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INTRODUCTORY DISCOURSE. 
 
 TO A 
 
 COURSE OF LECTURES 
 
 ON THE 
 
 THEORY AND PRACTICE OF PHYSIC 
 
 CONTAINING 
 
 OBSERVATIONS ON THE INDUCTIVE SYSTEM OF PROSECUTING 
 MEDICAL INQUIRIES; 
 
 AND 
 
 A TRIBUTE TO THE MEMORY OF THE LATE 
 
 DR. BENJAMIN RUSH. 
 
 DELIVERED 
 AT THE COLLEGE OF PHYSICIANS AND SURGEONS, 
 
 ON THE THIRD OF NOVEMBER, 1813. 
 
 BY DAVID HOSACK, M. D. F. L. S. 
 
 )>< 
 
 PROFESSOR OF THE THEORY AND PRACTICE OF PHYSIC AND CLINICAL MEDICINE IN THE 
 UNIVERSITY OF THE STATE OF NEW-YORK. 
 
 NEW-YORK: 
 
 PRINTED BY C. S. VAN WINKLE, 
 
 No. 122 Water-street. 
 
 1313. 
 
^ 
 
 COLUMBIAN 
 
 19 
 
 
 d, / , 
 
New-York, December G, 1813. 
 Sir, 
 
 The great satisfaction which was universally expressed, on the delivery of the 
 Discourse introductory to your course of Lectures on the Theory and Practice of Physic, 
 in the College of Physicians and Surgeons, as well as the excellent eulogy it contained on 
 that ornament of the profession, the illustrious Benjamin Rush, have induced the Medicaj 
 and Surgical Society of the University of the State of New-York to appoint us a committee 
 to request a copy of the same for publication. Your consent will confer a favour not only 
 on the Society, by whose authority we have the honour to act, but on every cultivator of 
 medicine, and every lover of general science. 
 
 With due respect, we are, Sir, 
 
 Your obedient servants, 
 
 JOHN SCUDDER, 
 WILLIAM P. aUITMAN 
 To David Hosack, M. D. 
 
 New-York, December 6., 1813. 
 Gentlemen, 
 
 I receive with emotions of great sensibility and gratitude, the flattering resolution 
 which you have conveyed from the Medical and Surgical Society of the University of the 
 State of New- York. My respect for that institution induces a compliance on my part 
 with their request. I must be permitted, however, to observe, that the merit which they 
 have assigned to that discourse, is chiefly lobe ascribed to the very important subjects to 
 which it relates ; especially, the memory of that distinguished physician, the late Dr 
 Benjamin Rush, whose services to our profession must ever awaken an interest in the 
 bosom of every pupil and practitioner of medicine. 
 I am, Gentlemen, 
 
 With sentiments of esteem and respect, 
 Yours, 
 
 DAVID HOSACK. 
 To Mr . John Scudder, and Mr. Wm. F. Quitman, 
 Committee, &c. 
 
*:v 
 
 INTRODUCTORY DISCOURSE, &c 
 
 GENTLEMEKT, 
 
 Amidst the numerous improvements which have recently 
 faken place in the literary establishments of the city and state 
 of New-York, the institution of a College of Physicians and 
 Surgeons, exclusively devoted to the great purposes of medi- 
 cal education, is certainly an event deserving the highest 
 commendation. It reflects equal honour upon its founders, 
 the Regents of the University, and upon the Legislature, from 
 whom it has received its first endowment and patronage. 
 This institution was first projected, and a law passed, au- 
 thorizing the Regents of the University to carry it into 
 effect, as early as 1791 ; but motives of respect to the 
 Trustees of Columbia College, who had annexed a medical 
 school to that seminary of learning, prevented the Regents 
 from carrying the views of the Legislature into operation until 
 1807, when a charter was first granted for that purpose. 
 
 The exercise of the power delegated to the Regents by the 
 act of the Legislature referred to, has afforded just cause of 
 congratulation to the friends of science, as an event, of all 
 ©thers, calculated to advance the usefulness and respectabi- 
 
 [2] 
 
( ti ) 
 
 lily of the medical profession, the celebrity of the state, and 
 the honour of our country. That the high expectations 
 which were entertained of the benefits that would flow to 
 the community from its establishment were well founded, 
 the history of the College, even during the short period it 
 has been in operation, abundantly testifies : for, during the 
 six sessions that have elapsed, nearly four hundred gentle- 
 men have received the benefits of instruction afforded at 
 this establishment, and of that number about forty have 
 been admitted to the honours of graduation. 
 
 But the Regents of the University, as well as the members 
 of the profession in general, have ever been duly sensible of 
 the benefits that would result from an union of the Professors 
 of this College with those constituting the Faculty of Physic 
 of Columbia College. Impressed with the importance of 
 such union, the Regents of the University, in the winter of 
 1811, respectfully solicited the friendly offices of the Board 
 of Trustees of Columbia College in combining the two medi- 
 cal institutions. This event, so desirable in itself, and which 
 promises to be productive of signal and permanent advantages 
 to the profession and the community, has at length been hap- 
 pily accomplished. 
 
 Permit me, gentlemen, students of medicine, to offer you 
 my congratulations upon the favourable auspices under which 
 the present session of this College commences : for to you 
 it must prove peculiarly beneficial ; as in no other part of 
 the United States can you obtain so extensive a system of 
 medical education as that now afforded by this university. 
 
