BECK 
 
 An Introductory i»ecture 
 
 ;--■••-•» 
 
 ■ 
 
M-K736 
 
 .;- . 
 
 Columbia (Bntoetsitp 
 
 College of logicians anb burgeons; 
 ILtorarp 
 

 DR. BECK'S 
 INTRODUCTORY LECTURE. 
 
 NOVEMBER 5, 1830. 
 
AN 
 
 INTRODUCTORY LECTURE, 
 
 DELIVERED AT THE 
 
 COLLEGE OF PHYSICIANS AND SURGEONS 
 
 CITY OF NEW-YORK, 
 
 NOV. 5, 1830. 
 
 » 
 
 BY JOHN B. BECK, M. D. 
 
 Prof i i Materia Medicaand Medical Jurisprudence in the University of the 
 State ol New-York< 
 
 NEW-YORK : 
 
 H i ai;\ ILL 108 BROADW K\ 
 
 IHUI). 
 
- V 
 
 % 
 
 /&0 
 
TO THE STUDENTS 
 
 * 
 
 OP THE 
 
 COLLEGE OF PHYSICIANS AND SURGEONS 
 
 OF THE CITY OF NEW- YORK, 
 THE FOLLOWING LECTURE IS AFFECTIONATELY INSCRIBED, 
 
 BY THEIR FRIEND 
 
 THE AUTHOR. 
 
Digitized by the Internet Archive 
 
 in 2011 with funding from 
 
 Open Knowledge Commons 
 
 http://www.archive.org/details/introductorylect1830beck 
 
LECTURE, 
 
 In the whole career of human existence, there is perhaps 
 no question to the determination of which a man may be 
 called, so really important to himself as that which relates 
 to the business or profession which is to occupy the thoughts 
 and labours of his future life. According to the decision which 
 he here makes, may his fortunes be prosperous or adverse, 
 and his name destined to honour or contempt. The reason 
 is obvious. Man is the creature of circumstances. Con- 
 stituted by his Creator a social being — endowed with sus- 
 ceptibilities of being influenced by others of his species, it 
 is evident that his character and destiny must, to a very great 
 extent, be controlled by the associations which necessity — 
 or accident — or fortune may have forced upon him. Hence 
 it ifl that by education and example he is formed to good or 
 to evil. By the kindred spirits with whom he sympathizes 
 Bod acts, I": ifl stirred to lofty purposes and a noble ambition, 
 or sunk into base thoughts and unworthy practices. 
 
 It is not merely, however, this general influence, which, 
 morn "i leu i itensively, is fell in every occupation and in 
 
 m ry situation in life, t li:ii invests with so high an interest) 
 
6 
 
 the choice of a profession. The minds of men differ as 
 much as their physical structures. It is impossible therefore 
 that all can apply themselves to the same subject with equal 
 chances of success. On this account it is that instances are 
 so frequently met with of men, even of powerful under- 
 standings and abundant knowledge, proving unsuccessful in 
 particular professional avocations. Energies are lost or 
 wasted on subjects unsuited to their nature, which had they 
 been directed to other and more congenial pursuits, would 
 have placed them in the foremost ranks of successful com- 
 petition, and perhaps transmitted their names with renown 
 to after ages. 
 
 It is evident, therefore, that much of a man's character in 
 life may depend upon the profession which he may select, 
 and the adaptation of it to his peculiar powers. 
 
 You, Gentlemen, have made this selection, and, I doubt 
 not, with a due regard to its just importance : and you have 
 chosen a study which in its dignity, general interest, and ex- 
 tended practical utility, is inferior to none. Of its dignity 
 and utility, it is almost unnecessary to say any thing. Its 
 claims to these do not rest upon the dubious grounds of ab- 
 stract speculation — they are laid deep in nature. There is 
 nothing so valuable to man as his life ; and the means designed 
 to save and prolong it must be viewed as among the greatest 
 of earthly blessings. Hence it is that wherever human be- 
 ings have been found, Medicine has always been held in the 
 highest esteem. While in civilized society and among cul- 
 tivated nations, it has been looked upon as one of the noblest 
 and most liberal of arts, among savage nations it has been 
 
invested with a character more sacred, and allied to the 
 Divinity itself. A concurrence of opinion so universal 
 among mankind — in countries most remote from each other 
 — in periods most distant — of nations the most rude and the 
 most refined, could never have existed without a sure and 
 just foundation in truth. Of the general estimation there- 
 fore in which medicine is held, as well as of its public utility, 
 there can be no doubt. It is not in these points of view 
 solely, however, that it should be looked upon by those who 
 propose to make it the study of their lives. They should 
 look upon it in its relations to the wide range of human 
 knowledge, and the influence which it may exercise imme- 
 diately or remotely upon their intellectual and moral natures. 
 It is only by such an analysis that the question can be de- 
 cided, whether they are about to devote their labours to 
 studies which shall mature and expand and brighten their 
 faculties, and render their career honourable to themselves 
 and useful to the world. 
 
