R708 B384 1849 Beck Address to the graduates of the College of Physicians and Surgeons of New York, Columbia &lntoet#ttp intljeCttpofBrwgork THE LIBRARIES JfleMcal Mrarp Digitized by the Internet Archive in 2011 with funding from Open Knowledge Commons http://www.archive.org/details/addresstograduatOObeck ADDRESS TO THE GRADUATES COLLEGE OF PHYSICIANS AND SURGEONS OF NEW-YORK, AT THE COMMENCEMENT, HELD MARCH 12, 1846. BY JOHN B. BECK, M. D., Professor of Materia Mediea and Medical Jurisprudence. [COMMUNICATED FOR THE NEW- YORK JOURNAL OF MEDICINE.} NEW-YORK. HENRY G. LANGLEY, 3 ASTOR HOUSE, (BARCLAY-STREET.) 1849. <, i~i* £3?j6 o M-CCLI.E ^S7>ec- >7>t /Ufa// ■ ^J&fJ TTM. OSBORN, PRINTER, COR. SPRUCE & NASSAU-BTB. ADDRESS. Gentlemen, Graduates, — The occasion on which we meet this evening, is one of deep interest. Having completed your various courses of study with credit to yourselves, and as your reward, having received the highest honors which it is in the power of this College to bestow, you are now about to leave us, and to become busy actors in the drama of human life. Although this is a period which has long been anticipated and wished for by you, the ties which bind you to us cannot be broken with- out emotion, and as you look forward, you find your bosoms swelling with mingled feelings of hope and fear. To those who have had the care of your instruction, it is no less an occasion of interest. They see issuing from these halls a large class of young men, associated in their minds with the most pleasing recollections of intelligence, industry and good conduct. Influenced as your minds and habits have necessarily been by their instructions and example, they cannot but feel a deep re- sponsibility in your welfare, and their ardent prayer is, that your future career may be such as to do honor to yourselves and to this Institution. They hope to hear of you hereafter as successful and eminent physicians, and as honored men — elevating and improving the noble profession which you have chosen, and blessing society by your virtues. Deputed by my colleagues to give you their parting counsel and ad- vice, I feel oppressed with the crowd of ideas that flow in upon my mind. Like the anxious parent taking leave of his children, I feel as if I should like to touch upon every thing that relates to your future life. This, however, may not be, and fortunately is not necessary. In this institution you have been looked upon, not merely as the recipients of professional knowledge, but also as moral agents, destined to exert a wide influence, either for good or evil, on those around you, and your teachers bave not left it to the few brief moments that remain to us, to endeavor "to infuse into your minds such feelings and principles as they trust, un- der Providence, may conduct you through life with honor and safety ; and if your uniform behavior during your pupilage can give any just ground of hope, they do not doubt that their most sanguine expectations will be realized. My duty, therefore, at present is comparatively limited, and I shall content myself with throwing out a few suggestions of a general nature, which I trust may be useful to you. And first, and above all, let me beseech of you, not to consider, because you have gone through the round of study prescribed by this Institution, nor yet because you have received the degree of Doctor in Medicine, that your education is now completed. If you do, notwithstanding all the time and labor you have expended, you had better at once abandon the profession and un- dertake some different occupation. Valuable as lectures are, they are, nevertheless, to be looked upon by the student simply as the preliminary means by which he may be enabled to perfect himself afterwards in a knowledge of his profession. They are merely the guides to show him how he is to pursue the never-ending course of self-instruction which he ought to propose to himself. The instruction of others never can make a man a physician. That he must make himself — and to do it requires a kind of study and training very different from that of listening to the prelections of the lecture-room. When you leave, therefore, this seat of learning, consider that you are merely changing the mode of your studies, and that you are now beginning a new and higher course of instruction. If you are deeply imbued with this feeling, every case that may present itself when you get into practice, will afford you ample scope for the ex- ercise of all your faculties. The practice of medicine is not a mere mat- ter of routine. The same disease occurring in different individuals is modified by a thousand different circumstances. The age, sex, habits of life, season of the year, climate, all exercise a controlling influence over its character, and accordingly demand a modification of the treatment. Every case, therefore, should be studied by itself, and should be made the subject of profound thought and investigation. If you pursue this course, you will find not merely that the practice of your profession is one that requires incessant study, but that it is one of surpassing inte- rest. With regard to the modes of conducting your studies, so