(7) 
 
 But the establishment of this College, and the ultimate union 
 of the Medical Schools of New-York, constitute an important 
 era in the history of our state ; and may I not add, in the 
 history of medical science ? For what advantages and im- 
 provements may we not reasonably anticipate from the unit- 
 ed labours of those who now occupy the several professor- 
 ships of this College, and of the numerous pupils who may 
 be expected hereafter to resort to this city for instruction ? 
 New- York, in her commercial and agricultural character, 
 has long been distinguished. In these respects, she has 
 justly been considered one of the most important states of 
 the union ; but when we take into view the immense provi- 
 sion she has made for common schools ; the extensive pecu- 
 niary contributions made to her numerous academies ; the 
 appropriations granted to her different colleges ; the incor- 
 poration of new literary societies in different parts of her 
 extensive territory ; the acts lately passed for the promo- 
 tion of medical science ; the incorporation of state and 
 county medical societies ; the liberal provision made for that 
 invaluable charity and practical school of medicine, the 
 New- York Hospital ; and the establishment and endowment 
 of the Institution in which we are now convened, it must be 
 admitted that her pre-eminence is not confined to her popu- 
 lation, her commerce, or her agriculture, but that she is, 
 equally distinguished for her protection and cultivation of 
 the arts and sciences, and shortly must combine every ad- 
 vantage that the most favoured states of the union may have 
 individually enjoyed. 
 
(«) 
 
 My anticipations lead me still further : When peace may 
 be restored, and the benefits of commercial and literary in- 
 tercourse with the old world be again experienced by this 
 western hemisphere, but a few years can elapse when the 
 universities of New-York, of Pennsylvania, of Massachusetts, 
 of Connecticut, and of Maryland, will hold an honourable 
 competition with the most distinguished seats of learning 
 that now adorn the European continent. 
 
 In the profession of medicine it may already be said, that 
 in the United States we possess all the necessary resources 
 for the most finished system of education that can be obtain- 
 ed in any part of the world, not excepting the justly cele- 
 brated medical schools of Edinburgh, London, or Paris. 
 
 In anatomy, physiology, the principles and practice of 
 surgery, midwifery, the materia medica, chemistry, botany, 
 mineralogy, and other branches of natural history, we have 
 the most abundant means of instruction both practical and 
 theoretical. And in the study of the theory and practice of 
 physic, in acquiring a knowledge of the diseases of our coun- 
 try, we enjoy advantages, which, to the American pupil, are 
 superior to those of any of the schools of the old world : for 
 such is the influence of soil, climate, vicissitudes of season, and 
 the state of society, upon acute diseases, that in this country 
 they exhibit in many respects a character different from those 
 of Great Britain or of the continent of Europe. Hence it hap- 
 pens, that the American physician, who may have had all the 
 advantages of a foreign course of study, who may have enjoyed 
 all the benefits of instruction which the infirmary of Edinburgh 
 
(9 ) 
 
 or the hospitals of London or Paris afford, if he has not pre 
 viously acquired a knowledge of the febrile and other acute 
 diseases of this climate, upon his return to his native coun- 
 try has still the most important practical lessons to learn, 
 and which experience alone can supply. In this respect, 
 you have advantages at home which you cannot obtain 
 abroad ; nay, more, although we have been indebted to Europe 
 for most of the knowledge we possess in the healing art, the 
 European physician has still much to receive in return : he 
 has yet to learn the history of the febrile and other diseases 
 of this country ; the varieties they exhibit ; the effect of pe- 
 culiarities of constitution and climate ; the causes which pro- 
 duce them, and the various modes of treatment they severally 
 require, before he can attain to those principles which are 
 necessary to constitute a system of practice. For it is justly 
 remarked by an eminent medical writer,* that " no system of 
 medicine can be perfect, while there exists a single disease 
 which we do not know, or cannot cure." There cannot, there 
 fore, be a complete system of medicine until our country has 
 furnished the description and the cure for all its peculiar dis- 
 eases. 
 
 American genius has already largely contributed to the 
 improvement of the arts, and has done much in developing 
 the principles of civil government. For you and your suc- 
 cessors, probably, is also reserved the discovery of those prin- 
 ciples in medicine which are necessary to complete the fabric 
 that has been begun by a Sydenham, a Boerhaave, a Hoff- 
 
 * Dr. Rush. 
 
(10) 
 
 Inan, a Cullen, anel other celebrated physicians of Europe. 
 Cherish, then, the feelings which this prospective view ex- 
 cites, and let your exertions correspond with the obligation 
 it imposes. 
 
 The Practice of Physic, which, in connexion with. 
 Clinical Medicine, it is my province to teach in this Uni- 
 versity, is very properly defined, by a great systematic 
 Writer, to be the art of discerning, distinguishing, pre- 
 venting, and curing diseases. The discernment of a dis- 
 ease, as Dr. Cullen very properly denominates it, is only 
 to be acquired by long and habitual observation at the bed- 
 side of the sick, for it frequently happens, that not only the 
 symptoms, but the causes of disease, are so concealed, that 
 they escape the observation both of the patient and the by- 
 stander ; and, even by the physician, are only to be disco- 
 vered by habitual attention to the phenomena of health as 
 well as the symptoms of disease. But this discernment ad- 
 mits of still more extensive application, as it presents to the 
 mind those circumstances attendant upon diseases, which no 
 language can define. For although books of practice, and 
 systems of nosology may furnish the description of the symp- 
 toms of disease, and faithfully delineate the more prominent 
 features by which they are characterized, there are certain 
 nicer shades of discrimination, which frequent converse with 
 the sick can alone detect : for diseases, like plants and animals. 
 
(11 ) 
 
 have their peculiarities of character, which no system of no 
 sology will supply, no description, however voluminous or mi- 
 nute, can impart, which no medical Lavater has yet delinea- 
 ted, and with which practice alone can make us acquainted- 
 It is only the practical botanist who can distinguish plants 
 which have a close resemblance. The eye of the practical 
 physician, in like manner, when quickened by habit, readily 
 distinguishes one form of fever from another, but which are 
 ail confounded in the eyes of the hasty observer, or of him 
 whose preconceived notions have interposed a medium which 
 obscures his vision. But this knowledge of the symptoms of 
 disease is not sufficient to lead us to their prevention and 
 cure. Whatever may be the readiness with which diseases 
 may be perceived, or however minute may be our acquaint- 
 ance with the varied phenomena they exhibit, it is only the 
 knowledge of the various causes by which they are produced, 
 and of the structure of the system upon which they operate, 
 that can direct us to a safe and judicious practice; for, from 
 these sources alone, the great principles upon which the treat- 
 ment of disease is to be conducted must be derived. 
 