 In casting round for a subject on which I might address 
 you on the present occasion, it has struck me that there could 
 be none more appropriate than such an analysis of the study 
 of medicine, mainly with a view of urging upon you its 
 proper cultivation. The subject is one of interest and im- 
 portance, and to do full justice to it would require more time 
 mil discussion than could with propriety be appropriated to 
 the present exercise. I shall therefore conlinc myself to a 
 i;i|>i<l notice of two or threw important points, reserving the 
 hi' future opportunit) . 
 
 The great and l< lading idea that I would present to you, is 
 
that the science of medicine is essentially the study of man, 
 To a certain extent this is true, also, of the other liberal 
 professions : not however in the broad sense in which it is 
 so of medicine. Man is a compound being, and it is only 
 here that in all his parts, animal, moral and intellectual, he 
 is made the subject of profound investigation. It is this 
 knowledge of man, which in fact is the basis of our science. 
 He is accordingly first considered and analyzed as an ani- 
 mated piece of mechanism, furnished with certain organs 
 and endowed with certain powers designed to support and 
 prolong his own existence, and to perpetuate the species. 
 Next he is viewed as the creature of passions, under whose 
 stormy sway he is impelled to good or to evil, rendered 
 happy or miserable. Finally he is contemplated as gifted 
 with an intellectual nature, shining out gloriously in those 
 mental operations which so pre-eminently raise our species 
 over the brute creation. Now, constituted as man is, all 
 these different parts of his being reciprocally influence each 
 other. At one time, we see the whole physical organization 
 agitated and disturbed by the fury of the passions, or sinking 
 before the deeper impulses of the intellect. Then again, 
 we see the passions running wild, and the intellect itself 
 shaken on its very throne, by perverted conditions of the 
 physical organs. To trace out there relations and to mark 
 their varied results, as it is one of the most profound, so is 
 it one of the most interesting and important studies con- 
 nected with our science. 
 
 But it is not merely as an individual, that man is to be 
 examined. In all his relations with the species, under all the 
 
various circumstances, and in all the different situations in 
 which he may be found, he is to be analyzed. When first 
 placed upon this earth, his dwelling limited to one region, 
 using the same diet, subject to the same atmospheric vicissi- 
 tude", and influenced by the same moral and religious causes 
 -the probability is, that for a long period the human family 
 was characterized by striking resemblances. Diseases were 
 few and simple ; and the susceptibility of the system to the 
 impression of external agents, whether noxious or salutary, 
 morbid or medicinal, marked by a general uniformity. In 
 process of time, however, man overleapt the limits of his 
 originalOiabitation, and urged his way to other and remote 
 regions, until finally he overspread the surface of the earth ; 
 and he is now found under every climate, in every state of 
 society, with manners and customs the most diverse. Yield- 
 ing to the sway of varying causes, he now loses his unifor- 
 mity. Preserving only those great general features which 
 identify the unity of his origin, in other respects he becomes 
 changed and modified. His colour varies, and we see in one 
 part of the globe, the white man ; in another, he assumes the 
 yellow or olive tint ; in a third, we find him of the red or cop- 
 per colour ; in a fourth, brown or tawny ; while in another, 
 he is perfectly black. Along with his colour, his structure un- 
 dergoes various modifications, and hence we have what arc 
 called the different varieties of the human race. From the 
 same causes, the vital properties of the system become mo- 
 
 (ll i 1(( l. In cold northern regions, the g sral sensibility is 
 
 blunted by the rigour of the climate. While the muscular 
 system is fully developed, the brain and nerves exert but little 
 
 2 
 
10 
 
 influence. There is a general dullness and slowness of body 
 as well as of mind : capable of great efforts when roused, 
 but requiring extraordinary excitements to rouse them. In 
 equatorial regions, the reverse of all this is seen. Here the 
 nervous system predominates. All the sensibilities are awake. 
 The skin, constantly stimulated by the heat of the climate, 
 keeps up a corresponding excitement in the digestive organs. 
 While the muscular system is enfeebled, there is a general 
 excitability, which is called into full development by the 
 slightest stimulants. It is owing to this, that so marked a 
 difference is found in the effects which are produced by sti- 
 mulating liquors upon the inhabitants of northern and south- 
 ern regions. What w r ould intoxicate the latter, produces 
 scarcely any effect upon the former. ' A quantity which 
 barely ruffles the frozen current of a Norwegian's blood, 
 would scatter madness and fever into the brain of the Hin- 
 doo.' The mind itself participates in these effects — the 
 imagination rises ascendant over the other faculties — and 
 man sinks into indolence and voluptuousness. 
 
 If we follow man still further and trace him in different 
 states and stages of society, we shall find him marked by 
 striking peculiarities. In one he will be found with a body 
 inirritable, and a mind inactive and obtuse; while in another, 
 he will be exhibited as the victim of sensibility and excite- 
 ment, physical as well as moral. 
 