as to yield you the greatest amount of profit, let me suggest to you, in the first place, to lay it down as an invariable rule, that when you undertake the study of a subject, to do it thoroughly ; and in doing this, I do not mean that you should merely acquire a knowledge of all the facts connected with it, but that you should investigate as far as possible the general principles nmning through these facts. There is nothing so destructive of the tone and vigor of a man's intellect, or so detrimental to his ad- vancement in knowledge, as to rest satisfied with vague and superficial notions. When he comes to turn his supposed knowledge to practical account, every thing will be hazy and misty before him, and his action will be uncertain and inefficient. Endeavor, then, to acquire the habit of hanging onto a subject until you obtain clear and precise ideas in rela- tion to it. Once acquired, you will find it of incalculable value. The very process of acquiring it will invigorate your understandings, and instead of retarding, as might be supposed, will accelerate with tenfold rapidity your subsequent acquisitions. Recollect that all knowledge is more or less connected, and the thorough mastery of one subject, with its facts and principles, will really aid you more in your progress than a vague and shadowy acquaintance with the whole circle of the sciences.* In the second place let me advise you now to begin a systematic course of reading in relation to yoiu profession. In the course of his studies, and especially during his attendance upon the lectures, the student has little leisure for doing any thing more than to run over the ordinary text- books on the various branches to which his attention may be called. Useful as this class of books unquestionably is, there is another which is still more valuable. I mean those standard works on particular subjects, which embody the results of years of the thought and labor and expe- rience of the ablest men, who have adorned our profession. In these, you will find subjects discussed in a very different way, from what they are in the popular text-books of the day. It is these, therefore, that you ought now to begin to read, and among others I would refer especially to the writings of Hippocrates, Boerhaave, Sydenham, Huxham, Sir John Pringle, Hillary, Moseley, Sir Gilbert Blane, Cleghom, John Hun- ter, Rush, and the thousand valuable monographs with which our pro- fessional literature abounds. In alluding to Hippocrates, I would re- mark, that it is hardly to be expected that many of you will be able to peruse him in the original language in which he wrote. Of many of his more important works, however, you will find good translations, and these I would recommend to you. While on this subject, I cannot suf- fer this opportunity to pass without calling your attention to a work which is in progress, and which I trust will shortly make its appearance, and that is a condensed, yet full abstract of the writings of the father of Physic. This work is undertaken by our learned countryman, Prof. John Redman Coxe, of Philadelphia. Should the task be executed, as from the ability of the person engaged in it, I anticipate it will be, I know of no learned labor that will reflect more credit upon the author or upon the professional literature of his country, and at the same time confer a more lasting benefit upon his professional brethren. Should the work be patronized as it ought to be, it will furnish a good omen of the future progress of medicine in this country.f * It is related of one of the ornaments of the English bar, Sir Edward Sugden, that he attributed his great success in professional life, to the cultivation of this habit. Sir T. F. Buxton states, in his memoirs, that he once ventured to ask him what was the secjet of his success. To which he replied, " I resolved, when beginning to read law, to make every thing I acquired perfectly my own, and never to go to a second thing till I had entirely accomplished the first. Many of my competitors read as much in a day as I read in a week ; but at the end of twelve months my knowledge was as fresh as on the day it was acquired, while theirs had glided away from their recollection." t Since the delivery of this address, the work of Prof. Coxe has made its appear- ance, under the title of " The Writings of Hippocrates and Galen, Epitomized from the Original Latin Translations," in an 8vo. volume of 681 pages, and comes up to all that was anticipated. I have only to unite with the venerable and learned author, in the wish expressed at the close of his work, "that it may awaken an inte- rest in favor of our great predecessors, and eventually lead to a full and complete translation of their works." 