 These causes are of three kinds : such as are generally in- 
 herent in our frame, and predispose the system to be acted 
 upon ; those which are the most immediate, and for the most 
 part external agents in exciting disease ; and lastly, the proxi 
 mate cause, which denotes the condition of the part affected, 
 or of the whole system, and upon the change or removal of 
 which the corresponding changes or removal of the disease 
 depends. To use the elegant language of Dr. Gregory, thaJ 
 
( 12 ;' 
 
 ornament of our profession and of classical literature, " causa 
 proxima est, quae presens, morbum facit, sublata tollit, muta- 
 ta mutat."^ 
 
 The theory of physic, therefore, may be defined to be, that 
 fsystem of principles which is deduced from a knowledge of 
 the human structure, and of the predisposing, exciting, and 
 proximate causes of disease, and by which the practice of me- 
 dicine is to be directed. By many, however, the term theory 
 has been abused, by considering it as synonymous with every 
 hypothesis that has been promulgated for the purpose of ex- 
 plaining the phenomena of diseases, and with which medicine, 
 like every other branch of philosophy > has in all ages been, 
 corrupted. The question then presents itself, by what pro- 
 cess are we to attain to those principles so necessary as sub- 
 servient to practice? I answer, by accurate observation, 
 judicious experiment^ and cautious induction from the 
 facts which they present. These are the sources whence 
 was deduced that luminous system of philosophical in 
 vestigation introduced into physics by Lord Bacon, Robert 
 Boyle, and Sir Isaac Newton. They are the same sources 
 whence those celebrated metaphysicians, Reid, Gerard, 
 Campbell, and Stewart, have drawn those principles which 
 have recently been applied, with so much success, in explain- 
 ing the phenomena of mind. And from the same sources, as ex- 
 emplified in the pages of Hippocrates, Sydenham* and Boer- 
 baave, are to be derived those principles in medicine which 
 
 * Conspectus medicine 
 
( 13 ) 
 
 can alone conduct us to a judicious and successful prac* 
 tice. Suffer me to arrest your attention in the contemplation 
 of those distinguished benefactors to medical science. 
 
 Anterior to the days of Hippocrates, we have no traces of 
 any thing like theory or principles in medicine, much less a 
 regular system of practice. On the contrary, before his 
 time, the only medical knowledge which existed, was the re- 
 suit of random experience, or accidental observation, of the 
 effects of remedies in particular diseases ; totally uninfluenced 
 by principles derived from the structure of the human frame, 
 the symptoms of disease, or the causes which produced them. 
 The practice of that day was consequently purely empiri- 
 cal, in the strict etymological sense of the term ; but it is to 
 be observed, that at that early period of society, the diseases 
 of mankind were few in number when compared with those 
 which intemperance, luxury, and what are called the refine- 
 ments of civilized life, have since introduced. 
 
 Hippocrates was the first physician, of whom we have any 
 record, who attempted to deduce from the facts which were 
 presented to him, certain principles upon which to conduct 
 the cure of diseases. He, therefore, first united the theory 
 with the practice of physic ; but it was not that speculative 
 theory which proceeds from hypothesis to facts, but from 
 facts to principles. Hippocrates was in medicine what Lord. 
 Bacon was in philosophy : he first pointed out the true road 
 to correct knowledge in our art. Permit me to devote a few 
 moments to this grateful theme, while I endeavour to res- 
 cue his venerable name from the imputations which have 
 
 [3] . 
 
( 14 ) 
 
 been cast upon it, even by Lord Verulam himself, and who 
 it is more than to be suspected, drew from the works of Hip- 
 pocrates, with which he was intimately acquainted,* that 
 Very system of investigation which characterizes the Novum 
 Organum, but which no less distinguishes the writings of our 
 great progenitor 
 
 Hippocrates was born in the island of Cos, about four huu- 
 dred years before Christ. At that memorable period of Gre^ 
 cian splendour, in which Apelles, Praxiteles, and Demosthe- 
 nes, adorned the several arts of painting, sculpture and elo- 
 quence.. Hippocrates was not less distinguished for his im- 
 provement in the healing art, and for which he received not 
 only a crown of gold, but the highest honours Athens could 
 bestow. Having applied himself with indefatigable industry 
 to the various branches of human learning, then most gene- 
 rally taught ; having become a proficient in the philosophy of 
 the schools of Cnidus and of Cos, and afterwards added to his 
 stock of knowledge by travel ; with a mind thus enriched, 
 and a bodily frame no less vigorous than his mind, (for it sus- 
 tained him upwards of an hundred years) he entered upon the 
 practice of physic. 
 
 Here his talents appear eminently great. The same 
 system of inductive reasoning, which was afterwards 
 adopted by Lord Bacon, was no less the guide of Hip- 
 pocrates. For it was the maxim of the latter, as of the 
 former, that every principle should be founded upon the 
 
 * Bacon on the ;Vdv .ncement of Learning, book II. See his works, vol. 1. p- 
 122, &c. Lond. Ed. 1803, 
 
( 15 ) 
 
 firm basis of observation and experience, and that the only 
 correct mode of reasoning is that which proceeds from the ef- 
 fects to the causes which produce them. With this view he 
 not only availed himself of that mass of facts which the temples 
 of Greece supplied,* but he patiently sat down at the bedside 
 of the sick, recorded every successive symptom of disease, 
 the changes it underwent, as well as the manner of its termi- 
 nation, whether in the dissolution or the recovery of his pa- 
 tient. Although he was unacquainted with the circulation 
 of the blood, or the value of the pulse as the index of dis- 
 ease, he carefully attended to every change in the respira- 
 tion of his patient, which led him to conclusions equally cor- 
 rect ; nor was he less attentive to the various secretions of the 
 system, both in the healthy and in the morbid state. Indeed, 
 so minute is the description which he gives of the various ap- 
 pearances the secretion from the lungs undergoes in the dif- 
 ferent stages of pneumonic inflammation, that to him alone are 
 we yet, at this very day, indebted, not only for the best, but 
 I do not hesitate to say, the only correct and satisfactory 
 description that has been given of that disease. Although 
 totally unacquainted with the nature of the materials con- 
 stantly emanating from the surface of the body in perspira- 
 tion, and which is but of recent discovery, he well knew the 
 importance of that function, both in health and disease. But 
 the observations of Hippocrates were not confined to the 
 human body, and to the phenomena it presents in the morbid 
 