 Now in all these varied conditions man is to be studied in 
 all his peculiarities, inasmuch as upon these depend, not 
 merely the character of the diseases to which he may be 
 subject, but also the mode in which they are to be treated. 
 
11 
 
 Extensive and profound however as this investigation may 
 already appear, it is very evident that it would be exceed- 
 ingly defective were it not, at the same time, connected with 
 the study of the various agents which exert their modify- 
 ing influences over the human frame. Hence it is that 
 medicine levies contributions upon almost every department 
 of human knowledge. Artificial agents too, employed in 
 the cure of diseases, are to be carefully investigated, and as 
 they are drawn from the different kingdoms of nature, they 
 form a natural association with a number of sciences, the 
 most elegant and useful. 
 
 From this simple view of the nature of medical science, 
 it must be obvious that it is of vast extent and abundant 
 variety. Even to those who have no idea of practising it, 
 there is no subject which can form so proper and solid a basis 
 for the study of general science, or for any other profes- 
 sional pursuit, to which taste or ambition may subsequently 
 invite. The natural tendency of all individual studies, to a 
 certain extent, is adverse to any great enlargement of the 
 mental faculties. By making one subject a matter of par- 
 amount attention, the mind is led to attach an undue import- 
 ance to it. Indeed, so much of the grand capital of a man's 
 life, labour and time, may have been expended upon it 
 as to invest it with a real consequence to him, which intrin- 
 sically it does not possess. In proportion as this feeling 
 predominates, the mind is abstracted from other subjects, 
 and insensibly depreciates their value. All the professions 
 -iill'-r from this cause, more or less, and all professional men 
 feel the <l< leterious influence of it on their intellectual powers. 
 
12 
 
 To this general tendency of professional pursuits, medi- 
 cine, however, is the least obnoxious ; and the reason obvi- 
 ously is, because it is based on a wider extent of knowledge, 
 and presents to the mind a more expanded and liberal view 
 of the relations of man to the various sources of knowledge, 
 as well as of the connexion and dependencies of the sciences 
 upon one another. 
 
 Hence it is that medicine has always sustained so high a 
 reputation among the learned. Sir William Temple says of 
 it, " it is certain that the study of physic is not achieved in 
 any eminent degree, without very great advancement in the 
 sciences ; so that whatever the profession is, the professors 
 of it have been generally very much esteemed on that ac- 
 count, as well as of their own art, as the most learned men 
 of their ages." Hence too can be explained, very readily 5 
 the fact of the versatility of physicians, and the facility with 
 which they can pass from their own profession to other stu- 
 dies and occupations, and why they are found to excel fre- 
 quently more in these than they would have done in medicine. 
 The study of medicine puts it in their power to take a ge- 
 neral and wide view of all the departments of knowledge, 
 and thus enables them to select for especial pursuit such as 
 may be most congenial to their taste. In this way it is that 
 scarcely a spot in the vast domain of science has been left 
 untrodden by the footsteps of medical men. Chemistry, so 
 wonderful in itself and so incalculable in its applications to 
 the useful arts, owes every thing to the labours of physicians. 
 Who are our zoologists, geologists, botanists, mineralogists ? 
 Generally, physicians. In the noble expeditions fitted out 
 
13 
 
 by enlightened monarchs and governments, to extend the 
 knowledge of our earth, who have been among the most 
 efficient agents in carrying them through 1 Why, physicians. 
 Indeed, wherever curiosity, enterprise, or the love of sci- 
 ence have drawn men, there you will find the votary of medi- 
 cal science. At one time you see him diving into the 
 mysteries of Babylonian antiquities — then unravelling the 
 manuscripts of Herculaneum — now expounding the subtle- 
 ties of metaphysical science — or shining in the walks of 
 elegant literature. At one time you see him scaling the 
 Alps or the Andes — at another exploring the treasures of the 
 ocean. You see him in the frozen regions of the north, and 
 under the burning suns of the tropics — the pilgrim of the 
 desert — the companion of savage beasts and still more sa- 
 vage men ; and amid hardships, and privations, and dangers, 
 and sufferings, he is borne along by an enthusiasm as pow- 
 erful as it is unquenchable. 
 
 Now it is self-evident, that any study which has the magic 
 influence of thus setting on fire in its votaries, the love of 
 science, and inspiring them with a zeal so noble, cannot but 
 have a broad and liberal foundation. Without wishing to be 
 invidious, it may boldly be asked, what other profession can 
 claim to itself this honour? 
 
 It has been a common objection to our science, that it is 
 not certain in its principles — in other words, that it is a con- 
 ji rln nil art. That such an opinion should be entertained 
 by those who look at medicine simply on the surface, is not 
 to be wondered at \ and all who have not made it the subject 
 of especial study, may be considered as in this condition. 
 