1* In perusing the authors I have mentioned, do not, gentlemen, hurry over them. Make them the subject of meditation and criticism, and whenever you meet with a striking or important fact, or a new and in- genious train of reasoning, make a memorandum of them in a common- place book, for the purpose of subsequent reflection and investigation. By steadily following up this plan, only for a short time, you will be astonished at the treasures of knowledge which you will accumulate ; the new ideas which will start up in your minds, as well as the confi- dence which it will give to all your mental operations. In the third place, let me recommend you to practise the art of writing. Every physician, whether he be ambitious of the honors of authorship or not, must now and then, at least, put his ideas upon paper for the purpose of being communicated to others. If he do this at all, he ought certainly to do it in such a way as not to dis- grace either himself or the profession. Now, it is with writing as with every thing else. No man can do it well unless he make it a habit, and every student should, therefore, be in the daily practice of put- ting his thoughts upon paper. In a very short time this will impart an ease and facility which will render writing a pleasure rather than a labor. With regard to the style which you ought to cultivate, there are three things which I would more especially urge upon your no- tice &s eminently essential. 1. Perfect simplicity. By this I mean the avoidance of pedantry, bombast, and all attempts at fine writing. These are inconsistent with the dignity of science, and are as opposed to a correct style as elegance and grace are congenial to it. 2. Perfect in- telligibility. This is a cardinal feature in a good style, without which, in the present day at least, a book will not be read. The press is too prolific of books which can be easily understood, to expect the reader to stop and spell out his way to the meaning of an author. Some men, I am aware, plume themselves not a little upon the obscurity of their style, and flatter themselves that it is an evidence of their profundity. Do not, gentlemen, envy or emulate such profundity. You will gene- rally find it slumbering away its existence in the dusky garret of the printing shop, or, perchance, making its way into daylight through the kind offices of the trunk-maker. 31 Perfect integrity. By this I mean a true style, in other words, that a style should be such as not to convey a double, or an exaggerated or a lessened idea — but that it should con- vey " the truth, the whole truth, and nothing but the truth." The im- portance of this feature in the style of a medical writer, must be self- evident. An erroneous idea conveyed in a medical work, either from de- sign or inattention, may prove the source of incalculable mischief. I am the more desirous of calling your attention to this point, because the vio- lations of it are, I fear, too frequent. Men even of upright intentions and with an honest desire after truth, not unfrequently give such a co- loring to their statements as convey impressions very wide of what was, perhaps, intended, and certainly very wide of the truth. Let precision of thought and precision of language, then, characterize every thing that you write, and let the whole be conveyed in a style simple and intelli- gible. In what I have thus far suggested to you, gentlemen, I have looked upon you merely as students of your profession, and I trust no period of your lives will ever arrive when you shall divest yourselves of that cha- racter. But you are also to be practitioners of medicine, and as such your ambi- tion of course ought to be to render yourselves distinguished and useful. To enable you to become so, permit me to make one or two suggestions. In the first place, cultivate the faculty of observation. By many, it is sup- posed, that this is the exclusive gift of nature and not improvable by art. Differing as men do undoubtedly in their powers in this respect, there still can be no question, that much may be done to improve them, by appropriate discipline and cultivation. To dwell upon the particular means by which this is to be accomplished would occupy too much time on the present occasion. I cannot, however, refrain from suggest- ing, that it is not to be done as a matter of course, merely by the multi- plicity of the subjects for observation which may be presented to you. This is, indeed, the common opinion, and the public suffrage is accord- ingly too apt to be given in favor of those whose opportunities are the most extensive. The physician, therefore, who sees the greatest number of patients, is generally supposed to have observed the most, and to be the most experienced. Nevertheless, this is frequently a great error, proved by every day's experience. To have the opportunity of observing, is one thing ; to observe, is another ; and the observation of one case, correctly and thoroughly made, yields a richer harvest of knowledge and expe- rience than do years of ordinary practice by an unobserving practitioner ; and the history of one disease, or of the effects of a single remedy, given by the hand of a master, confers more lasting and real benefit upon the science and the world than ages of the experience of ordinary men. In fact, there is such a thing as seeing too much ; and the rapidity and even hurry consequent on the attendance upon a great number of cases, is utterly fatal to that close and detailed investigation, without which ob- servation is of no sort of value. Instead of following nature and explo- ring the peculiarities characterizing