 * VideCoacae prasnotio. Lib. Praenotion, I. Prasdiet. 11- 
 
( w ) 
 
 state : the action of every external agent no less attracted 
 his observant eye. The air he breathed, the water he drank, 
 the earth he trod upon, alike became the subjects of his at- 
 tention, as far as they were supposed to exert an influence 
 upon our system.* Nor were these the limits of his observa- 
 tion : The movements of the heavenly bodies ; their influ- 
 ence upon our planet and upon our frame, were also embra- 
 ced in his extended view.f From data such as these, and 
 from a long and extensive experience, he founded and built 
 up a system of pure and rational philosophy. As the great 
 object of all his labours was to arrive at truth, and as Bacon 
 discarded the logical definitions and distinctions of Aristotle, 
 so did Hippocrates reject the principal hypothesis of Py- 
 thagoras and the other mysterious dogmata of the sophists of 
 his age. Governed by the true spirit of what has lately re- 
 ceived the appellation of Newtonian philosophy, he admit- 
 ted so much only as enabled him to reason more justly in 
 investigating the causes, and in discovering the method of 
 cure in diseases. As the philosophy of Bacon differed from 
 the fashionable logic, or syllogistic form of demonstration, 
 which, until his time, was almost universally received ; 
 equally great was the difference between the method of Hip- 
 pocrates and that of his predecessors. 
 
 But while we offer the tribute due to this great philosopher 
 and physician, it is not to be denied that his knowledge of the 
 internal structure of the human frame was necessarily limited, 
 
 * Hippoc. de Morb. Epidem. Lib. l, 2, 3, &c. et de Aere, Aqui?, et Locis. 
 ? Vide Lib. citat. et in aphorism. Sect. 3, 4, 
 
( 17 ) 
 
 and, ia many respects, erroneous. But although, as has al- 
 ready been intimated, he was ignorant of the circulation of the 
 blood ; although he confounded an artery with a vein, and a 
 nerve with a tendon, he effected, even in his own time, more 
 real improvements in the healing art than all his predecessors 
 had done in the space of two thousand years before him ; and, 
 we may add, more than all his successors did in two thousand 
 years after him. But although he lived in the infancy of 
 medicine, his works, like those standards of perfection, the 
 columns of Grecian architecture, will ever remain the admi- 
 ration of the world, and the best models for our imitation. 
 "His fame," to employ the language of an able and eloquent 
 writer,^ " like a stupendous and solitary mountain, seems to 
 have acquired new height by the wasting effects of time upon 
 the adjacent country." 
 
 After the death of Hippocrates, little was done to complete 
 the building of that fabric of which he had laid the founda- 
 tion. But while the example which he sat was imitated, and 
 the road he pointed out was followed, though with unequal 
 steps, there was still a gradual but a sensible augmentation to 
 the stock of medical knowledge. Hippocrates was succeeded 
 by Plato and Aristotle, who concurred, though in different 
 ways, to check the progress of medicine for many centuries. 
 They corrupted almost every branch of human learning. In 
 the room of the Hippocratic method of induction, were now 
 substituted captious disputations and syllogistic quibbles. — 
 The mode of reasoning which they adopted, though it afford^ 
 
 * Dr. Rush. 
 
( 18) 
 
 <ed some aid in the detection of sophistry, gave little assistance 
 in the investigation and discovery of truth. In short, instead 
 of having recourse to observation and experiments, they mul- 
 tiplied hypothetical propositions, confounded realities with 
 fictions, preferred words to things : in the language of Lord 
 Bolingbroke, " they invented systems more baneful to truth 
 and real learning, than the ravages of the Goths and Van- 
 dals." 
 
 But the circumstance, which of all others, gave cur- 
 rency to the Aristotelian doctrines in medicine, was their 
 adoption by Galen, a man of great learning, little inferior to 
 Aristotle himself in genius, and an ardent admirer of his pe- 
 culiar talents. He laboured with great zeal to complete and 
 offer to the world a new theory in medical science. His fer- 
 tile imagination supplied the place of facts, and as he infused 
 into all his writings the subtle distinctions and metaphysical 
 notions of Aristotle, he so far corrupted, more than any other 
 writer in medicine, the true spirit of philosophical investiga- 
 tion. Yet it deserves to be remembered, and to the immor- 
 tal honour of Hippocrates, that Galen himself was aware, that 
 the practice of Hippocrates was the most just and rational, 
 and that he himself pursued it in the treatment of diseases. 
 What progress the doctrines of Galen made, and how long 
 they were implicitly adopted, are facts too familiarly known 
 to require further mention on this occasion. But happily for 
 mankind, and the interests of science, towards the conclusion 
 of the sixteenth, and beginning of the seventeenth century, 
 another galaxy of talents appeared that dissipated those clouds 
 
( 19 ) 
 with which the Aristotelian philosophy had enveloped the 
 world, and which both philosophers and physicians, Ixiou- 
 like, had embraced for nearly fourteen hundred years : You 
 will anticipate me in the names of Bacon, Boyle, Galileo, 
 Locke, and Newton. It was not until this period that phi- 
 losophers and physicians " emancipated themselves from their 
 vassalage to Aristotle and Galen." It was not until this pe- 
 riod that the human mind again recovered its freedom and 
 dignity, and genuine science began to develope what had re- 
 mained involved in the deepest obscurity. To commence 
 (his illustrious work was reserved for Lord Bacon, a man in 
 every respect qualified for so great an undertaking. By the. 
 publication of his Instauration of the Sciences, he rescued 
 reason and truth from the slavery in which they so lone- 
 had been held; he effected a total revolution in the empire 
 of science, and laid the foundation of the inductive system of 
 philosophizing, or rather, as we have already attempted to. 
 show, he revived the Hippocratic mode of acquiring know- 
 ledge. 
 