14 
 
 Ignorant of its real claims to confidence, they judge of it 
 from insulated facts and occurrences in ordinary practice, 
 where apparent contradictions are continually presenting 
 themselves ; or what is still more unjust, they form their 
 opinion of it from the speculations and theories of vain and 
 superficial minds, or the absurdities and ignorance of prac- 
 titioners unworthy of the noble science which they profess. 
 Tested by such a rule, every other science and art might 
 be shown to be equally uncertain and conjectural. What 
 can be more contradictory than the opinions of those who 
 practise the profession of the law ? And yet what man lay- 
 ing claim to even ordinary intelligence, will not allow that 
 the great principles of law are founded in truth and nature ; 
 or in the language of Lord Bacon, that " there are in nature 
 certain fountains of justice, whence all civil laws are derived 
 but as streams ; and like as waters do take tinctures and 
 tastes from the soils through which they run, so do civil laws 
 vary according to the regions and governments where they 
 are planted, though they proceed from the same fountains."* 
 Religion too, judged by the varying and contradictory opi- 
 nions of men, must be pronounced uncertain and conjec- 
 tural, not merely in its sacred and mysterious doctrines, but 
 even in its more obvious ethical precepts. A rule of judg- 
 ment, therefore, which is not just in law or religion, certainly 
 cannot be admissible in its application to medicine. Any 
 argument, therefore, drawn from this source against the cer- 
 
 * Advancement of Learning, p. 355. 
 
51 
 
 tainty of our science must fall to the ground, inasmuch as if 
 it proves any thing, it proves too much — if admitted in this 
 •case, it would subvert the certainty of almost every other 
 science. 
 
 The only method of accurately estimating the value of 
 our science is, to judge of it simply by itself, and if this 
 common justice be done, there will be little difficulty in 
 showing that its foundations are laid deep in truth and na- 
 ture, and therefore, that it is not conjectural. If medicine 
 be uncertain, it must be for one or other of the following 
 reasons. In the first place, because diseases are ever vary- 
 ing in their character. In the second place, because medi- 
 cines are uncertain in their operation. In the third place, 
 because in the application of remedies to particular diseases 
 so much tact and skill are required, as to place it beyond 
 the rules of an ordinary science. 
 
 It is only for one or other of these reasons that medicine 
 can be uncertain ; for if diseases are always the same — if 
 remedies are always certain in their operation, and if the 
 application of remedies to diseases be established upon clear 
 principles or certain observation, no one probably will pre- 
 tend that medicine is an uncertain art. For the purpose of 
 ascertaining how far all this is justly applicable, I shall make 
 a remark or two upon each of these points. 
 
 As diseases occur in a living machine which is liable to be 
 modified by a great variety of causes, it is very evident that 
 they cannot, in all persona and under all circumstances, put 
 on precisely the same appearances. Unless however it can 
 be shown that these differences are altogether arbitrary, and 
 
16 
 
 not governed by any rule, this fact, so far from showing the 
 uncertain character of diseases, goes rather to establish 
 the reverse. Now in tracing back the annals of medicine, 
 we shall find that in all their essential features, diseases are 
 the same in the present day that they were a thousand years 
 ago, and that the modifications to which they are liable in 
 particular subjects, or in different countries, are all owing to 
 the operation of causes, many of which are known and ap- 
 preciated. The descriptions given us by Hippocrates, espe- 
 cially of acute diseases, are true to this very hour, varied of 
 course in some respects by climate, modes of living, and 
 other circumstances. If therefore the fact of diseases differing 
 in this way were not known, then indeed all would be un- 
 certainty and confusion. The variety might surprise us un- 
 expectedly, and involve us in doubt and error. As the fact 
 however is known that such varieties do occur, and as it is 
 one of the fundamental businesses of our science to analyze 
 these, as well as the causes which give rise to them, it can- 
 not, with any justice, be urged that on this account there is 
 any uncertainty in the general character of diseases. 
 
 In the next place, in regard to medicines, they are no 
 more doubtful and uncertain in their operation than diseases 
 are in their symptoms. An emetic will vomit and a cathar- 
 tic will purge as certainly and invariably now, as they did 
 hundreds of years ago. Under the different circumstances 
 however in which the human system may be placed, they will 
 produce their effects with greater or less facility, and in larger 
 or smaller quantities. Children, for instance, are vomited 
 with greater ease than adults ; as a general rule too in warm 
 
17 
 
 climates, from the greater sensibility of the stomach, smaller 
 doses of emetics are required than in northern regions, 
 where the stomach participates in the general insusceptibi- 
 lity of the whole system. It is very obvious, nevertheless, 
 that all this does not prove any uncertainty in their opera- 
 tion. It merely proves that their effects are controlled and 
 modified by certain circumstances, which it is the province 
 of medical science to elucidate. 
 