individual cases, every thing is viewed in the wholesale way, and remedies are prescribed accordingly. Now, it is very evident that such practice, however extensive, can never make an enlightened physician. In fact, the more he sees in this way, the less likely is he to become so. It is an interesting fact that Hippocrates prac- tised only in small towns, not one of which, it is affirmed, was of itself able to support a physician. It is not, therefore, the mere amount of cases, or the extent of his opportunities ; it is the capacity of observing and the power of extracting from each case every thing that is valuable, that forms the great physician. To the young practitioner just com- mencing his career, I do not know anything so truly encouraging, as the consideration of this very circumstance. During the first few years of his professional life, instead of repining at his want of business, he should recollect that this is a wise allotment, intended for his ultimate benefit. If he rightly improve the leisure he then enjoys, he has it in his power to make himself all that his highest ambition can crave. But, gentlemen, you will find the observation of facts of comparatively little value, unless you possess the power of reasoning correctly upon them, and the culture of this faculty should be another object of your ambition. When I speak of the power of reasoning, I do not mean the- ability to speculate or frame theories, but I mean the power which shall 8 enable a man to compare individual facts, and draw from them just and legitimate conclusions. Important as observation is, it is chiefly so as forming the basis of reasoning ; and its being so, is the main reason why accurate observation is so invaluable. The necessity and importance of cultivating this faculty by the young practitioner, is self-evident. The whole of practical medicine is, or ought to be, an exercise of this faculty, and other things being equal, just in proportion as a physician is gifted with this talent will he become preeminent. As I have already stated, the practice of medicine is not a mere matter of routine. No two cases are exactly alike, and the same disease occurring in different individuals, presents itself under different forms and modifications, and in the just appreciation of these differences and modifications, and in the nice adap- tation and adjustment of remedies to them, a constant exercise of the reasoning powers is called for. It is not, however, in ordinary practice that the necessity of the reasoning faculty appears most striking. To the enlightened physician, questions of grave import are continually present- ing themselves, upon which he is required to give an opinion, and which, to be of any sort of value, must be the result of more or less elaborate trains of thought and reasoning. Questions in medical jurisprudence, for example, are only to be determined in this way. In cases of this kind, mere science, however profound, mere learning, however extensive, are not sufficient. It requires the exercise and application of a severe logic to arrive at just conclusions. By the absence of this, amid all the parade of learning, juries have been misled ; life and character have been jeopardized ; justice has been evaded, and the professional witness dis- graced. Questions relating to the spread of epidemic diseases furnish another example. Whether yellow fever, for instance, is a contagious or a non-contagious disease ; whether it is imported from other parts of the globe, or is of domestic origin, are problems of great interest, espe- cially in all our commercial seaports, and have for a great length of time continued to agitate and distract the public mind. These every medical man who lays the least claim to intelligence ought to have investigated, and should have come to some decision in relation to them. And yet how can he do so intelligently and satisfactorily, unless he has cultivated the power of reasoning, or in other words, the power of comparing the general mass of facts which the subject presents and of drawing legiti- mate inductions from them. Had this power been possessed, even in a moderate degree, by many of those who have talked the most loudly and written the most boastingly on this subject, how much empty asser- tion, how much bloated dogmatism, how much noisy absurdity would not the world have been spared. Had their minds been better disciplined, instead of appealing to the fears and prejudices of the public, always alive on such subjects, they would have rested it on the sure ground of fact and judgment. Instead of attempting to decide it by names and authori- ty, it would have been subjected to the test of reason alone. There is only one other incentive which I shall offer to show the ne- cessity of cultivating the power of close and accurate reasoning, and this is the incessant tendency which there seems to be in our profession to indulge in theories and hypotheses. From the remotest periods down to the present day, this has been the current vice of physicians. Why this has been the case, is a subject of interesting inquiry, and would lead 9 to many important views of our science. This, however, is foreign