 Nearly cotemporary with those distinguished characters 
 was Thomas Sydenham. As he possessed a strength of un- 
 derstanding, an accuracy of discernment, and an ardour of cu- 
 riosity no less rare than desirable, he soon perceived the ab 
 surdity and pernicious effects of the visionary theories which 
 had preceded. He accordingly devoted the most indefatiga- 
 ble attention to the study of nature, and what he considered 
 of nearly the same importance, the aphorisms and other 
 Writings of Hippocrates. He caught the true spirit of phi 
 
( 20 ) 
 
 losophy which they inculcate, and was the first in rnedicine 3 
 after the revival of learning, who adopted the inductive me- 
 thod of Bacon, and enforced the plan of study first pursued 
 by the father of medicine. In his preface to his works he 
 states, that we are to arrive at perfection in our science by 
 two means ; a faithful relation of the causes and symptoms of 
 diseases, and from thence deducing and establishing their 
 method of cure. Like his great prototype, he accurately 
 noticed the phenomena and progress of diseases, and the 
 manner of their termination, as well as the effects of medicine 
 and diet, in their prevention and cure. He also, more mi- 
 nutely than any other writer, recorded the prevailing epi- 
 demics of each year ; the influence of seasons, climate, and 
 the sensible qualities of the atmosphere. Want of time, how- 
 ever, forbids that 1 should here enlarge upon his merits. But 
 while I recommend to you a close and repeated examination 
 of his writings, in order to enable you the better to appre- 
 ciate them, I shall conclude this imperfect sketch of his cha- 
 racter in the words of his celebrated successor : " He was the 
 ornament of England, the Apollo of the art, whom I never 
 consider but my mind presents me with the true picture of an 
 Hippocratic physician, and to whom physic is so much in- 
 debted, that all I can say will fall far short of his merit."* 
 Let us now take a brief notice of another individual, to 
 whom, next to Hippocrates and Sydenham, our profession is 
 most indebted — the illustrious Boerhaave, who was no less 
 
 - Boerhaave. 
 
(21 ) 
 
 eminent in "medicine than Sir Isaac Newton in philosophy. 
 Boerhaave flourished about forty years after Sydenham. I 
 shall content myself with giving you some idea of the extent 
 of the knowledge which he possessed, rather than of the man- 
 ner in which he acquired it. He was well versed in the Latin, 
 Greek, Hebrew, and other of the oriental languages, and 
 also in those of modern Europe. He was a profound ma- 
 thematician, and algebraist, and a remarkable proficient in 
 the philosophy both of mind and matter. He studied the 
 works of Hippocrates, and all the Greek, Roman, and Arabian 
 physicians, as well as those of the most eminent among the 
 moderns. He was the advocate of experimental science, 
 and was himself a distinguished practical anatomist and che- 
 mist. In botanical knowledge he was among the first of his 
 age, and in his acquaintance with the various departments of 
 the materia medica, exceeded by none. He thus furnishes 
 the most striking example to show, that it is practicable for a 
 single individual to excel in almost every branch of human 
 learning. Of the numerous writers on medical science whom 
 he studied, he particularly admired Hippocrates among the 
 ancients, and Sydenham among the moderns. Upon his 
 election to the professorship of medicine, in 1701, he pro- 
 nounced an oration " de commendando studio Hippocratico," 
 in which he not only recommended the writings of the Coan 
 sage as among the most valuable sources of practical informa- 
 tion, but particularly enforced the Hippocraik mode of con. 
 ducting medical inquiries. 
 
 if] 
 
(22) 
 
 He delivered lectures on the theory and practice of medi- 
 cine, botany and chemistry, with the greatest clearness, pre- 
 cision and eloquence ; and had such a conflux of students, 
 from all parts of the world for his hearers, as never, probably, 
 had been presented before any professor. Upon the death 
 pf Le Mort, he was placed at the head of every branch of 
 medicine, when the number of his students became so great, 
 that, according to his biographer, Dr. Matty, Leyden itself 
 was scarcely sufficient to accommodate them. In his Insti- 
 tutions of Medicine and his Aphorisms, which have been pro- 
 nounced two of the most concise, yet comprehensive works 
 which have ever been presented to the medical world, and 
 which have been the text books of the universities of Eu- 
 rope for nearly a century, you will find the result of all that 
 learning, experience and talents, for which he was so emi- 
 nently distinguished. But the great talents, the indefati- 
 gable application, and the extensive knowledge of Boerhaave 
 held but a second place in his character : In the language of 
 Dr. Johnson, " he was an admirable example of temperance, 
 fortitude, humility, and devotion ;" and we may add, Chris- 
 tianity enrols his name among her firmest and steadiest sup- 
 porters. 
 
 But, gentlemen, while we thus revere the great and good 
 of the old world, let us do homage to merit in the new. 
 While we acknowledge the benefits which the science of 
 medicine has received from the physicians of Europe, let us 
 not be unmindful of the debt of gratitude we owe to a native 
 pf our own soil, who was no less an ornament to human nature, 
 
(23 ) 
 
 -than his various exertions Lave been precious to his profes- 
 sion, to science, and his country. 
 
 Your feelings, I trust, will be in unison with mine, while, 
 in addition to the numerous offerings of public and private 
 respect, which have been paid to the memory of Doctor 
 Benjamin Rush, we devote a few moments to the contem- 
 plation of the professional attainments, the public services 9 
 the moral and religious character, which make up the portrait 
 of that distinguished philosopher and physician. 
 