 In the last place, with regard to the tact and skill required 
 in the application of remedies to diseases, it is not necessary 
 to say much. It should be recollected that medicine is 
 not a mere mechanical art, and therefore does not admit 
 of being reduced to mechanical rules. This, however, 
 by no means proves that it is uncertain, or that it does 
 not rest upon a sure foundation. To become acquainted 
 with the facts and principles which it embraces, is within the 
 reach of any ordinary capacity. But in this, as in every other 
 pursuit, men are not all found equal, and high excellence 
 is not to be attained without a peculiar adaptation of genius. 
 The same holds true of every science. It does so of the 
 mathematics, the most exact of the sciences. Of music 
 also, the principles are well founded, and yet how few are 
 there capable of creating those combinations of sounds which 
 have immortalized the names of Mozart, Handel, and Ros- 
 sini ? And so it is with medicine. In the development, com- 
 bination, and application of its principles, the genius of one 
 man will shun- pre-eminently above his fellows. 
 In ilni- conti tiding foi the certainty of our science, if is 
 
 :: 
 
18 
 
 by no means to be considered as perfect Resting <an the 
 basis of observation and experiment, and these requiring to 
 be made upon man in all his phases, it is very obvious that 
 it must necessarily have been of slow growth. Encoun- 
 tering in itself intrinsic difficulties, we shall find in tracing 
 back its history, that it has suffered from the same causes 
 which exerted an influence so baneful over the other sci- 
 ences. Eminently fortunate in its first father, who laid 
 its firm foundations, after his time, medicine in common 
 with every other department of knowledge, became the 
 victim of a false philosophy, which if it did not wholly 
 extinguish the lamp of truth, so dimmed and obscured its 
 light, that men groped their way without an object and with- 
 out a guide. For centuries the human mind was like a vessel 
 driven about on the trackless ocean, without a star or a pilot 
 to direct it. There was one general eclipse of truth over 
 the world. At last the great orb of day arose upon the 
 chaos of the intellectual world. Lord Bacon appeared, and 
 advancing with a giant's strength, bore away upon his shoul- 
 ders the pillars of the temple of error. With one tremen- 
 dous crash, the stupendous fabric fell to the ground, burying 
 amid its ruins the labours and genius of ages. Previous to 
 this grand catastrophe, it is true that medicine did not ad- 
 vance, and at this period its condition was such as, fully to 
 justify what Bacon says of it. " Medicine is a science which 
 hath been more professed than laboured, and yet more la- 
 boured than advanced ; the labour having been, in my judg- 
 ment, rather in a circle than in progression. For T find much 
 
19 
 
 aeration, but small addition."' Since this sentence was 
 pronounced upon our science, whoever will take the trouble 
 of examination, will find in it the most wonderful improve^ 
 ment. Perhaps a more satisfactory method of showing this 
 could not be resorted to than simply to notice the deficien- 
 cies in it, pointed out by Lord Bacon himself. With that 
 intuitive comprehensiveness which so peculiarly character- 
 ized his mighty intellect, he saw not merely that the mode of 
 investigating truth was erroneous, " being a philosophy only 
 strong for disputations and contentions, but barren of the 
 production of works for the benefit of the life of man "f 
 but casting his view over the whole map of knowledge with 
 the hand of a master, he showed wherein the sciences were 
 wanting, and how these wants might be supplied. Among 
 those which he enumerates in medicine are the following. 
 
 First. Abandoning the method of Hippocrates in observ- 
 ing, describing, and recording the histories of individual 
 cases of disease. 
 
 Second. The neglect of dissections, both of the human 
 subject and of animals, and also post mortem examinations, 
 with the view of comparing the appearances with the symp- 
 toms during the disease. 
 
 Third. Want of due attention to mitigating the sufferings 
 .1 patients in diseases which arc considered incurable. 
 
 fourth. TV glecting to search for special remedies foi 
 pellicula] 
 
 i 
 
20 
 
 Fifth. Not taking advantage of the benefit derived from 
 mineral waters, to ascertain their peculiar virtues, so as to 
 make " an imitation by art of natural baths and medicinal 
 fountains." 
 
 And lastly. The deficiency which he considers the most 
 important, I shall give in his own words. " The prescripts 
 in use are too compendious to attain their end ; for to my 
 understanding, it is a vain and flattering opinion to think any 
 medicine can be so sovereign or so happy, as that the receipt 
 or use of it can work any great effect upon the body of man. 
 It were a strange speech, which, spoken, or spoken oft, should 
 reclaim a man from a vice to which he were by nature sub- 
 ject : it is order, pursuit, sequence, and interchange of ap- 
 plication, which is mighty in nature ; which, although it require 
 more exact knowledge in prescribing, and more precise obe- 
 dience in observing, yet it is recompensed by the magnitude 
 of effects."* 
 
