathy and Allopathists, im- propriety of the names 252 American Colleges of Pharmacy 99 American Journals of Pharmacy 95 Amphitheatre of the Hospitals at Paris 308 Animal Magnetism, as a Remedial Agent 161 Apothecaries in England 259, 284 Apothecary, Standard of Attain- ment and Character of the.... 5 Arabian Writers on Materia Me- dica 61 Association for Medical Instruc- tion, Philadelphia 403, 446 Authors on Materia Medica, Ame- rican.... 86,93 Authors on Materia Medica, mod- ern 73 30 PAGE Bache, Franklin, M.D.. 30,93,301,446 Bachelor of Medicine, Degree of, in the University of Pennsyl- vania 344 Barton, Benjamin Smith, M.D. 86,194 Barton, John Ehea, M.D 446 Barton, Win. P. C , M.D 89 Bartram, John 85 Basil Valentine 64 Beck, John B., M.D 94 Beck, Lewis C, M.D 94 Bell, John, M.D 93, 94 Biddle, John B., M.D 94 Bigelow, Jacob, M.D 89 Biographical Memoirs 385 Bond, Dr. Thomas 335 Broussais 110, 260 Brown, Dr 110 Carson, Joseph, M.D 94, 95 Celsus, Writings of 68 Chapman, Nathaniel, M.D., sketch of the character and life of. 208 Chapman's Therapeutics and Ma- teria Medica 92 Character and Objects of the Medical Profession 230 Chemists, Sect of the 64 Choice of Medicines 160 Christison, Dr 282 Clayton, Dr. John 85 Clinical Instruction, Importance of 225 Clinical Instruction in Europe.... 307 Colden, Dr. Cadwallader 85 College of Physicians of Phila- delphia 28 (457) 458 INDEX. Colleges of Pharmacy, American 99 Continent of Europe, Medical Profession in the 300 Coxe, John Redman, M.D 92 Death, in what manner to be viewed 381 Degree in Pharmacy, Importance of establishing 15 Demonstrative Teaching, Import- ance of 222 Dewees, Dr.Wm. P 342 Dioscorides, Writings of 59 Dogmatists. Sect of the 56 Dorsey, John Syng, M.D 341 Dunglison, Robley, M.D 93,94 Eberle's Materia Medica and Therapeutics 93 Efficiency of Medicine 266 Ellis, Benjamin, M.D 30, 93 Elmer, Jonathan, M.D 336 Elmer, William, M.D 336 Emotions as Remedies 149 Empiricism 138, 186, 367 Empirics, Sect of the 56 European Continent, Medical Profession on the 300 European Schools of Medicine.... 304 European Writers on Materia Medica, modern 73 Examinations, Importance of, in Medical Instruction 222 Examinations in the Medical Schools of Europe 310 Faith as a Remedy 155 False Theory, Influence of, in the Use of Medicines 130 Fashion, Influence of, in the Use of Medicines 129 Feelings as Remedies 149 Frost, Henry R., M.D 94 Galenists Sect of the 64 Galen, Writings of 59 General Practitioners in England 284 Gerhard, Wm. W., M.D 423 PAGE Germany, Medical Schools of 305 Graduates, Annual Number of, in the Medical Department of the University of Pa 343, 344 Graduates of the Philadelphia College of Pharmacy, Address to the 30 Great Britain, Medical Profes- sion in 275 Griffith, R. Egglesfeld, M.D 94, 95 Griffitts, Samuel Powell, M.D 393 Hare, Robert, M.D 180 Harlan, Richard, M.D 440 Harrison, John P., M.D 94 Hippocrates, Writings of 55 History of Materia Medica 53 History of Materia Medica in the United States 76 History of the Medical Depart- ment of the University of Pa.... 331 Hodge, H. L., M.D 210 Homoeopathy and homceopathists, 132, 252, 260 Hooker, Worthington, M.D 94 Hope as a Remedy 153 Horner, Wm. E., M.D 210, 321 Hospitals as Schools of Medicine in Europe 292, 307 Hospitals in Europe 313 Imagination as a Therapeutic Agent 158 Imperfection of Medicine 257 Imperial Medico -Chirurgical Academy of St. Petersburg.... 318 Importance of Materia Medica... 105 Importance of the Practice of Medicine 214 Intellectual Faculties, Remedial Influence of the 157 Introductory Lectures on Ma- teria Medica 51 Introductory Lectures to the Course on the Theory and Practice of Medicine 191 INDEX. 