 Doctor 'Rush was born on the 24th of December, 1745, on 
 Iris father's estate, about twelve miles from the city of Phila- 
 delphia. His ancestors followed William Peun from England 
 to Pennsylvania, in the year 1683. They chiefly belonged 
 to the society of Quakers, and were all, as well as his 
 parents, distinguished for the industry, the virtue, and the 
 piety, characteristic of their sect. His grandfather, JameS 
 Rush, whose occupation was that of a gunsmith, resided oil 
 his estate near Philadelphia, and died in the year 1727* 
 His son John, the father of Dr. Rush, inherited both his 
 trade and his farm, and was equally distinguished for his 
 industry and ingenuity. He died while his son Benjamin 
 was yet young, but left him to the care of an excellent and 
 pious mother, who took an active interest in his education 
 and welfare. In a letter which I had the pleasure to receive 
 from Dr. Rush, a short time before his death, and which was 
 written upon his return from a visit to the tomb of his ances- 
 tors, he thus expresses the obligation he felt for the early 
 impressions of piety he had received from his parents s 
 
( 24 ) 
 
 " I have acquired and received nothing from the world 
 which I prize so highly as the religious principles I inherited 
 from them ; and I possess nothing that I value so much as 
 the innocence and purity of their characters."* 
 
 But this was not the only source of that virtue and religion 
 for which he was so eminently distinguished. His mother 
 as if influenced with a presentiment of the future destinies 
 of her son, resolved to give him the advantages of the best 
 education which our country then afforded : — For this pur- 
 pose he was sent, at the early age of eight or nine years, to 
 the West Nottingham Grammar School, and placed under 
 the care of his maternal uncle, the Rev. Doctor Samuel 
 Finley, an excellent scholar and an eminent teacher, and 
 whose talents and learning afterwards elevated him to the 
 Presidency of the College of Princeton. At this school 
 young Rush remained five years, for the purpose of acqui- 
 ring a knowledge of the Greek and Latin languages, and 
 other branches necessary to qualify him, as preparatory for 
 a collegiate course of study. But under the tuition and 
 guidance of Dr. Finley, he was not only instructed in 
 classical literature ; — he also acquired what was of no less 
 importance, and which characterized him through life — a 
 habit of study and observation, a reverence for the christian 
 religion, and the habitual performance of the duties it incul- 
 
 * The letter here referred to was originally addressed, by Dr. Rush, to theJ3on. 
 John Adams, Esq. late President of the United States : from a copy of the same, 
 sent to the author by Dr. Rush, several of the preceding interesting partieula?? 
 have been taken, 
 
(25) 
 
 cates. For his accomplished and pious instructor not only 
 regarded the temporal, but the spiritual welfare of those 
 committed to his care. 
 
 At the age of fourteen, after completing his course of 
 classical studies, he was removed to the College of Prince* 
 ton, then under the superinteudance of President Davies, 
 one of the most eloquent preachers and learned divines our 
 country has produced. 
 
 At college, our pupil not only performed his duties with 
 his usual attention and success, but he became distinguished 
 for his talents, his uncommon progress in his studies, and 
 especially for his eloquence in public speaking. For this 
 latter acquirement, he was doubtless indebted to the exam- 
 ple set before him by President Davies, whose talents as a 
 pulpit orator were universally acknowledged, and were fre- 
 quently the theme of his pupil's admiration. 
 
 Dr. Rush received the degree of bachelor of arts in the 
 autumn of 1760, at the early age of fifteen. The next suc- 
 ceeding six years of his life were devoted to the study of 
 medicine, under the direction of Dr. John Redman, at that 
 time an eminent practitioner in the city of Philadelphia. 
 Upon commencing the study of medicine, the writings of 
 Hippocrates were among the very first works which at- 
 tracted his attention ; and, as an evidence of the early im- 
 pression they made upon his mind, and of the attachment he 
 had formed to them, let it be remembered, that Dr. Rush, 
 when a student of medicine, translated the aphorisms of Hip- 
 pocrates from the Greek into his vernacular tongue, in the 
 
(26) 
 
 seventeenth year of his age. From this early exercise kg 
 probably derived that talent of investigation, that spirit of 
 inquiry, and those extensive views of the nature and causes 
 of disease, which give value to his writings, and have added 
 important benefits to the science of medicine. The same 
 mode of acquiring knowledge which was recommended by 
 Mr. Locke, and the very manner of his commonplace book 
 was also early adopted by Dr. Rush, and was daily continued 
 to the last of his life. To his records, made in 1762, we are 
 at this day indebted for many important facts illustrative of 
 the yellow fever, which prevailed in, and desolated the city 
 of Philadelphia, in that memorable year. Even in reading, 
 it was the practice of Dr. Rush, and for which he was first 
 indebted to his friend Dr. Franklin, to mark wish a pen or 
 pencil, any important fact, or any peculiar expression, remark- 
 able either for its strength or its elegance. Like Gibbon, 
 "he investigated with his pen always in his hand ^'—believ- 
 ing with an ancient classic, that to study without a pen ie 
 to dream — "Studium sine calamo somnium." 
 
 Having with great fidelity completed his course of medical 
 studies under Dr. Redman, he embarked for Europe, and 
 passed two years at the University of Edinburgh, attending 
 the lectures of those celebrated professors, Dr. Monro, Dr. 
 Gregory, Dr. Cullen, and Dr. Black. 
 
 In the spring of 1763, after defending an inaugural disser- 
 tation " de coctione ciborum in ventriculo," he received the 
 degree of doctor of medicine. In that exercise which was 
 written with classical purity and elegance, it was the object 
 
(27 ) 
 
 of Dr. Rush to illustrate, by experiment, au opinion that had 
 been expressed by Dr. Cullen, that the aliment, in a few 
 hours after being received into the stomach, undergoes the 
 acetous fermentation. This fact he established by three 
 different experiments, made upon himself; experiments, 
 which a mind less ardent in the pursuit of truth, would 
 readily have declined. 
 
 From Edinburgh Dr. Rush proceeded to London, where, 
 in attendance upon the hospitals of that city, the lectures of 
 its celebrated teachers, and the society of the learned, he 
 made many accessions to the stock of knowledge he had 
 already acquired. 
 