from my present purpose. If these theories had been confined to subjects of abstract speculation alone, their consequences would have been as harm- less as their textures were frail. Unfortunately, however, they have formed the basis of modes of practice, under the operation of which hundreds and thousands of human beings have been hurried into pre- mature graves. Now, how is any correct judgment to be formed con- cerning the respective merits of these theories and practices except by an observing, thinking and reasoning mind, which shall be able to ana- lyze the principles upon which they are founded as well as to detect the fallacies by which they are supported. Again, gentlemen, if you hope to succeed as good practitioners, culti- vate a generous love of your profession. By this I do not mean that love of an occupation which yields a man great pecuniary rewards, nor yet that love of it which arises simply from habit or long-accustomed use. To inspire either of these requires neither learning, nor talent, nor generous feeling. I mean something nobler than this. I mean that love of your profession which shall induce you to devote all your faculties to the cul- tivation of it, and which shall inspire you with the lofty ambition of sig- nalizing yourselves in it, by improving the science and benefitting mankind. JS"ow the onlv way to do this, is to consider your profession as a learned one. Without learning, no just conception can be formed even of the nature of medicine as a science, while the connection between principles and the application of them can never be appreciated. Hence, without this, it must be practised as a mere art or trade, and the interest taken in it can be nothing more than that taken in any ordinary occupation or labor. More than this, in the practice of medicine there are so many things posi- tively disgusting ; there is so much of actual suffering to be witnessed ; so much of frailty and rice to become privy to ; so much of caprice and even insidt to be encountered ; and, besides this, so many humiliating offices to be submitted to, that were this all, no man of generous mind would be found in the ranks of the profession. Viewed, however, with the eye of philosophv, and with the cultivation which learning engenders, all these disadvantages are as nothing. It is found to be a noble science, inVOlV- ing subjects of the highest interest, and the most momentous import. Every practical detail is found associated with some interesting fact in rela- tion to the animal economy, or with some important principle in the manage- ment of disease. The humblest offices rise into consequence, and every- thing is teeming with interest and instruction. Every fact, however trivial or apparently unimportant, calls into exercise the power of obser- vation, and in its wide spread relations to other facts, supplies incessant materials for all the powers of thought and reason. Thus it is that the glow of enthusiasm is enkindled, without which genius is cold and science barren. In this way it is, that learning creates a love of the profession, which can be acquired in no other way ; and in no profession is such enthusiasm so essential, as that of medicine. A science, boundless in its extent ; and in many respects most abstruse in its nature ; built upon long-continued and repeated observation ; requiring aids and helps fre- quently most difficult of attainment ; nothing can be accomplished with- out zeal and devotion, and with these, it is truly astonishing what may be done. Inspired with these, even ordinary intellects have performed 10 prodigies and left behind them imperishable monuments of labor. To the young practitioner of medicine it is hardly necessary to say, how absolutely essential it is that he should cultivate such a love of his pro- fession. If in the uncorrupted period of his existence he do not acquire it, it is in vain to hope for its attainment in after life. As he advances in years, other feelings and passions gain the ascendancy, and he will find, perhaps before he is aware of it, that he is pursuing his profession with no higher motive than that of gaining consequence in society, or, of amassing a fortune. From such a man, science has nothing to hope, and he gives to the world and to his profession nothing but the influ- ence of a barren and bad example. But, gentlemen, I must bring these desultory observations to a close. Before I do so, however, let me urge upon you, amid all your acquisi- tions — amid all the honors and success, which I trust may flow in profu- sion upon you, to cultivate a spirit of humility and modesty. Recollect that this is the gem, which shines the brightest in the crown of the greatest men that ever adorned our nature. Look at Newton! Although by his wonderful intellect he towered so immeasurably above the rest of mankind, yet his unaffected modesty raised him still high- er in the scale of excellence. And what think you was the reason ? Why, his eagle glance had pried into so many of the mysteries of nature ; he ha.d ascended Pisgah, and had seen so many of the wonders of creative power before him, that he was humbled with the consciousness of his own weakness and