 To any one acquainted with the present state of medicine, 
 the bare enumeration of these deficiencies carries with it 
 the proof of the vast improvements which have been made 
 since the period in which Lord Bacon wrote. Were it 
 proper to go into details, it might triumphantly be shown, 
 that physicians, guided and illumined by the principles of the 
 Baconian philosophy, have been pursuing the path which has 
 led the way to so many discoveries in the other sciences. 
 The Hippocraiic method of studying disease has been re- 
 
 * Advancement of Learning, p. 199, 
 
21 
 
 vived. Anatomy and physiology, as built upon dissections 
 of animals and of the human subject, have been pursued with 
 unparalleled ardour, and are now justly considered as the only 
 rational basis of practical medicine. The post mortem ex- 
 aminations with the view of ascertaining the seats of disease, 
 and comparing them with the symptoms previous to death, 
 have been carried far beyond what might have been antici- 
 pated. For many diseases, before intractable to general 
 methods, special remedies have been discovered. By the 
 aid of chemistry, mineral waters have been analyzed, and the 
 knowledge thus obtained successfully applied in the treat- 
 ment of disease. All this has been done, and it is glory 
 enough for any science to have accomplished every thing 
 which the capacious mind of a Bacon could suggest as ne- 
 cessary. 
 
 Notwithstanding all this, I am aware that it may be said 
 that the spirit of theory and hypothesis still contaminates 
 our science, and exerts its deleterious influence over our 
 practice. To this it is sufficient perhaps to reply, that the- 
 orists are not the just representatives of medicine any 
 more than those visionaries who mystify their brains to dis- 
 cover perpetual motion, are the just representatives of natu- 
 ral philosophy ; or than the aberrations of a disturbed intel- 
 lect arc to be taken as a fair sample of the operations of a 
 sound understanding. The truth is, theories do infest medi- 
 and will probably continue to do so to the end of time. 
 
 These bow< ve\ ar i to be considered as making up anj 
 
 1 01 portion oi th< cience On the contrary, they are 
 
the mere blots upon the surface — the excrescences, which 
 like those of the body, shoot out from the weakest parts, 
 They are the intervening bodies, which may for a time 
 eclipse, but cannot extinguish its glory. Unlike, truth and 
 true philosophy, the spirit of theory is arrogant and exclusive. 
 That prince of quacks and theorists, Paracelsus, acted it out 
 in full when he ordered all the works of his predecessors to 
 be solemnly burnt before him while gravely seated in his 
 professorial chair, at Basil ; at the same time declaring, that 
 no one need scruple getting certain secrets of physic from 
 the devil, and boasting of his holding a conversation with 
 Galen and Avicenna at the gates of hell. Another cele- 
 brated theorist of the present day, although the taste of the 
 age does not permit him to consign to the flames the labours 
 of those who have gone before him, with quite as little cere- 
 mony, denounces the whole of them as useless and vain, and 
 holds himself up as the first and true founder of medicine. 
 Trusting to the representations of the author of the " new 
 doctrine," as it is styled, we should be led to suppose that he 
 is at last the true prophet, sent to expose the errors and 
 delusions of all preceding times — that for centuries men have 
 been wandering in darkness, and that he has been commis- 
 sioned for the first time to hold before their astonished eyes, 
 the torch of truth — that he has found the key to the para- 
 dise of knowledge, and at his " open sesame," all its flood- 
 gates are to be thrown open — that he is the mighty necro- 
 mancer, who is to pour out his oil and calm the troubled 
 waves of controversy and disputation — that he is to extend 
 
23 
 
 his magic wand over the medical world, and the millenium 
 of our science is to commence. And what is the wonderful 
 revelation which is to effect all this ? What is the " philo- 
 sopher's stone" which, after the search of ages, has at last 
 been discovered ? Substantially nothing more nor less than 
 this — That what physicians have been in the habit of call- 
 ing Fever, from time immemorial, is nothing more than 
 " Gastro-Enteritis," and that the whole of the practice of 
 medicine is to be reduced down to the use of leeches and 
 gum-water ! A discovery about as profound as Paracelsus 
 flattered himself he had made in his famous elixir, by 
 means of which he gravely maintained that he could prolong 
 the life of man to the age of Methusaleh ; and a practice 
 about as rational as the bloodletting and hot water of Di% 
 Sangrado ! 
 