 In the spring of 1769, after visiting Paris, he returned to 
 his native country, and immediately commenced the practice 
 of physic in the city of Philadelphia, in which he soon be* 
 came eminently distinguished. 
 
 Few men have entered the profession in any age or coun- 
 try with more numerous qualifications as a physician, than 
 those possessed by Dr. Rush. His gentleness of manner, 
 his sympathy with the distressed, his kindness to the poor, 
 his varied and extensive erudition, his professional acquire- 
 ments, and his faithful attention to the sick, all united in 
 procuring for him the esteem, the respect, and the confi- 
 dence of his fellow citizens, and thereby introducing him to 
 an extensive and lucrative practice. 
 
 It is observed, as an evidence of the diligence and fidelity 
 with which Dr. Rush devoted himself to his medical studies, 
 during the six years he had been the pupil of Dr. Redman, 
 
( 28 ) 
 
 that he absented himself from his business but two days in 
 the whole of that period of time. I believe it may also be said, 
 that from the time he commenced the practice of medicine to 
 the termination of his long and valuable life, except when con- 
 fined by sickness, or occupied by business of a public nature, 
 he never absented himself from the city of Philadelphia, nor 
 omitted the performance of his professional duties a single 
 day. It is also stated, that during the thirty years of his at- 
 tendance as a physician to the Pennsylvania hospital, such 
 was his punctuality, his love of order, and his sense of duty, 
 that he not only made his daily visit to that institution, but 
 was never absent ten minutes after the appointed hour of 
 prescribing. 
 
 In a few months after his establishment in Philadelphia? 
 Dr. Rush was elected a professor in the medical school which 
 had then been recently established by the laudable exertions 
 of Dr. Shippen, Dr. Kuhn, Dr. Morgan, and Dr. Bond. For 
 this station his talents and education peculiarly qualified him* 
 As in the case of Boerhaave, such too had been the atten- 
 tion bestowed by Doctor Rush upon every branch of medi- 
 cine, that he was equally prepared to fill any department in 
 which his services might be required. 
 
 The professorships of anatomy, the theory and practice 
 of physic, clinical medicine, and the materia medica, being 
 already occupied, he was placed in the chair of chemistry, 
 which he filled in such manner as immediately to attract the 
 attention of all who heard him, not only to the branch he 
 taught, but to the learning, the abilities, and eloquence, of 
 the teacher. 
 
(29) 
 
 In the year 1789 Dr. Rush was elected the successor ot 
 Dr. Morgan to the chair of the theory and practice of physic. 
 In 1791, upon an union being effected between the college of 
 Philadelphia and the university of Pennsylvania, he was ap- 
 pointed to the professorship of the institutes of medicine and 
 clinical practice ; and in 1805, upon the resignation of the 
 learned and venerable Dr. Kuhn, he was chosen to the unit- 
 ed professorships of the theory and practice of physic and of 
 clinical medicine, which he held the remainder of his life. 
 To the success with which these several branches of medi- 
 cine were taught by Dr. Rush, the popularity of his lec- 
 tures, the yearly increase of the number of his pupils, the 
 unexampled growth of the medical school of Philadelphia, 
 and the consequent diffusion of medical learning, bear ample 
 testimony ; for, with all due respect to the distinguished 
 talents with which the other professorships of that university 
 have hitherto been, and still continue to be filled, it will be 
 admitted, that to the learning, the abilities, and the eloquence 
 of Dr. Rush, it owes much of that celebrity and elevation to 
 which it has attained. What Roerhaave was to the medical 
 school of Leyden, or Dr. Cullen to that of Edinburgh, Dr. 
 "Rush was to the university of Pennsylvania. 
 
 But Dr. Rush did not coufine his attention and pursuits 
 either to the practice of medicineor to the dudes of his profes- 
 sorship: his ardent mind did not permit him to be an inactive 
 spectator of those important public events which occurred 
 in the early period of his life. 
 
 The American revolution ; the independence of his couh- 
 
( 30) 
 
 try ; the establishment of a new constitution of government 
 for Use United Slates, and the amelioration of the constitu- 
 tion of his own particular state, all successively interested 
 Ilia feelings, and induced him to take an active concern in 
 the scenes that were passing. He held a seat in the cele- 
 brated congress of 1776 as a representative of the state of 
 Pennsylvania, and subscribed the ever memorable instrument 
 of American independence. In 1777, he was appointed phy- 
 sician general of the military hospital for the middle depart- 
 ment ; and in the year 1787 he received the additional grati- 
 fication and evidence of his country's confidence in his talents, 
 his integrity, and his patriotism, by being chosen a member 
 of the state convention for the adoption of the federal consti- 
 tution. 
 
 These great events being accomplished, Dr. Rush gradual 
 ly retired from political life, resolved to dedicate the remain- 
 der of his days to the practice of his profession, the perform- 
 ance of his collegiate duties, and the publication of those doc- 
 trines and principles in medicine which he considered calcu- 
 lated to advance the interests of his favourite science, or to 
 diminish the evils of human life. In a letter which I receiv- 
 ed from him as early as the year 1794, he expresses this de- 
 termination, adding, "I have lately become a mere spectator 
 of all public events." And in a conversation on this sub- 
 ject, during the two last years of his life, he expressed to me 
 the i,igh gratification which he enjoyed in his medical studies 
 and pursuits, and his regret that he had not at a much earlier 
 
(31 ) 
 
 period withdrawn his attention from all other subjects and 
 bestowed it enclusively upon ids profession. 
 
 Young gentlemen, let this declaration of that venerable 
 character, who, like Hippocrates of old, well knew the extent 
 of his art and the comparative shortness of human life, im- 
 press your minds with the duties before you; let it teach 
 you, too, the value of iime, ihat it may not be occupied in 
 those pursuits which are unconnected with science or your 
 profession ; and, especially, that it be not wasted in idle and 
 unprofitable amusements ; for, of the physician it is not; 
 enough to say, 
 
 "That here he liv'd, or here expired." 
 
 Pope. 
 