ignorance, and bowed with a lowly spirit before the great and incomprehensible Creator of all things. * And so it ought to be, and will be with every right-minded man. The farther he advances in the path of knowledge, the less will he think of his acquisitions, and the more deeply will he feel how narrow and feeble his powers are, and how little, very little, even of the sciences well understood, he can hope to compass. I am the more anxious, gentlemen, to urge upon you the cul- tivation of such a spirit as this, because I am convinced it is the offspring, as well as the ornament, of true knowledge. If you possess this spirit, you will not arrogantly set yourselves up to decide upon questions be- yond your comprehension. Above all, you will never suffer the preten- sions of science to sit in judgment upon the Almighty. With regard to the Bible you will reason thus — Here is a book which professes to be written under the inspiration of Heaven. If it be so, (and of this the evidence is overwhelming,) every word of it must be true ; it cannot be otherwise — and you will give to it your entire and unqualified belief. And you will not permit any apparent discrepancies between it and the pre- tended discoveries of modern science, to shake your belief. In the spirit * A short time before his death, it is stated that he uttered this memorable senti- ment : — " I do not know what I may appear to the world ; but to myself I seem to have been only like a boy playing on the sea-shore, and diverting myself in now and then finding a smoother pebble or a prettier shell than ordinary, while the great ocean of truth lay all undiscovered before me." — The Life of Sir Isaac Newton. By David Brewster, LL. D., F.R.S., p. 301. Of Socrates, it is said, that he declared that he knew no reason why the oracle of Delphos pronounced him the wisest of men, except it was that, being conscious of his ignorance, he was willing to confess that he knew nothing. 11 of true philosophy, as well as of true religion, you will confess that sci- ence is still in its infancy ; that man's powers are at best feeble and limited, and that it would be profanity, as well as folly, to set up these against what you believe to come directly from the Almighty. Under the influ- ence of such a spirit as this, too, gentlemen, I conceive you will best be enabled to perform all your relative duties. To your professional breth- ren, you will extend all the offices of courtesy and good feeling. To your patients, you will devote all your best energies. You will look upon them not merely as the subjects of scientific and professional interest, but you will sympathize with them as partakers of the same common na- ture, and destined to the same end as yourselves. While to the public, you will set a bright example of blended science and virtue. Before I close, let me throw out one word of encouragement, in relation to your future prospects. There is nothing so common for young men just entering upon life, and especially those of enthusiastic minds, as to call up to their fancies, the numerous difficulties and discouragements which are to obstruct their career. They look around them and see the whole world in action. Every post of honor and of emolument is already occu- pied. Every avenue to fame and fortune is already crowded with aspiring candidates. They turn with disgust from the scene — they despond, and they begin to imagine that success is impossible. Now, all this is founded on mistaken and imperfect views of human life. A few brief years will level all these distinctions. As you advance, you will find all the busy actors who now so greatly fill your imaginations and excite your fears, sinking, one by one, and leaving vacant more than enough to gratify your largest ambition. Let not, then, these conside- rations discourage you. Before you are aware of it, opportunities of distinction will present themselves, and the only question then will be, are you prepared to seize the proffered honor. The early part of your lives is the one, as a general rule, the best fitted for study and exer- tion, and if you loiter away that precious period in idle and vain fore- bodings, or what is worse, squander it in indolence or dissipation, you will find honor after honor eluding your feeble grasp — fortune will spurn you, and place the crown on other and worthier brows. Begin life, then, with a manly courage. Cast behind you that cold-blooded philosophy which would teach you that you are not to expect success. Recollect that it is a law of the Almighty himself, verified by the whole experience of mankind, that honest endeavor, with an humble reliance on Providence, will sooner or later meet with its reward, and you need not fear that you will be made exceptions to the general rule. It only remains for me now to bid you an affectionate farewell. COLUMBIA UNIVERSITY LIBRARIES 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 library rules or by special arrangement with the Librarian in charge. DATE BORROWED DATE DUE | DATE BORROWED DATE DUE - \ C28(115S)100M (0 g eg gr- A UNIVERSITY I 05085042 JMB c -1=^^= o M-Collecfion U: Collect;^ R708 B3Qh 18ii9 uates of ians and ^ 3 mi r - *» »w