 Now with such follies and extravagancies, medicine, in 
 its true and just acceptation, has nothing to do. As a sci- 
 ence, it is made up of that great mass of fact and principle, 
 which has been accumulated by the labours of successive 
 generations, having for its basis the certainty of observa- 
 tion and experiment. It is worthy of remark too, that how- 
 ever theorists may have differed and disputed, the great 
 principles of practice have not undergone any correspond- 
 ing mutations. An inflammation of the brain, for example, 
 I ways been treated veiy much as it is at this present 
 time. And with regard to the theories themselves, it is 
 -ratifying to observe how completely the spell of their 
 influent* broken During the laal century, for 
 
24 
 
 instance, how short-lived and limited have they been when 
 compared with those of earlier date ! The doctrines of 
 Galen, like the logic of Aristotle, held in base servitude the 
 whole medical world for upwards of twelve hundred years. 
 About the middle of the fifteenth century, the theories of 
 the chemical and mechanical physicians bore sway, and with 
 various modifications maintained their ascendency until the 
 time of Dr. Cullen. Since then, theory has followed theory 
 in quick succession, each succeeding one exposing the fal- 
 lacy of its predecessor, and the whole tending to strengthen 
 the general conviction upon the minds of intelligent and 
 reflecting men, that all should be discarded. Why these 
 theories have enjoyed even this ephemeral existence, is of 
 easy explanation. Generally speaking, along with much 
 error, they have contained some truth, and the whole has 
 been interwoven with so much plausibility as to gain them a 
 temporary currency. In addition to this, they have usually 
 been promulgated by teachers of medicine whose opinions, 
 especially if they contain any novelties, are apt to be received 
 with enthusiasm by youthful and ardent minds. In this way 
 have many theories enjoyed a popularity which, under other 
 circumstances, they would never have attained. Yet not- 
 withstanding all these artificial aids, they have scarcely sur- 
 vived beyond the death of their respective authors, and even 
 if they did, a single generation of physicians, educated un- 
 der another teacher, has been sure to sweep away every 
 vestige of them. Cullenianism — Brunonianism — Darwin- 
 ianism, and all the other isms, have chased each other down 
 
25 
 
 to their peaceful slumbers : and at present, if we except the 
 theory of Broussais, we have none prevalent of any import- 
 ance. And even the " new doctrine" is already sinking 
 into a premature grave. It is highly honourable to the inde- 
 pendence and discrimination of the profession on this side of 
 the Atlantic, that of the numerous schools of medicine which 
 we have in the United States, only one has been infected 
 with the gum- water theory. 
 
 There is another objection which has frequently been 
 urged against medicine, which it is proper should not be 
 concealed ; and this is, that it leads to religious infidelity. 
 In answering this charge, it is essential that its precise 
 nature and extent should be accurately defined and un- 
 derstood. A little reflection will make it obvious that it 
 involves two things quite distinct; and these are, in the 
 first place, that as a matter of fact, physicians are justly 
 tainted with the charge of scepticism ; and in the second 
 place, that supposing this to be the fact, it is the genuine and 
 necessary result of the study of medicine. Both these enter 
 into the general charge, and unless both can be substantiated, 
 the whole must fall to the ground. It is not necessary to 
 inquire very minutely into the first of these propositions. 
 Indeed, it would not be a very easy task to make out a scale 
 by which to judge of the relative degrees of scepticism 
 pervading the ranks of our profession and those of other 
 classes of individuals. That physicians have existed and do 
 • list, who by their infidelity have dishonoured the fair fame 
 •t '.in profession, i Huinol be denied. On the other hand, 
 
 I 
 
26 
 
 the fact is equally certain, that many of its most distinguished 
 members have been the sincere and unaffected believers in 
 the truths of religion. And another fact is equally unques- 
 tionable, that medical men, as a body, at least so far as we 
 see them in this country, are quite as distinguished for their 
 zeal in the cause of piety as any other class of men pur- 
 suing a calling purely secular. Admitting all this however, 
 the question still remains, does the study of medicine give 
 the mind any bias to infidelity ? Does it tend to weaken 
 the foundations upon which our faith in religion is founded ? 
 To my mind nothing is clearer than that it does not, if it be 
 followed by its legitimate results ; and for any other results 
 we certainly are not responsible. To a well disciplined and 
 reflecting mind, is there any thing in the study of that curious 
 and delicate structure, the human body, which displays the 
 power and skill of the divine architect more than all the 
 blazing wonders of the heavens — is there any thing in the 
 study of diseases, their symptoms, causes or cure, which can 
 possibly produce such effects ? On the contrary, is not the 
 direct tendency of such studies to force upon the mind the 
 conviction of the existence and controlling superintendence 
 of a superior Power — and at the same time, that man, though 
 fearfully and wonderfully made, is a frail and transitory and 
 dependent being, The truth is, it is impossible that medi- 
 cine, if properly cultivated, can ever be subversive of morals 
 or religion ; and the whole history of our art, from its ear- 
 liest infancy down to the present hour, furnishes the most 
 satisfactory evidence of the truth of this statement, Bat I 
 cannot stop to pursue this subject. 
 
27 
 
 I have thus, gentlemen, in a very rapid manner thrown out 
 some general ideas in relation to the science which you have 
 chosen as the study of your future lives, and have endea- 
 voured to show that it is founded in truth and nature — that 
 it is capable of giving full scope and development to all the 
 mental faculties, and if properly viewed, to strengthen the 
 feeling of reverence for the great Creator of all things. 
 It is truly a noble science, and the youthful votary need 
 not be afraid of giving up to it the full and undivided power 
 of all his faculties. 
 