459 PAGE Ireland, Medical Instruction and Profession in 296 Isaac of Holland 64 Jackson, Samuel, M.D... .12, 210, 321 Journals of Pharmacy, American 95 Journey in Europe 301 Kuhn, Dr. Adam 335 Lectures, Advantages of. 121 Lectures Introductory to the Course on Materia Medica in the University of Pennsyl- vania 49 Lectures Introductory to the Course on the Theory and Practice of Medicine 189 Lectures on the Theory and Practice of Medicine, plan of.. 206 Lee, Charles A., M.D 94 McClellan, George, M.D 449 Maryland College of Pharmacy./ 95 Materia Medica, Abuses of the.. 124 Materia Medica, American Wri- ters on 85, 93 Materia Medica, History of 53 Materia Medica, History of in the United States 76 Materia Medica, Importance of.. 105 Materia Medica, modern Euro- pean Writers on 73 Medical Department of the Uni- versity of Pennsylvania, His- tory of the.... 331 Medical Education in Russia 318 Medical Education on the Conti- nent of Europe 304 Medical Instruction, Philadel- phia Association for 403, 446 Medical Profession, Character and Objects of the 230 Medical Profession in Great Bri- tain, Lecture on the 275 Medical Profession on the Conti- nent of Europe, Lecture on the 300 PAOE Medical Schools in England 291 Medicines of American Origin... 77 Meigs, Charles D., M.D 435, 446. Memoir of Dr. Joseph Parrish.... 387 Memoir of Dr. Samuel George Morton 435 Memoirs, Biographical 385 Mental Agency in the Treatment of Disease 145 Mercenary Spirit in the Medical Profession, effects of 234 Mesmerism as a Remedial Agent 161 Michaux the Elder 87,88 Michaux the Younger 88 Mitchell, John K., M.D 164, 210 Mitchell, Thos. D., M.D 94 Moral Remedies 148 Morgan, Dr. John 334 Morton, Samuel George, M.D., Memoir of. .'. 435 New York College of Pharmacy.. 99 Novelty, Influence of, in the Choice of Medicines 176 Novelty, Influence of, in the Use of Medicines 129 Otto, John C, M.D 429 Paine, Martyn, M.D 94 Paracelsus 64 Parrish, Dr. Joseph, Memoir of.. 387 Parrish, Edward 94 Passions as Remedies 149 Pereira, Dr 282 Pharmaceutical Addresses 1 Pharmacopoeia of the Medical Society of Massachusetts 97 Pharmacopoeia of the United States 27, 98, 169 Pharmacopoeias, British 97 Pharmacy, State of the Profes- sion of 33 Philadelphia as a Seat of Medi- cal Instruction 345 Philadelphia Association for Me- dical Instruction 403, 446 460 INDEX. PAGE Philadelphia College of Phar- macy 3, 11 Physicians and Surgeons of the Continent of Europe 315 Physicians in England 277 Physick, Dr. Philip Syng, Notice of 340 Pliny, Natural History of 59 Polished Manner, Importance of, to the Physician 245 Poplar Worm 395 Practice of Medicine, Import- ance of 214 Practice of Medicine, not a Par- ticular System 251 ■ Practice of Medicine, Scope of.... 251 Procter, Prof. Wm., Jr 95 Professional Secrecy 249 Professional Spirit, Importance of ." 357 Profession of Medicine, Influ- ence of, on its Members 363 Professions of Medicine and Pharmacy, Separation of the, 20, 35 Pursh, Frederick 88 Quackery 138, 186, 367 Qualifications of a Physician 358 Ruschenberger, W. S. W., M.D. 448 Rush, Dr. Benjamin 110, 260, 336 Russia, Medical Profession and Schools in 318 Schools of Medicine, European.. 304 Scope of the Practice of Medi- cine 251 Scotland, Medical Instruction and Profession in 296 Scribonius Largus, Writings of... 58 Secrecy, Professional 249 Secret Medicines.... 184 Sessions, Length of, in Medical Schools 204 Shippen, Dr. William 334 Shoepf, Dr 86 Skepticism in Medicine 265 PAGE Smith, Daniel B 37 Somnambulism 161 Sordid Views in a Physician, Tendencies of. 234 Spontaneous Curability of Dis- eases 261 Stille, Alfred, M.D 94 Studies after Graduation 354 Study as distinguished from Reading 218 Study of Medicine, Requisites in the 213 Study of the Theory and Prac- tice of Medicine 221 Surgeons in England 282 Term of Study in the Schools, Extent of the 204 Thatcher, James, M.D 92 Theory and Practice of Medi- cine, Extent of, as a Branch of Study 196 Theory and Practice of Medicine, Importance of 197 Theory and Practice of Medicine, Introductory Lectures to 191 Theory in Medicine 256 Therapeutics and Pharmacology, Treatise on, by the Author 94 Tully, William, M.D 90, 94 Typhous Epidemic of 1812-13... 398 United States Dispensatory 93 University of Pennsylvania, His- tory of the Medical Depart- ment of the 331 Van Helmont 64 Wistar, Dr. Caspar, Notice of, 339, 411, 413 Writers on Materia Medica, Ame- rican 86, 93 Writers on Materia Medica. mo- dern 73 Wylie, Sir James, Sketch of the Life of 320 W,T.in igtyi 3477 ■ ■ I :» ■