 Such was the attachment of Dr. Rush to his profession, 
 that speaking of his approaching dissolution, he remarks, 
 "when that time shall come, I shall relinquish many attrac- 
 tions to life, and among them a pleasure which to me has no 
 equal in human pursuits \ I mean that which I derive from 
 studying, teaching, and practising medicine." But he loved 
 it as a science ; principles in medicine were the great objects 
 of all his inquiries. He has well observed, that medicine 
 without principles, is an humble art, and a degrading occu- 
 pation ; but directed by principles, the only sure guide to a 
 safe and successful practice— it imparts the highest elevation 
 to the intellectual and mora! character of man. 
 
 But the high professional character and attainments of 
 Poctor Rush, did not alone display themselves in his skill as 
 
( 32) 
 
 a physician, or his abilities as a teacher ; he was equally dis- 
 linguisMed as a writer and an author. 
 
 The present occasion does not allow me to recite to you 
 even the numerous subjects of his medical publications ; much 
 less does it afford an opportunity to review the opinions 
 they contain. In the ensuing course of lectures these will seve- 
 rally fail under our attention, as the various subjects to which 
 they relate may present themselves. Permit me, however, 
 generally to observe, that the numerous facts and principles 
 which the writings of Dr. Rush contain, the doctrines they 
 inculcate relative to the nature and causes of disease, and the 
 improvements they have introduced into the practice of me- 
 dicine, recommend them to your attentive perusal and study, 
 while the perspicuity and elegance of the style in which they 
 are written, give them an additional claim to your attention 
 as among the finest models of composition. The same re- 
 marks are equally applicable to the epistolary stile of Dr. 
 Rush and that of his conversation ; in both of which he emi- 
 nently excelled. 
 
 Mr. Fox declared in the British House of Commons, that 
 lie had learned more from Mr. Burke's conversation than 
 from all the books he had ever read. It may also be observ- 
 ed of the conversation of Dr. Rush, that such were the 
 riches of his mind; such was the active employment of 
 all its faculties; so constant was his habit of giving ex- 
 
 * For an ample and minute account of the writings of Dr. Rush the reader is 
 particularly referred to thp excellent and instructive discourse delivered before the 
 Medical Society of Charleston, by the Hon. David Ramsay, M. D. 
 
( 33 ) 
 
 pression to his thoughts in an extensive correspondence^ 
 in the preparation of his public discourses, and in his daily 
 intercourse with the world, that kw persons ever left his 
 society without receiving instruction, and expressing their 
 astonishment at the perpetual stream of eloquence in 
 which his thoughts were communicated. 
 
 It has frequently been the subject of surprise, that amidst 
 the numerous avocations of Dr. Rush, as a practitioner and 
 a teacher of medicine, that he found leisure for the com- 
 position and the publication of the numerous medical and lite- 
 rary works which have been the production of his pen. 
 
 Although Dr. Rush possessed by nature an active and 
 discriminating mind, in which were blended great quickness 
 of perception, and a retentive memory ; although he en- 
 joyed the benefits of an excellent preliminary and profes- 
 sional education, it was only by habits of uncommon indus- 
 try, punctuality in the performance of all his engagements, 
 the strictest temperance and regularity in his mode of life, 
 that enabled him to accomplish so much in his profession and 
 to contribute so largely to the medical literature of his coun- 
 try. Dr. Rush, like most men who have extended the 
 boundaries of any department of human knowledge ; who 
 have contributed to the improvement of any art or science, 
 was in habits of early rising, by which he always secured 
 what Gibbon has well denominated " the sacred portion of 
 the day." 
 
 The great moralist* justly observes, that " to temperance 
 
 Dr. Johnson 
 
I 34 ) 
 
 every day is bright, and every hour is propitious to dili- 
 gence." T.-ie extreme temperance of Dr. Rush in like man- 
 ner enabled him to keep his mind in continual employment, 
 thereby "setting at defiance the morning mist and the eve- 
 ning damp — the blasts of the east, and the clouds of the 
 south."* He knew not that " lethargy of indolence" that 
 follows the inordinate gratifications of the table. His ciesto 
 did not consist in indulgence upon the bed or in the a med 
 chair, to recover those powers which had been paralysed or 
 suspended by an excessive meal, or the intemperate use of 
 vinous or spirituous drinks. 
 
 Ds Johnson, during his tour to the Hebrides, when fa- 
 tigued by his journey, reti ed to his chamber and wrote his 
 celeb aied Latin ode addressed to Mrs. Tnrale.f Dr. Rush,, 
 in iike manner, after the fatigues of professional duty, refresh- 
 ed his mind by the perusal of some favourite poet, some 
 work of taste, some volume of travels, biography, or history. 
 These were the pillows on which he sought repose. 
 
 Bu> the virtues of the heart, like the faculiies of his mind, 
 were also in continued exercise for the benefit of his fellow 
 men ; while the numerous humane, charitable, and religious 
 associations, which do honour to the city of Philadelphia, 
 bear testimony to the philanthropy and piety which animat- 
 ed the bosom of their departed benefactor, let it also be 
 remembered, that, as with the good Samaritan, the poor 
 "were the objects of his peculiar care ; and that in the latter, 
 
 * Boswell, vol. I. p. 260, f Boswell. 
 
( 35 ) 
 
 and more prosperous years of his life, one seventh of his in- 
 come was expended upon the children of afflic.i ion and want. 
 D' Boerhaave said of the poor, that they were his best pa- 
 tten is, because God was their paymaster. 
 
 Let i, also be recorded, that the last act of Dr. Rush was 
 an act of charity, and that the last expression which fell 
 from his lips was an injunction to his son, ' Be indulgent to 
 the poor.' 
 
 " Vale egregium academiae decus ! tuum nomen mecum 
 semper durabit ; et laudes et honores tui in ceternum. mane- 
 bunt."* 
 
 * These words were addressed by Dr. Rush, upon his taking leave of the Uni- 
 versity of Edinhuigh, to his particular friend and preceptor, Dr. Cullen. Se£ 
 Inaus- Diss. De Coctione Ciborum. Edin. 1769. 
 
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