 In undertaking to lecture on a science of which I enter- 
 tain such exalted opinions, I feel conscious of assuming a 
 high and sacred responsibility. To the student, much, I had 
 almost said every thing, depends upon the impulse which he 
 receives on commencing his studies. Early impressions are 
 always the most vivid and lasting ; and it is in the lecture- 
 room that opinions are imbibed which may tinge the whole 
 professional career of the physician. It is here that he in- 
 sensibly acquires his habits of thinking in relation to medical 
 subjects. It is here that he receives, unconsciously perhaps, 
 a bias to particular doctrines or theories. It is here, if ever, 
 that he is to be inspired with a love of his science. It is 
 her©, in short, that he is to lay the foundation of a character 
 which is to bless or to curse mankind. Under the lull cop 
 viction of these; considerations, if should be llic constant 
 endeavour of tin- teacher to conduct all his instructions. 
 Vssociated with colleagues distinguished lor learning and 
 alent, and whose nervines in ihe cause of science are known 
 
28 
 
 and appreciated, not merely in this country, but in Europe, 
 I feel confident that you will hear nothing in this institution 
 which is not calculated to give a just and honourable direc- 
 tion to all your labours. 
 
 To reap the full benefit however of their instructions, 
 there is one thing essential, and that is, co-operation on the 
 part of the student. No one was ever yet made a learned 
 man, or a great physician, by simply listening to the in- 
 structions of others. To become such, he must labour 
 for himself. And by doing so, by the beneficent disposition 
 of Providence, it will be found that every one has his cha- 
 racter entirely at his own disposal. There are some men 
 so favoured of heaven that the outpourings of their mighty 
 intellects seem but like the transmissions of celestial intelli- 
 gence. These, however, are rare, very rare exceptions — 
 rari nantes in gurgite vasto — and beyond these, the universal 
 law of our nature holds true, that nothing great or good can 
 be accomplished without labour ; and with this, even ordi- 
 nary minds can accomplish almost every thing. This is the 
 true Aladdin's lamp which converts into sober realities all 
 the glittering visions of the imagination. It is this has 
 felled the forest — erected cities — founded empires — con- 
 trolled the world. Now this mighty agent every man has 
 at his command, and he has only to use it properly to secure 
 all that enthusiasm can inspire, or ambition covet. To do 
 this successfully, it is necessary to begin early. Youth is the 
 proper season for enterprise and exertion; and if they be not 
 displayed then, as a general rule, they will be looked for in 
 
29 
 
 \ain at any subsequent period. If you analyze the history 
 of the men who have astonished the world by their exploits, 
 you will find that a large proportion of them have performed 
 their greatest achievements in early life. Alexander the 
 Great, who sighed that he had no more worlds to conquer, 
 died at the age of thirty-two. At the age of twenty-five, 
 Napoleon crossed the Alps. At twenty-seven, Cicero un- 
 dertook the celebrated defence of Roscius the player, which 
 laid the foundation of his after fame — the very same age at 
 which Demosthenes first began to distinguish himself at 
 Athens ; " as if," says the historian of Cicero, " in these 
 geniuses of the first magnitude, that was the proper season 
 of blooming towards maturity."* The great Linnaeus 
 sketched the outline of his Systema Naturse before he was 
 twenty-four years old ; and at the early age of twenty-six, 
 Calvin published the work which has immortalized his name 
 — " the Institutes of the Christian Religion" containing a 
 system of doctrines which with no material alterations, con- 
 tinues to govern the religious creed of a large section of the 
 christian world. 
 
 In our profession, the absolute necessity of early and assi- 
 duous study is especially evident. A knowledge of medi- 
 cine is not to be gained by intuition. What is true of the 
 poet, Poeta nascitur, nonfit, is altogether inapplicable to our 
 science. Such attainments in it as shall make their posses- 
 
 • Mulrlli ton's I ii ■ >" 
 
30 
 
 sors revered while living and transmit their names with ho- 
 nour to remote posterity, must be the result of long and 
 ardent labour, for which the most protracted life is but too 
 brief. It was under the full conviction of this truth, that the 
 father of medicine uttered that memorable apothegm — ars 
 longa, vita brevis est Begin then, gentlemen, early, and let 
 nothing interfere with the great object to be proposed to 
 your ambition— -that of distinction in your profession. 
 
COLUMBIA UNIVERSITY LIBRARY 
 
 This book is due on the date indicated below, or at the 
 expiration of a definite period after the date of borrowing-, 
 as provided by the rules of the Library or by special ar- 
 rangement with the Librarian in charge. 
 
 DATE BORROWED 
 
 DATE DUE 
 
 DATE BORROWED 
 
 DATE DUE 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 C28(239)M100